Louisville Medicine Volume 66, Issue 2 | Page 14

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- 12 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.