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QAP Supports Hurricane Felix Relief

In the aftermath of Hurricane Felix, QAP requested and received approval from the United States Agency for International Development (USAID) to participate in the humanitarian response to the disaster in Nicaragua. During relief efforts, QAP provided much needed health systems expertise in a rapid assessment of the storm’s effects in the country’s Atlantic North Autonomous Region (Región Autónoma del Atlántico Norte ((RAAN)).  Since 2005, QAP has been providing technical support in Nicaragua focused on improving care for severely ill and malnourished children and improving the quality of essential obstetric and newborn care.

Clinic damaged by Hurricane Felix

Clinic damaged by Hurricane Felix

In the RAAN area of Nicaragua, Hurricane Felix
exacerbated an already difficult situation. The region’s extreme poverty, the deteriorated infrastructure of its health facilities, the lack of skilled personnel, and limited equipment and supplies had fostered a situation that was especially vulnerable to an emergency. Because of the low technical capacity of the health system in RAAN, many critically ill patients are transported to Managua by air, often under difficult conditions, and many do not survive transport. 

A QAP team, comprised of Drs. Oscar Nuñez, Roberto Jiménez, and Luis Urbina, traveled to Bilwi, Nicaragua—where a “State of Disaster had been decreed—on September 9th, 2007.  They were joined by QAP’s Dr. Carlos Jarquin. The Ministry of Health (MINSA) asked the team to develop an emergency plan for reorganization of its regional hospital in Bilwi which had been evacuated as a result of the storm. After a review of the hospital’s records and data, they identified several areas that limit the hospital’s capacity: underutilization of some physical areas (such as the men’s ward and burn unit) and overcrowding in others (e.g., assignment of two women per bed in the women’s ward), lack of warehouse space, and, a shortage of orthopedic equipment.

As has occurred in much of the region’s infrastructure, the hospital had undergone damage that will require time and investment to rebuild. However, the QAP team was able to implement emergency reorganization plans for the hospital and ambulatory care polyclinic that represented the best use of remaining resources. Once patients returned to the hospital, they were re-assigned to wards according to gender and age (children were separated from adults) in accordance with the reorganization plan. Children were placed in the ward that previously was reserved for private care, and women were relocated to a single ward with sanitary services separate from those for men, who were re-assigned to a third ward. The number of beds assigned to each ward was made based on historical admission and occupancy data.  
For more on QAP’s work in Nicaragua, please contact Dr. Oscar Nuñez, at onunez@ibw.com.ni.


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The Quality Assurance Project (QAP) is funded by the U.S. Agency for International Development
(USAID) under Contract Number GPH-C-00-02-00004-00.