USF Health Nicaragua’s 4th Capacity-Building Trip

Our time in Nicaragua always tends to feel too short. And the same can be said for our 4th annual capacity-building trip two weeks ago. However, our time there was packed full of activities, from clinical care to education to fun, and we’re thrilled with the results.

This was one of the largest groups we’ve had participate in our capacity-building trips and proved to be one of the best teams we’ve had yet. Our volunteers were motivated, passionate, and consistently willing to step in and lend a hand wherever needed.  There were 13 students and residents led by attending Dr. Elimarys Perez-Colon, Dr. Candice Mateja, and Dr. Bob Melosh. And of course, we couldn’t do what we do without our partner NGO, Manna Project International. Our clinical program director, Shanelle D’Alessio, assisted in leading the team throughout the week.

During the trip, we offered expertise in the specialties of internal medicine, pediatrics, and for the first time, surgery. We saw approximately 170 patients during the week. These included acute care visits and well child checks, and also wellness exams for all of our patients enrolled in our Chronic Patient Program. 

Our Chronic Patient Program is comprised of community members with diabetes mellitus and/or hypertension, and these individuals are closely monitored. USF Health Nicaragua has created evidence-based, community-specific guidelines for the management of these patients, and we’ve seen significant improvement in their blood pressures and A1Cs since instituting these guidelines. It has been wonderful to work with Dra. Wendy in developing and applying these guidelines, and Dra. Wendy continues to follow these guidelines when our team is at home in Florida. Our patients receive monthly supplies of their life-saving medications from the clinic, and they have extensive appointments with our specialists during our capacity-building trip. They all receive lab work at least twice annually, and more often if needed. The visits during our capacity-building trips include review of lab work, discussion on medication adherence and tolerance, and extensive education on lifestyle modifications and long-term management of disease. We were thrilled this trip to see that the majority of our chronic patients continue to be well-controlled. And spotlight on Yolanda (pictured second from the left below), whose Hemoglobin A1C continues to decline, dropping from 7.8 in our spring trip to 6.3 this trip!

Home visits are a huge part of what we do, and we know that they can have a large impact on the health of the community. We are grateful that we can work with our Community Advisory Board to identify needy or at-risk patients who may benefit from a home visit. And we’re happy to say we saw more home visits than ever this trip! Our team visited 13 patients in their homes, and were able to provide interventions to decrease morbidity and mortality associated with a variety of conditions. Given the sustainability of our program, we will be able to monitor these individuals for improvement and look forward to visiting them again personally on our next visit.

As always, we strive to make education a focus during our trips. This time, Dr. Elimarys Perez-Colon led a community discussion on the Zika virus, which included a focus on methods for prevention. This topic was requested by the community, and was very well received, with over 40 members in attendance. Furthermore, thanks to generous donations from the Tampa General Hospital, USF, and City of Lakeland communities, we were able to hand out bug spray to pregnant women in the Cedro Galan area, helping reduce the risk of serious birth defects associated with the Zika virus.

We are thrilled with the outcomes of our trip, and miss our friends in MPI and the Cedro Galan community already! Can’t wait to return in the spring!  

Meet Program Director Brooke Wilson

#HumansOfManna: Meet Brooke Wilson

Happy Friday! Inspired by the moving work of HumansOfNewYork, We are hereby launching our weekly #HumansOfManna posts as spotlights on our incredible volunteers. Without further ado, meet Program Director Brooke Wilson!

Brooke, walk me through the busiest day of your week: 

6:30 am

Tuesdays are my busiest day! I start with a rich cup of coffee. I then begin a mile-long walk to the Chiquilistagua public school for Lacrosse the Nations (LtN) practice at 7:30am.

9:00 am

After practice, I hop into the Manna micro (bus) to go to the Club in Villa Guadalupe for more lacrosse fun. I then meet with Coach Maycol for a half hour to discuss training plans, then segue into LtN practice #2 for an hour and a half.

12:00 pm

The public transport bus ride takes me approximately an hour to get home, just in time for a quick lunch before I have to leave again for Camp JAM in El Farito - our arts, music, and games class for the children of Cedro Galán.

2:45 pm

At around 2:45 pm, I return home to catch up on emails and finish preparing lesson plans for my hour-long Level 4 English class.

6:00 pm

English class begins at 6:00 pm, and I teach our level 4 students, who are improving by the day!

7:30 pm

My day of program responsibilities ends at around 7:30pm, upon my return from English.

What is your favorite thing about living in Nicaragua?

The energetic, smiling children in LtN who are always enthusiastic to learn, despite early morning practices every week. They are undoubtedly a wonderful start to my long days. (Shout out to Team Managua, my team competing in this year’s LtN Cup on November 19th! Please consider supporting this cause here.

Favorite place to “treat yo’ self”?

It’s a toss-up between Tip-Top’s popcorn chicken and PriceSmart’s supreme pizza!

What has been your biggest struggle while living in Nicaragua?

Being so far away from family!

Why did you commit to spending a year of your life here?

After graduating from college, I knew I had so many diverse interests and was uncertain about what to pursue in the future. Working with Manna Project International exposes me to a majority of these interests on a daily basis, ranging from healthcare and education to coaching lacrosse; I am confident this multi-faceted role will allow me to gain new experiences and further develop my passions.

On another note, while I rarely had the opportunity to travel during college while juggling school and DI women’s lacrosse commitments, my job as a Program Director in Nicaragua lends itself to so much travel!

Thank you, Brooke!

Click here to learn more about Brooke's work with MPI's partner organization Lacrosse the Nations.


Stephanie's Cedro Galán Homestay

Spending a week in the community gave me a new perspective on how community members live.

It’s hard to believe I have been living in Nicaragua for almost three months now!  I have finally adjusted to my new home (although still adjusting to the blazing heat), new community, and new family.  I finally feel confident using the public transportation system, further increasing my street smarts.  I even learned to drive a huge stick shift micro and can maneuver through the crazy drivers of Managua.  Every day is a new adventure living in a foreign country, and I have come to embrace every single moment. My thirteen-month contract seemed like an incredibly long commitment at first, but now, it does not seem long enough.

Manna Project International provides Program Directors with the opportunity to foster stronger relationships and engage in complete cultural immersion through week-long homestays with members from the community.  This past week, I stayed with one of my English students, María, and grew close to her family. They welcomed me with open arms, and I felt completely at home.  I had such a wonderful experience and promised to return to visit soon.

Here are some highlights from my homestay week:

Tuesday

After my programs are finished for the day, I catch a ride into the community with the  micro and walk to María’s house with some of my students.  She welcomes me into her home and shows me my new room for the next five nights.  Her six-year-old daughter, Nicole, is letting me sleep in her room while she shares a bed with María and her husband.  There are seven people living in a three-bedroom house, so I am very lucky to have my own room. 

Today is the day before my birthday, and I am excited to share it with my new Nica family.  When I arrive, some of my students are at Maria’s house getting dressed up and cooking a huge dinner.  We hop in the back of the truck en route to another community member’s house. It turns out that María, one of my other students, and my fellow Program Directors have organized a surprise birthday party for me!  I was completely taken by surprise and am so thankful they remembered!  We ate homemade fried chicken, gallo pinto, pico de gallo, and cooked yucca (a very typical Nicaraguan dish).  It's probably the best meal I have eaten yet in my time here.  I spent the rest of the night listening to the guitar (mostly listening since none of us sing very well) and dancing with the niños.  I am thankful to live and work in such a tight-knit community.

Wednesday  

I wake up to the smell of fried eggs, (more) gallo pinto, and fresh fruit served with avena con leche - a drink made with oatmeal and cinnamon.  María introduces me to all the animals living around her house, including talking parrots, pigs, birds, dogs, cats, and roosters.  She also grows many different kinds of spices in her garden to use for cooking.  We play the card game, UNO, with Nicole.  I already understand how to play and don’t have to go through trying to understand the Spanish translation for the rules of the game.  Later, we walk to English class together to prepare for the upcoming exam next week.

Saturday

Nicole and I share my favorite Nicaraguan dish for breakfast – NACATAMALES!  Nacatamales are a dish consisting of chicken, pork, rice, and vegetables wrapped in banana leaves.  Mariá serves us homemade fresh calala (passion fruit) juice.  Perfect start to the day.  While Nicole is getting ready for dance class, I chat with Maria’s father in law about Nicaraguan culture, politics, and economics.  He speaks fast, so I have to constantly remind him to speak slower so I can understand.  I promise to practice my vocabulary for when I return next time. 

We catch two different buses to get to Nicole’s dance studio in Managua in the afternoon.  During the middle of the day, the chicken buses tend to be overly crowded and cramped to the point where you cannot move. 

After about an hour, Nicole finished dance class and we meet up with Maria’s friend Lupe and Program Director, Sanjana, who is also doing a homestay.  We take another bus to Salvador Allende, a nearby boardwalk with a stunning view of Lake Managua.  I order a batido from my favorite smoothie shack and eat too many pupusas (another common Nicaraguan dish made with corn, beans, and meat).  After taking many pictures and selfies, we head home.  Nicole, María, and I watch the movie Me Before You with English subtitles, and I have to hold in my tears because this is the saddest movie I have ever watched.

Sunday

I have to go back to the Manna house today, but I do not want to leave my new family.  I have grown so close to María and Nicole over the past week.  Spending a week in the community gave me a new perspective on how community members live.  I am overwhelmingly thankful to be part of this community.  These are the little things that make me feel like I am at home.

Until next time,

Stephanie

5 Things I Learned in Nicaragua

Executive Director Samantha Church reflects on her August visit to MPI's Nicaragua site.

1. Manna Project is deeply connected with the communities it serves.

During my week-long trip, two community members, Sonia and Chepita, hosted me in their homes for traditional Nicaraguan lunches. Sitting on the porch, listening to the women tell timeless stories about the volunteers they have gotten to know over the years, emphasized MPI’s commitment to its motto, "Communities Serving Communities." 

2. Progress takes time.

I was extremely fortunate to be in Nicaragua when the Clínica Médica MPI (MPI medical clinic) in Villa Guadalupe received its official license from the Nicaraguan Ministry of Health (MINSA). Country Director Christina Palazzo and her clinic team started the licensure process in December 2014. Being there to see Christina hang this license up in the clinic was especially exciting, and a testament to the team's hard work! The license includes both primary care and specialized OB/GYN care, and will allow the clinic to actively collaborate with MINSA on community health initiatives (i.e. vaccination drives, direct referrals for specialized exams/patient follow-ups, and public health campaigns).

3. Nicaragua is breathtakingly beautiful. 

Christina brought me to Masaya Volcano National Park, which showcases one of Nicaragua’s most active volcanoes. I also had the opportunity to relax in Laguna de Apoyo’s refreshing lagoon water!

4. Everything is more colorful in Nicaragua.

Whether it be the public school playgrounds, or the massive, brightly-lit trees that line the streets of Managua, Nicaragua and its people are visibly vibrant.

5. MPI Nicaragua staff and volunteers work tirelessly to fulfill Manna Project’s mission. 

I am so honored to be working with MPI's teams. A HUGE thanks to Christina and the team for welcoming and introducing me to the impactful health, education, and livelihood programs we operate daily on-site!


Want to join the team? Early registration for Program Director positions in Nicaragua and Ecuador ends October 1st. Learn more here or apply below:

40 Things to Love About Nicaragua

The following post was written by Nicaragua Program Director Mike Fisher, who returned home to England after seven months with Manna Project in Nicaragua. Looking back on the experience, Mike shares some of the things he will remember most about Nicaragua.

Back in England

I'm back in England after seven and a half months working for Manna Project in Nicaragua.

I’ve not written a blog whilst out here, and I could say so much about the work I did, the friends I made from the U.S., the local families who welcomed me as one of their own, etc. ... but I’ll stick to Nicaragua in general for now. Since my Buzzfeed-addled mind can now only think in lists, here’s a sample of things I’ll associate with a country I’ve grown to know and love:

Part 1

  • Pouting to gesticulate everything like you’re Jagger in his heyday;
  • inexplicably deserted beaches (for now);
  • crimson sunsets;
  • mad cheap travel;
  • mosquitoes;
  • dogs;
  • geckos;
  • iguanas;
  • more mosquitoes;
  • more dogs;
  • birds of paradise;
  • swarms of gorgeous butterflies;
  • smoking volcanoes on the horizon;
  • and churning lava you can’t drag your gaze from.

Part 2

  • Berserk street parties;
  • walking through six back gardens to get to your friend’s house;
  • a total openness of home and heart;
  • beer wars: Toña vs Victoria Clásica;
  • no one likes Victoria Frost;
  • postal addresses which are literally just directions from landmarks so you end up having “Sr. Flores, three km south of the Western Fire Station and two blocks to the East, the second house to the left of the little blue church, Nicaragua”;
  • gallo pinto and every other combination of rice and beans imaginable;
  • and turning all the fans in the world on to your face full blast in order to make it through the week.
  • The bus experience: essentially a riot in motion as locals ply their goods over the music whilst the money collector screams the name of the destination out the window over and over again – "RIVAS RIVAS RIVAS RIVAS RIVAS GASEOSA AGUA RIVAS RIVAS RIVAS!";
  • a complete inability to organize into two teams for a football game;
  • and humbling graciousness and helpfulness embedded so deeply into the national culture it’s almost ubiquitous.

Part 3

  • A weariness of a war-battered past and a determination for peaceful progress;
  • the Daniel Ortega phenomenon;
  • driving through red lights because it’s getting a bit dark outside;
  • horse-drawn carts going past whilst kids play marbles and hopscotch in the street;
  • that one ten-year-old boy who tears through Cedro Galán on a white stallion like a Boss.
  • Two cent bananas and two dollar apples;
  • everywhere a ceaseless reggaeton and bachata party;
  • night skies coated in the clearest stars;
  • the radio station which ingeniously pirates Magic FM from the UK and throws over their own jingles;
  • getting a one dollar haircut every fortnight;
  • suave chele,
  • todo tuani,
  • fist bumping fifty kids before you get into the classroom... the list could go on.

 Nicaragua, and the people I met there, I’ll be paying you a visit again as soon as I can.


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