Day 25: Visit to Los Pipitos Clinic Managua

Well, today we finally visited the big clinic in Managua run by Los Pipitos! What an amazing place! To begin with, the clinic is open to Los Pipitos associates. In other words, only people who are parents or friends of individuals with disabilities who have signed on to Los Pipitos as members are able to access care at the clinic. One day a week, the clinic is free for any chapter of Los Pipitos. So, on Tuesdays, if you are a member of a chapter of Los Pipitos, you can have free care. The only problem is when there is a follow-up appointment necessary, you may not be able to get a free appointment for a few weeks because the free days are booked in advance. If someone with no money needs a follow-up appointment, the parent may just give up rather than come back and have to pay for the visit. This is a problem for the children in Granada.

The clinic has an intake office where a physician does an assessment and determines if the child needs a specialist. Then, if necessary, a specialist (audiologist, physical therapist, ophthalmologist, etc.) will see the child. There are a number of people who work specifically with children with hearing deficits from the time it is noticed. Unlike in the U.S., here in Nicaragua, children do not automatically get screened for hearing loss at birth. It's up to the parents to discover when there is a problem and have the child seen. We observed a 2-month-old baby having a hearing test using probes to assess the response of the tympanic membrane to sound while the child slept.

The professionals made a point of the focus on teaching parents to work with the children at home rather than expect the child to improve with only periodic appointments with specialists. They do extensive therapy with the children, including music therapy and play therapy. We met with a young man who is responsible for the hearing aid molds who was obviously extremely hard of hearing himself. Children are fitted with hearing aids when they can benefit from them.

Hearing Aid Molds

"Light Room"

Vision Deficit Diagnostic Equipment

Children who are suspected of having visual problems are also diagnosed and provided with specialist care. There was a "light room" where children with vision problems are screened for specific problems.

Physical Therapy Room

There was a physical therapy room where therapists work with parents either individually or in groups to teach them how to provide therapy for the children at home.

In addition, there was a beautiful pool area for the children, as well as a room with a variety of play equipment for the children, including paper mache chairs made by the parents.

Paper Mache Chair

Pool Area

Funding for the clinic was raised through a telethon in 2004. All in all, the whole facility was spectacular and it gave us an idea of what might be possible for Los Pipitos Granada if we could only find the funding to support it. I suppose miracles do happen!

We returned to Granada and spent the rest of the day applying laminate to health-related posters to prepare them for hanging in the clinic. We had hoped to do ear lavages; however, although we had sterile water and the rest of the equipment to do this, we didn't have sterile basins or other sterile equipment to maintain the sterility of the solution, so we decided not to do them. Hopefully, we can refer the children who have impacted wax to physicians who can do this procedure.

Child at Los Pipitos

Tonight, my husband and I accidentally discovered a celebration of some kind in the church in the central plaza. There were fireworks and a procession out of the church with the Virgin Mary and the entire congregation following behind. At the very front was an ambulance leading the procession! We learned later it was the Prosecion de la Virgen Maria.

Prosecion de la Virgen Maria

We wanted to eat at the "Monna Lisa" restaurant; however, when we got there it was closed, so we had pizza at another pizza restaurant and braved the rain and lightning to return to the hotel. Tomorrow we will spend the day touring the area with a driver.