The Grounds For Health model is based on a three-way partnership between the nonprofit, the Ministry of Health within the government and local coffee cooperatives.
(Get it? Grounds… for Health.)
In this way, the goals of GFH are unique. The hope is that the government will support the proposed changes to the health care system and the coffee co-ops will provide a rural patient population.
During the first week of this campaign, local Nicaragüense health providers attended a training that was hosted by Grounds for Health volunteers – an OBGYN, two nurse practitioners and a midwife from the U.S., and a doctor from Nicaragua. The students all worked in the medical field as general doctors or nurses, but they had not received specific training regarding women's health issues.
Our training covered everything from female anatomy to diagnosis and treatment of cervical cancer. We also offered a thorough explanation as to why the focus is on cervical cancer (1. It is the number one cause of cancer-related deaths in developing areas and 2. It is preventable with early detection).
The clinic during the second week allowed the students to practice their new skills in an intense medical "rotation." The clinic was set up in a small medical building that was equipped with five rooms with exam tables, only one of which had stirrups.
We covered each table with colorful oilcloth that could be easily wiped down with Clorox spray and we used metal speculums instead of disposable, plastic ones. Each room was supplied with resources that are easily found in the area, such as wooden spatulas and Q-tips.
There have been advances in the materials we use in America, but those upgrades are still too expensive to use in poor areas. Training providers to use an expensive product and then leaving them with a limited supply of materials would have an adverse effect on a medical center in a poor village. I learned that it is important to use instruments that are available to medical centers.
Almost 300 women came in four days, some of them having traveled up to six hours! They were all associated with the coffee co-op, Cecocafen, and had been encouraged to come by a promoter assigned to their region.
The women received a free exam, and if they showed any abnormalities they received treatment in the form of cryotherapy. I don't know how many treatments we gave in total, but there was one day when we did 21. The esperanza is that when the students return to their villages they will be vigilant in their practices and continue to spread the message about women's health.
As I said in my last column, Cecocafen is a key player in GFH Nicaragua; without the cooperative's participation, many rural women may never have had the chance to see a health provider. As it was, our exam was the first and last for many of the women we saw. It's crazy how different our two cultures are and the level of importance placed on preventative medicine.
So just a quick message to all my ladies: Next time you find yourself cursing the stirrups and the stupid little mittens that supposedly make them less scary, just take a moment to think about how lucky you are to be in that position. At least you have stirrups.