One of the things I find most difficult is describing experiences. Every experience is so unique to the individual going through it, and every emotion is so deeply felt. In my past article, “For Better or For Worse,” I wrote about my upcoming spring break trip to Nicaragua with Bridges to Community and my skepticism with service trips in general. It was only after a tearful Skype session with my parents after my return when I had to abruptly log off because the culture shock I faced was too overwhelming, that I finally understood how much the trip had impacted me.
After spending just over a week in Siuna, Nicaragua, I cannot emphasize enough how important and meaningful a short-term stay can be. I had trust in the program I was going with, but at the back of my mind I couldn’t help but question the extent to which our work would really help and support the community. Was it enough time? How much work could really get done? Would the beneficiaries be appreciative of Americans coming to their community? Did they want us there in the first place?
I figured out soon enough. Every morning, we woke up at 6 a.m. and chose which work site to go to. After the second day, I started going back to one work site with a family who had a daughter named Daniela. Just like I find it difficult to describe how meaningful this trip was — devoid of any clichés — I find it hard to explain the connection I had with this little girl. Seeing as she only spoke Spanish and I spoke very little of it, I thought a language barrier would hinder our interactions greatly. I didn’t know how it was possible to be so invested in a relationship where words were completely irrelevant and useless. But after Daniela got comfortable with me, we became attached at the hip. In between working on the latrine for her family, I would play “kitchen” with her, using rocks as food and leaves as plates. I taught her handshakes and games while she taught me words in Spanish. We played thumb war and built mini houses together using pieces of wood she found lying around (originally used to build the structure of the latrine). She would run around the house, put on a pair of one of our working gloves and help pick up cement bricks or shovel dirt into buckets that were used for structural purposes. On top of that, she still had the energy to laugh and play with us. I don’t think I ever stopped smiling.
What surprised me the most was how much her family appreciated our connection. Her mother would bring her camera out and take pictures of us, and whenever she saw me arrive in the morning, she gave me the warmest smile. She knew I wanted to contribute in helping her family have a latrine, but she also knew how much Daniela meant to me and me to her.
These connections we form with people in the community make the experience visiting the country unexpected, but more impactful. For anyone who has visited a developing country, it is one thing to learn about the country in school or read about it on the internet and another to actually visit it in person. Sleeping in 90 degree weather with no pillow or sheets, making sure my mosquito net was tucked in at night but realizing bugs would still find their way into the bed and “bathing” in the river because there were no bathroom facilities or running water was quite an experience. But so was playing card games at night because there was no Wi-Fi and technological distractions, learning dance moves from community members, realizing how beautiful and untouched the landscapes were and interacting with families everyday. Their lives are different from us, but not inferior. The people I worked with and the others I got to meet are some of the most hardworking, inquisitive and loving people I’ve ever encountered.
It was hard coming back to campus and hearing people complain about their breaks. I didn’t want to seem conceited or act as if I was superior — if I hadn’t gone on the trip, I may have been the one complaining about what I know now are trivial things. But when I heard someone saying that they didn’t have enough time to buy new spring clothes back home, or complaining about how they didn’t have enough space in their car to bring back more luggage, I couldn’t help but think about where I had just come from. On one of the work days, a Nicaraguan I was working with asked if he could try on my work gloves. Earlier, I had realized none of the workers wore them, even though everything was done by hand and the labor was intense. He put my gloves on and looked at them with an expression of awe and appreciation. He then told me how expensive gloves were in the country, and how hard they were to even come by in the first place. It’s difficult to fathom just how much we have. We complain so frequently about what we don’t have or what we want to have, that we don’t realize the extent to which we have. Gloves are items I pass over in a store, not because I can’t afford them, but because I don’t need them. The amount of consumer goods we have available for us is overwhelming. Yet some of the simplest products are unavailable or unaffordable to people who need them the most. And here we are, constantly complaining.
Bridges to Community brings dozens of medical students, doctors, and pre-med students down to Nicaragua each year to assist with preventive medical care, trainings, and infrastructure support in rural communities in the province of Siuna. These brigades provide much needed medical attention and medicine for thousands of Nicaraguans. One of these groups is Dartmouth College, who has brought students down with Bridges to Community for over 8 years through their Cross Cultural Education and Service Program (CCESP). Last December, 25 volunteers went down to hold medical clinics that attended to over 600 patients. They chronicled their experience with this great video. This is their story.
“I think what stood out to me the most was the participation of the community members in the construction. People traveled for an entire day by foot to help. We realized then the real importance of the maternity house–how much these communities needed it.” -Apolinar Centeno, Project Coordinator, Siuna
The idea for the Siuna Maternity House came unexpectedly during a community meeting in Hormiguero to discuss a proposed health center. “As we were talking about the health center, the focus shifted to a maternity house, and in the diagnostic study that we conducted, it was mentioned by almost everyone in the community.” The nearest hospital to Hormiguero is a 15 to 16 hour walk away, making it very difficult for pregnant women to receive the care they need during and after childbirth.
For that reason, community members prioritized the construction of a maternity house. A maternity house is a place where women can go and stay a little before their due date, that has access to vehicles to transport women to a nearby hospital when they go into labor.
Bridges to Community volunteers began construction on the maternity house in March of 2014 with the DC-IT Professionals Group. Hugo Gonzalez, International Volunteer Coordinator in Siuna at the time, remembers that group well: “There were only four people in the group, but you could just feel the excitement. That first day, we began the foundation–digging, mixing cement–it was very difficult, but we saw that it was possible. At that moment, the passion that would continue for the rest of the project was born.”
Even on that first day of construction, community members were out in strides helping with the construction. Men, women, and children all came. “The children were helping to pass out water to everyone working. No one asked them to do it. They just did it,” remembers Apolinar. And they came from all over, not just Hormiguero. “We realized then that the project was going to benefit more than just the community members of Hormiguero, and it has.”
Since its opening in August of 2014, 120 women have stayed at the maternity house. What came as a surprise, however, was that more than just pregnant women close to their due dates have been receiving care. Women have been coming in after giving birth to receive care before returning to their faraway homes; non-pregnant women have been coming to get their check ups done; and now, even children have been coming in with their mothers to see the doctor. Apolinar believes that this is because the closest health center can get very overcrowded and is rather small, while the maternity house has extra rooms for consultations. Plus, there is a doctor at the maternity house every day, thanks to Nicaragua’s Health Department ensuring that the maternity house be fully staffed.
Another great unexpected outcome of the project has been that community midwives are now accompanying pregnant women from their communities to the maternity house. Since the women trust these midwives and know them well, they can help to communicate better with the doctors and ensure that the women feel comfortable and safe. One midwife from Hormiguero, Francisca, has been attending to childbirths for over 30 years. She now visits the maternity house frequently as a volunteer, and her daughter, Yadira, is now studying to become a nurse and also volunteers at the maternity house. Both of them have received valuable trainings over the years from the medical brigades that come down with Bridges to Community, and this has been very helpful at the maternity house.
Overall, the Maternity House has exceeded all expectations, and continues to grow as a center for women’s health. Today, the soon to be mothers in Hormiguero will never have to experience a two day walk to get to a hospital when there are complications in their pregnancies and childbirths. They now have a place to go where they will be cared for and treated well. All of that is thanks to the incredible supporters, volunteers, and donors of Bridges to Community and this Siuna Maternity House project.
“My inspiration to study nursing is my mother. She has always helped our community as a health leader and midwife. I was inspired of what she was capable of doing without ever having received a formal education, but was still able to have a profound impact on my community.”
Mariela Martinez, a nursing school graduate from the community of Santa Rosa, Siuna, worked hard to get where she is. Mariela was Bridges to Community’s very first scholarship student from Siuna in 2003, when her family struggled to cover the expenses for her to attend high school. Upon graduating, Mariela was driven to continue studying and enrolled in college, but due to personal financial difficulties, she was unable to continue and had to drop out. “I always wanted to prepare myself with an education to be able to support my family. I come from a family of 8, and a good education paid by my family just wasn’t an option.”
Luckily, Bridges had grown our scholarship program to include University students, and Mariela once again applied to Bridges to complete a nursing degree. “My inspiration to study nursing is my mother. She has always helped our community as a health leader and midwife. I was inspired of what she was capable of doing without ever having received a formal education, but was still able to have a profound impact on my community.”
Throughout her nursing studies, Mariela has also been a great support to Bridges to Community in return; when she had vacation from class, Mariela donates her time and skills to assist in the clinics hosted by Bridges and visiting medical students and doctors, such as Tufts Medical School, Dartmouth Medical School and Lawrence Family Medicine, among others.
Mariela graduated with a nursing degree with a specialty in maternity care from UNAN University in Leon in December 2014. She is now looking for steady employment in the Siuna area, and continues to support Bridges medical brigades. She also hopes to learn English to better support Bridges’ projects and volunteers in Siuna.
When asked where she thinks she would be if she had not been able to receive a scholarship from Bridges, Mariela laughs and says “On the farm surely, taking care of the cows and chickens! I think the best thing Bridges can implement is the scholarship program, education is first. With just a little financial help the investment in our education has exponential results. I am so grateful to Bridges and its donors because thanks to them, I’ve set my life goals high…I hope to one day speak English to be able to personally say…. Gracias Bridges to Community.”
The maternity center in Hormiguero, Nicaragua, nears completion.
Masaya – Bridges Nicaragua Country Director Kenia Ramirez has announced a wonderful donation from the Nicaraguan Ministry of Health that will help us stock and furnish our Maternity House in Siuna! “Bridges will complete construction of the Maternity Clinic by July 10th and is excited to see its great impact on the people of Siuna. Thanks to the Ministry of Health, the clinic’s effect will be amplified and accelerated,” stated Director Kenia Ramirez
In partnership with the community, City Hall (alcaldía), and the Nicaragua Ministry of Health, Bridges chose to build the Maternity House in El Hormiguero, a rural community with limited access to health treatment. The concept of the Maternity House is a key strategy in global health planning to ensure pregnant women in isolated rural areas can receive proper treatment throughout their pregnancy.
This lack of treatment and medical attention for pregnant women is a big problem in this region of Nicaragua, where more than 18,780 people live in a very remote and diffuse set of 28 communities. Most pregnant women either give birth at home or must travel very far to reach a hospital, both of which can be extremely dangerous. We are building the Maternity House to offset this issue by providing mothers a facility with sufficient resources. Its purpose is to have a place for women to go in their last months of pregnancy where they can have access to a doctor and nurse prior to giving birth. The Maternity House will allow more consultations, faster emergency care, and greater access to medicine. Additionally, workshops will be held at the clinic to inform people of safe practices during pregnancy and birth. The before and after treatment offered is to reduce the chances of death due to things like complicated births and infections in both mother and infant.
As we neared completion of the facility, the Ministry of Health was eager to contribute to the project. They will donate 15 beds, mosquito netting, bedding, towels, chairs, a large stove, kitchenware, and a water tank. Executive Director John Hannan thanks the Ministry of Health “for providing these necessary items that will help to increase maternal and infant health.”
Nine medical students and doctors will establish and run a clinic
We are extremely excited about the University of Nevada, School of Medicine’s (UNSOM) fast-approaching trip to Tadazna, Nicaragua. The medical school has been sending students to Nicaragua for five years and continues to do so because of the positive feedback it receives from the volunteers. One alumnus described the experience as “a really wonderful opportunity to give people in need medical attention, improve global health, gain applicable medical experience, learn about different health care systems, and discover other cultures.”
Nine medical students and doctors from the university will volunteer a week of their time to provide medical care to a community that would otherwise have very limited access to health treatment. There is a health post in Tadazna that is organized by the National Health Ministry of Nicaragua, but it is often understaffed. As such, many people are not able to see a doctor and do not receive the care they deserve. The UNSOM delegation will help alleviate this problem during their stay.
To give more people in Tadazna and the surrounding region medical attention, the delegation will establish and run a clinic for five days from 8am to 5pm. The medical students, under the supervision of UNSOM and Nicaraguan doctors, will see between 60 and 100 patients each day. They will also hold workshops to teach safe practices and minimize health risks, decreasing the need for medical attention in Tadazna.
In their free time, the medical students will work on constructing a safe, sanitary, and environmentally friendly stove and latrine. These projects will reduce the contraction of debilitating diseases, again lowering the number of patients seeking medical assistance. The Tadazna community is “thankful to the University of Nevada students for improving the standard of health and health care through a variety of measures.”
Construction on Maternity House in El Hormiguero continues at a fast pace
Bridges to Community Siuna Site Coordinator Bryan Kirkup is proud to report that our major project in his area, the Maternity Clinic in El Hormiguero, is fast moving to completion.
Throughout the month of April great progress was made on site, Bryan tells us. Walls went up, holes for septic tanks were dug, doorways were constructed, and an electricity pylon was installed. El Hormiguero residents, Bridges employees, and a Fox Lane High School delegation will finish construction and painting of the clinic with the ribbon cutting ceremony slated for early July.
When completed, the clinic will not only offer medical opportunities, but also educational ones. Workshops for midwives, doctors, and pregnant women will be held by Nicaraguan health officials as well as Bridges volunteers to inform people on safe and healthy practices during pregnancy and birth.
Since we started planning this project, community members and Nicaraguan health ministry staff have told us how important they think this project is for the whole Siuna area population. Most pregnant women living in this rural, highly dispersed region give birth at home under dangerous conditions or travel great distances to the Siuna city hospital. According to local community members, mothers who go to Siuna “are uncomfortable, miss the support of friends and family, and have limited access to water.”
The Bridges to Community maternity house will benefit the local communities and the region by providing a closer birthing facility that offers sufficient resources, the comfort of home, and the comfort of loved ones. Additionally, it will provide the area access to more doctors, more consultations, faster emergency care, and greater access to medicines. These factors will lead to lower maternal deaths in the region.
Upon viewing the outpouring of support from Bridges volunteers and the integrated planning process Bridges uses, the nearby community of El Torno approached Bridges with the concept of building a school. This need will be investigated as Bridges staff complete their new five year assessments and planning process this summer. “The community’s outreach displays Bridges’ success in Nicaragua,” stated Executive Director John Hannan. “We are excited that new communities are continually approaching Bridges with projects. We hope to incorporate many of these new initiatives as we roll out our updated strategic plan in the fall, expanding on our commitment to improving the quality of life in Nicaragua and the Dominican Republic.”
On May 19 six volunteers from Carnegie Mellon University will travel to the geographically remote, rural community of Rosa Grande, Nicaragua. Throughout their seven-day journey the students will work together, along with local community members, to improve health conditions, teach computer and art skills, create a mural, and discover the similarities and wonderful cultural differences that exist in the world and amongst themselves.
In Rosa Grande they will target two major causes of health issues: cooking equipment and sanitation. Many families in the community cook meals using a wood-burning stove that sits in a corner of their small one-room home. These stoves produce immense amounts of smoke, which leads to debilitating respiratory problems for humans and deforestation of the surrounding environment. The stoves the volunteers will install are more efficient and have better ventilation, leading to decreased wood consumption and fewer respiratory infections.
The other main health target of this trip is the sanitation facilities. Most latrines in existence offer no privacy, result in environment and water contamination, and are shared among up to four families. But this situation is not even available to many- 57% of the population does not even have a latrine. Due to a lack of running water, Bridges must build pit latrines. While not like a modern indoor toilet, these far surpass the common sanitation facilities in Rosa Grande. Carnegie Mellon students will construct latrines that have a hole between 10 and 15 feet deep and provide privacy with 8-foot walls and a door. While we often ignore these seemingly simple things, if proper necessities are not met, people’s basic health needs cannot be reached.
After long mornings of construction, the students will spend afternoons exploring their more creative side. Along with community participants, the volunteers will paint a lively mural on the local chocolate factory wall. They will also delve into concepts of community and culture with elementary school kids through art classes. In order to give Rosa Grande citizens better occupational opportunities, students will hold computer classes to advance technological skills. The Carnegie Mellon students will help Rosa Grande in many facets ranging from bathroom facilities to artwork, leaving their mark on the community and forever changing themselves.
Check the Bridges to Community Facebook page to see the great work and success from the Carnegie Mellon delegation!
Construction of the Casa Materna in the community of Hormiguero near Siuna, Nicaragua began on February 17th, 2014. That same day a portion of the construction site was cleared with the support of four community members from the Paragua neighborhood. The 20th of February we began leveling the ground with the support of our engineer who directed members of the communities of Agua Sucia, El Caraus, and Waspuko Central.
It is important to emphasize the participation of the communities in the work of preparing the ground for construction. Additionally, women from the Community of Santa Rosa participated in the work of cutting iron and putting together columns of iron. All of this participation increases the motivation of other families in other communities in the zone of Hormiguero.
After the design, leveling and measuring of the land were completed, columns for the seismic beams were tied together and put up. In addition to community members, Bridges volunteers arrived to help. Our Engineer identified a few issues that had not been outlined in the project design plan. One of the difficulties was the site location grading was more than anticipated with a total difference of 2 meters between lowest part and highest part. We requested help from the Mayor’s Office but the needed equipment was already being used to improve the highway.
In a meeting with the contractor Miguel Perez and the engineer it was decided to lower the highest part half way and use the soil to raise the lower part. This work was done with the support of the communities who are always willing to work so that the project succeeds.
Achievements Obtained in the first 10 days of work:
1. Setting up of the construction site by the contractor;
2. Storage of all the construction materials in the security shed;
3. Visit by Engineer Julio Munoz to the construction site and participation in the final design and leveling of the construction site;
4. Participation by 8 communities in the Hormiguero zone; 33 men and 2 women participated for a total of 35 community members;
5. Request in ENEL Siuna for the installation of 45 meters of 3×4 wire for 220 and installation of a post for lighting installation;
6. Leaders of the community of Hormiguero were made aware of the construction process in order to lead advancements by community members;
7. Needed tools such as shovels, picks, wheelbarrows, and bars for digging are all available for digging and leveling;
8. Purchase of materials for local construction.
1. The unexpected magnitude of difference in slope of the land;
2. The final part of the regional elections decreased participation of community members in this phase of the construction of the maternity house;
3. Adjustments to the budget to include needed higher qualified workers;
4. Request to the Mayor’s Office for their machines to help level the land was not achieved because the machines were not available.
This report documents our first ten days of work. Despite the difficulties we have achieved a lot this initial phase of the project and continue working very hard in all aspects of the project so that we can achieve a very successful finished product with the help of all.
We want to thank everyone involved for the incredible support of this project, without your dedication to our aspirations none of this would be possible. Our deepest thanks to the Houston Family and the Sarita Kenedy East Foundations for their support of this project. On behalf of the more than 20,000 family members who live in the communities that will directly benefit from this facility Bridges to Community thanks you for making this dream a reality. We also want to recognize our in-country Director, Kenia Ramirez, and the Siuna region Community Project Coordinator, Margarito Peralta, for their constant involvement and problem solving throughout this process. We will continue to update you and hope you will be able to be with us for the ribbon cutting in some near future date.
This trip is organized by leaders in the Information Technology industry working in the Washington, DC area. This will be their TENTH trip since 2006! This group has built dozens of houses, multiple schools and have raised thousands of dollars in the past eight years in Nicaragua and the Dominican Republic. What an amazing group! This trip is open to anyone interested in helping make the world a better place!