Newsletter

Project Health for León

PO Box 1209

Greenville, NC 27835

EIN:  56-1917546

http://projecthealthforleon.org/

2018 ANNUAL PROJECT HEALTH FOR LEON NEWSLETTER

October 27, 2018

2018 has been an unusual and unprecedented year for both Project Health for Leon and for Nicaragua. We would like to share our experiences with you, briefly review the tumultuous events within the country, and share our plans for the future. Many of you have been loyal supporters of PHL for many years, but we certainly welcome the interest and participation of new friends. As you may know, the goals of the organization are threefold: 1. To provide specialty and general health care to the citizens of Nicaragua, 2. To educate Nicaraguan and American medical professionals, and 3. To provide needed medical supplies and medications to health care facilities in the country.

In terms of the third goal, to provide supplies, 2018 was another rewarding year. With assistance of many of you, we were able to purchase a C-arm X-ray machine, which allows portable X-rays when we are not there and is necessary for our catheter-based interventions and electrophysiology services and donate it to the hospital in Leon. Dr. Susan Keen at ECU was able to obtain a grant for another echocardiographic machine for student education, which we are able to bring to Nicaragua with us on every trip, and which gives us a total of 3 functioning echo machines in the hospital and for our clinics. We also obtained essential ventilator replacement parts and medications for use in surgery, electrophysiology procedures, the hospital, and the clinics.

In February, we made our accustomed two-week journey to Nicaragua to provide direct medical care, which is often unavailable in Nicaragua because of the general impoverishment of the country and the scarcity of medical resources. We had over 50 participants from ECU, UNC-CH, Georgetown, Raleigh, Asheville, and other locations from coast to coast. We saw 270 patients in the cardiology clinic, and another 50 patients in the pediatric cardiology clinic. Many of these patients need catheter-based interventions or open heart surgery. The interventional team performed six very successful catheter-based procedures (two Atrial Septal Defect closures two Patent Ductus Arteriosus closures, and two openings of stenotic pulmonary valves), considerably augmenting their previous experience of openings of stenotic mitral valves, with an expanding itinerary of life saving procedures planned for the future. With respect to our educational goals, we had a total of nine students with us, five from the medical school, and four from the nurse practitioner program. They had a wonderful experience in a medical and cultural education, and worked closely together, an unusual example of inter-professional collaboration. We also regularly educated and worked with Nicaraguan medical students and residents. The nurses, led by Dr. Debra Kosko, maintained their extensive collaboration with their counterparts in the Rosales hospital, and functioned very efficiently in the clinics.

The students and several faculty members also participated in a local general medical clinic in a small nearby village (Poneloya) and in a large general clinic in the community of Lechecagua. A midwifery professor also joined us for the first time to explore educational opportunities for students. She will present a proposal to Dean Brown for consideration which may result in midwifery students joining the team in the future. We met with the dean of the medical school, the director of the hospital, and with many old friends and colleagues. We planned to return in September with the surgeons and interventional team to provide an unprecedented number of open heart surgeries and catheter-based interventions.

However, our plans were interrupted by the tumult that engulfed the country in April. The government decided to lower social security payments and increase taxes. This was followed ty large scale protests, then demonstrations, roadblocks, burning of parts of some cities, including Leon, and a violent response by the police and paramilitary groups, resulting in hundreds of deaths and more imprisonments across the country. Treatment of wounded demonstrators in many hospitals was halted, and many doctors were fired. Tourism virtually halted, many others lost their jobs, and the economy sharply declined. We felt that we could not function effectively in such an environment, and even more importantly the safety of our volunteers was endangered. Accordingly, we cancelled the July trip for electrophysiological procedures by Dr. Brumfield and his group in July, and our proposed large return in September. Currently, the violence has diminished and the roadblocks have been removed, but the situation remains unstable and uncertain. We do feel strongly that we should return at some point, as we have many patients who depend on us and the care we can provide. We hope to return in February, but this is uncertain and many feel would not be wise. We hope to send a small group of us to personally investigate the situation, so that we can make more rational decisions, in December.

At this time, it is difficult to make our annual request for donations with our plans uncertain. Of course, we do have ongoing expenses for supplies, including reagents for the laboratory and sorely needed medications. The national budgets for health care and education have been severely cut, and we will not turn down donations from those of you who feel so inclined. We hope to be able to report more definite plans in the near future.

Best wishes for the holidays and for the coming New Year.

Best regards,

John Rose                                                                  John Paar

The mission of Project Health for León is to promote the improvement of medical care for the people of Nicaragua through education of health professionals, the acquisition of appropriate medical technology, and, when necessary, by direct patient consultation and medical and surgical care, both in Nicaragua and in the United States.