Sierra Morena*

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

Overview

Global Brigades Monitoring & Evaluation team meeting with community members in Sierra Morena to conduct the Rapid Needs Assessment

Sierra Morena is located in the mountainous region of central Nicaragua in the department of Jinotega. A typical house is made of wood. The community has access to a health center in the neighboring community, La Colonia, 5Km away. Within Sierra Morena is a primary school that 98 students attend, with five teachers and five classrooms. The primary school goes up to grade six, and there is no secondary school located in Sierra Morena. Most people in the community work as agricultural laborers or coffee farmers.

Global Brigades will begin working with the Medical and Water Program in Sierra Morena in May 2018. Community bank establishment with the Business Program began in February 2018. In their communication with Global Brigades, the top three needs expressed were lack of latrines or properly functioning latrines, limited access to potable water, and limited access to medications. Sierra Morena is on the waitlist for continuing Holistic Model implementation as part of Global Brigades’ strategic plan in Nicaragua.

Municipality: Jinotega
Department: Jinotega

*Brigades to this community are temporarily suspended at this time

Homes : 178
Population : 720
Water System : Yes
Community Bank : Yes
Electricity : Yes
Health Center : No
Community Health Workers : Yes
% of Homes with Latrines : 43%
Education : Up to 6th Grade
Distance from Lodging Facility : 37 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 center (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.  

Sierra Morena has access to a health centre in the neighbouring community, La Colonia, 5 Km away. 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 Sierra Morena expressed were diarrhoeal diseases, and respiratory infections. For adults, common illnesses are chronic diseases such as diabetes and hypertension, as well as urinary tract infections, and asthma. 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. 

27

Volunteers

735

Patient Consultations

N/A

Vision Screenings Provided

33

Health Education Workshops

COMMUNITY HEALTH WORKERS

Sierra Morena has 2 Community Health Workers that are trained by the Ministry of Health monthly. 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 Sierra Morena Community Health Workers and the Ministry of Health, and is looking forward to providing these Community Health Workers with blood pressure cuffs, stethoscopes, glucometers, and first aid kits, to facilitate more impactful work. 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 Sierra Morena attend Medical Brigades in the community church of Sierra Morena. This location has rooms for triage, consultation, dentistry and pharmacy stations.

Sierra Morena 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 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 sanitation and hygiene, chronic diseases, contraception, Women’s health, and water purification.Sierra Morena’s community volunteers are essential the efficiency and effectiveness of Medical Brigades.

AVERAGE PATIENTS ATTENDED PER DAY: 807
NEARBY COMMUNITIES: SAN PABLO, LA FORTUNA, LA PAZ DEL TUMA

MEDICAL/DENTAL VOLUNTEERS IN SIERRA MORENA

Chapter Date # Of Volunteers
University of Western Ontario Medical Brigade May 2018 27

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 centres, or even the municipality health centres. 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.

122

Patients Consultations

86

Number of Extractions

87

Fillings Performed

20

Dental Education Workshops

221

Fluoride Treatments

DENTAL 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 Sierra Morena attend Dental Brigades in the community church of Sierra Morena.

Sierra Morena 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. Sierra Morena’s community volunteers are essential the efficiency and effectiveness of Dental Brigades.

AVERAGE PATIENTS ATTENDED PER DAY: 807
NEARBY COMMUNITIES: SAN PABLO, LA FORTUNA, LA PAZ DEL TUMA

MEDICAL/DENTAL VOLUNTEERS IN SIERRA MORENA

Chapter Date # Of Volunteers
University of Western Ontario Medical Brigade May 2018 27

Water

Program Status

  • Planning
  • Active
  • Complete

SIERRA MORENA’S WATER CHALLENGE 

Prior to Global Brigades’ involvement, Sierra Morena had an outdated gravity water system. This system required many community members, typically women and children, to walk to acquire water. This meant carrying buckets, many times over long distances to have water daily. Additionally, the quality of the water was often not adequate for drinking.

Currently, there is only one sector of the community, called La Plancheta, that has a small private water system. The system has in-home connections to only 53 homes (approximately 29% of the community). For the remaining homes of the community, they must utilize spring water or walk to La Plancheta to receive water.

193

Volunteers

494

Project Beneficiaries

10

Kilometers of Pipeline Installed

6,605

Storage Tank Volume (gallons)

SIERRA MORENA’S WATER SOLUTION  

In April 2018, a partnership between Sierra Morena, Global Brigades Nicaragua and the Municipality of Jinotega was officially formed. In order to plan a water system custom-designed for Sierra Morena, the land was first surveyed by a contracted technician.  

With this and the land survey in mind, it was determined that the best fit for Sierra Morena would be to build a surface water system with a pump.

With the hydrogeological research results in hand, construction took place beginning in May 2018. The goal was to set a plan moving forward and elect a Water Council. The job of those on the Water Council or CAPS (Comités de Agua Potable y Saneamiento) (Comités de Agua Potable y Saneamiento)would be to mobilize community volunteers, support Water Brigades on-site, and keep record construction process, tools, and laboured hours.

Over the course of 13 months of construction, Global Brigades volunteers worked alongside the committee and community members to construct a system that now reaches the entire community.The celebration of this system’s water inauguration was in June 2019!

In the interest of sustainability, members of the CAPS were trained in water treatment and system maintenance, administration, and operation, so they can continue adequately managing the water system. Sierra Morena has also established a monthly water fee in order to pay the CAPS for water treatment, maintenance costs, and system sustainability.

WATER VOLUNTEERS IN SIERRA MORENA

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
University of Michigan – Dearborn Medical Brigade April 2018 26 London, Ontario Medical Brigade May 2018 27
University of Utah Medical Brigade & University of Central Florida Medical Brigade & Florida International University Dental Brigade May 2018 25 University of Central Florida Medical Brigade May 2018 37
Pennsylvania State University Medical Brigade May 2018 50 Ohio State University Medical Brigade May 2018 28

Business

Program Status

  • Planning
  • Active
  • Complete

SIERRA MORENA’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 assets consumer goods to offer as collateral. Additionally, maintaining savings is not a common practice in rural communities in Nicaragua, and when families do save, they often do not have a safe place to do so.

In Sierra Morena , the average family income is estimated to be low per household. The main form of employment in Sierra Morena is Agriculture. Economic growth faces additional obstacles due to the community’s dependence on agriculture and day laboring, as its inhabitants’ incomes are earned on a seasonal basis, determined by crop yields, and susceptible to external factors like drought, disease, and international market trends.

*No volunteers have been able to support in this program’s work but continued progress has been able to be accomplished through the generous support of the Merkel Foundation.

0*

Volunteers

21

Loans Disbursed

114

Savings Accounts Opened

$277

Capital Invested

SIERRA MORENA’S MICROFINANCE SOLUTION

The Business Program works to stimulate the local economy by organizing community residents around a community bank, which is entirely owned and operated by its members. Focusing on providing access to low-interest loans credit and savings for the members, its Bank Council members are tasked with growing 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 can be used by members for everything from farmers taking out loans to buy their seeds before planting, to a family taking out a loan to cover medical expenses. 

Sierra Morena’s community bank, named Dios Proveera, was established March 2018 with the support of Global Brigades. The community bank has 46 female and  62 male shareholders who meet every 15 days with the bank council that leads the shareholders and oversees the meetings. 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. Additionally, Global Brigades provides matching capitalizations once these capitalizations meet established benchmarks.

Global Brigades and Sierra Morena’s community bank are working towards being able to disburse loans, increase savings and train individuals on financial management.

Public Health

Program Status

  • Planning
  • Active
  • Complete

SIERRA MORENA’S PUBLIC HEALTH CHALLENGE 

Many community members in Sierra Morena lack the resources to make improvements to their household infrastructure, leading to numerous public health challenges. The majority of homes in Sierra Morena are made of adobe and bricks. If a household does not have access to a shower, they often bathe in the river, which may contain run-off agricultural fertilizers and animal waste. Although 43% of homes have latrines, the community does 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. 

Global Brigades is currently working with Sierra Morena to implement the Public Health program with all families interested in installing and partially financing household infrastructure projects. These projects allow community members to avoid preventable diseases and foster improved hygiene and sanitation practices. During their time in Sierra Morena, Public Health volunteers will conduct educational workshops, or charlas, with community members on project maintenance and various public health topics. Additionally, Global Brigades will train the Basic Sanitation Committee, a community body formed by local leaders. The committee advocates for proper hygiene and sanitation practices and monitoring the maintenance of completed projects. 

To promote the sustainability of the Public Health Program’s projects, families will be required to contribute a portion of the project cost. This instils a sense of ownership and encourages proper maintenance of the projects. Therefore, before the Public Health Program starts its projects, the Business Program will work 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 Sierra Morena, loans remain available through the community bank and local masons who will be contracted to complete the projects will then hold the skills to perform any necessary repairs or construct new units. 

*No volunteers have been able to support this program’s work but continued progress has been able to be accomplished through the generous support of the Merkel Foundation.

0*

Volunteers

25

Sanitation Units Installed

107

People Benefited with Public Health Infrastructure

N/A

Hours of Public Health Education

Local Reference Points

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

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