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Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts

Monday, April 18, 2022

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.

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 



Tuesday, March 8, 2022

Help Just Around the Corner?

The Nueva Vida Clinic Health Promoter Project went on hold during COVID outbreaks. Now that 86% of Nicaraguans have at least one dose of a COVID vaccine and 64% are fully vaccinated, we have decided to open back up the Health Promoter Project.

 


What is the Health Promoter Project?

 

We have 20 promoters in this project. They open their homes to the community around them in order to serve people who need immediate health care…here are some examples:

 

  • Let’s call the first person in need “Martha”. Martha is feeling woozy and she has hypertension and type 2 diabetes. It's nighttime and going to the hospital is a long 45-minute walk, or if a bus comes by it is a 20-minute ride. Plus, the neighborhood is dangerous after dark. So Martha opts to go to the promoter’s home only a few blocks away. The promoter “Ana” asks her questions, takes her blood pressure, temperature, and tests her blood glucose…all of which Ana has been trained to do by the medical staff in the clinic. These tests will help Ana determine what might be going on. Ana then talks to Martha to help her to figure out if she can wait until morning when our clinic is open, or take the meds that Martha already, has or go straight to the hospital. 
  • Our second person is "Josue"…nine years old and he has suffered from asthma since he was three. It is 2 AM, and he wakes his mom up with his wheezing. She takes him to the promoter in their area, "Miguel", who is trained to triage asthma. He listens and watches Josue after giving him two puffs of a rescue inhaler. Miguel talks to the mother and Josue, trying to create an atmosphere of calm, all the while watching how Josue is breathing. After 10 minutes, Josue is breathing easier and Miguel gives the mom the inhaler and instructs her to take Josue to the clinic in the morning. 
  • Our third person is "Alejandro", who while chopping wood in the early morning with his machete slices his arm as the machete slips. His wife helps him get to "Teresa'' for first aid. Teresa is the promoter on their block and looked after Alejandro’s wife when she was pregnant with their third child. Teresa cleans the wound and pulls the skin together as well as she can with the supplies that our clinic gave her. She wraps it, but tells Alejandro he has to go to the hospital to get stitches, as the wound is too deep and too long for it to heal well on its own. 

  • Our fourth person is "Lisa", who is five years old. She has come home early from kindergarten; her cheek is swollen and she is in tears. “Enrique”, Lisa’s older brothe,brought her home because their mom is at work. Grandma is bed-ridden. Grandma tells Enrique to take Lisa to see his uncle, "Tomas", who is a health promoter. Tomas was trained by dental volunteers as well as by our medical staff. He looks at Lisa and examines her mouth. She has a rotten tooth. The clinic is open and he takes Lisa to our dentist who puts her on an antibiotic and a pain reliever before giving Tomas an appointment for Lisa to return for an extraction.

 

These are some of the many ways that the health promoters respond from their own homes.

 

Outside their homes, they keep a pulse on changing community needs, and they let us know what is going on. They help us keep an eye on patients who are at a higher risk than others.

 


They also do home visits with Elizabeth, our general physician, and Emir, who oversees the Health Promoter Program. Last week, while on their home visits, they found a diabetic patient of ours whose blood glucose was over 500…that is five times what it should have been. She had drunk some milk with a banana blended in it. Elizabeth talked with the woman, treated her to bring down the glucose level, and the promoter then knew to return for another check-up visit on this patient soon.

 

In their walk-abouts in the Nueva Vida community, another patient was a pregnant mother who it turns out had actually miscarried and was doing poor physically. Elizabeth sent her to the hospital to make sure the uterus was completely expelled. The promoter then knew to follow-up with the grieving mother.

 

This Health Promoter Program is vital. It is the most cost-effective program that we provide in the clinic. These promoters learn, share their knowledge, open their homes, visit others in their beds, and provide services at night and on the weekends that no one else provides.

 

Besides monthly classes on various topics, we provide the promoters with first aid kits containing needed supplies and a small stipend each month. The Nueva Vida Clinic expects to see 9,600 patients this year, and the total cost of the Health Promoter Program is $15,380. Will you help?

 

Sponsor one month’s stipend for a health promoter - $15

Sponsor 20 patients - $25

Sponsor one month of supplies for a first aid kit - $50

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

 

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.
Website: jhc-cdca.org

Tuesday, November 23, 2021

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

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 

Thursday, October 7, 2021

Nicaragua is the Exception: Letter to a Cynic

 [Español Abajo] 

“That’s unbelievable,” my father-in-law wrote me from Ireland after watching me give a statistic-heavy webinar on the advances for the poor in Nicaragua since 2007.

“I know, right?” I replied.

“No, I mean it’s actually unbelievable,” he wrote back. “For cynical and tired privileged people like ourselves, our faith in humanity has been undermined and we’ve lost all hope of goodness. The story of a government really looking after ordinary people is too good to be true.”

I understand what he means. If I hadn’t been living in Nicaragua for the last 20 years and hadn’t seen with my own eyes the changes since the Sandinista government came back in to power with a pro poor strategy 14 years ago, I know that I, too, would dismiss the statistics as nothing but propaganda.

But I have seen these changes, so how can I reach those who are too cynical to believe in a government working for the good of its people?

My father-in-law has been to our home in a rural village just outside Managua many times over the past 20 years, but it’s been awhile since he visited. His favorite pastime in Nicaragua has been sitting on our porch, chatting with our neighbors and taking part in village life. Perhaps if he understood how the statistics translate into real changes for these villagers he cares for, then he might allow himself to believe that it’s not just propaganda. So here is a letter to him:


Potable Water: Today, access to potable water in Nicaragua has risen from 65% of urban homes in 2007 to 92%. Access to water in rural areas has risen from 28% to 55% and 3,127 community water committees have been established.

Do you remember the afternoon you spent walking down to the village well with our neighbor Oscar, waiting in line with all the village boys to fill three barrels of water for our household, then riding on the ox cart back up the hill? It was a unique thrill for you, but it was an ordinary afternoon for Oscar. At that time, our whole village rationed water for washing, bathing and drinking. Our neighbors only had chickens and a few cows because they had to carry all the water for livestock. No one had much of a garden, it was too expensive – we and our neighbors often paid $55 per month for water and hauling it from the well.

Now, a new well provides water for two villages – 575 households – and we have clean drinking water coming out of the tap in our homes. The water project is administered by a community water and sanitation committee which has installed meters and collects monthly charges – usually less than $10. Our neighbors have more cows, pigs, and most grow seasonal kitchen gardens – getting starts and seeds for free from a government program – in addition to their fields of beans, corn and rice. The boys of the village – the ones who used to spend all afternoon down at the well – can now do their homework instead…much to their chagrin!

Electrical Coverage: Electrical coverage has gone from 54% to 99%. In 2007, Nicaragua’s electricity was sourced at only 26% renewable. Today with huge investment in wind, biomass, geothermal, solar, and hydroelectric, more than 80% of Nicaragua’s electricity is produced using renewable resources. Since 2007, 38 million barrels of oil have been saved, thanks to this switch.

Do you remember when you first came to visit us and you tried to show us a video, but every time the refrigerator motor kicked in, the computer turned off? Like all our neighbors, we were bringing our electricity from the well, and even though we had purchased proper wire, at a distance of 900 meters, the electricity wasn’t stable. You probably remember visiting Mario’s house, which was barely lit by one bulb at night by electricity conducted through pieced-together barbed wire.

Well, now every house in the village is connected to the grid. Each family pays their monthly electric bill, although those with low consumption – 80% of the population – receive a subsidy to cover 45% of their bill. Now Mario doesn’t just have one light bulb, he and his wife Sara have one of the largest shops in the village, with two refrigerators for selling perishable food and drink.

Education: In 2003, the average Nicaraguan had 3½ years of schooling and only 30% of those starting 1st grade were expected to finish 6th grade. Today, youth with no schooling at all has dropped from 24% to 4%. Rates for passing primary and secondary grades have increased from 79% to 91% and remarkably, the percentage of the population with a university degree has risen from 9% to 19%.

Do you remember when our daughters started preschool at the village primary school when they were two and three? Remember how their teacher earned less than $20 per month? Remember how they started the food program, and all the children would line up with their bowls and spoons to be served beans and rice at recess? Remember when our younger daughter started first grade and you were so shocked to see a 13 year old in her class who had never learned to read and write?

Do you remember Armando and Junior who used to come up and juggle on our porch? When their older cousins finished sixth grade, there wasn’t a secondary school in the village so students had to travel out to the highway. It wasn’t far, but families couldn’t afford the transport costs, and so many kids never even made it to 7th grade. Well, by the time Armando and Junior finished sixth grade, the government had started a program using rural primary schools for secondary classes on Saturdays. Kids from surrounding villages now come to our school here for secondary classes every Saturday. Armando was able to help his grandpa with their cattle during the week, and Junior got a job in Managua, and on Saturdays they attended school. Both Armando and Junior graduated last year. They didn’t go on to university, but they are both now studying at a technical school – culinary arts and hotel management. Their classmates are in auto mechanics courses, veterinary school and studying at the university, all for free. Our village now has agronomists, doctors, nurses, accountants, pharmacists, and engineers.

Health Care: Since 2007 there are 212% more maternal wait homes and 88% fewer home births, maternal mortality rates lowered by 70% and infant mortality rates lowered by 61%. There has been a 46% reduction chronic malnutrition children under 5 and a 66% reduction chronic malnutrition in children 6 to 12 years old.

Remember when our girls were born at home? We were lucky enough to pay a doctor to be there with us. Many of our neighbors had given birth at home too – with no doctor. I remember talking with a co-worker who told me how she birthed all but one of her thirteen kids at home by herself! When I was pregnant with Orla, our neighbor Nelson stopped me on my way to work and asked, “Are you in a hurry?” It turned out his wife was in labor and needed a ride to the hospital, I was worried because she was silent during the 30 minute trip – she gave birth just 10 minutes after I dropped them off! Now, our pregnant neighbors don’t have to worry about traveling in labor, they can go in to the maternal wait home for the last two weeks of their pregnancies where they are monitored by doctors. Their moms or sisters can be with them during labor, and they give can give birth closer to home.  

Do you remember on your first trip to Nicaragua 20 years ago when we drove into the barrio of Nueva Vida and you remarked at how cute the blond kids were with their fat bellies and I had to tell you that straw-like hair and potbellies are symptoms of severe malnutrition? You were heartbroken. Thanks to increased medical care – more medical professionals, hospitals, health centers, mobile clinics – and the school lunch program, it’s rare to see kids with visible malnutrition anymore.

Infrastructure: Nicaragua now boasts the best roads in the region. Since 2007 the country has doubled the mileage of paved roads, paving new nearly 2,000 KM, repairing another 2,000 KM, building 120 km new bridges and drainage systems.

Do you remember when we first moved to the village and you would call us on your land line once a month and we always had a new story about getting stuck in the mud and pulling the truck out with three teams of oxen, or the road washing away and having to walk in and out, or the tires going flat constantly from debris carried into the road? How long has it been since we had a new story like that for you?

Even following two Category 4 hurricanes in two weeks last year, the roads were fixed in a matter of days. Now we have bridges over every arroyo between our house and town, many of the roads are paved, and the dirt roads are maintained regularly. Even when it’s raining hard, we can get to work and home again safely, our neighbors get their crops to town, and the buses and motorcycle taxis run their full routes year round.

Agriculture: Since 2007, $548 million has been given in credits to small farmers, attending around 25,700 farmers per year. Since 2007, nearly 318,000 members have been inducted into 5,900 new cooperatives. Nicaragua now produces 90% of its own food.

Do you remember our neighbor Wilmer who used to wave to you as he’d drive his horse cart loaded with tree trunks? He was feeding his family then by chopping down trees and selling them for firewood. Well, I recently saw Wilmer at the mayor’s office. Like us, he was picking up a donation of hardwood seedlings from the Forestry Institute. He’s not only reforesting his own land, but he’s also learned aquaculture and has a fish tank for tilapia, and he takes a load of organic vegetables to market once a week. He and some other neighbors helped us to get black sesame seeds for a test plot. The farmer co-op we work with has 220 acres of organic sesame planted in the village this year, and now another 15 acres of black sesame. For the third year in a row, they’ll give seasonal work to 80 of our neighbors – mostly women – during the harvest.

Creative Economy: Since 2007, 23,345 micro and small businesses have been formalized, meaning those workers are now in the social security system. 3.5 million women have taken free courses, internships, workshops, and seminars to strengthen work skills. The government has sponsored 32,552 fairs and built 144 municipal markets. 3.5 million women have taken free courses, internships, workshops, and seminars to strengthen work skills. 800,000 women have received loans at 5% annual interest; an average of $18 million dollars is loaned per year.

Do you remember Paula? When you last saw her she was a single mom working cleaning and cooking to support her son. Paula now works an office job and runs two small businesses on the side. Both businesses are legally registered, and her two employees are registered with social security, receiving benefits and paying toward their retirement pensions. Together with a dozen other women, Paula just finished a free two month-long course on design and product development and is exhibiting her products at fairs. Her employees attend regular free seminars on customer service, leadership, and hygiene.

Gender Equality: Since 2006, overall gender equality Nicaragua has gone from 62 out of 153 countries to number five worldwide. Nicaragua is number one in the world for women’s health and survival, for women’s educational attainment and for women cabinet ministers.

One of the things that have always impressed you about Nicaragua is its people. In particular, Nicaraguan women come across even to foreigners like you as strong, independent, and uncompromising. After hearing the tales of our village, and knowing Nicaraguans as you do, it should not surprise you that Nicaragua is one of the most gender equal countries in the world, and that in the past 14 years, it has closed the gender gap by 80%. Nicaraguan women like the ones you know from our village finally have the legal framework and opportunities to guarantee them the equality they have always insisted on.

So, after this, are you still feeling cynical? I know it’s hard to believe that any country has so intentionally and diligently worked to improve the lot of ordinary people, but I want you to know that we are witnesses to the exception to the rule that is Nicaragua. 

- Becca Mohally Renk, Jubilee House Community

NOTE: Names and identifying details of the people mentioned have been changed.

SOURCES: PLAN NACIONAL DE LUCHA CONTRA LA POBREZA 2022-2026, Gobierno de Nicaragua Junio 2021; World Economic Forum Global Gender Gap Report 2020; United Nations Development Program 2003.


 Nicaragua es la Excepción: Carta a un Cínico

[Ingles Arriba] "Eso es increíble," me escribió mi suegro desde Irlanda después de ver un seminario web donde yo di muchas estadísticas sobre los avances para los pobres en Nicaragua desde 2007.

“¿Verdad que sí?” Respondí.

“No, quiero decir que es realmente increíble,” respondió. “Para los privilegiados cínicos y cansados ​​como nosotros, nuestra fe en la humanidad se ha visto socavada y hemos perdido toda esperanza de bondad. Un cuento de un gobierno que realmente se ocupa de la gente común es demasiado bueno para ser verdad. "

Entiendo lo que quiere decir. Si no hubiera estado viviendo en Nicaragua durante los últimos 20 años y no hubiera visto con mis propios ojos los cambios desde que el gobierno sandinista regresó al poder con una estrategia a favor de los pobres hace 14 años, sé que yo también, descartaría las estadísticas como nada más que propaganda.

Pero he visto estos cambios, entonces, ¿cómo puedo hacer entender a aquellos que son demasiado cínicos para creer en un gobierno que trabaja por el bien de su gente?

Mi suegro ha estado en nuestra casa en una comarca rural en las afueras de Managua muchas veces durante los últimos 20 años, pero no ha regresado desde hace varios años. Su pasatiempo favorito en Nicaragua ha sido sentarse en nuestro porche, platicar con nuestros vecinos y participar en la vida del pueblo. Quizás si entendiera cómo las estadísticas se traducen en cambios reales para esta gente que le importa, entonces podría permitirse creer que no se trata solo de propaganda. Así que a continuación le mando una carta a él:

Agua potable: Hoy en día, el acceso al agua potable en Nicaragua ha aumentado del 65% de los hogares urbanos en 2007 al 92%. El acceso al agua en las zonas rurales ha aumentado del 28% al 55% y se han establecido 3.127 Comités de Agua Potable y Saneamiento (CAPS).

¿Recuerda la tarde que pasó caminando hasta el pozo del pueblo con nuestro vecino Oscar, esperando en la fila con todos los muchachos del pueblo para llenar tres barriles de agua para nuestra casa y luego montando en la carreta de bueyes de regreso? Fue una emoción única para ti, pero fue una tarde cualquiera para Oscar. En ese momento, toda nuestra comarca racionaba el agua para lavarse, bañarse y beber. Nuestros vecinos solo tenían gallinas y algunas vacas porque tenían que acarrear el agua para las bestias. Nadie tenía huerto, era demasiado caro; nosotros y nuestros vecinos solíamos pagar hasta $55 dólares al mes por el agua y el transporte del agua.

Ahora, un nuevo pozo proporciona agua a dos comarcas, 575 hogares, y tenemos agua potable que sale del grifo de nuestras casas. El proyecto de agua es administrado por un comité de agua potable y saneamiento de la comunidad, y el comité ha instalado medidores y cobra mensualmente para pagar los gastos de suministrar el agua, generalmente menos de $10. Nuestros vecinos pueden tener más vacas, cerdos y la mayoría cultivan huertos obteniendo semillas y plantas gratis de un programa del gobierno para complementar sus siembros de frijoles, maíz y arroz. Los chavalos del pueblo, los que solían pasar toda la tarde en el pozo acarreando agua para sus familias, ahora tienen tiempo para hacer su tarea... ¡aunque no estoy segura que les guste este cambio!

Cobertura eléctrica: La cobertura eléctrica ha pasado del 54% al 99%. En 2007, la electricidad de Nicaragua se obtuvo con solo un 26% de energía renovable. Hoy, con una enorme inversión en energía eólica, biomasa, geotermia, solar e hidroeléctrica, más del 80% de la electricidad de Nicaragua se produce utilizando recursos renovables. Desde 2007 se han ahorrado 38 millones de barriles de petróleo gracias a este cambio.

¿Recuerdas la primera vez que viniste a visitarnos y intentaste mostrarnos un video, pero cada vez que se encendía el motor del refrigerador, la computadora se apagaba? Como todos nuestros vecinos, traíamos la electricidad del pozo y, aunque habíamos comprado el cable adecuado, a una distancia de 900 metros, la electricidad no era estable. Probablemente recuerde haber visitado la casa de Mario, que apenas estaba iluminada por una bombilla por la noche por la electricidad conducida a través de tucos de alambres de púas.

Bueno, ahora todas las casas del pueblo están conectadas a la red. Cada familia paga su factura de luz mensual, aunque las de bajo consumo, el 80% de la población, reciben un subsidio para cubrir el 45% de su factura. Ahora Mario no solo tiene una bombilla, él y su esposa Sara tienen una de las ventas más grandes del vecindario, con dos refrigeradores para vender alimentos y bebidas perecederos.

Educación: En 2003, promedio, los nicaragüenses contaban con 3 ½ años de escolaridad y se esperaba que sólo el 30% de los que comenzaban el primer grado terminaran el sexto grado. Hoy en día, la juventud sin escolaridad ha bajado del 24% al 4%. Las tasas de aprobación de los grados de primaria y secundaria han aumentado del 79% al 91% y, más impresionante todavía, el porcentaje de la población con un título universitario ha aumentado del 9% al 19%.

¿Te acordás cuando nuestras hijas empezaron el preescolar en la escuela primaria del pueblo cuando tenían tres años? ¿Te acordás que la profesora ganaba menos de $20 al mes? ¿Te acordás cuando comenzaron el programa de alimentación y todos los niños hacían fila con sus platos y cucharas para que les sirvieran frijoles y arroz en el recreo? ¿Te acordás cuando la chiquita comenzó el primer grado y te sorprendiste tanto ver a un estudiante de 13 años en su clase que nunca había aprendido a leer y escribir?

¿Te acuerdas de Armando y Junior que llegaban a practicar malabares en nuestro porche? Cuando sus primos mayores terminaron sexto grado, no había una escuela secundaria en el pueblo, por lo que los estudiantes tuvieron que viajar hasta la carretera. No estaba lejos, pero las familias no podían pagar los costos de transporte y muchos niños ni siquiera llegaron a séptimo grado. Pero cuando Armando y Junior terminaron sexto grado, el gobierno había iniciado un programa que utilizaba escuelas primarias rurales para las clases secundarias los sábados. Los niños de las comarcas cercanas ahora vienen a nuestro colegio para clases de secundaria todos los sábados. Armando pudo ayudar a su abuelo con el ganado durante la semana, y Junior consiguió un trabajo en Managua y los sábados iban a la escuela. Tanto Armando como Junior se graduaron el año pasado. No fueron a la universidad, pero ahora ambos están estudiando en una escuela técnica: artes culinarias y administración hotelera. Sus compañeros están en cursos de mecánica automotriz, programas de veterinaria y estudian carreras en la universidad, todo gratis. Nuestro pueblo ahora tiene agrónomos, médicos, enfermeras, contadores, farmacéuticos e ingenieros.

Infraestructura: Nicaragua ahora cuenta con las mejores carreteras de la región. Desde 2007 el país ha duplicado el kilometraje de carreteras pavimentadas, pavimentando casi 2.000 KM nuevos, reparando otros 2.000 KM, construyendo 120 km de nuevos puentes y sistemas de drenaje.

¿Te acordás cuando nos mudamos al pueblo por primera vez y nos llamabas desde tu línea fija una vez al mes y siempre te teníamos un nuevo cuento sobre quedarnos pegados en el lodo y tener que sacar el camión con tres yuntas de bueyes, o que los caminos se quedaban incomunicados y tuvimos que entrar y salir a pie, o de llantas ponchadas constantemente debido a la basura llevado al camino por los corrientes? ¿Cuánto tiempo ha pasado desde que te tenemos un nuevo cuento como esos?

Incluso después de dos huracanes de categoría 4 en dos semanas el año pasado, las carreteras se arreglaron en cuestión de días. Ahora tenemos puentes sobre cada arroyo entre nuestra casa y la ciudad, muchos de los caminos están pavimentados y los caminos de tierra se mantienen regularmente. Incluso cuando llueve mucho, podemos llegar al trabajo y volver a casa de manera segura, nuestros vecinos llevan sus cosechas a la ciudad y los autobuses y mototaxis recorren sus rutas completas durante todo el año.

Agricultura: Desde 2007, se han otorgado $ 548 millones en créditos a pequeños agricultores, atendiendo a unos 25.700 agricultores por año y 318.000 miembros se han incorporado a 5.900 nuevas cooperativas. Nicaragua ahora produce el 90% de la comida que consume.

¿Te acordás de nuestro vecino Wilmer, que te saludaba mientras pasaba en un carretón de caballo cargado de troncos de árboles? Entonces ganaba la vida talando árboles y vendiéndolos para leña. Hace poco le miré a Wilmer en la Alcaldía. Igual que nosotros, estaba recogiendo una donación de árboles de madera preciosa de INAFOR. No solo está reforestando su finca, sino que también ha aprendido de acuicultura y tiene una pecera para tilapia, y cada semana lleva sus verduras orgánicas al mercado. Él y algunos otros vecinos nos ayudaron a conseguir semillas de ajonjolí negro para una parcela de prueba. La cooperativa de agricultores con la que trabajamos tiene 150 manzanas de ajonjolí orgánico sembradas en la co marca actualmente, y ahora otros 10 manzanas de ajonjolí negro. Por tercer año consecutivo, darán trabajo por temporada a 80 de nuestros vecinos, en su mayoría mujeres, durante la cosecha.

Economía Creativa: Desde 2007, se han formalizado 23,345 micro y pequeñas empresas, lo que significa que esos trabajadores están ahora en el sistema de seguridad social. 3,5 millones de mujeres han realizado cursos, pasantías, talleres y seminarios gratuitos para fortalecer sus competencias laborales. El gobierno ha patrocinado 32,552 ferias y construido 144 mercados municipales. 800.000 mujeres han recibido préstamos al 5% de interés anual; se les presta un promedio de $ 18 millones de dólares por año.

¿Te acordás de Paula? La última vez que la viste era una madre soltera que trabajaba limpiando y cocinando para mantener a su hijo. Paula ahora trabaja en una oficina y además tiene dos pequeñas empresas propias. Ambas empresas están inscritas y sus dos empleados están inscritos en el INSS, reciben prestaciones sociales y están acumulando semanas para poder jubilarse con una pensión. Junta con otras mujeres, Paula acaba de terminar un curso gratuito sobre diseño y desarrollo de productos y exhibe sus productos en ferias. Sus empleados asisten regularmente a seminarios gratuitos sobre servicio al cliente, liderazgo e higiene.

Igualdad de género: Desde 2006, la igualdad de género en Nicaragua ha pasado del 62 de 153 países al número cinco en todo el mundo. Nicaragua es el número uno en el mundo en salud y supervivencia de la mujer, en acceso y logros educativos de la mujer y en mujeres ministras.

Una de las cosas que siempre te ha impresionado de Nicaragua es su gente. En particular, se nota que las mujeres nicaragüenses son fuertes, independientes e intransigentes. Después de escuchar las historias de nuestro pueblo y conocer a los nicaragüenses, no debería sorprenderte saber que Nicaragua es uno de los países con mayor igualdad de género en el mundo, y que en los últimos 14 años se ha cerrado la brecha de género en el 80 %. Las mujeres nicaragüenses como las que conoces en nuestra comarca por fin tienen el marco legal y las oportunidades para garantizarles la igualdad por la cual siempre han luchado.

Entonces, después de esto, ¿todavía te sientes cínico? Sé que es difícil de creer que un país haya trabajado de manera tan intencionada y diligente para mejorar la situación de su gente, pero quiero que sepas que nosotros somos testigos la excepción que es Nicaragua. 

– Becca Mohally Renk, Jubilee House Community

NOTA: Se ha cambiado los nombres y detalles identificadores de las personas mencionadas.

FUENTES: PLAN NACIONAL DE LUCHA CONTRA LA POBREZA 2022-2026, Gobierno de Nicaragua Junio 2021; World Economic Forum Global Gender Gap Report 2020; United Nations Development Program 2003.

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