News Archives - 2004

Even though they each took two suitcases filled with medical supplies, it barely made a dent in this country so in need. But what did make an impact is the experience these eight second-year physician assistant students from Augsburg College brought back with them, an experience they describe as being unbelievably rewarding.

The students, along with an instructor, an adjunct faculty physician, another emergency room physician, a hospital administrator, and a medical school applicant, made up this medical delegation to Leon, Nicaragua from July 9-18. They were part of the Project Minnesota Leon (PML), an organization that has worked with grass roots groups in Nicaragua for the past 20 years. PML primarily focuses on education, arts and health, and is hoping to expand its involvement in health care.

The goal of this delegation was to identify needs within the medical system in Leon, and start the process of forming relationships with groups in Minnesota. Although the relationships are the primary goal, the needs in Leon and surrounding communities are great. According to Donna DeGracia, instructor with the physician assistant program, Nicaragua is the second poorest country in the western hemisphere with no signs of economic relief in sight.

The hospital where the delegation spent most of its time, Hospital Escula Oscar Danilo Rosales Arguello (HEODRA), is a teaching hospital that receives referrals from all over Nicaragua. The hospital operates a 420-bed capacity on the same budget as it did in 1969 when it had only 200 beds. Much of the equipment, DeGracia said, is broken and obsolete. The emphasis is placed on serving the most vulnerable population. Each member of the delegation carried two suitcases full of medical supplies with them. Some of the supplies and equipment were donated, others were bought with money raised by the students prior to the trip.

"Those supplies and equipment, although very much appreciated, will do very little towards the long-term improvement in health care delivery," DeGracia said. "So much more is needed."

The PA students split up to research the needs in different areas of the hospital, and they found there were needs everywhere. For example, equipment that is considered standard in the United States was missing, antiseptic solution was poured from old gallon jugs, and clear rags were used instead of gauze.

Dr. Mario Orozco Berios, pediatric faculty, reported that diarrhea with sepsis as a major cause of death among the children. "Indeed," DeGracia said, "half the cases brought into the pediatric emergency room that morning had diarrhea. The doctors reported that the onset of sepsis is these children was escalated by widespread malnutrition."

The students also learned that in orthopedics, diabetic amputations are common.

"Everywhere we turned, we heard about complications from diabetes," DeGracia said. "The limited resources for monitoring and treating diabetes, coupled with poverty and poor diet, makes diabetes a major problem."

Outside of the hospital, in the health centers, the group learned about the well-organized health care system, however, again the resources, or lack of resources, are a major issue. Not only is there not enough medications, but many times patients have to find a way to purchase it themselves, which is difficult since there is not enough money to even feed the family. In rural areas, those too ill to walk or in labor, are transported in a hammock, which is carried between two men. Their journey to the health care center could be three hours down steep mountain paths.

The PML delegation is now charged with the task of looking for resources and long-term relationships to help the people of Leon and the surrounding area receive better health care.

All agreed that the experience in Nicaragua was unbelievably rewarding. Some of the students are hoping to return for elective medical rotations.