Some pics from the field

Surveying in Montoya

Our truck! Able to cross rivers and carry 15 people!

 

Rachel and Josie conducting a survey 

 

The new hospital being built just outside the center of town

 

This is where we slept for three weeks in El Sauce

 

El Sauce on a clear morning

    

Piloting the survey in the Centro de Salud, El Sauce

Trabajando...

(The church in El Sauce)

We encountered a few hiccups the first week which I did not think to write about because I was so excited to start working on the project. The hiccups mainly had to do with lack of communication and miscommunication.


We showed up the first day for work without lunches for the guides who would be introducing us to the families all day long. No one told us explicitly that they we were expected to bring lunch for them. They were hungry by the end of the day and finally accepted our offer to share our PB&J sandwiches, though they were totally confused about why we would put peanut butter, jelly and bread together. We felt so bad about the fact that they were hungry, and we made sure we had proper lunches for them the next day.


When we originally put together a preliminary survey schedule with Dr. Peña and the coordinator from the El Sauce Centro de Salud (Paola), we decided that we would send out four survey teams per day in order to reach as many houses as possible. Our understanding was that we would have four guides and that the schedule would necessarily have to be flexible depending on the rain. We didn´t realize until after a few work mornings full of confusion that there were only 3 guides, that Paola had no control over the number of guides, and that the guides´ first priority is to handle issues related to vector control. Vector control is any work related to the spreading of disease by animals or insects (e.g. mosquitos, rats, etc.). Whenever there is a case of dengue, malaria, or any other vector-borne disease, they are required to investigate and, if necessary, fumigate. We spoke to the head Epidemiologist at the Centro de Salud, who informed us that we would only ever have three men at most to accompany us. Once everyone realized what was going on, we readjusted our plans and the journey has been smooth ever since....except of course for the rivers we have to cross to get to some of these communities, but that´s another story...:-)

Work has been continuing steadily and we have accomplished more than we originally thought we could over the past two weeks. We have visited communities with varying access to health care, education levels, and topography. As of last Thursday, we had visited 247 houses and conducted 143 surveys. We only have a couple of communities left to visit, and I can´t believe how quickly these couple of weeks have gone by.

My favorite thing about this whole experience has been the interaction with the women we interview. The women are always so gracious as they set up the few chairs that they have for us and welcome us into their homes. They are generally very open with us, which makes our work easier, and they are patient when we get tongue-tied in Spanish. We bring crayons and jumpropes with us to each house and sometimes we get to play with (i.e. distract) the kids while interviews are being conducted. Most of the houses we visit have 2 or 3 rooms, corrugated metal or ceramic tile roofs, dirt floors and many children. Some villages have houses close together, while others are more remote with houses a significant walk/hike away. Many are set in beautiful surroundings with cloud-topped mountains and vibrant green fields. As is to be expected during the rainy season, there is a TON of mud. We are well-equipped with tall rubber boots, quick-dry pants and the understanding that we will return home muddy almost every day.

On Friday we went to Montoya, a small village of about 20 houses, set in the lush green hills about 45 minutes outside of El Sauce. We split up in groups and spent the day walking far and wide to reach each house in the area. My group met back up with another group that was accompanied by a woman who was leading them around to the remote houses. The woman told me that she was a ´brigadista´ and that she was passing out flyers at each of the houses for a local health promotion initiative. Brigadistas recieve technical training in order to provide basic health care and medicine to mothers and children remote communities. The main function of brigadistas is to find and treat the most common infectious diseases in their communities, with the broader goal of saving the lives of children under 5. This program allows mothers and children to access basic services such as vaccination, treatment for diarrhea, and family planning methods without having to make the difficult trek to the nearest health post. Brigadistas mainly work from a ´Casa Base´ where locals can go to benefit from their services, but they also do some outreach and educational work in the communities. One of our teams had passed by the brigadista´s house earlier in the day and was told that the eligible woman was not at home. Luckily for us, she was happy to do the interview with me while walking us back the truck at the end of the day - a true field survey. It was a great ending to a long day, and we looked forward to our well-deserved weekend trip to Matagalpa.