The Republic of Nicaragua is a Central American country with an estimated population of 6 million. The healthcare in this impoverished and politically ravaged country is highly problematic. Children under 1 year old make up about 2.7% of the population, with infant mortality of 40/1,000 live births.

Managua, Nicaragua

The main health facility dedicated to child-care is the Hospital de la Mascota de Corazon de Jesus, in Managua, the capital of Nicaragua. La Mascota is a 280 bed hospital, badly in need of literally everything. Throughout the years, the International Medical Outreach (IMO) Program has responded and continues to respond to several calls for assistance for various hospital supplies and surgical instruments from the Director, Dr. Jose Gerardo Mejia, and his Chief of Surgery, Dr. Francisco Escobar, including the refurbishment of the hospital’s only diagnostic x-ray machine.

Additionally, we were asked to refurbish the institution’s 12-bed Pediatric Intensive Care Unit, which lacked a centralized oxygen supply system, contained only two working respirators and an unreliable monitoring system. Children, who required artificial respiration, were hand-ventilated around the clock by nurses. Using donated and refurbished equipment, we were able to fully re-equip the Intensive Care Unit and bring it into new millennium technology. We recently sent an additional x-ray machine and a container full of medical supplies to the La Mascota Hospital.

The National Cardiology Center

The Program’s activities in Managua have continued with our involvement with the Centro Nacional de Cardiologia, the only public facility available to provide specialized cardiological services to the population of Nicaragua. Their principal problem was that the country’s only public heart catheterization laboratory had broken down over five years ago and they could not afford the cost of repair and maintenance. Because of the lack of funds, only a few patients in extreme need were referred to a private clinic with the proper facility. The great majority of patients were placed on medication; if, and whenever, it was available.

“Last year, I had a heart attack. I thank God for the donors – they gave me an opportunity to live”, said Geronimo Ramirez, a heart catheterization patient. “I had only a few hours to live, but the cardiology center was open and the doctors were able to do a procedure on me. I thank God because [the donors and the center] provided me one more opportunity of life.”

Cardiac Catheterization Labs

With the assistance of Transtate Equipment Company, the James H. Heineman Heart Catheterization Laboratory at the Nicaraguan National Cardiology Center in Managua was officially opened in 2009. As a public care facility led by the country’s Ministry of Public Health, the Cardiology Center provides free services to any patient seeking care. In early 2011, the IMO Program upgraded the cath lab and supplied Nicaragua with a fully equipped, self-contained diagnostic laboratory suitable for various cardiac imaging.

In December 2012, a second public cath lab was donated by the IMO Program and installed outside of the National Cardiology Center (Centro Nacional de Cardiología), located by the Roberto Calderón Gutierrez Hospital. IMO’s two laboratory donations have helped rebuild the country’s National Center of Cardiology. Prior to the first donation, Nicaragua’s six million residents had no public heart catheterization laboratories. Today, one laboratory can perform 40 catheterizations per week.

“We are grateful for the opportunity to help Nicaragua’s medical facilities treat additional patients and to facilitate the delivery of contemporary health care to the country’s six million residents,” said Francis Robicsek, MD, PhD, vice president of the IMO Program. “This donation will immediately improve accessibility to heart care and help the National Cardiology Center offer sustainable, consistent services for years to come.”

Provider Training in Orthopedic Care

A new aspect of the Program’s involvement in Nicaragua is our partnership with the International Assistance Program of OrthoCarolina, Charlotte’s largest orthopedic group. Dr. Thomas Fehring, orthopedic surgeon, recently joined the Heineman Board of Directors, and we actively assist them in bringing health providers to Charlotte from Nicaragua and Africa, for extended professional training.

Mobile Medical Clinic

Representatives from Carolinas HealthCare System joined public health officials and government representatives in Chinandega, Nicaragua, for the official opening of a mobile medical clinic donated by the International Medical Outreach (IMO) program, a collaboration between the System and the Heineman Foundation of Charlotte.

Chinandega_Pic9The lab is a large, mobile unit used to provide a range of primary care and specialty medical services, including women’s health care, heart disease and glucose testing. The clinic will be stationed at and managed by the Coen Foundation’s William Montealegre Clinic in Chinandega and will be moved to different areas of the country to provide care in rural communities in need.

“These communities have no adequate health services and their access to primary care represent mobilization costs that cannot be afforded for them. We aim to bring them closer to a healthier life with this integrated program that combines health care and preventative education” said Piero P. Coen, President of Coen’s Foundation.
Chinandega is Nicaragua’s fifth largest city, with a population of more than 121,700. Healthcare is delivered primarily through Hospital España, which serves nearly all residents along the West Coast of the country. The Coen Foundation clinic will provide continuous staffing of the mobile unit, and the IMO program will send medical teams from Charlotte to help as needed.

“We are grateful for the opportunity to help Nicaragua’s medical facilities enhance their services and deliver more up-to-date healthcare to those who need it most,” said Francis Robicsek, MD, PhD, vice president of the IMO Program. “We hope this donation reduces barriers to healthcare access and helps the city of Chinandega offer sustainable services for years to come.”

Since 2008, the IMO program has led projects aimed at improving the health of adult and pediatric patients in Nicaragua. Its first project was to repair and replace equipment in the Intensive Care Unit at La Mascota Pediatric Hospital, Nicaragua’s only pediatric facility. That same year, the program helped rebuild the country’s only cardiac catheterization (cath) laboratory, which was broken and remained unused since 2003. In 2012, it donated a mobile cath lab to the Nicaragua’s national heart center in Managua.