Friday, January 28, 2011

More Donations!

     Every day I see 2 new children and 6 children who have returned for follow up.  I send a consultative note to the referring physician for each visit and every day 8 letters are faxed back to these doctors within 24 hours of the child's visit. 

     Two weeks ago I started to send a request for donations of medical supplies with each of these letters.  Almost every physician receives samples of various medications from pharmaceutical companies.  Many of these samples are used and many are thrown away on the expiry date.  My letter requested that my colleagues consider setting aside desirable medications for me to take to Nicaragua. 

     I did this before I left for Haiti last spring, but this time I started earlier and I will reach out farther into the Calgary medical community.  Michele Holstbaum, my assistant, will pick up the medications on specified days, once in February, and a second time in early March. 

     We will take all the medications out of the packages, sort them into categories (antibiotic, pain, asthma, etc), sort them again by specific medication, and sort them again by expiry date.  When the medications arrive in Nicaragua they will be ready to use in the most efficient way possible.  This is considerably better than the jumble of meds I took to Haiti in two duffle bags.  

     Last week we received donations or promises of donations from 

Dr. Susan Kinnie, 
Dr. Michael Guiffre,
Dr. Ashref Jeeva,
Dr. Patricia Bryden, 
Dr. Marilyn Lee, and
Dr. Aravind Subramanian.

     Many thanks to these colleagues for their help and for their gift to the children of Nicaragua. 

Saturday, January 22, 2011

Thank you Pharmascience!

         Pharmascience donated 150 boxes of Electrolyte Gastro, which is ideal to rehydrate children with diarrhea.  Many thanks to Julia Keshen,
Product Manager for Pharmascience, and to Cathy Chan their local representative, for arranging this helpful donation.  Pharmascience is a Canadian Company founded by two pharmacists in 1983 and which now employs over 1300 people.

         Diarrhea is common in Nicaragua.  Diarrhea is one of the leading causes of death in children.  The cause of death is usually dehydration and oral or intravenous fluids can be a lifesaver. Thank you Pharmascience for a donation that might well save lives.

         Contaminated drinking water is often the source of the germs that cause diarrhea and access to safe drinking water is a big problem in Nicaragua.

         One major lesson I learned in Haiti was to make the treatment very simple for the family.  Giving a family some packets of rehydration powder and expecting them to mix the powder in water at home would not work.  The family either did not have access to safe water or could not afford bottled water, and even if they had water, they often could not read the instructions on the packets, and even if they could read the instructions, many would not mix the powder in the correct amount of water.  The solution was to purchase 1 liter bottles of water, mix the packets in the water, and to write simple directions in French about how much the child should drink, and to tape the instructions onto the bottle.  We never had enough water or powder so we were never able to give a family more than one day of rehydration solution.  Courtesy of Pharmascience and the water we will purchase in Managua, this should not be a problem for our Nicaragua trip.

         This donation started me thinking about the water situation in Nicaragua. 

         A five year-old child needs about 1.5 liters of water a day.  Where would a 5 year-old Nicaraguan child who lives in a rural area obtain 1.5 liters of fresh water that was safe to drink?

         There are community wells with variable quality and sanitation and family members often need to walk long distances for this water.  World Health Organization (WHO) data indicates that access to improved water supply in rural areas of Nicaragua increased from 46% in 1990 to 63% in 2004.  Access to improved sanitation in rural areas or Nicaragua increased from 24% in 1990 to 34% in 2004.  Going in the right direction.

         Rainwater is collected in cisterns during the 7-month May-to-November rainy season, but these sources are often not chlorinated or filtered and stagnant water that sits out in the heat is soon not safe.  In Haiti last spring I had a shower from a rooftop cistern and tadpoles came out of the pipe! 

         Lake Managua and Lake Nicaragua are large fresh water lakes but Lake Managua is polluted and the country has a very limited water pipeline infrastructure.  The country has salt water on both the Pacific and Caribbean coasts but desalination is not currently an option.

         Bottled water is available in commercial centers, costs about 30 cordobas ($1.35) for five gallons (19 liters), or about 7 cents a liter.  This doesn’t sound like much by Canadian standards, but to supply just the drinking needs for a family of two adults (2.5 liters per day per adult) and two children (1.5 liters per day per child), requires 8 liters of drinking water a day and this is more than 50 cents a day.  Many Nicaraguan families subsist on a dollar a day and paying this much for water is not possible. 

         Many Canadians take water for granted.  We shouldn’t.  Nicaraguan families don’t.  For them, living in a lush tropical rainforest, only 11 degrees north of the equator, there is water everywhere, but sometimes, like the Ancient Mariner, “Nor a drop to drink.” 

Thursday, January 20, 2011

Time to Give Back!

Here I am,
working as a Pediatrician
in a poor country.
I've wanted to do this all my life.
In 1974 I signed up with Save The Children
to work six months in Cambodia, 
but Pol Pot and a genocidal war
interfered with that project.
Then family, profession, and the years flowed by.

Now is my time. 

Last year, in March 2010,
I rearranged my practice
to help out in Haiti for two weeks.
You can read an abbreviated description
of my time in Haiti on my clinic website,
I worked hard
and returned with conflicted emotions,
but with the certainty 
that I wanted to do more. 

In October 2010 I spent
ten days in Nicaragua
to scout out a new opportunity to help.

I will return to Nicaragua in March 2011
to work in a rural clinic
as a pediatrician.

I hope to sustain this dream come true. 

Life has smiled on me
but frowned on much of the world. 
Time to give back, time to help out. 

Nicaragua is the second poorest country
in the Americas,
and deserving of our help.

There are doctors in Nicaragua.
After the revolution, the government
established schools and medical clinics
in most of the major communities.
But there are not many doctors
and there are very few specialists.

A doctor in Nicaragua is paid $500 a month,
and they are rich
compared to the average worker
who makes less than $100 a month.

Time to give back!

If you would like to help,
If life has smiled on you
and you also desire to give back, 
if you can help in any way,
please contact us at

Thank you.

Lane Robson MD