By March 2020, we knew that COVID 19 was inevitably going to come to Nicaragua. With the tight living situations in barrios, the close-knit high-touch nature of Nicaraguan society, and the health care available to our families, we were afraid it would really hit hard. Over the course of several emergency meetings, we formulated a plan for the next months. At the start, I needed to ask everyone to what extent they were willing to stay on, keeping in mind the risk involved. The team was determined to find ways to continue to support our communities.
The home visit and health team were the most affected because they also had the most work to do in a short time. The number one task at hand was to run a significant educational campaign to create an informed awareness of COVID and its risks to our 204 families, as well as best practices to lower their risks. Then there were all the other health and emotional issues that we would surely need to support in the near future. To keep them safe, it was decided to work remotely. Auxiliadora, Brenda, and Olga were given cell phones and short training on how to effectively connect and communicate with people on the phone. This was not a simple task since the information we needed to ask and address was sensitive and could escalate over time with COVID and the pending isolation. Besides the need to give families information on COVID 19 and best practices to keep their family members safe, the team needed to learn to screen and support the families via phone calls on such issues as intrafamilial violence, unemployment, hunger, mental health, and physical illness.
Since those ‘early’ days of COVID 19, we have not stopped, nor has the need for our support. The team of three averages 600 calls a month. The calls are also supplemented with SMS and WhatsApp text messages. The feedback is overwhelmingly positive; the families are feeling very supported during these frightening times where the only support available to them has been Empowerment International. On a “normal'' day, each team member uses their list of families they are responsible for. Each separates in our now quiet and empty educational center where they distance from each other, making their calls and texts and documenting them in our database.
Besides offering support to the families, the information collected is vital and is the key to how we are able to assess and evaluate the ever-changing reality of the situation in the communities we serve. The situation they are facing for example in June was found to be the following: ·
unemployment has reached an astounding 60% (up from less than 30% in January 2020)
23% of the homes have at least one person with a pre-existing condition that puts them in the high-risk category for COVID-19
20% of the homes presented with one or more household members with a case of probable COVID-19 (tests are not readily available).
The data collected and compiled arms us with the ability to determine the best use of our resources in this fast-changing and daunting situation. Key decisions are made on how we can improve our programs and support our families in the best way possible with our few resources. For example, as COVID-19 continued to spread rapidly, we shifted our daily take away meals for the children to an emergency food relief program. This unprecedented program supports our families with the basics they need to feed their children and also provides them with basic hygiene materials to help prevent the spread of the virus.
During calls, we also support each family with organizing medical care and appointments with private physicians as needed, as well as support them with medications. For example, this was the case of doña Marlene who has chronic diabetes and needed to get her monthly medication. And then there was Gladys, a university student who needed her thyroid medication. For Covid-19 cases, we are creating a reserve fund for the rest of 2020 to support medication, physician appointments, and funeral expenses as needed.
Our home visit program has always been the foundation of our program, upon which all other things have been built. While face to face encounters is always the preferred method, the team has proven that we can support the families and stay close and accompany them while also maintaining a safe distance. Continuing to take the time to connect with our children and families has been one of the best decisions we have made during the crisis. And, even though we are not able to see the children's faces, hug them, or see their smiles, we are continuing to strengthen our connections with them and their families, and meet their greatest needs in this time of extreme duress. In the end, the knowledge that they are not alone, even now, is helping them to get through this pandemic with faith in a better future and with the strength to start again.
By Marcia Miranda