Partnering to Serve

The Power of a Nickel partners with JustHope, an organization whose mission is to create global partnerships that facilitate long-term partnerships grounded in solidarity, mutuality and collaboration between Nicaraguan and U.S. communities.

In addition, we partner with the two Rotary International clubs in Leon to help facilitate needs of the Chacraseca community.

Team Information

Teams are made up of physicians, nurse practitioners, other healthcare providers, medical students and helpers. We can always find opportunities to put skills to beneficial work!  Typically activities include evaluating and treating patients, making referrals to local health facilities if necessary, serving as educational resources to our Nicaraguan counterparts, immersing ourselves in the local culture, providing healthcare educational opportunities to the local communities, making house calls for those unable to come to the clinics, conducting field research to help improve the health of the community, and serving as a resource for the community leadership team. The typical team size is 30 participants.  The ratio of healthcare providers to medical students is a minimum of  1 to 3.

Where We Will Stay

We stay in a moderate hotel in Leon, Nicaragua (the closest facilities to Chacraseca).   The hotels used have A/C and private bathrooms.   It is about a 30 minute drive from the main clinic in Chacraseca and about an hour to some of the outlying villages.

Supplies and Baggage

We’ll be gathering material supplies to donate to the community, so travelers should limit luggage to a carryon with personal needs for the trip reserving the checked bag for supplies for the community — it’s a chance to see what we can do without!  If you have access to a wheelchair or adult crutches – they are always needed.  Donations of vitamins and funds are always needed.

Your Investment

The cost of the global outreach medical program is typically $975 plus airfare from your departure city.  During some times of the year, airfare may be significantly less on Friday than Saturday – in any case you must arrive into Managua by Saturday of the trip by 3pm. If you arrive Friday, the Best Western Managua Resort, directly across the street from the terminal, is the recommended hotel. This is where the team will meet to leave for Leon. You may book directly through the Best Western website.

Your application and a deposit of $206 must be received to hold your space.  The trip cost covers lodging (including the last night at the Best Western Mercedes in Managua (Friday)), most meals, in-country transportation, translator expenses, many cultural activities and trip coordination.  Personal costs will be meals en route to and from Nicaragua, souvenirs, $10 visa upon arrival, $50 for the Thursday cultural day (zip line, beach, local family and pottery making) and any unscheduled activities the team decides to add. Final payment for the trip will be due 60 days prior to departure. 

You are required to have evacuation insurance. Suggested site www.squaremouth.com for a variety of evacuation policy companies.  You may also consider trip cancellation insurance which would reimburse you for costs of the trip should you cancel after final payment is made.

If the team is full at the time of your deposit, you may choose to be placed on the wait list.  If you are unable to clear the wait list, your deposit will be refunded.

Cancellation Policies

After deposit to 60 days:  $50 administrative fee (except if waitlist not cleared)

59-30 days:  deposit forfeited (lodging and transportation is pre-paid)

29 - 0 days:  no refund

It is suggested that you purchase trip cancellation insurance to avoid cancellation penalties.  

Vaccinations and other Health Information

The CDC recommends the basic immunizations :  Hepatitis A (two doses),  Hepatitis B (three doses).  MMR (2 doses), Tdap (every 10 years).  CDC recommends typhoid - but there has not been a case of typhoid since hurricane Mitch over 15 years ago in the areas we are serving - and we drink purified water so the risk is negligible. If, however, you are doing some pre or post-travel, you might want to consider typhoid.  The CDC also recommends malaria prophylaxis, and the meds used are chloroquine phosphate, 500mg weekly (which may not be not available in the US due to manufacturer problems) so it is perfectly acceptable to substitute hydroxychloroquine sulfate.  If using hydroxychloroquine sulfate, you will need to take 2 pills once a week because it is only 200 mg and you will need 400mg per week.  Another alternative is atovaquone-proguanil (malarone) which is a daily med.  

Because there is a risk of chikungunya, dengue, and zika, and there are no vaccines for these diseases, you will need to take personal insect precautions.  That is the application of an insect repellant containing 25-35% DEET...  higher concentrations tends to cause skin reactions on many which can be very uncomfortable.  

 

 

 

PACKING FOR NICARAGUA

· It will probably be warm 86-92 during the day and 70-80 at night.
· Attendings and med students will wear scrubs. You will need 4 pairs.
· After hours, pants, long shorts, capri’s and loose dresses. It is culturally unacceptable to wear short shorts, please be respectful.
· Night clothes, ear plugs (roosters, dogs, and snorers go all night)
· Sun hat; sunglasses; sunscreen; umbrella and/or rain poncho.
· Swim suit (hotel has pool); light jacket for evenings for some
· Travel alarm; small flashlight & batteries; camera & batteries (plugs are same as in US)
· Closed toed shoes for clinic; sandals or flip flops for evenings
· Personal toiletries (including wet wipes you can carry in your day pack); shampoo, body wash etc.
· Towel (fairly thin and will dry quickly in humidity) for beach
· Insect/mosquito repellant containing 25-35% DEET IMPORTANT – CHICKENGUNYA IS THERE
· Passport (carry a photocopy in separate place)
· Book for leisure reading & book-light if you’re a night reader/writer; journal; pens/pencils
· IPad/Computer if desired. Wifi USUALLY available at hotel. May consider outlet strip if multiple devices.
· Medications – Bring Pepto Bismol Caplets for traveler’s diarrhea
· Most travelers also take an anti-malarial. It is recommended by the CDC (chloroquine or malarone (atovaquone/proguanil). Chloroquine phosphate is not available in US due to a manufacturing glitch presently, so acceptable per CDC to substitute with hydroxychloroquine sulfate.  You will need 2 - 200mg tablets each week for one week before, the week there, and for 4 weeks after leaving Nicaragua.  
· Personal Water bottle (water provided in 5 gallon jugs), snacks for your day pack (granola bars, crackers, etc) - you will eat from this "stash" for your lunch during clinics. (There is a large grocery store within walking distance from the hotel.  
· Backpack/day pack; list of emergency phone numbers
· Spending money: $10 entrance/visa fee; meals en route to/from Nicaragua; & souvenirs. One dinner in Leon and one at the beach restaurant. Adult beverages not included.
· Your smile; your sense of adventure; your ability to be flexible; your openness to new people, new places and new ways of doing things.

IMPORTANT: Make sure US bills are not torn or have ANY marks -- no one, not even banks, will take marked or torn bills. Major credit cards are accepted in SOME of the hotels and restaurants, but usually not in the markets. ATMs are available if they are working.

 

TYPICAL WEEKLY SCHEDULE

Typical Week in Nicaragua – FLEXIBILITY is always a key word because we are there to serve the people in Chacraseca and we will change our plans to accommodate their wishes whenever possible.

Saturday:
· Load bus/van after last person arrives or no later than 3pm for 2 ½ -3 hour drive to Leon (depends on traffic)
· Check into hotel (San Juan de Leon) (hotel should be only our team)
· Purified water is provided for the team throughout the week. You will need to bring your personal water bottle as the water is in large multi-gallon jugs.
· 6:00 Dinner catered at hotel
· Introduction to the staff, plans for the week, questions
· Start preparing medications, supplies, donations your team has brought

Sunday
· Breakfast 7:30- in hotel
· Free time to go to church, mass, or walking around town
· 10:30 Meet in hotel for first cultural adventure
· Lunch catered at hotel
· Afternoon – complete work on medications, supplies etc. Presentations on what to expect in clinic, diseases to be encountered
· 5:00 Cultural activity
· 6:30 Dinner catered at the hotel
· Final presentations regarding clinics, medications available, or any other preparations necessary
· Posted list of team member responsibilities for the following day by the end of dinner each day

Monday – Thursday clinics
· 6:30 breakfast
· Clinical “pearl” presentations given each morning at 7:15 – all medical students expected to be in attendance
· Leave at 7:30am for clinic
· There will be 2 teams each day – you will be partnered with an attending that will change daily or you will be assigned to pharmacy, vision, or other task. Because we want you to have experiences with different attendings who go about the art and science of medicine a little bit differently – you will have a different “role” daily and maybe even on a different colored team. If you are accidentally placed in a non-patient role for more than one time (i.e. pharmacy, reading glasses, lab) during the trip – please let Barbara know asap so it can be changed.
· Each team will be going to a different location. We do not need such a large group at any one place and there are so many villages in Chacraseca that want us to come… this way each week we can be in 8 different locations. Please do not ask to be put with a friend - we will all be together every morning and evening and we will share our experiences then.
· You will need to bring snacks to munch on for your lunch…. There are no places to eat and having food prepared several hours ahead of time and not refrigerated is not a good idea in this climate. (there is a large grocery store within walking distance of our hotel if you need to purchase things in Leon)
· We will see patients each day in each location until there are no more. Some locations and days we may see 60 and some 150. When we are finished, that team will head back to the hotel in Leon. It is not about quantity – it is about quality. We encourage OMM and education – there can never be enough given.
· Sunday, Monday, Tues, Thurs, Friday we will have reflections – usually after dinner. Each will have an opportunity to tell about experiences you may have had during the day.
· Mon, Tues, Wed, and Thurs we will post the names of the persons who are responsible for re-stocking the supply bag and the pharmacy bag for the next day… please feel free to recruit your friends so that the job can be completed quickly and you can head off to Eskimo’s for ice cream. Many hands can make a task so much easier and quicker.
· Wednesday as soon as your clinic is completed and you are back at the hotel.. you are encouraged to take a quick shower and be ready to head to the beach. The sooner everyone is ready the sooner we go. It is always nice to be able to see the sunset at about 5:30 there… it is about 40 minutes from our hotel. We will be eating dinner at a beach restaurant and you will find everything from chicken fingers to whole fresh fish to spaghetti for your pleasure. This meal is not included in your land package.
· Monday, Tuesday and Thursday dinner will be at 6:00 at the hotel
· Friday – “Gringo Day” You will have your bags ready to load onto the buses by 8:00am. You will have a choice of ways to spend your day on the way back to Managua. You will be given the choices prior to your departure date then we will discuss further when you arrive in Leon.  You will make your choice and pay the fee before you leave Wednesday morning for clinics.  
· Friday evening… pizza at the BW by none other than Pizza Hut. Final reflections at this time.
· Saturday – full buffet breakfast available at 7… you MUST BE AT THE AIRPORT JUST ACROSS THE STREET 2 HOURS IN ADVANCE OF YOUR FLIGHT

  • If you plan to deviate from the group schedule to participate in other activities, you will need to sign a release from the group.  When you release from the group, all lodging, meals, transportation from that time forward will be forfeited.