¡Hola! ¿Cómo están y sus familias? Hoy, escribo sobre nuestro viaje al campo- a El Roblar.  El Roblar es una comunidad en las montañas, nord y este de Managua- esta cerca San Jose de Los Remates, y tiene 500 pesonas- aproximamente 90 familias.  MINSA tiene una clinica en San Jose, pero el aceso no es facil por la gente que vive en la comunidades de las montañas. Pues, AMOS tiene una oficina en San Jose, también, y le da apoyo a la comunidad de El Roblar. Hay una promotora de la salud, Ariela. Ella es una de la comunidad y les da cuido a la gente aqui.  Visita las embarazadas y niños, les da tratimiento a los enfermos (cronicos y agudos), y le da educación a la comunidad- en escuela y charlas de  El Roblar.  Hay un comité de Salud en El Roblar- consiste a miembros de la comunidad.  En charlas, miembros hablan de la salud de la comunidad y hacen planes a mejorar.  Pronto, enseña las madres sobre nutricióny anemia.  Además, AMOS le ayuda Ariela a recomendar por El Roblar con MINSA.

¡Manos Limpios!
(Clean Hands!)





En Inglés:  Today I write about our trip to El Roblar, one of the many mountain communities here in Nicaragua.  It consists of 500 people, about 90 families. It is north and east of Managua, near a village called San Jose de Los Remates.  There is a MINSA clinic (Centro de la Salud) in San Jose, but it is not easily accessible for those who live 6-8000 meters above, especially when there are not really any roads- but paths-- that often ascend (or descend- depending which way one is headed) rapidly.  AMOS also has an office in San Jose, and has trained Ariela to be a health promoter in El Roblar. She is a member of that mountain community (--and will start nursing school next year--) and provides care: prenatal & postnatal visits, treats people with chronic & acute diseases (and makes appropriate referrals), and educates the community about health issues. She also facilitates the health committee of the community.  We attended a meeting- the involvement was very impressive.  In order to address the issue of childhood anemia, the committee is going to begin to have nutritional education for mothers & families. AMOS also helps the promoters learn how to advocate for their communities with the government.

The Hike to El Roblar is a bit arduous- I really enjoyed it, but at the same time, I cannot imagine hiking either way And being 38 weeks pregnant- or suffering from an illness...or being debilitated in any form or fashion. In addition, once one has ascended up the mountain side, the houses are not collected in any type of fashion that one from a more urbanized area would consider a village, or hamlet.  Saying that- families often live closer- but one's nearest neighbor might be a 1/2mile or more away.  The photo to the right reflects a picture I took whilst only partially up the mountain side- one can see San Jose in the distance. 

Now we are back in Managua, and tomorrow is our last day of clinic.  It has been a really good time, I will elaborate a little more on this in another blog.  I think that both Caroline and I are really appreciative of this experience- and have learned alot about Nicaragua, the people, and (of course) the clinical aspects- especially in another language.  The brain gets quite full at times.  I have great empathy for those who come to our country and the difficulties they have with English. In improving Spanish, there are days where it is easier than others, and depending on how tired, or anxious, or whatever I am, the language is easier or more difficult.  It was gratifying to hear today, from Dr Gonzalez, that she saw a patient today that Caroline & I saw last week- the patient said she didn't think we understood her- but when Dr Gonzalez reviewed our Soap note, we had understood her perfectly & ordered the appropriate treatment for her complaints- and then told this to the patient.  Also- the people we have come across have been very kind and patient with our language skills- and have also helped us.  Here is to hoping for good relations between North and Central Americans.