GLMS FOUNDATION
NEW REWARDS in Nicaragua
Cynthia Rigby, MD
T
his was my eighth trip to Nicara-
gua with GLMS and Hand In Hand
Ministries. Every trip changes with
the number and disciplines of the
participants. Our group this year was smaller,
but proved to be quite effective.
We enjoy seeing the children and their families
in Hand In Hand’s educational program. We do this by providing
school physicals at a free clinic, promoting health literacy for the
families, and giving time and attention to people who would oth-
erwise spend hours in a crowded clinic and not always get the care
that is available to others of better means. It has been a pleasure
to see the students as they have grown and flourished in school.
Spending time with parents and older relatives has allowed us to
provide health education that they embrace and try to implement,
as well as attend to their health concerns.
We have also established contacts and resources at some of the
hospitals. My first year’s visit to the national maternity hospital,
Berta Calderon Roque, was a short tour. In following years, we were
asked to present lectures on cervical cancer, tumor boards and as
our presence was accepted, an invitation to the operating room was
extended. The new CEO of the hospital is one of the residents we
lectured years ago; she welcomed us warmly this year, and gave us
a personal tour of the hospital. We were encouraged to see progress
in the emergency room facilities, the implementation of palliative
team care for cancer patients, and to visit the new NICU facility.
A few years ago, we were invited to work at another NGO, AMOS
(www.amoshealth.org) in their suburban Managua clinic – El Sa-
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LOUISVILLE MEDICINE
maritano, which serves the Nejapa area. My first year’s work was to
cover for a staff member who was on maternity leave. The following
years have included consults, delivery of educational materials and
equipment, and most of all, a chance to share information. The
NGO also trains public health workers who travel to five other rural
regions in the country, providing screening, education, triage, and
even delivering babies. This year, I was joined by our family practice
doctors – Dr. Sharon Laufer and Dr. Fran Weinstock, our Med/Peds
resident Dr. Molly Brockman, and Dr. Goetz Kloecker, who consult-
ed on cancer patients. They have invited us to come back, possibly
for a longer visit, in the future. (If anyone can help us acquire an
A1c machine, please advise. The clinic has to send out their tests,
and it takes 10 days to get results; not an optimal management tool
for patients who come from outlying rural areas for care.)
Our hosts in country, the Dunsworths, supervise the education
program and try to give us a historical and cultural perspective in
addition to our health care duties. It is a great lesson to understand
the factors outside the exam room that influence health and health
care. The satisfaction of having a positive impact has been an in-
spiration to continue volunteer activities, at home and abroad.
Dr. Rigby works as a consultant/contract medical examiner for Ken-
tucky Retirement Systems, and also for ACOG’s Safety Certification in
Outpatient Excellence in Women’s Health program.