Medical Teams

International medical aid has always been seen as a positive impact in different areas, such as economic and psycho-social, especially in developing countries (such as Nicaragua) after natural disaster. US universities and faith based organizations are primary participants in Nicaragua. These do invaluable interventions for the Nicaraguan Ministry of Health that benefits patients by travelling to uncommunicated communities and attending patients in areas with lack of medical supplies or professionals in health. But without a good leadership, coordination and follow up the medical foreign intervention can end in wrong use of resources and waste of materials. It is our experience, cultural immersion trips incorporating in-country networks (universities, governmental/ non-governmental institutions) offering medical coordination, research, and training will provide a more effective and efficient impact in the health of Nicaraguans. Here is the importance of a well-structured intervention that takes in count different aspects besides the medical aid per se.

• Medical teams reach areas where MINSA cannot go.
• Medical teams support rural clinics with equipment and medicines.
• More inter-professional work is been done, allowing the flow of information about new procedures and techniques.
• When team purchase medicines in the country impulse the local economy.

FACTS ABOUT THE NICARAGUAN MINISTRY OF HEALTH



• Nicaraguan Ministry of Health (MINSA) is distributed in rural and urban areas all over the country. The Headquarter is in Managua and every department in Nicaragua has an office (called SILAIS). HEALTH CENTERS are the ones in charge of one specific zone and at the same time this one controls several PUBLIC HEALTH CLINICS (PHC) in the area.
• Minimum requirements of the PHC facilities are: waiting area, pharmacy (which gets monthly refills on medicines and disposable material, if possible), observation area, OB/GYN and consultory. Most of the facilities are old structures and lack of diagnoses equipment and office supplies. As essential human resources: MD or Nurse is in charge of running the clinic. Patients can get an appointment with a professional in health, going through the respective channels (including specialized attentio such as: OB/GYN, pediatricians, surgeons, etc); also, when possible, free lab exams (eg: blood, stool and urine lab test,etc).
• MINSA do offers free medicines to patients with chronic-illnesses. These groups are prioritized and receive their monthly supply of medicines for FREE. For periods of time , based on demand, some medicines are not available on any pharmacy (hospitals´, health centers´ and rural clinics´). In this case the patient needs to purchase medicines.
• MINSA has structured protocols of attention, a list of basic medicines and forms to fill for specific works (eg: PAPs). MINSA focus its efforts on chronic illnesses and mother-child care, putting a lot of interest in pregnant ladies.
• MINSA has connections with several universities that offer Health-related careers; in this way students and professionals, via Communitarian Practices/ Social Service, are been trained by working and being in contact with the reality of the country.
• MINSA is the only authority to grant entrance to foreign professionals and allow them to practice medicine, do research and/or realize short-period professional practices as long as they fill the requirements.
• MINSA has structured protocols of attention, a list of basic medicines and forms to fill for specific works (eg: PAPs). MINSA focus its efforts on chronic illnesses and mother-child care, putting a lot of interest in pregnant ladies.

C-IT LOGISTICS AND CULTURAL BEHAVIOR


C-IT offers an amalgam between medical work and immersion in the reality of the communities being aided. Not only numbers are important, quality of attention and BE where the most needed IS also creates important impact.

• C-IT as the In country coordinator hires Nicaraguan health professionals (eg: local pharmacist to dispense medicines and answer questions about foreign/local drugs; local physician to answer doubt about diagnoses and treatment, etc) and also translators with experience in medical terminology.
• Most entities offering medical trips are faith based organizations (whose goal is to provide health care but also share their faith). C-IT understands the importance of physical and spiritual health and arranges different activities in order to find a balance between both.
• C-IT coordinates activities with MINSA and other important organizations, like: local community leaders, spiritual leaders and other governmental organizations.

DENTAL MISSIONS


Is well documented that good oral/dental health has greater impact in the nutrition of the individual. In nicaraguan rural poor communities the risks that rotten pieces damage the permanent ones in kids is higher. Also their knowledge about oral hygiene is poor and the purchasing power of parents cannot buy the necessary tools to improve their hygiene.

Few MINSA clinics are equipped with dental consultory. If so, the main work will consist in extractions and providing information to patients about oral hygiene.

C-IT works with Rural Primary Schools to get a greater impact of the dental mission. Most of the work is done on kids; providing basic oral hygiene information and dental care supplies (eg: floss, toothpaste and toothbrush), fluoride application and…

• Extraction of rotten pieces is the main task which have a great impact in preserving future permanent pieces.

C-IT work can be also coordinated with the local dental school and use students for follow up purposes.

PHYSICAL THERAPY


• MINSA has PT clinics in their main Health Centers. PTs have scheduled patients based on their need, but patients must go to the clinic. Sadly some patients cannot afford transportation and are not able to attend to this important rehabilitation.
• Complicated and severe injured patients are seeing at the local hospital, which is equipped with basic tools for special cases.
• C-IT coordinates with MINSA door-to-door visits to patients that by any reason cannot assist to the clinics. Teams also work with creativity and develop customized exercises for each patient in their respective home.

Benefits of having foreign PTs working alongside with local profesionals:

• Work is developed in homes.
• Lectures and workshops can be arranged to teach in local health schools.

INTERNATIONAL RESEARCH


Nicaragua is a country where research is not well developed. In many universities, areas such as public health and epidemiology are not focused on research in students of health sciences careers.

• Some of the statistics offered by MINSA are not accurate.
• Some information about Nicaraguan health statistics are based on MINSA data.

Observations:

― Adjust the instruments to the reality of the country and the core group of investigation (eg: teens, illiterate, professionals, communities in rural/urban areas, etc.).

― Is recommended and useful to do a "pilot/scout" trip with a small team prior big group of students arrival, preferably with one professor and medical team coordinator. This way the scout group can collect first-hand information about the local point of contact, local academic responsible and the environment in the selected areas of research.

― Part of the research must include Cultural Immersion Trips, this will allow to every single participant a better understanding of:

• The history, ergo customs of rural and urban communities.
• Geography to understand demographic data.
• Art.

C-IT OFFERS


Professional interpreters with vast experience in medical terminology.
Transportation.
Authorization from MINSA to develop Medical activities in Nicaragua.
Liaison with educational entities (eg: health Science department in several universities).
University educational trips.
All logistics related to hosting.

Download the poster presented at THE 4TH ANNUAL CONFERENCE OF PUBLIC HEALTH AT UGA, GA - USA