Project C.U.R.E. recently traveled to Nicaragua to provide medical care to the community. The team brought boxes and suitcases of supplies including vitamins, medications, neonatal resuscitation devices, and more. In just the first day, the team treated over 150 patients.
An account of one of the volunteers:
As many of you are aware, this was my second volunteer trip to the rural areas surrounding Jinotega, Nicaragua with Project C.U.R.E. clinics. A team of 3 physicians, 1 physician assistant, 4 nurses, 4 non-medical people, 2 trip leaders, and several Peace Core volunteers (our interpreters) rallied to care for 537 people over 4 clinic days. We saw a range of ailments including diabetes, hypertension, urinary tract infections, chicken pox, lice, and scabies; but the majority of the complaints were of “gripe” (cold and flu symptoms), lower back and neck pain, and kidney pain. I even had one woman tell me it “burns like hell when I pee!” We gave out a lot of advice on healthy diet, exercise, stretching, as well as gave out a lot of vitamins and Tylenol. I was much more comfortable in my role as a triage nurse this year which enabled me to start to examine overall health issues that could improve the quality of life for the population we were treating. In general, the majority of the workers live in large dorms constructed of wood or cement and sleep in rooms that hold 16 people each. The floors may be concrete or dirt, and the latrines are located a good distance away from the living quarters, although you can smell them hundreds of feet away. You can only imagine how quickly infectious diseases spread when a large number of people are living in crowded dorm rooms. Chronic dehydration is a major problem for people “cutting coffee” (picking coffee cherries) and the workers drink very little water while in the fields. Adults and children drink a lot of coffee and “fresco,” which is basically sugar water (like Kool-Aid), which only dehydrates them more, and eventually these people can end up with renal disease and even renal failure. Their diets consist of a lot of rice and beans, as well as fried tortillas and fried chicken or beef (when they can afford it). Women spend a great deal of time cooking over open fires in enclosed areas which leads to a chronic cough. Some men are responsible for spraying pesticides and herbicides in the coffee fields and are not wearing masks or eye protection. These men have chronic respiratory problems because the chemicals work to shut down the respiratory systems of insects, but it also damages human lungs. I even took care of a man that got pesticide in his eye a few years ago and has an awful flap of inflamed skin that borders his lower eye lid. A large migrant population influxes into the coffee farm every year which introduces higher rates of sexually transmitted diseases, including AIDS, due to promiscuity and rape.
Taking the health history of every person opened my eyes to just how many factors go into the health of these people and the problems seem daunting…but not impossible to fix. A large-scale public health campaign would have to be implemented in order to educate the large number of rural inhabitants on job safety, diet, hydration, exercise, safe sex, and sanitation. There are so many volunteer organizations present in Nicaragua (seriously, our whole airplane was full of volunteers going to and leaving Nicaragua) that want to make a difference, but there seems to be little communication amongst groups to coordinate projects to ensure the greatest impact. As for our group, we only scratched the surface of what is needed to care for the hard-working coffee pickers. I personally think the owner of the farm we visit should make more of an effort to provide masks for chemical sprayers and water to coffee cutters. Perhaps even a group stretching time before they start working every day in the fields would decrease the amount of musculoskeletal pain experienced by the laborers. The owner boasts that he built a new dorm and kitchen for more workers, but it is still incredibly crowded and women are still cooking over open fires fueled by plastic bottles, trash, and wood. It is difficult to approach a proud owner about the poor working and living conditions, but maybe they ARE better on his farm than on surrounding farms; who am I to judge? But I do know that these people work incredibly hard and deserve to have their health protected by people that have more resources than they do.