Three Stories, One Community: One Mother To Another

This Mother's Day, give the gift of healthy moms and babies! Donate to our New Mothers Program in your mom's honor, to see pregnant women safely through to birth and also the first year of their baby's life. To give you an idea of how this vital program is helping women, Emir Fonseca, social worker and the Health Promoter Coordinator for the Nueva Vida Clinic, has shared the stories of Katherine, Solange and Sara* with you.

The Nueva Vida Clinic runs programs that benefit mothers, babies, and children of all ages. Together with the community we are helping to raise healthy children and we are proud to be bringing this contribution to Nueva Vida. We have the privilege to work with brave families with incredible stories of perseverance.

Katherine is a 28-year old patient from the Nueva Vida neighborhood. Last year she came to the clinic very worried because she suspected she was pregnant. The test came back positive, and Katherine was upset because it was not something she had expected. 

After the test result, we talked to Katherine and enrolled her in the New Mothers Program and gave her counseling to help her during her new pregnancy.

Katherine did all of her prenatal care at the clinic and today the baby is 6 months old. She says the program has been instrumental in helping her and she is thankful for the free consultations, medications, educational talks and lab tests.

“I was terrified when I became pregnant, financially I was in bad shape and I did not feel capable of having a baby. Today I thank God and the Clinic for the support they have given me since my pregnancy. The child that I once doubted I wanted is now the joy of our home, he has changed all of our lives. He is a healthy and strong child.”

Another inspiring story is that of Solange, who at 14 years old became pregnant; the father was also a teen. Her family is dysfunctional, she does not have much support from them, and throughout her pregnancy she was part of the New Mothers Program. Because of her young age, she also received psychological counseling.

Unfortunately, Solange’s baby was born two months premature and the newborn spent more than a month in the hospital in an incubator. As a result, the young mother suffered from anxiety and depression, which our psychologist Dr. Dominga treated.

Since the baby was discharged from the hospital, we have been taking care of her through our New Mothers Program. Over the past three months, the improvements in the baby's health are impressive; she is growing rapidly and every day she has fewer health complications. In addition, Solange has overcome her emotional problems with the notable positive change in her daughter.

Solange, in the New Mothers Program, leans through monthly educational talks, we provide the baby with all the medication she needs, lab tests, and we are monitoring her development.

There are many young mothers like Solange's case at the clinic: teen pregnancy remains one of the biggest public health problems in this community. 

Finally, I would like to talk about Sara, she is the mother of an 8 month old baby girl. The girl was born with multiple disabilities including facial malformation and vision problems.  

One day while we were making house calls, Sara called us from the door of her house. We approached and she whispered to us about her daughter, who was sleeping in her crib near the door. Sara explained her disabilities and the economic problems their family has.

Since then, we have been attending Sara and the baby in our clinic in the New Mothers program. It is incredible to see how the mother, in spite of the malformation in her baby’s face, takes the child with discipline and love to her medical appointments and to the educational talks. 

As a social worker, there are situations that affect me, and the case of this baby patient is one of them. She is a super intelligent and sensitive girl who reacts quickly to environmental stimuli, despite her vision problems.

- Emir Fonseca

*Patients' names have been changed.

Este Día de la Madre, ¡regala mamás y bebés sanos! Dona en honor de tu mamá a nuestro Programa de Nuevas Madres para atender a las mujeres embarazadas con seguridad desde la gestación, el nacimiento y el primer año de vida de su bebé. Para darle una idea de cómo este programa vital está ayudando a las mujeres, Emir Fonseca, trabajador social y el Coordinador del Programa de Promotores de Salud de la Clínica Nueva Vida, ha compartido las historias de Katherine, Solange y Sara* con ustedes. La Clínica Nueva Vida lleva a cabo programas que benefician a madres, bebés y niños de todas las edades. Junto con la comunidad estamos ayudando a criar niños sanos y estamos orgullosos de llevar esta contribución a Nueva Vida. Tenemos el privilegio de trabajar con familias valientes con increíbles historias de perseverancia. Katherine es una paciente de 28 años del barrio de Nueva Vida. El año pasado vino a la clínica muy preocupada porque sospechaba que estaba embarazada. El resultado de la prueba fue positivo, y Katherine se sintió muy triste porque no era algo que esperaba. Tras el resultado de la prueba, hablamos con Katherine y la inscribimos en el Programa de Embarazadas y le dimos asesoramiento para ayudarla durante su nuevo embarazo. Katherine realizó todos sus cuidados prenatales en la clínica y hoy el bebé tiene 6 meses y actualmente forma parte del Programa de Lactancia Materna. Dice que los programas han sido fundamentales para ayudarla y agradece las consultas gratuitas, los medicamentos, las charlas educativas y las pruebas de laboratorio. “Me sentí aterrada cuando Salí embarazada, económicamente estaba mal y no me sentía en la capacidad de llevar con éxito mi embarazo, hoy agradezco a Dios y a la Clínica por el apoyo que me brindan desde mi embarazo. El niño que un día dude quererlo tener actualmente es la alegría de nuestro hogar, nos ha cambiado la vida a todos. Es un niño sano y fuerte”. Otra historia inspiradora es la de Solange, que a los 14 años se quedó embarazada; el padre también era un adolescente. Su familia es disfuncional, no tiene mucho apoyo de ellos, y a lo largo de su embarazo formó parte del programa de Embarazadas. Debido a su corta edad, también recibió además consejería e intervención psicológica. Lamentablemente, el bebé de Solange nació dos meses antes de tiempo y el recién nacido pasó más de un mes en el hospital en una incubadora. Como consecuencia, la joven madre sufrió ansiedad y depresión, que nuestra psicóloga, la Dra. Dominga, trató. Desde que el bebé recibió el alta hospitalaria, nos ocupamos de ella a través de nuestro Programa de Lactancia Materna. En los últimos tres meses, las mejoras en la salud del bebé son impresionantes; está creciendo rápidamente y cada día tiene menos complicaciones de salud. Además, Solange ha superado sus problemas emocionales con el notable cambio positivo de su hija. Estamos dando charlas educativas mensuales a Solange, le proporcionamos al bebé toda la medicación que necesita, pruebas de laboratorio y hacemos un seguimiento de su desarrollo. Hay muchas madres jóvenes como el caso de Solange en la clínica: el embarazo adolescente sigue siendo uno de los mayores problemas de salud pública en esta comunidad. Por último, me gustaría hablar de Sara, que es madre de una niña de 8 meses. La niña nació con múltiples discapacidades, entre ellas una malformación facial y problemas de visión. Un día, mientras hacíamos visitas a casa, Sara nos llamó desde la puerta de su casa. Nos acercamos y ella con su voz entre cortada nos habló de su hija, que dormía en su cuna cerca de la puerta. Sara nos explicó su discapacidad y los problemas económicos que tiene su familia. Desde entonces, atendemos a Sara y al bebé en nuestra clínica del programa de Lactancia Materna. Es increíble ver como la mama, a pesar de la malformación en el rostro, lleva con disciplina y amor a la niña a sus citas de niños sanos y a las charlas educativas. 

Como trabador social hay situaciones que me marcan, y el caso de este paciente bebe es uno de ellos, es una niña súper inteligente sensible que reacciona rápidamente a los estímulos del ambiente, a pesar de sus problemas de visión.a pesar de la malformación en la cara de su bebé, lleva a con disciplina y amor a sus citas médicas y a las charlas educativas.

- Emir Fonseca

*Los nombres de los pacientes han sido cambiados.

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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

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Under Pressure

[Espanol abajo]

In 2015, every time our son, Coury, would walk into the hospital and look at my vitals, he would say, “I wish I had gotten your blood pressure and not Papaw's”.  I have always had low blood pressure my whole life, until later that same year…

Starting that July and before Thanksgiving, our family had a year from hell...I almost died; my dad did die; then my brother died; I broke my rib in a car accident; and my mother had a stroke.  Now I was home here in Nicaragua and we went to see an immunologist because I now had no spleen…(the me almost dying part).

Before the appointment, I had just found out that Mama was taking a turn for the worse.  We met with this baby who “claimed” to have gone to medical school (OK! Yes! I have become one of THOSE people) who first took my blood pressure.  Then this child who had just been potty trained had the audacity to announce I had high blood pressure.  How dare he! 

Needless to say, my blood pressure numbers never did go back down in his office.  I have since learned that when I get stressed or upset, my blood pressure spikes.

Why am I sharing this with you?

I had some really stressful months in 2015; can you imagine what my blood pressure would be if I lived in Nueva Vida:

• Wondering if we have enough to feed the children tomorrow?

• Wondering if we have enough to buy wood to cook what food we might have to feed the children tomorrow?

• Wondering what will happen to our mother as she grows more and more frail?

• Wondering if the gangs are going to bother my family?

• Wondering if someone is going to get sick in the household maybe with COVID?

My blood pressure would be a million over a million!  It is a miracle that EVERY patient we see in our Nueva Vida Health Clinic does not have hypertension.

In 2018, twenty-five percent of the deaths in Nicaragua were due to cardiovascular disease.  Most cardiovascular disease and strokes are due to hypertension.

Nicaragua has the highest CVD mortality rate in Central America.  Managua, the capital of Nicaragua, has the highest prevalence of hypertension among various other Central‐American capitals with men having higher blood pressures than women.  Women have more awareness of the issue of hypertension.

The Ministry of Health is doing a much better job than past administrations did of identifying and getting medicine to people with hypertension, but with sanctions imposed and an embargo threatened, who knows the levels of suffering that are on the rise? More stress...higher blood pressure….more deaths..

In our clinic we commit to providing care and medicine monthly to 140 plus patients with NCD.  Hypertension is a large percentage. 

We wish we could provide this level of care for all the patients but we do not have the funds.  At least those 140 patients can rest easier at night knowing they will have the medicines they need.

- Kathleen

 

[English above]

En 2015, cada vez que nuestro hijo Coury entraba al hospital y miraba mis signos vitales, decía: "Ojalá hubiera heredado tu presión arterial y no la de Papaw.” Siempre he tenido la presión arterial baja toda mi vida, hasta más tarde ese mismo año ...

A partir de ese mes de julio y antes del Día de Acción de Gracias, nuestra familia tuvo un año de pesadilla ... Casi me muero; mi papá murió; luego murió mi hermano; Me rompí una costilla en un accidente de carro; y mi madre sufrió un derrame cerebral. Ahora estaba en casa aquí en Nicaragua y fuimos a ver a un inmunólogo porque ya no tenía bazo…(a raíz del incidente donde casi me muero).

Antes de la cita, acababa de enterarme de que mamá estaba empeorando. Nos reunimos con este doctor bebé que “afirmó” haber ido a la escuela de medicina (¡OK! ¡Sí! Me he convertido en una de ESAS personas) que primero me tomó la presión arterial. Entonces, este niño que acababa de aprender a ir al baño tuvo la audacia de anunciar que tenía la presión arterial alta. ¡Como se atreve!

No hace falta decir que mis cifras de presión arterial nunca volvieron a bajar en su oficina. Desde entonces he aprendido que cuando me estreso o me molesto, mi presión arterial se dispara.

¿Por qué estoy compartiendo esto contigo?

Tuve algunos meses realmente estresantes en 2015, ¿se imaginan cuál sería mi presión arterial si viviera en Nueva Vida?

• ¿Se pregunta si tendremos suficiente para alimentar a los niños mañana?

• ¿Se pregunta si tenemos suficiente para comprar leña para cocinar cualquiera comida que tendremos para alimentar a los niños mañana?

• ¿Se pregunta qué le pasará a nuestra madre a medida que se vuelva cada vez más frágil?

• ¿Me pregunto si las pandillas van a molestar a mi familia?

• ¿Se pregunta si alguien se va a enfermar en el hogar tal vez con COVID?

¡Mi presión arterial sería de un millón sobre un millón! Es un milagro que TODOS los pacientes que vemos en nuestra Clínica Nueva Vida no tengan hipertensión.

En 2018, el veinticinco por ciento de las muertes en Nicaragua se debieron a enfermedades cardiovasculares. La mayoría de las enfermedades cardiovasculares y los accidentes cerebrovasculares se deben a la hipertensión.

Nicaragua tiene la tasa de mortalidad por ECV más alta de Centroamérica. Managua, la capital de Nicaragua, tiene la mayor prevalencia de hipertensión entre varias otras capitales centroamericanas, donde los hombres tienen presión arterial más alta que las mujeres. Las mujeres tienen más conciencia sobre el tema de la hipertensión.

El Ministerio de Salud está haciendo un trabajo mucho mejor que el de las administraciones anteriores en la entrega de medicamentos a las personas con hipertensión, pero con sanciones impuestas y un embargo amenazado, ¿quién sabe los niveles de sufrimiento que están aumentando? Más estrés ... presión arterial más alta ... más muertes ...

En nuestra clínica nos comprometemos a brindar atención y medicamentos mensualmente a más de 140 pacientes con enfermedades crónicas, la hipertensión es un gran porcentaje.

Deseamos poder brindar este nivel de atención a todos los pacientes, pero no tenemos los fondos. Al menos esos 140 pacientes pueden descansar mejor por la noche sabiendo que tendrán los medicamentos que necesitan.

- Kathleen

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Assembly of People into Giving a Sh*t: Me and Ted Cruz

In the wee hours of Friday morning, Mama woke up with serious pain, and after trying to determine what was going on, Daniel flew through the empty roads of Managua with Mike, Mama, and me going to the hospital.

Mama is 91 years old. She came to Nicaragua Christmas of 2019 to stay a few months, but with COVID-19, she has been stuck here since...much to our great delight. She has been doing very well until the last two weeks when her health has been getting a bit shakier.

After we got to the hospital emergency room and many hours later, the ER doc determined that she had a case of acute pancreatitis. She had to be admitted. So, as I write this on Saturday, she is sleeping in a nice hospital bed with four pillows. I have WIFI. Sarah who stayed with her last night so I could sleep…bless her heart…slept on a pull-out couch with sheets, pillow and blanket. The room is air-conditioned. Everyone in and around the hospital follows PPE protocols to the max. Nurses come in with rolling stations to take her vitals. Mama’s internist speaks English as well as Spanish, so Mama can talk to him directly. And it is really nice, and all I can think of is how glad I am that she can afford to be in this hospital with her insurance so that she feels as comfortable as she can.

 
Nicaraguan public hospitals are great. But they cannot afford all the niceties that this particular private hospital can. This same week, Diana’s son…our office administrator… had surgery in a public children’s hospital…one of the new hospitals built in the last years. He had a good bed. He was in a good clean room and she had a chair to sit with him. The staff did their best to follow PPE protocols.

When Hagan, Diana’s son, went home they did not have a hospital bill. None. So far, we’ve paid out $700 for Mama's ER bill and - I know – even that is a small cost compared to the U.S. health system.

The other thing that I am grateful for is that this private hospital has thorough testing laboratories: besides a battery of blood tests, she has had several EKGs and an ultrasound. The ER doctor thought that maybe Mama was having a heart attack until all the blood work results came back and her pancreas enzymes were “out the roof” and “wacky”…those are both medical terms, I am sure.

I kept thinking about our hemoglobin laboratory machine at our Nueva Vida Health Clinic being broken. What if someone right now had serious pain like Mama's and we could not test them until we come up with the $6,500 needed to replace the machine?

In many ways our clinic services are limited by funding, as are the public hospitals here. Nicaragua is a poor nation and even poor this government has taken amazing steps to bring the quality and access to health care up, but they cannot provide what this private hospital does. Because not only do the public hospitals NOT charge their patients, but this private hospital has a robust tourism plastic surgery service and the hospital was built by the only Central American billionaire who lives and prospers in this poor nation. The hospital is also on the side of Managua that is completely opposite of where we live. Besides being opposite locality-wise…the neighborhoods are wealthier over around the hospital. More infrastructure…more resources…well, you get my drift.

Mama woke up a bit ago and being bored asked me about news. I told her about Sen. Ted Cruz getting in trouble when he flew to Cancun instead of being with his fellow Texans in their time of need. She nodded and smiled…and I thought to myself, “he is in solidarity just about as well as I am, sitting here in the A/C in a cushioned chair in the ‘fancy’ hospital. Cruz wanted to be a ‘good dad’ as he said and I want to be a good daughter.” I should reread my blog on hypocrisy.

My bottom line is that I wish every Nicaraguan could come to a hospital like this and walk out with no bill, unlike we will. I wish every Texan had water and heat no matter the neighborhood they live in. I wish every person on earth had what they need to live and then a bit more to be more comfortable. I do hope that my trying to bring that last bit to fruition makes me not AS hypocritical as Ted Cruz, but I’m not so sure it does.

-Kathleen

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When There's No Such Thing as a Rainy Day Fund

Thanks to so many of you, we finished 2020 in the black!  We even have a small surplus which clinic expenses are going through like water through a sieve.

We have to order some medications from abroad now, because some labs here in Nicaragua closed in 2018, and the U.S. State Department has imposed sanctions on Nicaragua.  To make it worthwhile to the distributors, we have to order in bulk, as the sellers will not bother with a small order.

As a result, we buy all our birth control implants for the year at once.  They are good for three years and it will save us money in the long run, not to mention no unwanted children being born to families barely getting by financially.

We also buy a year's worth of medications for our Parkinson's and epilepsy patients.  If you have ever watched someone having a seizure, you can identify with the need to control them for patients.  If you have ever seen someone with Parkinson's try to steady their hands to grab a fork, you can identify how desperately people with Parkinson's just want to control their shakes.  

Chronic Care patient receiving medicine at Nueva Vida Clinic

With the purchase of the implants and these medications, we are looking at spending an extra $11,400!

We are also needing to vaccinate our Nueva Vida Clinic staff with the two doses each of Hepatitis B vaccine, which will cost $1,950.  Nicaragua now vaccinates children as part of its free childhood immunization program, but does not have enough vaccine to cover all the adults, and there is Hepatitis B in Nueva Vida.  I know that this need seems outside of everyone's focus on COVID-19 vaccines coming, but Hepatitis B is not curable and is passed through blood. In a health clinic - blood is an issue.

Add to all of that - our lab needs a new hemoglobin testing machine.  We have an old, working one, but the machine's reagents are no longer available.  Sometimes I get extremely frustrated that the industry has to make old, reliable machinery obsolete.  The least expensive machine not in the old unusable style, is $6,500.  Yikes!

Lab technician Massiel at Nueva Vida Clinic

If we just laid out all this money, our funds would be gone.

When the Israelites wandered in the wilderness, God sent them manna to eat, but they were not to save the manna, except for use on the Sabbath.  We save very little, using what we have as we have it.  Some of us worry that if a staff member resigns, we won't have saved the five months' salary of severance pay that the law requires us to pay, and yet we always manage to pay people.

We try our best to keep reserves, but when an expense arises, somehow we always pay for it. Our finances drive business people crazy.

But manna appears when needed, thanks to you and the Provider.

- Kathleen

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