Health Brigades




The rural areas of Nicaragua tend benefit last from the country’s development. While Nicaraguans are gaining improved access to care overall [world bank], there are still some corners of Nicaragua where people face considerable obstacles to access health care services. Read below to learn more about two of those corners:

El Rosario

El Rosario is a fishing community located on Pacific coast at the northernmost tip of the Cosigüina peninsula. When Carmen lived in the community of El Rosario for a 4 month period in 2009, she was saddened to see residents traveling on a bus at 2 am to the nearest town of Potosí, only to wait 7-8 hours in line for medical attention from a doctor who visits for one 1/2 day per week to serve thousands of local families. If they were lucky enough to be seen, they would usually be referred to a pharmacy or specialist in Chinandega, over 4 hours away. The cost and/or difficulty of traveling to the specialists, hospitals or pharmacies would usually deter the patient from following the recommendations of the doctor, and often the outcome was fatal.

In 2009, friends and family members of Carmen’s father, Bill Lishman, contributed to a ‘birthday donation’. With ~$1500, Carmen worked in collaboration with the Doctor who visits Potosí to set up a medical brigade to El Rosario. She was so pleased by the donation that she promised to make the trip to El Rosario in the afternoons, after her visits to Potosí, if I could ensure that she had the medications she would need on hand. She agreed to do this at no cost as she sympathized with the residents of El Rosario, having seen many desperate patients in the past. With a list of the medicines she recommended, Carmen purchased the medications, multivitamins and vaccinations she recommended.  Over the following two years, two more medical visits like this one were arranged in El Rosario.

Carmen wanted to know how she could help the community improve their access to care in the longer term and through meetings and conversations with community members, a common vision for locally-based services was born. The first question was: “who would like to train to become a nurse or a doctor?” and the response from the community was silent. When asked why nobody was interested, Carmen was told that many people were interested in the training, but practically nobody had finished primary school, let alone received their high school diplomas, and nobody felt they had the resources to receive the training necessary. This is where Purple Hill Humanitarians became involved in improving access to education in the community. 

Fast forward to 2015: Several members of the community have now completed their high school diplomas and 2 local women (Ana & Maria) are training to become nurses. Ana is only months from graduating with her nursing diploma and has proposed to build a small medical centre and adjacent pharmacy in the community on a piece of land her family will donate for the purpose. We are currently fund-raising for this project, please read more here.


Sontule is a community of 400 family within Miraflor Natural Reserve, near the city of Estelí in Northern Nicaragua. This community is has a long history of community-level organization. There are two cooperatives for coffee producers, a youth cooperative and a woman's cooperative. The people of Sontule have lived through some very difficult times: a violent dictatorship, a bloody, but successful, revolution and finally the counter-revolutionary war. They work hard to cooperatively maintain their shade-grown coffee plantations and are always happy to tell you that they now live in a peaceful and organized community.

The coffee producers in the area are almost all certified organic and both cooperatives are certified "fair-trade." The higher price that customers pay for "fair-trade" coffee contributes towards savings that are used to help the communities develop better health care, education and social systems.

Thanks to these “fair-trade” savings they were able to construct a doctor's office in 2008 where a doctor visits weekly and a nurse will be on duty 24 hrs / 7 days per week. The only remaining problem was that prescriptions given to the patients are of little use when most can’t afford the 4-6 hour bus ride into the nearest pharmacy nor the cost of the medication. Your donation was collected for this purpose.

In collaboration with the local doctor Carmen purchased a year’s supply of the medications that would be useful to have on-hand in the doctor's office.

A full breakdown of the medication purchases can be viewed here, and the full report on the follow-up in 2010 can be seen here.