It was a full and exhausting week, but a rewarding one. In mid-March, I (Cassie) headed up to La Dalia and El Tuma in association with my work with Accion Medica Cristiana, with the objective to assist with the coordination for a group of medical personnel from Texas.
For five days, we were able to attend to the medical needs of the surrounding communities. We would leave bright and early in the morning, head out on some of the worst roads you have ever seen and after an hour or two, arrive at our "clinic" for the day. Each day, when we arrived, there were lines of people waiting to be seen.
With help, we quickly set-up the registration while others set up the clinic, vital station, ob/gyn room and pharmacy. My job for the week was to welcome the patients, register them for their appointment and record their medical history. While the medical field is completely foreign to me, I really enjoyed the work and learned a lot from the team of doctors and physician assistants. I found that I was able to utilize my Social Work skills, building rapport with the patients, learning about their social and health histories and providing them with basic health information.
Women's health is a big issue here in Nicaragua, and while we still have a long way to go, I was impressed with the changes that have been made in the recent years.
Here are a few things that I noted during my time:
- Part of the intake involved me asking women about the number of pregnancies, live births, miscarriages, abortions and living children they have. For women, 45 years and older, I noticed that many of them had ten or more pregnancies and live births. However, many children passed away in early childhood due to sickness and lack of medical care.
- For women younger than 45 years, the number of pregnancies and living children decreased dramatically along with the number of deaths among young children. Women seemed to average four or five children.
- Many of the women that I saw were and still are having their first child in their teenage years, thirteen and fourteen years of age was not rare to see. There were very few women who were twenty years old and without a child.
- Almost all of the women (I would guess 90%), even though they live in very rural communities, have access to birth control. The Ministry of Health arrives in their community every three months to provide women with their deposhot.
- Many women were hesitant to have a pap-smear completed. For many, it felt like an invasive procedure and there was a lack of education as to why this was important for them.
- The majority of women are now delivering their children in a maternity home, which depending on where they live can be a several hour bus ride from their home. This has greatly decreased the number of maternal deaths. This situation is extremely different on the Atlantic coast of Nicaragua, where in my experience, many women continue to deliver their children in their home.
- It was interesting to note that the majority of the women had never experienced any infertility issues or miscarriages. Whereas my experience with women in the United States is that miscarriage and infertility is very common. It would be interesting to learn more about why this is. One doctor suggested that it could be that the women are unaware that they are pregnant when they miscarry. I would also find it interesting to look at diet differences, impact of birth control, having children at a younger age, etc. and it's impact on women's fertility.
Overall, the week was very rewarding and I was able to learn a lot. The doctor's were able to provide consultations to over 700 patients.
Thank-you Temple, Texas medical team for your time and service.
**The above statements are based on my interactions with the clients and have no statistical data to back them up. I should also note that this is not comprehensive for all of Nicaragua. The maternal health conditions in the Northern and Southern Caribbean Coasts are much less hopeful.