A New Approach by Willa Chen

            The past week in Nicaragua has been interesting. Despite the geographical proximity to Costa Rica, the similarities in their universal healthcare systems, and the origins of their cultures, everything there seemed to have a unique Nicaraguan flare.  The culture was friendly, but in a different way – my host family was hospitable but to a different degree than my Costa Rican host family.  Even the nature walks we took and views we saw were vastly different; rather than visiting the tropical forests of Costa Rica, we saw lakes and volcanoes.  The whole feel of the country was just something different.  In particular, I was fascinated by the healthcare system and the new approaches Nicaragua had taken.

Both Nicaragua and Costa Rica have taken a very preventative and primary care-based approach to healthcare.  Nicaragua, however, seemed to take the prevention aspect to a whole new level.  In one of the lectures we received, we learned that in order to prevent the spread of Chikungunya, as soon as a Chikungunya case is found, people go in and spray the entire neighborhood to kill the mosquitoes.  It made me wonder if the rates of cancers or lung disease had increased in those regions, but apparently the method was working.  As a less extreme method of prevention, Nicaragua was also big on advertising preventative healthcare to the public, which I feel I have not seen as much in Costa Rica.  I frequently saw billboards and posters everywhere informing people about diseases or misconceptions about diseases. For example, the following picture about AIDS says, “Please hug me even though I have AIDS.  I can’t get you sick,” teaching the population that people with AIDS should not be stigmatized.

            Another interesting approach Nicaragua has taken to medicine is working on integrating natural and alternative medicine into regular healthcare.  We saw this when we visited the EBAIS in La Casona in Costa Rica, where there was a local traditional medicine practitioner working right next to the conventional medicine doctors.  However, it seemed that was a rare case in Costa Rica, with the EBAIS being the exception because it was in the middle of an indigenous community.  In Nicaragua, however, there was a natural medicine and complementary therapy clinic right in the middle of a hospital!  They even had a natural medicine garden (see picture).  I was astounded by Nicaragua’s openness to new approaches to medicine.  Although I think much more research needs to be done on things like the cost-effectiveness of short-term Chikungunya prevention vs. possible long-term health side effects or the effectiveness and chemical properties of the natural medicine, I applaud Nicaragua for its novelty.