Clínica Apoyo

 Providing Holistic Health Care 

 

In December, 2020, Clínica Apoyo celebrated it's seventh year of operation. The Clinic provides basic health care, medicines and health education to the 3,000 residents of  Las Comarcas de la Laguna de Apoyo. For a two dollar contribution, a patient receives a consultation with the doctor and up to a month’s supply of medicine.   No one is turned away for lack of funds. The clinic facility includes a waiting porch, reception area, triage area, dental clinic, private exam room, pharmacy/store, and education area. This 700 square foot space is ideally sized to meet the needs of the community. 

Managing the Pandemic in the community has changed the way we operate.  Now more than ever the Clinic emphasizes health education and outreach.  Two days a week clinic staff spend their time making house calls, visiting families, checking in on the homebound and providing individualized services and education. 

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Serving the Community: Our doctor sees patients primarily for respiratory problems, parasites and diarrheal diseases, hypertension, diabetes, infections of all types, muscular aches and pains, and diseases transmitted by mosquitoes such as dengue and zika. 

We provide vaccines, well baby check-ups, family planning services, pap smears and pre and post natal care.

The doctors and dentists working at the clinic perform average around 4000 consultations each year. Over the years we have treated nearly two thirds of the residents of the community, many multiple times.  About 5% of our patients each month are now also coming from surrounding communities.

 

Our pharmacy fills between 200 to 300 prescriptions each month.  Medicine is free with a consultation, and over the counter sales are made at a fraction of commercial pharmacy prices.  The clinic sponsors  2 to 4 monthly,free health education classes for people of all ages. These seminars reach between 50 to 100 residents each month. Topics this past year have included, dental hygiene, family planning, also COVID prevention.

The Promotoras and clinic staff also organize monthly community-wide events. These events serve three purposes; to bring the community together for fun and relaxation, to enhance and improve the life of the entire community by holding community-wide clean up days and health fairs, and to raise some money directly from the community to help support the clinic.  Events have included a monthly women's beauty day, cultural events, movie nights, sales of used clothing and pop-up restaurants, just to name a few.

Staff and Community Health Promoters: One of the things that make Clínica Apoyo so successful is the dedication of our staff and the eight volunteer Community Health Promoters (Promotoras) that work tirelessly on behalf of the community. The clinic employs one full time doctor and two full time Pharmacy Technician/Administrators/Medical Aids.

 

In addition, the eight Promotoras, representing different neighborhoods in the comarcas, act as our eyes and ears into the community.  They work in exchange for free medical care for themselves and their families and act as our advisory committee.  The Promotoras also help keep the clinic clean, assist with visiting medical personnel, provide some basic health education and assist us with all special community events.  Some of this year's events were community health education seminars focused on COVID prevention, nutrition, natural medicine and pre-teen sexuality and self esteem.  The Promotoras handle the distribution of pre-natal vitamins to every pregnant or lactating women in the community, clean ups of the roads, and help put on celebrations such as the small piñata parties in each neighborhood  Any profits from community events go to support clinic operations.

 

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Clínica Apoyo Adds a Permanent Dental Clinic 

2016 began with the addition of a full blown dental clinic at Clínica Apoyo.  Thanks to the help of Kim Wright an Oregon Dentist, we obtain all the dental equipment and tools necessary to do teeth cleanings, fill cavities, extract teeth and provide sealents and fluoride. In December of 2015, the equipment arrived with Kim who set it all up and held our first two-day dental clinic.  Starting that February we hired Thelma, a just-graduated dentist who lives in the Comarcas.  She practices twice a month and provides dental hygiene education to students and residents of the community. Over the past two years we have added additional dental clinics, where American dentists come down to practice a week or more, some times several times a year. These dentists keep us supplied with all the dental equipment and disposables we use. Children in our community rarely see a dentist, only showing up for emergencies, generally requiring extractions. In order to create more of a "dental culture" we have trained one of our health promoters to clean children's teeth and provide referrals to our dentists before situations become an emergency. Note: During the pandemic we have suspended all dental checkups for the safety of the staff.

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Health Education: Health education is key to the mission of Clínica Apoyo.  Education will ultimately reduce the number of doctor visits and lead to more productive, happier and healthier lives for community residents. During the first year of operation the staff, health promoters and community members all received varying degrees of health education.  Our Medicine Dispensers each took sixteen weeks of class every Sunday and became registered Pharmacy Technicians.

 The Promotoras attended classes monthly in subjects ranging from sanitation, dengue fever prevention, to first aid training. 

The lower grades at the two public schools received hand washing and tooth brushing instruction. Community members receive many types of health education, most recently workshops have been presented in their neighborhoods on nutrition, planting backyard gardens, COVID safety, methods to avoid zika and other mosquito borne illness, sexuality and self esteem.

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Pharmacy+Store=A Strategy for Sustainability: In February of 2015 we inaugurated a new expanded pharmacy as well as a small store which sells items needed for the health and welfare of the residents; items that are not currently available in the comarca. Currently we carry over 290 prescription drugs. We sell all medications at a small fraction of retail prices making them readily available to community members.

 

Items sold in the store include; school supplies and uniforms, toiletries, bicycle parts, clothing, hardware and cosmetics.  Our current staff runs the store, does the buying and keeps the books; so we won’t be incurring additional labor costs. The non-medicine merchandise is sold at regular Granada retail prices, but with the convenience of buying locally.  

Note: In 2018, patient fees, sale of medications, store profits, in kind donations and community fund raising brought in about 30% of the clinic's $26,000 yearly operating budget.

Volunteers: Since the beginning the clinic has had an amazing cadre of volunteers, both Nicaraguan and American. Our volunteers help us keep the clinic clean, keep records, provide maintenance, care for the patients, educate residents, help at the store, create memorable community events, serve housebound patients and generally connecte with the community. In 2018 we are looking for additional volunteers to help educate staff and community as well as provide specialized medical treatment.

Partners: The success of Clínica Apoyo is in part due to our many fabulous partnering organizations.

We are indebted to Clínica Alabama (www.fornicaraguanhealth.org) and Clínica Verde (www.clinicaverde.org)  for providing us with models of how to run high quality medical clinics in Nicaragua.  They have been generous with their time and expertise. Without their help Clínica Apoyo would not exist.  Opportunity International (www.opportunitynicaragua.org) was invaluable to our start up as they obtained much of our initial donated medical equipment. They continue to help us by providing visiting medical practitioners and educational opportunities.

MINSA, the Nicaraguan Ministry of Health, provides medical specialists, vaccines and much of our family planning supplies.  They visit the Clinic two to three times a month providing free services to community residents. Clinic staff organizes all the patient visits, provides many of the medications and follows up on the identified medical services. MINSA also provides some of the health educators for special programs put on by the Clinic.

Casa de La Mujer has provided a variety of support services including psychologists who work out of the clinic, and health education services.

The America Nicaragua Foundation, provides the clinic with free medications and disposible medical supplies donated by American companies. 

 

Institute Juan XXIII (www.juanxxiii.org.ni) and Laboratory Ceguel have provided us with many of our low-cost drugs and some health education. 

 

Hotel Con Corazon  (www.hotelconcorazon.com/)  has coordinated health educational events in the local schools on behalf of the clinic. They have also provided the clinic with a nursing student intern and helped us with transportation to and from the clinic. 

We are always indebted to our partners and friends at the NICA Fund (Nicaragua Initiative for Community Advancement) (www.nicafund.org).  They generously accept donations through their 501c3 on behalf of Clínica Apoyo, without charging any administrative fees, thus allowing 100% of the donations to go directly to project work. You access the NICA donation process by pushing the Donate button on this web site.

How You Can Help:

 

  • Give us your ideas and your time to help pursue these ideas

  • Donate disposable medical supplies and toiletries

  • Donate non-expired medications

  • Help transport equipment and supplies to Granada, Nicaragua

  • If you are a medical professional and want to volunteer your time please contact us.  Our current priorities are dentists, gynecologists, urologists, pediatricians. Contact us directly at nancy.brian@gmail.com

  • Make a tax deductable donation to help defray clinic operating expenses by pressing the "donate" button below.