Learning from the Third World: health care in Nicaragua
Kugel, C.
Journal of the American Academy of Nurse Practitioners 3(1): 48-49
1991
ISSN/ISBN: 1041-2972 PMID: 2007063 DOI: 10.1111/j.1745-7599.1991.tb01061.xDocument Number: 315010
In this article, Candace Kugel, a family nurse practitioner in Pennsylvania who visited Nicaragua as part of an exchange program, describes her impressions of the country's health care system. Kugel is a member of the Project Gettysburg/Leon, a sister-city program that promotes cultural exchanges. She arrived in Nicaragua less than 2 weeks after the newly elected UNO government assumed power. In Leon, Kugel visited seven rural and urban clinics, the city's hospital, the health education organization, and the medical, dental, and nursing schools. In all health facilities, she discovered politically energized and committed health care workers. It is this determination that allows then to continue working in spite of perpetual shortages of even the most basic supplies. The hospital was out of insulin, and was having to reuse bulb syringes for newborns. One clinic lacked water supply. Kugel also found nurses to be in short supply. As she explains, the physicians outnumber professional nurse 3-1. Because of low salaries, 1 6-day work schedule, and staffing shortages, few are interested in becoming nurses. Furthermore, the nursing school is severely ill-equipped. Nonetheless, Nicaragua's health care system has accomplished health: immunization, family planning, prenatal care, well-child screening, health education, and treating open water for malaria and dengue-bearing mosquitoes. From 1979-88, infant mortality dropped from 93/1000-62/1000, and life expectancy increased from 56-63.3 years. Additionally, Nicaraguans now consider health care a right, not a privilege. Kugel hopes that with the end of the US embargo and the renewal of US aid, Nicaragua will accomplish even more.