The Santa Martha Clinic in the North Atlantic Autonomous Region of Nicaragua is no regular rural health center. It is a testimony of how nongovernmental organizations like Catholic Relief Services can strengthen healthcare delivery by promoting community ownership.
By contributing just one cordoba — equivalent to just a few cents — per family each month, the community in Santa Martha is guaranteed access to quality basic healthcare. Their contribution pays the monthly stipend for one health worker while CRS covers the other administrative and medical costs. CRS' partner, the Vicariate of Bluefields, provides medical supplies.
Nina Spellman's family has benefited greatly from the clinic. Her lastborn, Maria, now 6 years old, was delivered at the clinic. "I would not have had her if it were not for this clinic; malaria would have killed me while I was pregnant with her."
Her sentiments are echoed by Jorge Trujillo the clinic's health coordinator, who has noticed a steady increase in community participation and support since the introduction of community health insurance. "Because [participants] have a stake in the clinic, they feel compelled to participate in our health programs." The clinic can efficiently handle cases of malaria, dengue fever, diarrhea, and upper respiratory tract infections as well as maternal and child health. For other more complicated cases, the clinic ferries the sick to the provincial hospital in Puerto Cabezas, a good three hours away by road.
Keeping Tabs on Daily Operations
A quick tour through the clinic reveals a meticulous database of the community's statistics. Trujillo proudly displays the detailed community map, records of immunization as well as maternal health services. The records also indicate which parts of the community were more prone to malaria and dengue and what interventions were in place for them. Trujillo's only wish is for the clinic to get an additional doctor. "With just one doctor for over 6,000 people, sometimes we have to keep our patients waiting." The health center used to have another doctor paid for by the government, but Trujillo says the government has had difficulties funding another doctor, and most doctors do not want to work in this remote part of Nicaragua.
Securing the Future
For little Maria, the clinic means she does not have to take the three-hour bus ride to the provincial hospital in Puerto Cabezas for her immunizations. "I am healthy and do not miss my classes." And for the 757 pregnant women in the area, the health center means help is always close at hand.
CRS stepped in to rehabilitate the small clinic after Hurricane Mitch ravaged Central America in 1998. CRS renovated the damaged clinic and provided laboratory equipment. CRS continues to support the clinic with funds from the Sisters of Charity in Houston, Texas. Today, the clinic has one doctor, a nurse, a laboratory technician and a pharmacist who provide essential health care round the clock. The clinic provides a lifeline to more than 6,400 people who would otherwise be plagued by malaria and dengue fever.
