Eight Dartmouth undergraduates and two Dartmouth Medical School students traveled to Ocotal, Nicaragua last term to aid local people in social and health care development.
Rachel Wellner '97 organized much of the project, which was sponsored by the Tucker Foundation and received many grants from on-campus resources as well as companies and individuals.
Wellner first visited Ocotal, a remote village 230 kilometers north of Managua, during the summer of 1994.
Many of the children in Ocotal and its surrounding communities are malnourished, Wellner said. She said they eat starch and almost no protein, and they often choose to drink Pepsi instead of eating eggs or chicken, foods of high nutritional value yet ironically lower cost.
Wellner said the water in Ocotal, which comes from a river and is processed in a plant, is 85 to 90 percent drinkable, but inhabitants of nearby villages drink straight from the river. This river water has been contaminated after use and waste disposal. Often "malaria-borne insects would breed in the streets," she said.
Last term, Wellner took a group of Dartmouth students with her to work with the people of Nicaragua.
Firsthand experience
Each student who visited lived with a local family and had a specific job, Wellner said.
She said group members worked on a variety of projects, such as medical consulting, at the Centro de Salud, or the health center, and its outpost clinics, hospital maintenance, a bank loans project and the Movimiento Comunal, a national movement started to get the public involved in promoting health care.
Pam Deberghes, a student at DMS who said she volunteered for the project to gain firsthand experience in third world countries, worked with local physicians in the Centro de Salud.
Deberghes said she and fellow medical student Bekki Carlin assisted physicians in their consultations and often compared their treatments with how the same ailment would be treated in the United States.
Carlin said she noticed Nicaraguan doctors treated illnesses with medication to relieve symptoms without looking for the true etiology of the illness first.
She said the clinic was crowded and doctors sometimes had to send people home without being treated at the end of the day.
Nadine Laurent '98 and Wellner also worked in the Centro de Salud, where they assisted the medical students with consultations.
Laurent said often doctors would prescribe cheap medication or antibiotics that were paid for by the government even if they were not the most effective way to treat the patient's illness.
"It is sometimes sad that is what they have to resort to, but that is the way it is," she said.
Laurent, who is originally from Haiti, said the work she did in Nicaragua fits well with her future plans as a pre-med sociology major.
She said she would like to return to Haiti after going to medical school, where the health care situation is worse than in Nicaragua.
Wellner said Winnie Leung '98, who could not be reached for comment, worked with the Movimiento Comunal, a group led by Brigadistas, people who sought to promote health across regions by vaccinating children and teaching people about nutrition, hygiene and controlling water.
Wellner said volunteers made interactive presentations and performed skits for the Brigadistas about sexually transmitted diseases, nutrition and hygiene.
Shannon Lenahan '98 and Juan Carlos Serna '98 worked in a clinic in a village outside of Ocotal and traveled to outlying communities once a week.
Serna said many people had to walk several hours to reach the clinic for treatment.
Serna, who was born in Colombia, said he thought he wanted to be pre-med, but after the trip "I was definitely sure I want to go to medical school."
Lenahan said everyone who came to the clinic got at least one prescription, whether it was for antibiotics, acetaminophen or iron tablets.
Brent Laffoon '98, who worked in hospital maintenance, said he painted beds and did upkeep of the hospital.
Laffoon said he was mostly interested in volunteering somewhere where he could speak Spanish.
"The program turned out to be more centered on development," Laffoon said. He said he was interested to see what was being done in Nicaragua and why a lot of efforts don't work.
Chris Saccardi '97 worked on a bank loans project, giving small loans to the poorest people in Nicaragua.
Saccardi said the loans were about $50 to $450, and people paid them back with weekly payments of $3.50 for six to eight months.
"It was a struggle for many of them to meet these payments," he said.
Saccardi said the money for the loans had been donated, and was not given outright to the people who needed it -- in hopes that "they would appreciate it more if they had to pay it back. They are making a difference in their own lives."
Candida Harty '98 said she worked with a local project in Ocotal to get children aged 15 and younger off the streets, set them up with a trade and enroll them in school during the nights.
She said this was beneficial to the families because they could be earning money while their children still got educations.
Material Aid
Wellner said a secondary part of the project was to collect material aid for the physicians in Ocotal.
She said Dartmouth's Koop Institute, the U.S. Surgical Corporation and various local hospitals donated basic medical supplies including latex gloves and sutures.
The total value of the supplies the group brought with them was $25,000 to $30,000, Wellner said.
Wellner said there was a lot of broken-down equipment, such as ultrasound machines, that "just sits there. Maintaining such machines would exceed costs allocated to the health budget, and, since it is not their own technology, methods of upkeeping these machines eludes many people."
She said more developed countries donated much of this hi-tech equipment, but it is not of much use to the people in Ocotal because they are stricken with much simpler illnesses often related to hygiene and nutrition.
Many lessons to be learned
Wellner said she learned many lessons through her experiences in Nicaragua, especially that education is the best method of prevention and should be a top priority.
"Monetary constraints often make it difficult to provide education and prevention," she said.
Wellner said the group "is looking to have a public presentation" about their experiences, possibly at the end of April.
Wellner said the process she went through to get her project proposal accepted was rigorous, and this was the first time Tucker has ever sponsored a group rather than just individuals.
