San José*

  • Overview
  • Medical
  • Dental
  • Water
  • Business
  • Public Health

Overview

San José is located in the dry corridor of north central Nicaragua in the department of León. A typical house is made of mud brick or cement block. The community has access to a health center in the neighboring community of El Sauce, 6km away. 100 students attend the multigrade primary school with four teachers and four classrooms. The primary school goes up to the age of twelve, and there is no secondary school located in San José. Most people in the community work as agricultural and day laborers, or in cattle raising.

Global Brigades is currently working with the Medical and Business Program in San José. The Medical Program started with the first Medical Brigade in August 2016, and the Business Program in August 2017. In their communication with Global Brigades, the top needs expressed were lack of latrines or properly functioning latrines, limited ability to create microenterprises, as well as limited access to both medications and recreational space. San José is on the waitlist for continuing Holistic Model implementation as part of Global Brigades’ strategic plan in Nicaragua.

Municipality: El Sauce
Department: León

*Brigades to this community are temporarily suspended at this time

Homes : 131
Population : 455
Water System : Yes
Community Bank : Yes
Electricity : Yes
Health Center : No
Community Health Workers : Yes
% of Homes with Latrines : 89%
Education : Up to 6th Grade
Distance from Lodging Facility : 108 km

Medical

Program Status

  • Planning
  • Active
  • Complete

HEALTH CARE ACCESS

Healthcare access in Nicaragua is structured by the Ministry of Health, based in the capital, Managua. From there, each of the fifteen departments has its own department hospital, which is overseen by the SILAIS administrations (Sistema Local de Atención Integral en Salud). At a municipality level, there is a health centre (Centro de Salud) for every municipality within the department. While they are not hospitals, health centres in the municipality are typically staffed with one doctor, and two nurses, that can attend to patients with chronic, communicable, or noncommunicable diseases, as well as pregnancies. They, however, do not have the ability to perform surgeries.

Lastly, most but not all communities have a Puesto de Salud, a smaller health centre. These health centres are usually staffed with only one nurse and a rotating physician. Physicians are staffed in these health centres by Nicaragua’s Social Service. This is an initiative that requires Nicaraguan medical students to do two years of service in rural communities prior to graduating. The physician density in Nicaragua is approximately 1,099 people for every doctor. According to the World Health Organization, there should be a maximum of 435 people per physician to qualify a country as having adequate access to medical attention.

This density is significantly lower for the 40.6% of the population that lives in rural areas. It is for this reason that Nicaragua’s Social Service initiative brings medical students to these communities. However, access remains limited since these training physicians may be assigned to up to fifteen communities at a time.  

San José has access to a health centre 6km away in El Sauce. Even with this access, it is important to note that medications, supplies, and materials are often not available in these health centres and are dependent on government funding. There is no access to private pharmacies. Additionally, as noted above, access to trained medical professionals is limited.

During their initial communications with Global Brigades, the top illnesses in children that San José expressed were respiratory infections and poor nutrition. For adults, common illnesses are chronic diseases such as hypertension, as well as kidney infections and prostatitis. Without access to trained healthcare professionals and medications, chronic diseases can go unmanaged, leading to further health problems. Acute illnesses can also be severe and affect the quality of life.

154

Volunteers

2,779

Patient Consultations

207

Vision Screenings Provided

82

Health Education Workshops

COMMUNITY HEALTH WORKERS

San José currently has three Community Health Workers who finished their training in 2019. Community Health Workers, or Brigadistas de Salud, work on a volunteer basis as advocates for healthcare within their communities. They are tasked with treating and preventing common illnesses, and some of their responsibilities include first aid, supporting and caring for pregnancies and newborns, and responding to emergency situations. They are also responsible for following up with chronic patients to ensure proper administration of medications and treatments to avoid further complications.

Global Brigades is planning to establish a partnership with San José and the Ministry of Health to build up the Community Health Workers program and supply them with blood pressure cuffs, stethoscopes, glucometers, and first aid kits, to facilitate impactful work when feasible. The presence of these volunteers and their advocacy for health within their community contributes to the sustainability of healthcare supported by Global Brigades’ Medical Program and is one of the most impactful disease prevention strategies in rural communities.

BRIGADE INFORMATION

Community members from San José attend Medical Brigades in the community church of San José. This location has rooms for triage, consultation, dentistry and pharmacy stations. The average amount of patients seen per day is 213 patients.

San José offers strong support on Medical Brigades from the community volunteers. One way the 8-15 community volunteers assist is by running intake. Intake is the very first station of the clinic and is where the community volunteers write down the patient’s name, date of birth, community, and identification number. Additionally, community volunteers manage clinic organizations. They set up tables and chairs in the clinic prior to the brigade’s arrival as well as direct patients to the next medical station, once the clinic has opened for the day. Lastly, community volunteers lead adult health education sessions on sanitation and hygiene, chronic diseases, contraception, Women’s health, and water purification. San José’s community volunteers are essential the efficiency and effectiveness of Medical Brigades.

AVERAGE PATIENTS ATTENDED PER DAY: 780
NEARBY COMMUNITIES: LAS MERCEDES, SAN RAMON, SAN NICOLAS, EL GUACUCAL, BUENA VISTA

MEDICAL/DENTAL VOLUNTEERS IN SAN JOSE

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Elon University Medical Brigade & North Carolina State University Medical Brigade August 2016 27 SUNY Binghamton Medical Brigade January 2017 40
McMaster University Medical Brigade April 2017 40 University of New York Buffalo Medical Brigade March 2018 46

Dental

Program Status

  • Planning
  • Active
  • Complete

DENTAL CARE ACCESS

While medical access is low, dental access is even more sparing. Dental services are not available within the community health centers, or even the municipality health centers. Instead, if a patient was needing dental care, they would be required to travel to one of the country’s fifteen department hospitals. This could be up to a 2-3 hour bus ride, with many needing to first walk or horseback ride to the bus stop.

376

Patient Consultations

112

Number of Extractions

209

Fillings Performed

227

Dental Education Workshops

450

Fluoride Treatments

BRIGADE INFORMATION

Working closely with the Medical Program, the Dental Program provides fillings, extractions, and fluoride treatments as a standard part of medical brigades. Community members from San José attend Dental Brigades in the community church of San José . The average amount of patients seen per day is 28 patients, with approximately 10-15 minutes per patient.

San José offers strong support on Dental Brigades from the community volunteers. One way the 8-15 community volunteers assist is by running intake. Intake is the very first station of the clinic and is where the community volunteers write down the patient’s name, date of birth, community, and identification number. Additionally, community volunteers manage clinic organization. They set up tables and chairs in the clinic prior to the brigade’s arrival as well as direct patients to the next medical station, once the clinic has opened for the day. Lastly, community volunteers lead adult health education sessions on oral health and hygiene. San José’s community volunteers are essential the efficiency and effectiveness of Dental Brigades.

AVERAGE PATIENTS ATTENDED PER DAY: 780
NEARBY COMMUNITIES: LAS MERCEDES, SAN RAMON, SAN NICOLAS, EL GUACUCAL, BUENA VISTA

MEDICAL/DENTAL VOLUNTEERS IN SAN JOSE:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Elon University Medical Brigade & North Carolina State University Medical Brigade August 2016 27 SUNY Binghamton Medical Brigade January 2017 40
McMaster University Medical Brigade April 2017 40 University of New York Buffalo Medical Brigade March 2018 46

Water

Program Status

  • Planning
  • Active
  • Complete

San José has not been a community identified to be in need of the Water Program. Currently, San José has a system with in-home connection to 98% of the homes. The system was built in the early 2000’s and has been well maintained by San José’s Water Council. Community members have reliable access to clean water 24 hours of the day.  

Water System : Yes
Type of Water System : Artisan pump
% of Homes with Access to Water : 98%
Water Council : Yes

Business

Program Status

  • Planning
  • Active
  • Complete

SAN JOSE’S ECONOMIC CHALLENGE

Rural communities in Nicaragua face a number of structural obstacles when it comes to economic growth. Access to credit is limited by physical barriers in transportation and exclusion from formal financial institutions. This exclusion can be the result of a lack of financial literacy, credit history, and land titles or substantial consumer goods to offer as collateral. Additionally, maintaining savings is not a common practice in rural communities in Nicaragua.

San Jose’s residents work primarily in the agricultural sector, including livestock, horticulture, and agriculture. Economic growth faces additional obstacles due to the community’s dependence on agriculture, as its inhabitants’ incomes are earned on a seasonal basis, determined by crop yields, and susceptible to external factors like drought and plant disease.

20

Volunteers

137

Loans Disbursed

N/A

Savings Accounts Opened

$2,770

Capital Invested

SAN JOSE’S MICROFINANCE SOLUTION

The Business Program works to stimulate the local economy by organizing community volunteers around a community bank, which is entirely owned and operated by its members. Focusing on providing access to credit and savings for their fellow community members, its Bank Council members are tasked with socializing the community bank and managing the funds. The Business Program provides training and support to help strengthen these community banks and stimulate the flow of capital within the community. These financial services are especially beneficial for subsistence farmers, who can invest more heavily in their production with a loan, pay back the loan after the harvest, and generate an income with any excess.

San Jose’s community bank, La Bendición (The Blessing), was established in August 2017 with the support of Global Brigades. The community bank has 36 shareholders who meet in a local church bi-weekly, and a 3-person Bank Council that manages the shareholders and their funds. In order to pool funds together, increase the capital available to the community bank, and expand the impact of its financial services, each member contributes a monthly share or fee for which they receive a proportional amount of the bank’s dividends at the end of its fiscal year.

Global Brigades and San Jose’s community bank are working towards being able to disburse loans and train individuals on loan management and financial literacy.

SAN JOSE’S BUSINESS SOLUTION

In addition to working with the community bank, the Business Program provides technical support and consultations to support local entrepreneurs and microenterprises. The goal is to foster the development of efficient and practical business actions, grow enterprise assets, and create local employment opportunities. During this process, interested community members receive training to increase their familiarity with business terminology, develop their business administration skills, and promote innovation and diversification in the types of business ventures they pursue.

The Business Program has started hosting Business Brigades in San Jose to study the local market and work with existing microenterprises to create the best plan forward for the community’s economic development.

BUSINESS VOLUNTEERS IN SAN JOSE:

Chapter Date # Of Volunteers
 University of Southern California Business Brigade  March 2018  20

Public Health

Program Status

  • Planning
  • Active
  • Complete

SAN JOSE’S PUBLIC HEALTH CHALLENGE

Prior to partnering with Global Brigades, many community members in San Jose lacked the resources to make improvements to their household infrastructure, leading to numerous public health challenges. The majority of homes in San Jose are made of adobe. Before the implementation of the Public Health program, only 60% of homes have access to showers. If a household did not have access to a shower, many would often bathe in the river, which may contain run-off agricultural fertilizers and animal waste.

Although 80% of homes had latrines, the community did not have sufficient methods of waste disposal. Global Brigades Sanitary Stations, include a shower, latrine, handwashing station and water storage unit. This station is necessary for offering privacy while bathing and using the bathroom, facilitating handwashing, and allowing water storage for hygienic practices. Latrines further improve hygiene practices by preventing contamination of natural water sources caused by open defecation.

84

Volunteers

36

Sanitation Units Installed

145

People Benefited with Public Health Infrastructure

3

Hours of Public Health Education

SAN JOSE’S PUBLIC HEALTH SOLUTION

In 2018, the Public Health Program worked with all interested families to finance and install Sanitary Stations including a shower, latrine, handwashing station, and water storage unit. These projects allow community members to avoid preventable disease and foster improved hygiene and sanitation practices. During their time in San Jose, Public Health volunteers conducted educational workshops, or charlas, with community members on project maintenance and various public health topics. Additionally, Global Brigades trained a Basic Sanitation Committee, a community body formed by local leaders. The committee advocates for proper hygiene and sanitation practices, monitors maintenance of  completed projects . 

To promote the sustainability of the Public Health Program’s projects, families are required to contribute a portion of the project cost. This instills a sense of ownership and encourages proper maintenance of the projects. Therefore, before the Public Health Program started its projects, the Business Program worked with the community to train an existing community bank that would allow families to finance these contributions through microcredit. Although the Public Health Program has completed all planned projects in San Jose, loans remain available through the community bank and local masons who were contracted to complete the projects now hold the skills to perform any necessary repairs or construct new units. 

PUBLIC HEALTH VOLUNTEERS IN SAN JOSE:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Wright State University Public Health Brigade April 2018 21 University of Michigan Dearborn Medical Brigade April 2018 26
University of Central Florida Public Health Brigade May 2018 9 Ohio State University Medical Brigade May 2018 28

Local Reference Points

View the map to see the closest volunteer lodging facilities, hospitals, and other relevant points of reference.

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