Going the distance in Nicaragua

Community health workersHealthcarePoor Communities

How long would it take you to get to hospital, and how would you get there?  

According to a 2014 report, the average distance from home to an Accident and Emergency department in the UK is 7.2km (4.4 miles). There are numerous ways to get there: walking, cycling, private car or motorbike, ambulance, emergency helicopter, a ride from a friend, timely (yes, timely!) and safe public transport… You name it. 

Now think about getting to hospital while you are sick, but covering six or more times that distance – about 43.5km (27 miles). To make matters worse, you have no means of transportation, and need either to cross the jungle or navigate one the longest rivers in Central America, the Rio Coco.  

These are the only options for the people of San Jeronimo, a community in Nicaragua’s remote Waspam municipality. There are only three hospitals in the Caribbean region of Nicaragua – an area covering 55 per cent of the country. There, Tearfund’s partner Acción Médica Cristiana (AMC) has been working to bring health care closer to 17 indigenous communities. 

AMC trains local community leaders to become health promoters. Grandmother Santa Elena has been participating in the programme. ‘I’m grateful, grateful, grateful to AMC and Tearfund for providing training for us,’ she says. ‘They have taught us how deal with malaria, clean wounds, treat snake bites, suture, use serum... We know how to inject, and have had midwifery training.’  

This has had a positive effect on the communities. ‘People don’t die as frequently as before, children are better nourished, maternal and childbirth mortality rates have decreased, and we have better knowledge about preventing new diseases,’ says Santa Elena. Twice a year AMC also runs health campaigns in the 17 communities, coordinating with the Ministry of Health to provide transport for doctors and medicines. 

The distance to health care has been shortened by the amazing work the health promoters do. However, there are still challenges. ‘We still don't have access to medicines,’ says Santa Elena. ‘To get them, we have to travel all the way to Waspam (about 43 km), on foot or by boat. That is a great burden for people who are sick or for children and single mothers. It is expensive, and we have no certainty that medicines will be available.’ For this reason AMC also provides vitamins for children and vegetable seeds for vulnerable families, hoping this will help create healthier communities. 

So, how long does it take people living in poverty to get to a hospital? I always come back to this thought: surely praying for them can help shorten the distance. 

Norman Molina
Norman Molina is the Project Officer for Tearfund’s Central America office.