Unlike most of its Latin American neighbors, Nicaragua has not implemented basic preventive measures such as reducing mobility and concentration of people, testing, or quarantine of suspected cases to slow the propagation of the virus. In fact, public schools have been ordered to remain open and Easter week celebrations are encouraged even though many private schools have closed and the Catholic Church has canceled its events.
For a number of reasons we are extremely concerned if the virus takes hold, the spread of the disease will be relentless in the communities we serve:
- Nicaragua is a communal, not individualist society where extended families live together in small homes and most people rely on the always-packed public bus system for basic transportation.
- Hand washing is essential to prevent the virus but lack of access to water is a pervasive problem in most rural communities making frequent hand washing nearly impossible.
- The national health system is not equipped with the necessary medical supplies, equipment and expertise to screen and treat a major outbreak. Neighboring El Salvador ordered residents to quarantine at home for 30 days, citing the need for intense preventive measures to avoid overwhelming its fragile health system.
With this as a backdrop, The Lily Project is following the World Health Organization (WHO) guidelines and training, American Society for Colposcopy and Cervical Pathology (ASCCP) recommendations, and input from local partners to implement a short-term strategy that protects the health and safety of our team and patients. Currently we have the necessary medical and cleaning supplies to support this plan; however all are becoming very limited and prices skyrocketing. We will be monitoring everything and making changes whenever necessary but as of now we are:
- Canceling regular community health screening events. These events typically have 50-80 women in attendance, many of whom bring their children.
- Continuing, with modifications, Lily’s diagnostic screening and treatment events. These events are invitation-only for women with abnormal screening results who are on our ‘watch’ list, or scheduled to receive cryotherapy or a biopsy. Since the beginning of 2020 The Lily Project has uncovered three cases of invasive cervical cancer; it is essential women continue to receive this care. Each weekly event will be limited to no more than 10 women and enhanced procedures will include pre-screening women for illness (with referral to MINSA), educating about the virus with thorough hand washing for all participants, social distancing in the waiting area, disposable gowns and use of gloves and masks throughout all stages of the process. Lily will bring water if the location doesn't have access. The mobile clinic will go through a thorough disinfection process before and after each event.
- In addition to a weekly event, Lily’s offices in Leon and Matagalpa will be open 2 times a week until 3pm (when streets typically get more crowded) for Lily's nurses to manage the data and participate in online training and education advancing their knowledge and skills in this critical time. The office has Internet access, which is not available in their homes.
- In order to work, teammates are required to wash their hands frequently, avoid crowds and not take the public bus (Lily is paying for taxi service as necessary).
We have to believe that you, just like us started this year with a plan, exciting goals and passion to get it all done. It is so difficult to see everything change so abruptly without any sense in where it is all heading. But our team has found ways to overcome Nicaragua’s turmoil over the last couple of years by staying committed to Lily’s mission and flexible in our execution. We have complete faith we will do so now as well.
If you are interested in staying in touch with Lily and what is happening in Nicaragua, please follow our blog. We will also be posting opportunities for teens and adults to volunteer remotely with Lily during this time https://www.thelilyproject.org/lilyblog.
Thank you for caring about Lily. Believe this: you are helping save lives.