Nicaragua is among the poorest countries in Latin America and has been struggling to from recover from almost three decades of armed conflict and several recent natural disasters. The country’s overall infrastructure deteriorated dramatically following a major earthquake in 1972 and the Sandinista Revolution and Contra war. Hurricane Felix, which affected the northern Atlantic Coast, is the latest in this series of setbacks. The area of Nicaragua most affected, the Región Autonoma del Atlantico Norte (RAAN), is a historically isolated and underserved area due to a combination of factors. No paved road connects the Atlantic and Pacific Coasts. In addition, the two coasts are culturally and linguistically distinct. The scarcity of resources in this developing country combined with the geographic isolation of the Atlantic Coast, have resulted in an especially vulnerable population.
Hurricane Felix, a Category 5 storm, added to this burden (September 4, 2007), affecting over 180,000 people in Nicaragua [Relief Web, 2007]. The RAAN region was the most severely affected. The damage prompted the Nicaraguan President to declare a State of Emergency there [PAHO, 2007]. The destruction of homes, public buildings, sanitation, and water facilities has led to lasting public health issues and exacerbated disease burdens.
Collaborative Sahsa Health Initiative
Right after Hurricane Felix, University of Nicaragua, León (UNAN) began sending brigades of Nicaraguan medical students to the Sahsa community as part of a university-led relief effort. Upon their arrival, the brigades realized that they were not facing simply acute problems brought on by the storm, but issues due to underlying inadequate health infrastructure. In an effort to meet the health needs of the area, students and faculty from UNC Chapel Hill collaborated with UNAN to evaluate the existing infrastructure in a cluster of 47 communities known as Tasba Pri in Nicaragua.
Since the RAAN region is relatively unexplored, information is not available about the general health status and needs of the population. By conducting a basic health assessment in the Sahsa area, baseline data will be gathered, as well as community opinions and concerns regarding health issues. The Collaborative Sahsa Health Initiative aims to use a geographic surveillance system to assess the household health care needs in the Sahsa area of Región Autonoma del Atlantico Norte (RAAN) in Nicaragua with an emphasis on the burden of diarrheal diseases. This project will complement efforts from the University of Nicaragua, León (UNAN) to build the health capacity in the local community.
This past summer, UNC-CH SOM students worked in an integrated team with Nicaraguan medical students and local health promoters to collect household data through developed questionnaires. The data is being used to establish an epidemiology surveillance system around Sahsa and to help design future interventions. This system relies on GPS devices and Geographic Information System (GIS) technology to mark individual households, facilitating the creation of data maps and allowing households to be accurately re-sampled in future studies.