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UCSD Students Reach Across Borders to
Improve Children's Health as Part of Project Nicaragua

Ioana Patringenaru | June 9, 2008

Photo of student taking blood sample
Nicholas Gastelum, then a UCSD student, takes a blood sample from a little girl in the Nicaraguan countryside. The sample will be analyzed for signs of parasite infections.
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Scores of people were waiting in line for care in hospital hallways. Families slept on the floor in patients’ rooms. They hung their laundry out to dry outside the hospital’s door.

The sight that greeted UCSD alum Nicholas Gastelum when he first set foot in the El Hospital Antonio Lenin Fonseca in Nicaragua’s capital was not easy to take in, he recalls. But Gastelum, then still a student, had come to Managua to try and improve conditions at the hospital.

At the time, Gastelum was one of the students in charge of the UCSD Chapter of Project Nicaragua, a nonprofit organization run by UCSD and UCLA physicians and students. For more than two years, the organization has brought supplies to the Fonseca hospital in Managua, from gauze, to IV kits and surgical tools. It also has partnered with the International Neurosurgical Children's Association (INCA) to fly in medical equipment and UCSD physicians, who help train the hospital’s doctors. One of the groups’ advisors is Rahul Jandial, INCA’s director and a UCSD resident physician and local televison health correspondent for 10News.

Students also fan out to rural areas, where they try to identify children infected with intestinal parasites. In addition, they conduct research on spina bifida, a birth defect that results in an incompletely formed spinal cord that seems to be particularly prevalent in Nicaragua. The goal is to organize an effective prevention campaign to fight the disease, Gastelum said.

“I’ve learned that no goal is too small,” he said, when asked what he got out of working for Project Nicaragua. “Nothing is really out of the reach of people who put their minds together.”

Project Nicaragua allows premed students to get involved in world health issues and to experience first-hand the workings of a health care system outside of the United States, Gastelum said. That, in turn, allows students to start thinking about how health care can be improved in America, he added.

A Nicaraguan Hospital

Photo of surgery team
Surgeons at work in the operating room.

Gastelum still seems to carry with him vivid memories of the children and physicians he saw in Managua. At El Hospital Antonio Lenin Fonseca, many families brought in children for treament who had holes in the small of their back caused by spina bifida. “The children are the most innocent,” he said. “They’re just born with it and they have to survive.”

The hospital’s neurosurgery department tries to help the little patients and their families as much as possible, Gastelum said. But physicians are limited by the number of supplies available. For example, using hand saws instead of radial saws adds several hours onto a surgery, reducing the number of operations doctors can perform in one day. But the Managua surgeons have learned to work around these limitations, Gastelum said. When the hospital’s CAT scan machine was broken, they used an X-ray machine to take many pictures of each patient from different angles, approximating a scan as best they could.

“They’re a very scrappy team,” Gastelum said of the physicians. “They’re dedicated to serving people with the tools they have. They could leave the country and make more money, but they decided to stay put, in spite of meager wages.”

The International Neurosurgical Children's Association joined forces with Project Nicaragua to help these surgeons, said Allen Ho, director of the project’s UCSD chapter and a premed student here. “When Allen first approached about collaboration between INCA, Project Nicaragua and the National Neurosurgery Service of Nicaragua, it was a no-brainer, and a perfect fit for our organization and what we do,” said Dr. Jandial, INCA’s director and 10News correspondent. “The mission of effectively, efficiently renovating children's brain surgery and care was always my vision and passion with INCA—now others are coming along to help make it happen."

Making a Difference

Photo of Nicaraugan countryside
Allen Ho (left) and Gastelum hike in the Nicaraguan countryside on their way to a local village .

Gastelum said that he believes Project Nicaragua has been able to make a significant difference in patients’ and doctors’ lives over the past 2 ½ years. For example, the group’s study of intestinal parasites helped reshape the Nicaraguan government’s policy, Ho said.

His most vivid memories go back to the students’ hikes in the Nicaraguan countryside on their way to small villages, where they went to conduct surveys. The scenery was almost right out of “Jurassic Park,” Ho recalled. He also remembers thinking: “Right now, my colleagues are in class and here I am going to a school where kids have never seen an American before.”

“It’s a whole different prospective on life, on what’s important,” he said.

The children in these rural schools deeply touched both Ho and Gastelum. They were often anemic and unable to focus on their school work. “They could have all the opportunities in the world, but their body is holding them back,” Gastelum said.

Plans for the Future

Gastelum is headed for medical school at UC San Francisco this fall. Meanwhile, six of the project’s 30 members at UCSD will be graduating this month. Ho is one of them—and he will get to spend even more time in Nicaragua starting this fall. He has received a Fulbright scholarship, which will allow him to spend a year in that country, where he plans to continue working with Project Nicaragua. Then he will be back at UCSD, where he will study at the School of Medicine.

Photo of student and patient
A UCSD student poses with a young patient.

“Being a doctor is the only way I can help people on a daily basis and get paid for it,” he said.

In the future, Project Nicaragua would like to partner with AMOS Health and Hope, a nonprofit organization, to build a health outpost that would serve about 400 local residents in the Nicaraguan countryside, Ho said. The group also would like to raise money for a spina bifida program in Managua, which has been losing funding. “This will take a pretty monumental effort,” Ho acknowledged.

For now, Project Nicaragua draws its funding from several sources. Students sell concessions at Qualcomm Stadium and PETCO Park and get commissions based on the profits they make. The project will hold a fundraising gala Aug. 9 at UCLA. Ho also received a $10,000 Donald A. Strauss Public Service Scholarship to finance the project’s activities. Students still pay for their own room and board, Ho said. Their drive and doctors’ commitment to their patients are pretty amazing, as are the nonprofit organizations that work with them, he added.

“I gained a great deal of hope in humanity,” he said of his experience with Project Nicaragua.


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