Sylvia S. Estrada, RNC, WHCNP, CBCN, MSN, MSHCM, BSN

For a woman living in impoverished areas in underdeveloped countries it is extremely challenging to get preventative medical care as well as the treatment that is needed. Yet there are people who have taken on this challenge and are doing something about it right now.  Grounds For Health(GFH) is a non-profit organization whose mission is to create women’s health programs in coffee growing communities such as Nicaragua, Mexico, and Tanzania, with a focus on the early detection and treatment of cervical cancer. They achieve this through community partnerships with coffee cooperatives (co-ops), local health systems, volunteer teams, involved supporters, and implementing sustainable programs that will work for that respective country.

From September 21-30th, 2011, 7 GFH volunteers travelled to San Juan de Rio Coco, Nicaragua.  San Juan de Rio Coco is a rural coffee growing community in the northern highlands in the department of Madriz, Nicaragua; a six hour rustic drive outside of Managua.  The GFH staff was housed in a modest hotel in the center of town.  The  primary care hospital known as  Luis Felipe Moncada, had an outpatient clinic area that was used as the clinic site for the cervical cancer campaign.  The clinic was located in the outskirts of town approximately six city blocks from our hotel.  The clinic became the first dysplasia treatment center in the municipality of San Juan del Rio Coco to have trained medical personnel to screen for cervical cancer.

GFH had partnered with four local coffee co-ops to assist with logistics and management of the cervical cancer campaign. We trained a new cohort of 11 doctors and nurses on cervical cancer screening that included pap smears, Visual Inspection with Acetic Acid (VIA), and treatment of pre-cancer cervical lesions with cryotherapy. During the course of the campaign, a total of 306 women were screened.

Grounds For Health relies heavily on its volunteers.  I along with six other volunteers that included a pathologist, cytotechnicians, and nurse practitioners from the U.S. gave our time and expertise to bring education and clinical training to the rural Nicaraguan healthcare staff . I was one of five clinical preceptors. Each day I was given two students to supervise their new learned skills to take a gynecological history, evaluate their pelvic exam techniques, and evaluate their communication with patients regarding cervical cancer screening.  My proficiency in Spanish was a big asset and contributed greatly with my ability to establish a good rapport with my students.  My students were very curious about the way I practice back home and I was curious to find out about the different levels of “nursing” and education in Nicaragua.  I particularly enjoyed our “feedback sessions” at the end of a long clinic day where students, clinical preceptors, and lab staff would have the opportunity to talk about how our day went.  I was always eager to hear from the lab staff that our students had prepared their pap smear slides correctly.

Our goal was not to just provide screening and treatment but to collaborate with the communities (including the ministry of health, other local providers, the hospitals and clinics to name a few), to create a program that continues long after we are gone that doesn’t need spare parts or highly trained experts.  We helped create a “sustainable and effective” program so that when we leave Nicaragua, the local health care providers can continue to provide these health care services for women.

I am fortunate to be able to participate in this amazing program. I am fortunate to use my services to change another’s life experience for the better and fortunate for the medical care that is available to us here in the United States. Thanks to programs such as Grounds For Health and its dedicated volunteers, many lives in impoverished countries have been given a second chance at health. I am extremely grateful to ONAAT for the honor of being chosen as a scholarship recipient.