One of the questions I had early on was, “what do we do with patients with high blood pressure.”
Hypertension is called the silent killer. This condition damages the heart and can cause strokes and embolisms, while a person can walk around having a life, without knowing that they have high blood pressure at all. This I already knew, but … how do we treat them?
The nurse, Ann, said, “Well you have to decide whether you only treat acute diseases or do you include chronic conditions. Treating chronic conditions is a deep well into which funding goes because the treatments are daily, continuing costs.”
I winced, imagining the amount of money we might have to raise.
Ann said, “But… but most clinics here in Nicaragua do not treat chronic conditions especially for the poor. And there is a validity in keeping people alive and giving them a quality life.”
So, we started treating chronic hypertension in patients. At first, we only used donated medications, which meant that our patients were changing their medications about every six months. That was not effective for providing good treatment. We then committed to providing up to 150 people with monthly exams, all medications needed, and in return the patients signed a contract to attend monthly 10-minute classes.
We also treat other patients of hypertension, such as pregnant mothers and new patients, which means that a quarter of our adult patients have hypertension. So far this year we have provided anti-hypertensive medication for 1,727 patient visits. In the past we received anti-hypertensive medications donated in bulk. We could give consistent care using the donated medicines, and our costs were held to a manageable level.
Since April of 2018 and the political unrest for a few months here in Nicaragua, and the resulting high travel alert posted by the U.S. State Department, we have not had the 15 delegations coming annually bringing medications, but have had only two delegations. We have lost approximately $50,000 a year in donated medications. The result? This year we are spending $300.00 per month on anti-hypertensive medications alone!
We are committed to giving our patients the quality of life that offers the chance to care for their children and grandchildren. To look this silent killer in the eyes and say, “no.”
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