By Anna Ortiz, MPH, International Program Director
In the past year, Esperança’s surgical program has undergone tremendous change. The rise of the political crisis in Nicaragua last April challenged the sustainability of our longest standing surgical program at that time. It forced us to take a step back and acknowledge the areas of opportunity, both as a whole and within our individual programs in each country. Thanks to our hardworking and incredibly resilient partners in Nicaragua, the program has evolved to include primary care. Esperança’s Primary Care Brigades travel to low-resource communities once a week and offer primary care, dental care, and pediatric care free of cost. Most of the patients we see have little or no access to medications due to their high cost or complete unavailability at local health centers. Patients have expressed immense gratitude and have come to rely on the brigades as their primary medical home in many ways. Due to the political instability, Esperança has put a pause on surgical missions, typically staffed by international surgical volunteers. However, in 2019 we have scheduled two surgical missions which will be staffed by Nicaraguan surgical volunteers, many of whom have worked with our surgical teams in the past. We are moved by their dedication to their Nicaraguan brothers and sisters, who need them now more than ever.
Esperança’s Surgical Program in Peru will host general and gynecology missions this year and will expand in to the primary care arena as well. Our local team will do a baseline nutritional assessment for children in the Q’eros community. Our work in Q’eros began last year through the acclimatized home building project and, since Esperança’s visit to Q’eros in October 2018, we’ve expanded our support to diagnose and treat child malnutrition. A Peruvian nurse and physician will lead these efforts alongside the surgical missions.
All these changes have also promoted growth and shifted us from our traditional program model. The Esperança model is to partner with indigenous organizations that align with our core mission and values and work in the same areas we do: Nutrition and Food Security, Disease Prevention and Treatment, Home Building and Improvement, and Clean Water and Sanitation. However, in the last year we’ve been approached with opportunities to embrace a new model- partner directly with hospitals that require additional surgical support. In Ecuador, Esperança has partnered with a hospital to bring orthopedic, hand and ophthalmology missions. In Mexico Esperança is developing a relationship with a clinic close to the Arizona border as we determine how we can best support their operations- either by sending surgical teams, primary care teams, medical equipment or all the above! In Colombia Esperança plans to join another US-based healthcare nonprofit to bring primary care and surgical missions to attend the Venezuelan population seeking medical care in Colombia due to the economic crisis in their country.
The evolution of Esperança’s surgical program is possible thanks to the resiliency, flexibility and enduring spirit of our partners. We will continue to rely on their strength and wisdom as our program settles into its new territory.