Project Health for León

Improving The Quality Of Care For The Poor Of Nicaragua

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   Project Health for León


The mission of Project Health for León is to promote the improvement of  medical  care for the people of Nicaragua through education of health professionals, the acquisition of appropriate medical technology, and, when necessary, by direct patient consultation and medical and surgical care, both in Nicaragua and in the United States. 

September  2014

Dear Colleagues,

We just returned from our semiannual medical journey to Nicaragua, and I wished to give you a brief report of our activities.  Present were Drs. Harry Adams, David Hannon, John Paar, and John Rose, and head nurse Donna Lou Edwards.  Cardiology fellows Arjun Chagarlamudi and Carlos Espinoza were also there for a week.

In the adult cardiology clinic, we saw 260 patients, with a history, physical, echocardiogram, and discussion of plans for each patient.  The vast majority of the people we saw had significant cardiac disease.  A substantial number of them had mitral stenosis, mitral insufficiency, or mixed mitral valve disease, as well as aortic stenosis, aortic regurgitation, and mixed aortic valve disease.  We also encountered numerous cases of adult congenital disease, with a large number of Secundum ASD’s, and also several cases of VSD’s, PDA’s, and one Tetralogy of Fallot.  At least fifty of the patients were candidates for open heart surgery.  Since we don’t have the capability of performing this many operations, triage is obviously a very difficult and challenging problem for us.

David Hannon, in conjunction with his colleague Dra. Nubia Berrios, examined fifty pediatric patients with heart disease, including a number of very unusual and complex patients.   There is a team in Managua, the capital, which is capable of successfully performing congenital heart operations, and we are hopeful that some of these patients can be treated there.  We recently developed a relationship with Dr. Evan Zahn at Cedars Sinai in Los Angeles, and his surgical team corrected a complex Tetralogy in an 8 year old girl from León about two weeks ago, and we hope that we can further develop a program with them.

Harry Adams rounded on a daily basis with his colleague, Dr. Armando Matute, in infectious disease and also met with Dra. Karla Tellez to discuss clinical opportunities for students in February.

Dr. Jeff Brumfield, now in Kentucky, but a member of our team, brought a group to León the week before we arrived, and ran an electrophysiology clinic and implanted a number of pacemakers and defibrillators as well.  He also spent two days in Managua where he performed four ablations for supraventricular arrhythmias (I believe that this was a first for Nicaragua). We were able to see him in action as we were arriving and visited the hospital in Managua on our way to León.

We had a fruitful meeting with the new Dean of the medical school at UNAN-León, Dr. Jorge Aleman.  He was very appreciative of our program, now more than four years old, of bringing two Nicaraguan students each year for a 6 week rotation at Brody/Vidant.  He had some suggestions for expanding the curriculum of our students In León to include tropical diseases and more primary care clinical experience.  I think he will also be helpful in supporting us as we thread through the intricacies of the medical bureaucracy in Nicaragua to bring supplies and medical groups into the country.  I think that the collaboration between Brody and UNAN-León will continue to grow under his supervision.

We plan to return in February with our faculty members, nine medical students, Dr. Donna Lake and Debra Kosko with 4-6 nursing leadership and nurse practitioner students, cardiology fellows from here and Georgetown, Donna Lou Edwards and other nurses, and a cardiac surgical team that anticipates performing 11-12 open heart procedures.  Coordinating this large group will be a challenge, but I anticipate an excellent experience.

I am proud to be a member of this group and to help expand the scope and influence of our school.  Many thanks for your support in this endeavor.



John D. Rose, MD, FACC, FACP

Department of Cardiovascular Science




In 2014 we have a number of objectives:

1. Continue the regular missions as we’ve described.

2. Develop a collaboration between the ECU dental school and that at UNAN-León.

3. Continue and broaden the nursing educational and research projects.

4. Develop an ablation program --- electrical treatment of arrhythmias by catheter technique, not generally available in Nicaragua --- by Dr. Brumfield and his group.

5. Send a container.

6. Engage in a public health project to develop a clean water project in Poneloya, a village near León where the local physician identified impure water as a major health problem.

7. Continue to develop the educational and cross-cultural program between Nicaraguan and American physicians, students, residents, and nurses.

Your support is invaluable and badly needed. The above container was only one of many major expenses, and we have previously mentioned a long list of purchases. In the absence of funds from the Nicaraguan health ministry, for which we will continue to advocate, the reality is that if  progress in education of health professionals and medical care is to continue there, we must play an important supportive role.

While we are not the only NGO going to León, there is no other as involved at this level. We continue to be as cost-effective as possible and frankly, those of us who are involved in this are ourselves heavily involved in its financial support as well. But we need a broader base of support and for that reason we continue to come to you, our colleagues in these ventures. This is a long term commitment. We continue to have no employees, less than 1% overhead, and great needs and opportunities. Please know that what you do is very much appreciated.


Dr. John D. Rose        

                                Project Health for León

PO Box 1209

Greenville, NC 27835

EIN 56-1917546

Phone: (252) 917-4086
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