Fourth year students may participate in this four-week elective during Block 10. This global health rotation is in Hormiguero, Nicaragua. Hormiguero is a rural town located in the RAAN (Región Autónoma del Atlántico Norte), the north-eastern region of the country. Hormiguero is a market town that is a hub for many surrounding communities. The rotation is run in collaboration with Bridges to Community, a non-governmental organization (NGO) that works in Nicaragua and the Dominican Republic. Tufts has been working with BTC at this clinic site for more than 10 years. Students are accompanied by volunteer faculty members from Tufts and affiliated hospitals as well as some faculty from other institutions.
The rotation consists of three weeks of clinic (six days a week). At the clinic, each student will see upwards of 10-15 patients a day with the supervision of faculty. Patients are from Hormiguero and the surrounding communities. Many of the patients that students see in clinic walk or come on horseback from many hours away. The clinic is urgent care style with the most common conditions including chronic musculoskeletal pain, headaches, cough, cold, GERD/gastritis, and UTIs. Students also have the opportunity to provide pregnancy tests, prenatal ultrasounds/dating, and ultrasounds for other problems. Students learn treatment and dosing of medications, diagnosis and treatment of more rare conditions or conditions prevalent in the area (parasites, malaria, dengue, chikungunya, trench foot, and pterygium), and management of acute conditions such as dehydration and wounds/lacerations. Each student works one on one with a translator (translators work for BTC) while in clinic; however, previous Spanish knowledge/ability is very useful. During the rotation, students are also expected to give at least one talk to community health leaders and may be asked to give public health talks to patient groups. The rotation may also include a trip to an outlying community either to visit or provide medical care (this could include a couple hour walk/trek) and a tour of the local hospital.
All housing, food, and in-country travel is provided through a fee paid to the NGO from Tufts. Accommodations are modest-- a shared bunk house, latrines, and bucket showers. There is electricity, but no Wi-Fi.
The last week of the rotation includes a trip to the Pacific coast and possibly other cities in Nicaragua to explore. This is a group activity organized by BTC and occurs with BTC staff.
Please note that this rotation does include a fundraising requirement. The money raised is used to directly purchase supplies and medications for the clinic. The fundraising goal is $3,500 shared among the students accepted for the elective. While students are not individually held to any specific dollar amount, each student will be expected to ask/send an email appeal to 20-25 contacts. A sample fundraising email/letter will be provided to students to make this requirement as easy as possible. The group will create a fundraising website to use as the main platform for receiving donations.
In addition to fundraising, prior to departure students will work in pairs to complete a variety of tasks such as organizing and buying supplies and preparing talks to give to health leaders from the community.
Richard Rohrer, MD
Tufts University School of Medicine