Velez Páiz Hospital in Managua and a few comments about health care in Nicaragua

Velez Páiz Hospital

Velez Páiz Hospital

Our visit to Velez Páiz Hospital in Managua was on the first full day of our visit to Nicaragua but will be my last blog post dealing with Wisconsin/Nicaragua Partners programs (there will be a few more posts about Nicaragua itself). It has taken some time for me to put our visit into some semblance of a perspective.

IMG_2917Our visit was bittersweet, we saw kind and compassionate care givers working in an environment seriously in need of capital improvements and operating revenue.  I was gratified to see medical equipment that I had formerly used at Ministry St Michael’s Hospital in Stevens Point still providing good service at Velez Páiz. I was a little shocked to learn the hospital’s greatest need was not equipment but basic operating supplies such as patient gowns, bed sheets and diapers. Yes they need basic equipement, medical devices and medicines, but linens are a greater need.

It took me a while to reconcile what I saw at Velez Paiz with billboards advertising the high quality care available at Managua’s Hospital Metropolitano Vivian Pellas, only one of 220 hospitals worldwide  that has received accreditation of the Joint Commission International. Accreditation is a very impressive achievement and would have required an intensive use of resources far in excess of that used at Velez Páiz Hospital. Joint Commission reviewers would flunk Velez Páiz within their first few steps through the doorway.  The physical condition  of Velez Páiz was even a bit more unsettling since it serves a national referral center for pediatrics and pediatric subspecialties and is one of  only 32 public hospitals in the country.

W/NP has supported the Nicaragua’s health care system for many years.  Health care gets first dibs on any shipments made from Wisconsin to Managua.  As part of our trip, I transported a suitcase full of needed gowns and bed linens that I had the pleasure of delivering to the hospital.IMG_2910

Nicaragua is one of the poorest countries in the Western Hemisphere with 40% of the population lacking access to health services. Almost 80% of the employed population (more than 1,748,000 people) has no health insurance.

Nicaraguans depend on a three-tier health system. The upper class uses private health care such as is available at private clinics and Vivian Pellas Hospital. Salaried workers in government and industry are served by the Nicaraguan Social Security Institute. These workers and their families compose about 8 percent of the population, but represent in excess IMG_0083 copyof  40 percent of the national health care budget. The remainder of the population, approaching 90 percent, is served at public facilities such as Velez Páiz Hospital. While care at these public facilities is said to be free, stockouts of medications are very common transferring the cost of medications to patients and families. The cost of medicines is a significant barrier to receiving care.

I did a little research into Nicaragua’s health care spending that helped to put the situation at Velez Páiz Hospital into perspective. Nicaragua spends 8% of its GDP on health care, its annual per capita health care expenditure of just US$59 is the lowest in Central America. Annual out-of-pocket spending on health is approximately $27 dollars per person, with the remaining $32 covered by public funds and other sources. Government funds primarily cover current expenses, whereas capital expenses and investments rely largely on external sources of funding. Almost 90% of the national health budget goes toward current expenses such as payroll  (60%)  and materials/supplies (25%). The vast majority of investments in equipment, infrastructure and buildings is funded by donations and grants  external to the Nicaraguan government.

IMG_2915While the status quo looks grim, I am told there has been significant increased access to care over the past two decades.  Efforts to improve infrastructure (especially in rural areas) have suffered severe setbacks with natural disasters such as hurricanes, volcanic eruptions and earthquakes.

The medical need in Nicaragua is so great it seems almost impossible to know how to help.  I have always thought that people are your greatest resource.  Put the right tools in passionate hands and they can do miracles. On this trip I saw passionate people at so many locations including Velez Páiz Hospital in Managua and Nindiri Volunteer Fire Department.

In a previous post I listed how you can help Nindiri Volunteer Fire Department, here is how you can help Velez Páiz Hospital

  • Do you know of a good sustainable source of disposable diapers, gowns or hospital linen?
  • How about asking your church or civic group to sponsor the supply of diapers for the hospital.
  • Please consider asking your local health care providers to donate any good equipment that is being replaced to W/NP.  They can take care of the arrangements to ship it to Nicaragua.
  • After your donation has been shipped to Nicaragua, sign up for a W/NP tour and see you donation in action, it will warm your heart.

Sherin Rose Bowen, former W/NP Executive Director and mother of the current Executive Director (Amy Wiza) strongly believed in making a difference one person at a time. She wrote in her autobiography “People continue to ask, just how do you think you can change the world?   My answer, I am not changing the world, but I can make it a better place for at least one other person.  If everyone would do just one thing, it would be like grains of sand on a beach.   One grain doesn’t really mean anything, but many together can make a beautiful place to reside.”

My first few days in Nicaragua initially filled me with dispair but by the end filled me with hope.  Our daily national news is full of violence, death and human misery so similar to what Nicaragua has experienced in the not too distant past.  Today, I see  Nicaragua as a beautiful country filled with friendly industrious people. I see many Nicaraguans who are passionate about their people and wanting to make a real difference. I see W/NP making a difference one program, one person at a time and then seeing the people they have helped reach out and do the same for others.IMG_2913

I know there are many needy places like Nicaragua in the world, but at the same time, this place fills me with hope. If Nicaragua can emerge from its dark past, than other violent regions of the world can do the same.  By reaching out and making a difference to whatever part of the world grabs your heart, together  we can make a beautifal place to reside.

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One Response to “Velez Páiz Hospital in Managua and a few comments about health care in Nicaragua”

  1. Chris Kincaid Says:

    Of all the things we take for granted in this country, health care has to be one of the biggies. Here is my blog post of the clinic in Ayacucho, Peru.
    http://chrisloehmer.blogspot.com/2011/08/look-at-clinic.html

    Sorry that I am so behind on reading your posts!

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