Riscos de Oro, Nicaragua 2019

On May 4, 2019, an Ascenta team of 22 volunteers landed in Managua, Nicaragua. We were met there by two of the Peruvian translators who participated in our 2014 campaign to Cotabambas. In Rosita, we joined the same Calibre team as in 2016, and were met by new doctors and nurses, as well as the army for protection. In total the team numbered 101 individuals, our largest team to date. The clinic operated from May 6 to May 12 and offered medical, dental and optometry care, including a pharmacy stocked with medications, vitamins and supplies.

In 2015, we declared our intention to leave a positive legacy impact on our patients. This can only be achieved by repeatedly visiting the same location(s). In doing so, we also benefit from established relationships with local doctors, health agencies and sponsor partners. This marks our third medical campaign to Riscos de Oro with Calibre Mining since 2013 and we are delighted to see signs of a positive legacy impact show in the number of familiar faces among the patient group. Below is a summary of simple statistics.

It’s tempting to consider growth in these numbers a measure of success. While they are interesting from a planning perspective, they provide no insight into the quality of care we provide. The Foundation’s goal is not simply to increase the number of patients treated. In fact, to do so would actually diminish the quality of our care. Instead, we must match these statistics with qualitative metrics: How did our treatment impact the patient’s life? Are they in less pain (i.e. a cavity filled/tooth extracted)? Did we contribute to an increase in their abilities (i.e. better vision with glasses)? Did we prevent future issues (i.e. prenatal vitamins reduce the risk of cleft palates; sunglasses prevent eye damage)? Is the patient’s day-to-day life improved? We don’t currently track impact, but it would be much more interesting to evaluate our success based on these kinds of questions.

Optometry

Patients started with visual acuities along the exterior wall. Then they were assessed with the auto-refractor and tonometer. Next, each patient received a one-on-one screening with an ophthalmoscope, after which complex cases were passed on to the optometrists. Finally, patients who required were fitted for corrective lenses and/or sunglasses. We are grateful to our retail partners who provide readers at a discount and our optometry clinics who collect used prescription glasses. We are often able to find glasses for each case though sometimes we will custom make frames and send them after the campaign ends. Optometry, like dental, is an area in which we can make an immediate and lasting positive impact.

Dental and Sterilization

This was the first year we offered restorative treatment in Riscos. The evolution of services was made possible by our friends at Global Kindness Foundation (aka ABC Dental in Mission BC). Global Kindness performs frequent dental campaigns all over the world. Shortly before our departure they handed over five suitcases, and provided training on how to operate the units. Units were equipped with hand instruments, drill bits, suction and irrigation, curing lamps, amalgam and analgesia, among other necessary supplies. This, combined with the Dental Travel Pack from HPIC, allowed the team to treat 225 patients, performing 192 extractions and 168 fillings. Many of the people who visited the dental clinic have not been educated in dental hygiene. As a result, we saw many rotten teeth, often with abscesses. Unfortunately, these were beyond restoration and required extraction, some as many as eight teeth in one patient.

Medical

Much of the economic activity in the region is agricultural and very labour intensive. As such, pain relief is a significant consideration. Similarly, this activity relies heavily on the machete, which can be very dangerous when mishandled. Family planning is a primary consideration. Some women have their first pregnancy as early as 11 years old, and go on to have as many as eight children by their twenties. Being able to offer Depo Provera is helpful for those who choose to take it. Patients commonly present with a variety of skin conditions. The hot weather can cause uncomfortable rashes, which are greatly improved by anti-fungal and other medicated creams. Finally, most women suffer from vaginosis, likely due to the heat and contaminated water.

We witnessed quite a bit of trauma this year. One 70-year old woman was brought in by makeshift stretcher, consisting of bed sheets tied to a long stick carried over a man’s shoulder at either end. She had been kicked by her mule, resulting in a fractured hip and was in excruciating pain. We provided a nerve block, significantly reducing the pain, and transported her by car to the Rosita hospital. What stands out is this woman’s stoicism and resilience during such a painful experience. It is also a humbling reminder of what few resources are available in this area for such emergencies.

Another young boy received a deep cut to his forehead, which required stitches. The cut was due to a machete, a critical tool in the agricultural fields. He couldn’t have been much older than eight or nine years old. Dan Kalla stitched him up and provided pain relief and antibiotics to fight against infection.

The nature of these emergency visits naturally draws a lot of attention. The impact of treatment is significant and immediately beneficial, but the greatest impact we make from a medical perspective, is entirely unseen. It’s in the conditions we prevent. A good example is dispensing prenatal vitamins, which can prevent birth defects such as cleft palates. Similarly, we saw many patients with anemia. Long-term anemia in kids can lead to decreased IQ and intelligence potential, which is further injustice in a demographic already at risk due to high levels of poverty. Multivitamins, in addition to a healthy diet, can help prevent this condition.

As noted, we had more doctors than ever in medical. The additional team members allowed for more frequent breaks, without disrupting patient flow or causing congestion. The added resources also allowed us to spend more time with each patient and provide more thorough care.

Donors and Partners

We would not be able to do the work we do without the support of our volunteers, sponsors, donors and partners.

Thank you for your support!

• 0