We have a new physician…Dr. Oscar Gomez. He is from the Isla de Ometepe. He just finished his medical training as a cardiologist at ELAM in Havana,Cuba. This is the Latin American Medical school that takes students from all of the Latin American countries. It is a unique program as much of the training prepares their students for practicing medicine outside the big city and far from high tech medicine. The program emphasizes physical assessment and patient education skills along with a deep appreciation for the importance of prevention in their clinical practices. this background has enabled Dr. Oscar to fit right into our project. He has made home visits to almost all of our patients. Currently our enrollment is at about 200 diabetics. We are now operating 11 clinical sites…5 in the metro area of San Juan del Sur and 6 sites out in the countryside.
Also we have new Wish list for those that want to help:
1) Target brand glucometers (the Up and Up model) they are the best and cheapest glucometers on the market
2) RiteAid brand glucometers
3) test strips for the Target and RiteAid glucometers
4) lancets….any brand, for doing finger sticks to do blood sugar testing
5) stethoscopes
6) blood pressure cuffs

New Clinic Services:

Because of increased demand, this summer we expanded our diabetic clinics to sessions every thursday from 8:30 am to noon. We are in Casa de la Mujer and provide clinic monitoring, including blood pressure and blood sugar checks, medications for the month, nutrition counselling, an exercise session, and a visit with our doctor. We are adding 1 to 3 new diabetics to the San Juan groups each week.

New Clinic Site: We have also established a new clinic in Baston. This we have done through a partnership with the puesto de salud run by the Ministry of Health (MINSA) and began enrolling diabetics from the surrounding rural area. We provide the same basic services as we offer in San Juan del Sur. The program is a big success as we have added new patients throughout the summer.

Future Expansions: We have been asked to offer services in both Escamaquita and Ostional. We are committed to doing this and have waited until we had a reliable source of medications worked out and had developed the working relationships with the Centro de Salud (Ministry of Health) staff that work in those areas. We are confident that we will be starting up services soon in both areas.

New Prevention Services:

SURVEY: we have started a door to door survey for the San Juan del Sur area to help us identify already diagnosed diabetics and persons at high risk for developing the disease. Using volunteers and local brigadistas we have started the survey in several areas. La Cuesta, Cebadilla, Baston, Barrio Auxiliadora, Barrio Holman, and the central
district of San Juan del Sur. Our goal is to do all of the barrios surrounding San Juan and then go out to the almost 30 rural villages in the area. Currently, we are finding that about 2/3rds of the adults who are surveyed are at high risk for developing diabetes and we find 1-2 diagnosed but currently untreated diabetics during each of the survey sessions that we do.

To provide services to those at risk we have started prevention groups in several areas:

1. for La Cuesta we hold a session every monday morning at our clinic bldg at Finca Las Nubes

2. Baston once per month a morning session in the puesto de salud center

3. Barrio Auxiladora once per month at the local evangelical church

4. Cebadilla once per month at a local house.

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