Powering Health Care with Solar Energy

 [Español abajo]

Donate for Giving Tuesday here: https://donatenow.networkforgood.org/jhc-cdca

Today is Black Friday in the States when so much stuff is put on sale to entice people to come in and spend for the beginning of the Giving Season.  People have died in the crowds trying to get to that one particular thing or just getting in the store.  It’s nuts.

On Tuesday, social media outlets have an event call Giving Tuesday.  Some will match gifts and some will not, but it is their attempt at encouraging people to give to non-profits.  This year it falls on what would have been Mama’s 92^nd birthday, the 30^th of November.

When Mama died last summer, our family decided to offer people a chance to make a donation in her memory, to put solar panels on the Nueva Vida Health Clinic.  She would pray nightly and ask frequently if we had received enough to put the solar power system in yet.  “Not yet” I’d say.  “I’ll keep praying,” she would answer. (More on our Giving Tuesday goal here: https://www.jhc-cdca.org/giving-tuesday )

Mama was here when we had two hurricanes within two weeks of each other last year as the rains were slowing down. She was here with hot, hot temperatures.  She understood climate change.

According to the German Watch global climate risk index, Nicaragua is the fourth country in the world most affected by climate change. 

As a result, the government is actively trying to address the problem.  More than 80% of the energy Nicaragua generates is renewable: hydro, solar, geothermal and wind.  If the government had enough money to invest, they could provide all of Central America with geothermal energy with seven active volcanoes.

We want to do our part for renewables as well as cut expenses in running the health clinic.  We use a great deal of energy at the clinic:

•         Air-conditioning nine rooms (two dental rooms, lab, office with computers, clean room, intake room, pharmacy, ultrasound room, and the big room that stores medicines)
•         Refrigerating reagents, running the machines and microscope in the lab
•         Running dental machinery, x-ray, lights, etc. in our dental rooms
•         Running the ultrasound machine
•         Sterilizing all the equipment with autoclaves and water distiller
•         Refrigerators for medicines
•         Lights
•         Fans
•         Otoscopes
•         Computers
•         Microwave
• ·       And last but not least, a water pump

We need $6,200 to finish this project because costs have gone up.  This is our goal for Giving Tuesday.

I think Mama will rest easier knowing that we have enough money to put “those solar panels on the clinic,” I know I will at least. 

– Kathleen

[English above] 

Para donar a Giving Tuesday, haga click aquí: https://donatenow.networkforgood.org/jhc-cdca  

Hoy es Viernes Negro en los Estados Unidos, el día cuando se ponen a la venta tantas cosas para atraer a la gente a que venga y gaste para el comienzo de las fiestas de diciembre. Hay personas que han muerto en la multitud de gente por tratar de conseguir cosas en particular o simplemente por entrar en la tienda. Es una locura.

El martes, las redes sociales tienen un evento llamado Giving Tuesday, Martes de Donaciones. Algunas empresas donan por igual lo que donan sus seguidores y otros no, pero es su intento de alentar a las personas a donar a organizaciones sin fines de lucro. Este año cae en lo que habría sido el 92 cumpleaños de mi mamá, el 30 de noviembre.

Cuando mamá falleció hace unos meses, nuestra familia decidió ofrecer la oportunidad de hacer una donación en su memoria para colocar paneles solares en la Clínica Nueva Vida. Ella rezaba todas las noches y preguntaba con frecuencia si ya teníamos suficiente para instalar el sistema de energía solar. "Todavía no," le decía yo. "Seguiré rezando," contestaba ella.

Mamá estaba aquí cuando pasamos dos huracanes con dos semanas de diferencia el año pasado, cuando las lluvias disminuían. Ella estaba aquí con temperaturas cálidas y calientes. Ella entendió el cambio climático.

Según el índice de riesgo climático global de German Watch, Nicaragua es el cuarto país del mundo más afectado por el cambio climático.

Como resultado, el gobierno está activamente abordando el problema. Actualmente, más del 80% de la energía que genera Nicaragua es renovable: hidroeléctrica, solar, geotérmica y eólica. Si el gobierno tuviera suficiente dinero para invertir, podría proporcionar energía geotérmica a toda Centroamérica con los siete volcanes activos.

Queremos hacer nuestra parte por las energías renovables, así como reducir los gastos en el funcionamiento de la clínica de salud. Usamos mucha energía en la clínica:

•         Aire acondicionado en nueve salas (dos salas de odontología, laboratorio, oficina con computadoras, cirugía, clasificación, farmacia, sala de ultrasonido y la bodega de medicamentos)
•         Refrigeración de reactivos, funcionamiento de las máquinas y microscopio en el laboratorio.
•         Manejo de maquinaria dental, rayos X, luces, etc. en nuestras salas dentales
•         Operación de la máquina de ultrasonido
•         Esterilización de con autoclaves y destilador de agua
•         Refrigeradores para medicamentos
•         Luces
•         Abanicos
•         Otoscopios
•        Computadoras
•         Microonda         
•      Ypor último, pero no menos importante, una bomba de agua.

Necesitamos $6.200 dólares para terminar este proyecto porque los costos han aumentado. Este es nuestro objetivo para Giving Tuesday: https://www.jhc-cdca.org/giving-tuesday 

Creo que mamá descansará más tranquila sabiendo que tenemos suficiente dinero para poner “esos paneles solares en la clínica,” sé que al menos yo voy a estar más tranquila. 

- Kathleen

NOTE: If you are reading this blog using the mobile version, click on "web version" to see the full blog with all the features including "subscribe to blog by email".  

Please join us and also share on your social media.

Donate here to the ongoing work of the CDCA with the poor in Nicaragua:
https://donatenow.networkforgood.org/jhc-cdca 

Giving Tuesday: Please Help the CDCA Raise Its Goal of $5,400 to Save in the Future

Today is Giving Tuesday, a day fostering giving to non-profits online. The CDCA’s specific project goal for today is $5,400 to set up and maintain for one year an electronic patient record-keeping system for the Nueva Vida Clinic. We have been posting on social media about this day. We have written blogs explaining in more detail why we chose to focus on this project and how you can help. So far, these are the blogs we have written if you want to check them out:

1. a blog about the two hurricanes hitting Nicaragua in two weeks, climate change and why going green is important.
2. a blog about how typing data electronically makes for less mistakes and more time for patient care. 
3. a blog about HOW we are able to do this now and how appreciative we are, 
4. a blog on climate change and saving paper 
5. a blog about how much space and time we will save 
6. and today I will write on the importance of statistics and a summary of why we need this service.

With Hikma Health, a non-profit organization, working to provide “Smart Care, Everywhere,” we are now able to have access to an on-line software and cloud storage area designed specifically for all our patients’ health information... their paper charts. It is true what Hikma Health says on their web page “As of now, health data management systems are not designed to support low resource settings - and need to be adaptable to these increasingly common conditions.” 

Every time we tried to think of ways to move our information to on-line storage and have all our information not on paper, all the programs available were too expensive and too detailed. Creating one that we would have to code and set up is beyond our capabilities.

HIKMA Health also say, “Under acute conditions, populations are disconnected from health care providers, and humanitarian organizations have difficulty tracking rates of disease and the amount of equipment/medications they need to order.”

Josefa, our administrator, does a great job of knowing what we need for our patients in the clinic. She knows what medicines to order according to what the doctors prescribe monthly (available funds allowing)…but tracing diseases is difficult for us. We just do not have the means to really follow-up as we would like. This electronic records service will make that more possible.

“Under protracted conditions, chronic illnesses get worse because they go under treated and preventable complications occur too often.”

This too, is true. Many of our patients get some medications from the government as well as our clinic. Being able to record ALL the medications they are taking will allow our doctors to plan a strategy with the patients who suffer with chronic illnesses.

This service will also provide for us - at our finger tips - what is working and what is not. Statistics. Finding out if the medications are consistently lowering diabetes or not; and if not, why not. 

It will allow us to go through patients’ files and develop not only strategies for individual patients, but also methodologies for the future of service for the clinic. It will allow us to tap into grants and provide for the Nicaraguan government accurate statistics of the diseases we are seeing for their own nationwide public health programs.

In summary, this service:

• will save the clinic money in paper, file folders, printing costs, and maintenance on the file cabinets.
• will save trees and energy…we will go greener and with climate change (two hurricanes category 4 and 5 within two weeks), Nicaragua needs our clinic to be more ecologically sound. 
• will save on space in the lobby area as well as with storage of all the files…which means better social distancing. 
• will also allow us to make fewer mistakes because everything will be typed and not hand-written. 
• will save us time which will mean more patient care. 
• and will allow us to track and keep records of diseases and patient statistics to use for better public health and grant writing as well as developing strategies for the patients. 

Dr Jorge with patients... charting by hand

This is a win-win scenario. This project is valuable to us.  We would love to be able to just spend the money for it to happen; but the CDCA is struggling to pay payroll for staff and bills as well as buying medications and sending out hurricane relief. THIS is why we need YOUR help today. Help us reach our goal of $5,400 today.

Together we can solve problems. Thank you!

- Kathleen

NOTE: If you are reading this blog using the mobile version,click on "web version" to see the full blog with all the features including "subscribe to blog by email".  

Please join us and also share on your social media.

Donate here to the ongoing work of the CDCA with the poor in Nicaragua:

https://donatenow.networkforgood.org/jhc-cdca 

Giving Tuesday: Time, Money, and Space Savings

Tomorrow is Giving Tuesday, a day fostering on-line giving to non-profits. The CDCA sets a specific project goal for that day. Though Nicaragua has suffered with two hurricanes in two weeks, the goal we set awhile back for this year was $5,400 to set up and then maintain for one year an electronic patient record-keeping system for the Nueva Vida Clinic. We are posting on social media about Giving Tuesday and we are writing blogs explaining why we chose to focus on this project and how you can help. So far:  

1. a blog about the two hurricanes hitting Nicaragua in two weeks, climate change and why going green is important;
2. a blog about how typing data electronically makes for less mistakes and more time for patient care;
3. a blog about HOW we are able to do this now and how appreciative we are;
4. a blog on Future Friday and saving paper;
5. and today's blog about how much space, money and time we will save. 

We have seen well over 30,000 patients in our clinic …getting closer to 40,000. Files in the medical part of the clinic, dental clinic, eye glasses, and therapy areas take up a great deal of space. We have file cabinets everywhere: 

• in the lobby space,
• in a storage room,
• in the therapy room,
• in the warehouse,
• and in the vision correction room. 

Space we could use for other purposes, like:

• more social distancing inside the clinic,
• storing medical supplies and equipment,
• And more room for play in the therapy room, 

We jam files into limited space and as a result many patient charts get misfiled.  For years this has been an on-going problem…we spend so much time trying to find misfiled charts. For this Giving Tuesday, one donor gave a gift in honor of his friend, who has actually spent her visits in Nicaragua helping us refile all the files into correct numerical order. 

Bucknell Brigade students and professors have spent hours upon hours helping us find files on patients who have not been seen in the clinic in the previous five years. They pull those files and archive them to make room for newer files, and we then mark them on the computer as no longer active.   North Anderson Community Church Presbyterian volunteers have also done their fair share of standing at the file cabinets and ordering one file after another.

Filing has taken huge amounts of time, space, and money in purchasing file folders and hanging file folders. For many years we could not buy them here and so delegations would bring them down in their luggage instead of using the baggage weight for medicines. Plus we have spent money on fixing file cabinets as they break under the weight of so much paper.

With the digital on-line service we will slowly but surely remove the old files and have more space. We will not have to search and search for missing files at the start of every shift. We will not have to collate all the daily charts into the proper file and then find space for them at the end of every shift.

Time, space and money from the on-line service will save the staff of the clinic:

• time best spent with patients and developing good public health;
• space best used to maintain more social distancing;
• and money best spent on medications and supplies instead of file folders and cabinet maintenance. 

Please give this Tuesday. In the long run, the clinic will save money. 

Together we can solve problems. 

-Kathleen

NOTE: If you are reading this blog using the mobile version,click on "web version" to see the full blog with all the features including "subscribe to blog by email".  

Please join us and also share on your social media.

Donate here to the ongoing work of the CDCA with the poor in Nicaragua:

https://donatenow.networkforgood.org/jhc-cdca 

GivingTuesday and Future Fridays and Climate Change and...

 It all seems to roll over me in one giant growing ball of complications... we won't have many Future Fridays if we lose our trees and can't breathe... our children won't have many Future Fridays if we can't stop climate change.  Scientist say that unless we change, apparently we're going to keep having more severe weather patterns like the hurricanes that just swept over Nicaragua.  And we are creating environments that encourage the emergence of toxic pandemics, with their ongoing after-effects on the increased health needs of our patients... and with COVID-19 protocols and social distancing in place, how do we even attempt to continue to meet those needs?  And... and... and.... 

But that path of thinking is too big... the more the problems cycle around the bigger the ball keeps getting... problems too huge to wrap my head around. 

Instead...

One tiny step in the right direction: Using less paper in the Nueva Vida Clinic.  NOW.

This Giving Tuesday.  NOW.  

One attainable goal that we CAN help do, and can do it NOW. 

We can save eight trees each year starting NOW. We can create more space for patients by using less space for paper files. And we can protect our health givers and our patients in the process by switching to a digital patient record-keeping system.

We just have to get it in place... get it started... and then this ball of action can itself begin to roll and grow.  But we can not do it without your help.  We've been promised $1,350 so far.  We are a fourth of the way there.  It won't fix hurricanes.  It won't keep viruses from forming.  It isn't a magic answer.  BUT it is a real place to start, to help, to make a difference.

  https://jhc-cdca.org/givingtuesday/

Together we CAN tackle problems.

- Sarah

NOTE: If you are reading this blog using the mobile version,click on "web version" to see the full blog with all the features including "subscribe to blog by email".  

Please join us and also share on your social media.

Donate here to the ongoing work of the CDCA with the poor in Nicaragua:

https://donatenow.networkforgood.org/jhc-cdca 

Giving Tuesday: Thanksgiving

Today is Thanksgiving in the United States. It is also the day before Black Friday (a horrid tradition that has made its way down here to Nicaragua), and four days until Giving Tuesday, an opportunity to give to non-profits through social media. The CDCA sets a specific project goal for that day. Though Nicaragua has suffered with two hurricanes in two weeks, the goal we set awhile back for this year was $5,400 to set up and then maintain for one year an electronic patient record-keeping system for the Nueva Vida Clinic. We are posting on social media about Giving Tuesday and I am writing blogs explaining why we chose to focus on this project and how you can help. So far:

1.  a blog about the two hurricanes hitting Nicaragua in two weeks, climate change and why going green is important. 
2. a blog about how typing data electronically makes for less mistakes and more time for patient care. 
3. and today, a blog about HOW we are able to do this now and how appreciative we are.

We are grateful this Thanksgiving Day for the Hikma Health organization, whose philosophy is "Smart Care, Everywhere".  They found our website and asked if we were interested in having an electronic patient record-keeping system for the Clinic…duh!

Through the last eight years, we have been exploring many ways to do this, but we just did not have the expertise to implement this idea of moving from paper to digital. We finally started having internet in the clinic in 2018, thanks to Philip and Lydia, who came to volunteer from London.

Hikma Health volunteer staff have been working with Sarah who works with Ligia, our dental hygienist. Ligia also understands computers and has had more available time away from dentistry for this project, because she is pregnant; she needs to be extra careful about exposure to COVID-19, and so has not been working in our dental clinic. Thanks to the two of them, information collected from clinic administrator Josefa and from me has been interpreted into understandable data language and passed onto to the coders at Hikma Health who are custom-designing an electronic record-keeping system specifically designed for the Nueva Vida Clinic! This work will ensure that we have what WE need and not what a clinic in Kenya, for example, might need. 

For this online software program to work, we need tablets and smart phones.  Thanks to Hikma Health donations we have already received some which they managed to ship through Peaceworks (NJ) and Quest for Peace (CT)…to whom we are also most grateful.

We are extremely grateful to Hikma Health for all their hard work at: 

• custom-designed coding,
• working with lay folks and older folks to develop the best program for us, 
• seeking grants to allow us to use their services free of charge for six months,
• and donating tablets and phones. 

What a gift sent to us from The Divine to our clinic! That they choose to do this work and that they found us is a wonder.

And amidst all the needs of the world with hurricanes, fires, droughts, floods, economic loss with COVID-19, we are deeply, deeply grateful that many of you would choose to help us in this endeavor. It will save us money in the long term and help us limit our effect on climate change.

Thank you because together and ONLY together can we solve problems.

-Kathleen

NOTE: If you are reading this blog using the mobile version,click on "web version" to see the full blog with all the features including "subscribe to blog by email".  

Please join us and also share on your social media.

Donate here to the ongoing work of the CDCA with the poor in Nicaragua:

https://donatenow.networkforgood.org/jhc-cdca 

Giving Tuesday: Controlling Mistakes in the Health Clinic

Giving Tuesday is in six days is Giving Tuesday, an opportunity to give through social media to non-profits. The CDCA sets a goal for that day for a specific project. Though Nicaragua has suffered with two hurricanes in two weeks, the goal we set awhile back for this year was $5,400 to set up and maintain for one year an electronic patient record-keeping system for the Nueva Vida Clinic.

We are posting on social media about Giving Tuesday and I am writing blogs explaining why we chose to focus on this project and how you can help. Yesterday, we posted a blog about the two hurricanes, climate change, and why going green is important. Today, I want to talk about typing vs. writing. 

Each time a patient comes into our clinic, this is the process Clinic staff follow, printing or writing in cursive at each step:

1. We enter the patient's name and patient number and which doctor they will see on a roster.
2. We accept payment: either a coupon earned from volunteer work, or a token 50 or 60 córdobas (equivalent of $1.43 or $1.72) which goes toward the doctor’s exam, medication, and any necessary lab work. Then we write out their name, patient number, method of payment, check off what they need, and sign the receipt, giving them carbon copies.
3. The intake nurses take a clean daily check-in sheet and write out the patient's name, patient numbers, phone numbers and vitals. 
4.  If they are a new patient, then we add a medical history sheet and a patient card with name, patient number, address and phone number. 
5. The doctor takes the daily check-in sheet and fills in their medical evaluation and the prescribed treatment. 
6.  The doctor then fills out a prescription sheet with the medication that the pharmacy will fill for the patient and instructions for taking the medication. 
7. If the patient needs laboratory tests, the doctor fills out a separate lab exam order. 
8. The doctor then tallies symptoms or conditions treated on a separate pathology form for our records. 
9. The patient takes the prescription sheet to the pharmacy where our staff write separate printed slips of paper for each medicine, including the name of the patient, the medication, how to take the medication, and what condition it is for. 
10.  Afterwards the pharmacy staff write down in a notebook what medications were handed out to be entered into a computer later on to maintain the pharmcy's inventory.

We often see about 100 patients/day and hand out about five medications per person. Can you imagine writing all that down by hand? 

The more patients the clinic sees, the sloppier the handwriting gets…and we have had many doctors and nurses who cannot write legibly at all. This means that if a doctor sees a patient who was previously seen by a different provider, they often cannot read the patient’s chart to know what their medical history is. When we hire new staff OR have visiting doctors, this is a real problem.

We have had to track down patients who have already left the clinic to refill medicine orders because there was a mistake in dosing or the medication itself when the doctor wrote it incorrectly or the prescription was not correctly interpreted in the pharmacy. Amazingly, this has happened less often than you might think.

We often have problems filing or finding paperwork because in the hurry and with the patient moving from one area of the clinic to another, their names or their patient number get written down incorrectly.

With the new electronic patient records system, everything will be entered into a Cloud-based system on tablets or phones. How will this change work at the Clinic? It will:  

• eliminate confusion while trying to fill prescriptions
• eliminate the tedious writing and mistakes 
• eliminate the confusion with patient names and numbers and will eliminate physical filing work
• eliminate the confusion of trying to understand the written data when entering it into computers 
• eliminate the duplication of medications from one doctor to another if a patient has to see a doctor other than their primary care physician 
• reduce check-in time
• reduce the charting for doctors (after getting used to the new system) and allowing for better patient care 
• and mostly allowing other doctors to actually learn what has gone on with the patient by reading clearly typed notes.

For just $5,400, you and we can not only set up the tablets needed for this system, but also cover its internet and cloud-based costs for a year…amazing!

Together we can solve problems.

- Kathleen

NOTE: If you are reading this blog using the mobile version,click on "web version" to see the full blog with all the features including "subscribe to blog by email".  

Please join us and also share on your social media.

Donate here to the ongoing work of the CDCA with the poor in Nicaragua:

https://donatenow.networkforgood.org/jhc-cdca 

Giving Tuesday: Hurricanes, Climate Change, and Doing Our Part with Your Help

A week from today is Giving Tuesday. An opportunity to give through social media for many non-governmental organizations (or non-profits). The CDCA tries to set a goal for a specific project and though Nicaragua has suffered with two hurricanes in two weeks, the goal chosen before they ever arrived was to raise $5,400, to set in place and support for a year an on-line service to get the clinic files and information away from paper printing, instead stored in the Cloud. 

We are advertising GivingTuesday with daily posts.  In addition, I will write blogs explaining why this project is extremely important and why now we can accomplish it in more detail. Today, I want to start with the two hurricanes that just hit Nicaragua in two weeks…the impact of climate change.

Nicaragua produces less emissions than much of the world (in 2016…0.9 metric tons per capita, to the U.S. of A.’s 15.5 tons per capita). Yet with climate change, Nicaragua is at high risk as one of the areas most effected. As a global response to the ever-increasing temperatures and storms, we – as the CDCA – need to do our part.

Right now, we use up about 50,000 paper copies a year for the clinic: daily sheets on each patient exam; rosters for the patient loads; lab exam tests and results; daily tallying sheets for all the different services; patient history sheets; and then other miscellaneous forms. Putting all of this on tablets and phones and storing it in the Cloud will annually save the paper weight from about eight trees (8 inches in diameter and 45 feet high) a year in the paper alone. 

Eight trees saved will produce 1,300 pounds of oxygen in a year and will absorb 13 tons of carbon per year. That is more than what 14.5 people in Nicaragua create in one year.

When one adds in the process of making paper by using water to make pulp, the energy to create the paper and the energy to wrap and ship the paper…one ream of paper creates 4.59 lbs. carbon dioxide…so with this new system we are saving 459 lbs. of carbon/year going into the atmosphere (that is 0.23 tons/year). Plus one ream of paper uses 15,000 gallons of water so we will be saving 150,000 gallons of water in paper alone!

Every bit helps. Nicaragua is watching closely as another low pressure in the Atlantic is forming…if it does it will be Hurricane Kappa, the 31st hurricane of 2020 (it looks like it will not…thank God!). If it does its path is headed to Nicaragua.

Remember Nicaragua is the second poorest country in the hemisphere and although the government is doing a wonderful job, there is little money and the need is great (300,000 people need food; one-third of the population lives in poverty; and 70% of the population works in agriculture. Bean crops…a substantial food source…have been hit hard as well as other crops.

Doing our part to limit climate change is a must…and with your help we can.

Together problems can be solved.

- Kathleen

NOTE: If you are reading this blog using the mobile version,click on "web version" to see the full blog with all the features including "subscribe to blog by email".  

Please join us and also share on your social media.

Donate here to the ongoing work of the CDCA with the poor in Nicaragua:

https://donatenow.networkforgood.org/jhc-cdca