Antibiotic Resistance - The case for responsible NGO healthcare delivery in Nicaragua

The NNN has been a long-standing proponent for appropriate and collaborative healthcare delivery in Nicaragua.  Medical initiatives that unknowingly overlap with one another are at high risk of subjecting the patient population (the Nicaraguan community) to over prescription of medication, especially when it comes to antibiotics.  For perfectly logical reasons, medical records, maintained by the Nicaraguan national healthcare system MINSA, are not available for NGOs running clinical operations in Nicaragua, especially in remote locations.  In addition, many citizens in Nicaragua do not have a medical record on file with any office.  Without medical records, anyone delivering medical care, in any country, has little to no history for the patient's healthcare, including what medications they are taking.  The patient can indeed self-report their current medications to the healthcare provider, but in areas of the world where healthcare is sparse, such as the rural reaches of Nicaragua, patients have learned to report that they aren't currently taking any medications, even if they are, as this is the response that will secure them more medicine in the potentially long interim between the availability of healthcare. 

This dilemma puts NGOs, working to support local populations, in a difficult position.  Without medical records, NGO healthcare delivery has to hinge almost entirely on the statements of the patient.  As for the patient, they are in great need of effective healthcare and are perpetually uncertain of where that healthcare is going to come from, and when - which leads them to under-report the delivery of healthcare to their area.  What results is a system of healthcare delivery that is ill-aware of crucial aspects of a patient's current medical status and history.  At the least risky end of the spectrum healthcare initiatives are simply duplicating efforts and potentially wasting resources. At the high-risk end, over prescription of medication within the patient population can be causing real physiological harm and potentially increasing the risk for developing very serious outbursts of antibiotic-resistant bacteriological infections. The below video from Harvard gives a strong visual portrayal of how antibiotic resistance generates within bacteria via mutation and natural selection.  This same phenomena occurs in nature and within the human body. 

Antibiotic Resistance - Harvard University: Full story, Short Video

So what is the solution to this issue? Communication, collaboration, and networking of healthcare efforts - between NGOs and between NGOs and local government initiatives.  If organizations are well aware of one another's activities and healthcare delivery, they can adjust their own delivery to fit in the greater context of effective, efficient, and safe healthcare practices in Nicaragua.  The NNN itself is just a small aspect of the greater potential for networking in Nicaragua.  While the NNN was entirely created to address the overlap issue in Nicaragua, it is our hope that strong networking practices in Nicaragua are also taking place outside the membership of the NNN, as the overlap issue will not be solved by a simple website.   In the meantime, the NNN will be working to do whatever it can to support any networking initiative within Nicaragua and within the global community as a whole. 

- Matthew Jesse Fioravanti: Founder, Vice-Director - NNN

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