Rx for Survival — A Global Health Challenge

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Dispatches from the Field:

Malaika Wright

Changing Minds, Changing Lives

By Malaika Wright

July 2005

In El Matasanos clinic, heading towards the lowland jungle of north-central Nicaragua, the nurse is always in. The clinic takes its name from the community itself — "Matasanos," which is Spanish for "quack doctor." Interpreted literally, it means "healthy person killer." This unfortunate name speaks to the fact that many years ago the region was infamous for disreputable health practitioners. Today, however, nine communities with a total population of roughly 6,000 people turn with increasing confidence to the clinic's sole nurse, part-time personnel, and community volunteers to meet their health needs.

Three years ago, a worried Angela Flores took her new baby to the clinic when she was ill. Born prematurely and weighing only three pounds, 17-day old Francisca had a respiratory infection. Fortunately, Angela was a part of a program that was a partnership of the Ministry of Health, CARE, and several community partners. She had been visited regularly by trained community health volunteers who had educated her on the importance of pre-natal checkups, nutrition, good health and hygiene practices, and the importance of exclusive breastfeeding for the first six months of her child's life. She had been told by the volunteers that she could differentiate a simple cold from more dangerous pneumonia by whether or not her child's rib cage would sink or "draw in" as she struggled to breathe. And she had been cautioned not to wait too long before seeking medical attention if the child was ill. So when Francisca began to show signs of distress, Angela quickly made the 20-minute trek from her community to the clinic.

A glossy-haired child with bright eyes, the now three-year-old Francisca looks around quizzically from her perch on her mother's knee. Angela explains that after health personnel successfully treated what was in fact pneumonia, she continued to participate in the program by taking her baby to be weighed and receiving regular counseling from health volunteers. Mothers are urged to participate in the monitoring program for at least the first two years of their children's life. Angela played it safe. "I used to go in and have her weighed and checked regularly even after she turned two. They never turned me away," she says. "I've been very satisfied with the monitoring program." She notes that all of her three kids have diarrhea very seldom and are generally healthy.

The clinic still struggles to serve the needs of its clients. Space is at a premium and many women and children wait outside on benches for long periods to see the sole nurse. Every other week, medical personnel from the regional capital city of Matagalpa come for a day to help out. Medicines are sometimes in short supply and there simply isn't enough to go around, particularly for chronic conditions. But even with this limited care, children are healthier than before the clinic was in place. As one of the community volunteers who visits mothers like Angela, Melba Luquez would know. "I don't come across too many cases of diarrhea or pneumonia anymore," she says.

Angela lives with her husband and three kids in a sparsely furnished two-room brick home with a dirt floor. They have a plot of land where they plant corn, beans, and vegetables and raise a few animals. She notes proudly that her two older kids go to school just across the street and Francisca will start next year when she turns four. While life is hard, she has good reason to hope that her children will have a much better life than her. In fact, her eldest son dreams of becoming a doctor, and she hopes to help him realize that dream.

About the author:

Malaika Wright currently works as a knowledge management and research officer for the Emergency Capacity Building Project, a collaborative effort aimed at making humanitarian organizations better at providing emergency assistance. She visited Nicaragua while on assignment for CARE, a relief and development organization.

Image of Angela and her children, Nicaragua.

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