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. 


October 2013 

Dear PHL colleagues and supporters,

Each October we take the opportunity to review with you what many have done through their association with Project Health for León over the past year to promote our stated goals, which are to work for the improved health care of Nicaraguans through education of health professionals, the provision of appropriate medical equipment and other resources, and participation in the care of patients.

Project Health for León, officially formed in 1995 after 10 years of professional involvement at the Rosales Hospital by many of us, now serves as a point of interchange of educational efforts in León of the medical and nursing schools of East Carolina University’s Brody School of Medicine and the medical school and surgical residency programs of the University of North Carolina. East Carolina medical students, medical residents, cardiology fellows, and nursing students  have gone for electives at the Rosales Hospital with Drs. John Rose and Harry Adams and nursing students, and surgical and emergency residents from UNC­Chapel Hill have gone to León with Drs. Bill Sullivan, Jeff Abrams, and Osi Udekwu. A gastroenterologist and an urologist, Dr. Greg Murphy of Greenville, also accompanied Dr. Sullivan this year. Under Dr. Sullivan's sponsorship through PHL, 6 more fourth year surgical residents at Rosales Hospital have each spent 3 weeks at WakeMed and UNC hospitals in order to observe current surgical methods and postoperative care, with great generosity on behalf of radiology and pathology colleagues at WakeMed in providing instruction to these visitors. This year ECU renewed its affiliation agreement with the medical school at UNAN-León, and two Nicaraguan medical students completed a 6 week rotation at ECU; a total of 7 have now enjoyed this opportunity to date. The School of Nursing at ECU, under the leadership of Dr. Donna Lake, has been developing programs of nursing education with their colleagues at the Rosales Hospital in León and the nursing school at UNAN-León. This included cooperation with a Nicaraguan-born  Canadian nurse educator who assessed nursing educational needs, and presentation of teleconferences  from ECU with the León nursing school and Rosales nurses to further develop this interchange. Donna and her colleague Debra Kosko traveled to León in February and September and delivered educational seminars to nurses and students. They also neared completion of a joint research project with hopes for publication. The interprofessional collaboration of physicians, nurses, and medical and nursing students has been a grand success.

The need for additional medical equipment and the supplies necessary to keep that equipment functioning at the Rosales Hospital continues to be a major challenge. The reality is that we and our Nicaraguan colleagues cannot hope to duplicate the  technological advantages present in our and other more developed countries, but certainly can aim at least to support the provision of basic laboratory, operating room, and monitoring equipment needed to support the provision of care in the Rosales Hospital, which is a teaching institution for many of Nicaragua's practitioners. A persistent and unresolved problem is how to get the Nicaraguan Ministry of Health and our colleagues and friends in Nicaragua to accept responsibility  for the purchase of supplies needed to keep EKG machines, chemistry analyzers, and radiology equipment functioning  with the abysmally low budget for health in that country.

Much of the equipment we have donated over the years now represents an older edition and these supplies and devices, though still functioning, may require part replacements, and supplying this demand as well as purchasing new equipment when feasible draws on our resources. In 2013 we supplied parts and repairs for the autoanalyzers , the previously donated Phillips echocardiography machine, anesthesia machines, pediatric and adult ventilators and EKG paper.  As in the past, the past year has seen many trips to León by various specialists. As previously mentioned, Dr. Bill Sullivan and his surgical colleagues from WakeMed Hospital and the UNC-Chapel Hill medical school continue to travel twice a year to León to teach and participate in difficult surgeries and they continue to stay in touch with Nicaraguan surgeons who have trained in León and   have visited North Carolina. Drs. Rose and Adams went to León in February and September with medical students, residents, nursing students from ECU Brody School of Medicine and were joined by Drs. Dave Hannon, Jimmy Locklear, and John Paar and our echo tech colleagues, for examination of many pediatric and adult cardiac patients. In September, Drs. Rose and Paar evaluated 250 adult patients and Dr. Hannon saw 100 patients with Rosales Hospital pediatric cardiologist, Dr. Nubia Berrios. Cardiac surgeons Drs. Ted Koutlas and Curt Anderson and their team joined us in September  to perform 11 open heart operations in 5 days, an unprecedented volume for us.  The operative  procedures included valve replacements and repair of congenital heart  abnormalities. They also brought two patients to Greenville for more complex cardiac surgery.  All of these patients had splendid outcomes. As before, we worked closely with   Nicaraguan colleagues, residents, and students. Dr. Jeff Brumfield and his wife Dee Dee, and their team, made a trip to the Rosales Hospital to see many patients with cardiac rhythm problems and to implant pacemakers, donated by Medtronic, in September 2013.

We cannot stop without acknowledging the considerable ongoing support with our efforts in León by friends from North Carolina Rotary Clubs. The Clemmons Rotary group has access to some dental equipment, including donation of a retiring dentist’s office, and we hope to obtain this donation as part of our opening collaboration with the UNAN-León dental school. This year we sent a container including a heart-lung pump, other surgical equipment needed by the ECU group, and general supplies and replacement parts for equipment already in place. In 2014 we will once again send a container with much needed medical and dental supplies, an expensive but much needed endeavor.







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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