Our organization started as an unstructured, alternative spring break by four students at the University of Colorado at Boulder in March 2004. As members of the Colorado Alpha chapter of the Alpha Epsilon Delta Pre-health Honor Society, members James Byers, Britt Severson, Brian Morgan, and Anthony Rossi developed a plan for addressing medical need in an indigent community in Nicaragua. The model was simple. The team of four would drive a pickup truck to the center of the rural community where they met with local pastoral leadership to identify individuals in need of medical care. The identified individuals were then taken to physicians in the city of León, where the team would pay for the spectrum of care, from consult to medication, including all transportation expenses. The team was able to serve approximately 15 individuals a day over a period of 5 days.

The experience changed the lives of the four students, from the inspiring pride and appreciation of a people who seemingly had so little, to the incredible hands-on experience that each of them gained as pre-health professionals. Upon returning to Colorado, the word spread of the trip’s success. The team of four soon turned into a team of twelve for a repeat trip in March 2005.

The 2005 trip would be different, and served as the foundation for the organization that was to result. The original model was flawed. The focus on improving access and providing charitable care by taking individuals to care was very costly and time consuming. Rather, the new team would focus on taking care to the people. What resulted was a network of acute care clinics that were able to serve over 100 people each day at a cost almost 75% less than the previous model.

Between 2005 and 2008, the medical project in Nicaragua grew in interest and in organization. By October 2008, a leader who emerged throughout the organization’s evolution, David Baulesh, partnered with Anthony Rossi to incorporate the organization as a 501c3 nonprofit in Boulder, Colorado, now known as Health Outreach for Latin America (HOLA) Foundation.

After becoming its own entity in October 2008, the HOLA Foundation broadened its service scope by developing a mission to provide integrated and sustainable health care solutions to developing countries in Latin America. This is achieved through the establishment of acute care clinics and the promotion of community health improvement by means of veterinary care and public health services and education. As we continue to assess the communities we serve, we plan will be flexible in our strategies to ensure our services are aligned with community need.

Since those we serve do not have the means to pay for their healthcare needs, the focus of the HOLA Foundation is not only to provide access to care and health services, but to fully subsidize immediate and continual care. Further efforts involve the establishment of community health advocates, a First Aid program, and a teach-the-teacher public health education program to empower the community and lay the groundwork for a more sustainable impact. The public health operations include the provision of resources for improved sanitation, nutrition, and prenatal care. Efforts to improve the local water supply through the implementation of purification infrastructure are sustained by our strategic partners.

HOLA Foundation medical operations are delivered by physicians from the city of León who provide their services below the market value in Nicaragua. These physicians work alongside our volunteer operations staff that administers the operations and provides clinical support. Quality and process control measures ensure medical supplies, pharmaceuticals, vitamins, and over-the-counter drug inventories are all managed to avoid stock outs and reduce associated overhead. All supplies are donated either in-kind or purchased from charitable gifts. Our operations plan ensures continuity of care and continued improvement through the management of the flow of information and resources. Clinical rotations and timing strategy keeps the volunteer model effective under the pressures of the harsh environment and the demands of the challenging care delivery environment.

Continual education for HOLA Foundation volunteers is vital to its success. Medical documentation, care dynamics, cultural sensitivity, and clinical operations are continually evaluated and improved to ensure the highest level of patient care and satisfaction.

Recently the HOLA Foundation has added veterinary care services to its model. Its goals include the vaccination of livestock to protect community members’ vital investments, vaccination of animals and livestock to prevent the transfer of Zoonotic diseases to humans, and the neutering of animals and livestock to control populations.

By combining acute medical care, public health education, supplies, and services, and veterinary operations, the HOLA Foundation is taking an integrated approach to health improvement in the developing world.

The HOLA Foundation supports the rural communities of Chacraseca and Nuevo Amanecer, Nicaragua.

The communities of Chacraseca are comprised of 11 rural sectors, covering 19 square kilometers of subsistence communities. The project serves a population of over 6,000 indigent Nicaraguans from the elderly to newborns. These communities have been ranked among the poorest in Nicaragua, with many families of more than 7 individuals living in corrugated metal homes no larger than 150 square feet. Sanitary conditions have created a public health crisis, resulting in a high prevalence of acute illnesses ranging from dermatological irritations to urinary tract infections that greatly affect quality of life and threaten the lives of many others.

Nuevo Amanecer is a smaller, rural community northwest of León, in a remote location with poorly defined boundaries. A few hundred reside in the community, although the demographics are not well known given its lack of formal leadership and zoning. The community has been identified by Nicaraguan government as having arsenic contamination in its water supply, aside from the typical health concerns of similar communities like Chacraseca. Current efforts of the HOLA Foundation are to assess the community health needs and its demography, as well as assess water quality and support the sustainability of an improved water supply directly and through the efforts of our strategic partners.

Acute Care

Establishing Acute Care Clinics

During our medical relief trips, HOLA volunteers establish acute care clinics in communities that lack access to a health care facility. At these clinics, every patient is triaged and then allowed to see the physician. All medications that the physician prescribes for patients are paid for and provided by the HOLA Foundation. Furthermore, every patient that enters an HOLA clinic, whether infant, child, or adult, receives a supply of multi-vitamin tablets.

Partnering with Local Physicians
The HOLA Foundation differs from many other medical relief groups in that we partnersolely with local medical professionals to deliver acute care. We believe that local physicians have a better perception of the health disparities occurring in their communities than foreign physicians. Thus, these local professionals are in a better position to develop a rapport with the patient, understand the patient's needs, and prescribe an effective treatment course.

Veterinary Clinic

Improving Community Health
The HOLA Veterinary Care program strives to improve the health of the community by improving the health of its animals. Our veterinary team partners with local veterinarians to provide immunizations, vitamin supplements, and de-worming procedures for common livestock, all without cost to the community. These procedures help to lower the burden of zoonotic diseases on the community while simultaneously improving the health of the community's animals which serve as a source of both food and capital.

Invasive Procedures
The HOLA Foundation also provides some surgical care for animals in the community. Castrations are conducted in order to lower pet populations (a common transmission vehicle for many zoonotic diseases) as well as to prevent the occurrence of future disease, such as prostate cancer.

Public Health and Community Assesment

Public Health Education
The HOLA Foundation strives to promote the general health knowledge of communities by providing interactive health lectures and activities. Topics covered during these sessions include how to eat properly, how to keep proper dental hygiene, and proper pre-natal care, among many others. After a lecture is finished, the attending community members will participate in interactive games to better cement any new knowledge they have acquired.

Partnering with the Community
We strongly believe that a community can only improve their health standing when they are personally invested in the endeavor. To promote this investment, HOLA partners with the community by recruiting Community Health Leaders. These leaders are given a binder of health information, so that they may serve as health encyclopedias for their communities. These binders include information on acute diseases such as Hepatitis A/B/C and malaria, chronic diseases such as high blood pressure and diabetes, as well as common symptoms such as burns, bites, sprains, and fevers. By partnering with Commmunity Health Leaders, HOLA can extend its impact on communities even when we do not have volunteers abroad.

Research
The HOLA Foundation constantly conducts research in order to better identify the health needs of a community. This research consists of rigorous literature reviews, specific condition targeted studies, and full-scale community health assessments. The data we collect from our research activities provide excellent vectors for further development of our programs as well as ensure our methodologies are evidence-based.

2010 Community Assessment | 2011 Community Assessment