The most difficult problem
that we face in Nicaragua and other third world countries is sustainability. In this project we are partnering with
the Tierra Nueva Union of Cooperatives. This Union has twelve cooperatives ten of which produce coffee, with two producing
honey. They sell their coffee beans and honey “fair trade”. This allows them to make enough money
to help pay for healthcare. We hope to build a clinic soon which will be manned by students and faculty from UNICA School
of Dentistry and Medicine. The people will pay for the supplies, which is the major cost, not labor. We hope the
repeat this throughout the country.
Tierra
Nueva Clinic Project – Boaco, Nicaragua
Boaco is a city in Nicaragua with a population of about 19,000 people. It is located about
50 miles east of the capital city of Managua and the two cities are linked by an all-weather highway. The countryside
is in agricultural production or is undeveloped. The agricultural activities are primarily cattle raising, dairy products
and, to a lesser extent, coffee growing. In addition to a number of individual small coffee farmers, there is a large
farming cooperative called Tierra Nueva. The cooperative has over 500 members, of whom about 400 are coffee growers
and the remainder are honey producers. The farmers are scattered over a large area contiguous to Boaco. The produce
of the cooperative is gathered at its headquarters building in Boaco and shipped out from there.
Dr. Richard Piper of the Foundation for Worldwide
Health (FWH) visited the Tierra Nueva headquarters in February 2009. In discussions with Tierra Nueva personnel, Dr.
Piper learned that they are a fair trade cooperative and thus its members have more personal income than the majority of the
small farmers in Nicaragua who are at the mercy of the free trade market. Tierra Nueva has started a number of initiatives
to improve lives of its member families and the quality of their products. They have educational, microlending, and women’s
empowerment programs. They expressed an interest in having a healthcare component for their members and asked Dr. Piper
if the FWH and its affiliate Loma Linda University School of Dentistry (LLUSD) could conduct a dental clinic during our June
trip with dentists and dental students. Dr. Piper could not commit to this as the June 2009 trip was already fully scheduled.
FWH/LLUSD personnel have been providing dental care at no charge to impoverished
persons in Nicaragua since 2000. We have been collaborating with UNICA (The Catholic University of Nicaragua) for the
past two years. UNICA is liberal arts university with a number of professional schools and is located in Managua.
UNICA has both dental and medical schools. Dr. Lorenzo Muñoz, MD, DDS is the dean of both schools which are relatively
new. The medical school is ten years old and the dental school is five years old. The focus of both schools is prevention
and children and both are seeking community rotation sites for their students.
We had the idea that UNICA and Tierra Nueva could form a partnership that would serve the needs of both parties.
We believed that if a clinic could be started, then the Tierra Nueva growers would be able to pay enough for their healthcare
that this could at least meet the expenses of UNICA for providing the care. Following the February visit, we proposed
this idea to both UNICA and Tierra Nueva who then began a correspondence. By the time of our June trip they had agreed
in concept to such a partnership. To this end, Dr. Thomas Rogers (FWH president), Dr. Muñoz, the UNICA campus
architect, and several others travelled to Boaco for a face-to-face meeting at the Tierra Nueva headquarters. At that
meeting, Tierra Nueva and UNICA agreed to collaborate in the project, Tierra Nueva offered the large meeting room in its headquarters
as the location for a combined medical/dental clinic, FWH agreed to try to raise the funds to construct and equip the clinic,
and the architect drew up preliminary plans for the clinic.
Dr. Muñoz sent us a finished floor plan and estimated costs provided by the architect to complete necessary
improvements to the building and construct interior walls to make a usable clinic. Based on the elements for medical
and dental care that are included in the clinic design, the estimated costs are as follows:
Component
Estimated Cost
(US $)
Remodeling existing space
$ 19, 590
Dental clinic
33,200
Medical
clinic/pharmacy
17,210
Contingency
5,000
Total
$ 75,000
The great advantage of this project is that it can be self-sustaining once it is operational. FWH will
raise the funds and then will be able to step away and let the Nicaraguan partners manage their own operation. Additional
details of the component items listed above are available. The following graphics provide more information on the project.
