Nurse Natalie Ventures to Nicaragua

8 minute read

Hola, todos!

My name is Natalie Ball, and I am a recent University of Pennsylvania School of Nursing graduate. After taking a gap year between high school and college, and realizing my passion for global health, I committed myself to learning how to better health conditions around the world. Upon graduation I had a decision to make—either work in the hospital system in the United States or follow my passion for learning new cultures and peoples, bettering health conditions in developing countries and volunteering abroad. While at first I was unsure about my decision, as many classmates were getting hospital jobs, I can safely report that I am so incredibly happy with what I am doing and with the path I am on. Let me explain!

On August 19, 2014, I boarded a plane for Managua, Nicaragua, to begin a 12-month adventure with Manna Project International (MPI), a nonprofit organization committed to holistic community development in Latin America. Together with a group of recent graduates, I have been working in the outskirts of the capital city of Managua, and in the municipal city dump, where over 1,200 people live and work collecting and sorting trash to make a living where we will be designing and implementing community development programs in partnership with the community residents. I will be focusing on public health initiatives in the local community clinic, finding ways to create innovative, sustainable healthcare solutions, all while strengthening my Spanish skills and building lasting relationships.

I have been in Managua for about a month now, and having just received news of receiving the Christianson Fellowship from the InterExchange Foundation, I cannot report anything but excellent news (except for maybe some power outages here and there, freezing cold showers, cockroaches … but it's all in the experience!). Every day I wake up feeling more and more at home. As I get to know the community members and the other volunteers I am working with, I feel more situated and inspired to improve the health, educational, financial and social hurdles many of these people face. While many of you think I might just be working as a nurse, I am actually working on a lot of different programs, which is super fun and diverse! Here they are:

  • English Level 2: MPI runs five English classes spanning five levels that serve adults, teenagers and children, and I teach English level 2. All English programs meet at the community center in Cedro Galan. Holding these classes in the late afternoon/evening provides opportunities for individuals to further their education following school or work. I have found this to be a lot more challenging than I thought since I am teaching 98 percent of it in Spanish (and I am working on my Spanish skills myself!). I know sometimes the students get frustrated with me because I can't explain all the grammar clearly, but it is definitely a skill I am hoping to work on. I most definitely have a newfound respect for all my teachers!!
  • Child Sponsorship: MPI has developed a child sponsorship program to address undernourishment in children five and under who live outside the city dump. Working in Villa Guadalupe, MPI seeks out and matches each child with a financial sponsor in the U.S. MPI currently has 50 children in the program who receive milk formula, vitamins and oatmeal/cereal on a monthly basis at Milk Day. Program Directors (PDs) are responsible for visiting families in their homes throughout the month to address any health/family concerns. Other PD responsibilities include building trust and maintaining relationships, writing to sponsors and organizing monthly Milk Day. I have had a really great time working on establishing my relationships with the children/families I visit each week. With a vulnerable population that faces many financial, health and social issues (domestic abuse being a large one), I have been working on creating a trusting and supportive relationship. Once I develop that, I believe I can be more valuable to the families and hopefully aid them in some health and social concerns.
  • Women's Exercise and Nutrition: This program works to improve the physical, mental and emotional health in the women of Cedro Galan. It uses a mix of cardio, weight and strength exercises to increase fitness and promote a healthy, active lifestyle. PDs also address poor nutrition through lessons and cooking classes. PDs are responsible for developing exercise routines, planning nutrition lessons and other activities outside. My fellow PDs and I are collaborating with a local nutritionist to come to our classes and educate the women on important health diets and lifestyles. We are also in the works of creating a bootcamp, which will track the amount of exercise, diet and weight loss for each woman each week.
  • Girls' Health: Our health programs target preteen and teenage students at the local public school. We hold classes for girls on a variety of topics ranging from goal setting to human development sexual health to basic nutrition. The goal of this program is to give students a safe place to talk openly about sensitive issues that affect them on a daily basis. As PDs we are responsible for developing curriculum, administering classes and working together with school administration and faculty to further the program. For me, this is an important project as women's empowerment is a critical initiative to focus on, especially in a country that sees the heavy influence of "machismo." Building relationships with the girls, creating conversation and empowering them is a task I keep close the heart.
  • Jewelry Cooperative: The jewelry cooperative began in the summer of 2012 after MPI received a grant from Walmart to begin a women's empowerment program targeted at financial independence. Throughout the fall of 2012, the cooperative took shape as a legalized Nicaraguan cooperative with a governing board and core of approximately 20 women. The coop received full legal status in June 2013. There are currently 17 women working in the coop, and we are in the process of welcoming eight more women. The current president of the coop is a local Nicaraguan woman. PDs are responsible for working with the women to run a success coop by organizing orders, purchasing supplies, managing payments, organizing materials, managing different markets and a collection of other odd jobs. Currently, we give the women materials to make jewelry every Wednesday. They have space to work in at our MPI house, but they do a lot of jewelry making at home. Each woman can make up to $100USD monthly. Again, this is another important initiative as we get women out of their houses and give them an ability to create their own income. The community of women we work with is very closed, on account of their social histories, and therefore it will take time to create a trusting, open relationship. This is a goal I look forward to and one I will be hoping to report back on with good news.
  • Business Development: The business development program has recently been redesigned and now targets community members within Cedro Galan. As PDs we approach already established businesses, such as ventas (small home-based stores), as well as members with solid business ideas. We help members establish a business plan and teach the members important principles to follow. Small loans are then distributed and are expected to be paid back following an agreed upon timeline. We are expected to provide guidance to loan recipients, collect payments and look for new potential loan recipients.
  • Cedro Health: The Cedro Health Clinic opened in October 2013. The clinic provides affordable primary care to our community for only 20 cordobas (less than $1.00 USD) for a consultation and medication. Our doctor, Wendy, and nurse, Selma, work for the clinic three days a week. Selma also works as our community health promotor. The Cedro Health program also includes a generation class, where youth between 12 and 18 interested in a career in health progressions are able to learn about health care and different biological and medical topics. PDs who take part in this program are expected to work in the clinic conducting intakes or basic vital signs, accompany the nurse on community walks and plan lessons for the generation class. So far, I have really enjoyed my community walks with Nurse Selma as I get to see the living conditions of many community members and really see their health from a holistic approach (Manna's vision). I have had the opportunity to provide physical assessments and care to patients all around the community. Furthermore, I am excited to announce I am helping launch a health promotion and education project, focusing on preventative health measure and community outreach.
  • I am also working with Lacrosse The Nations (LTN), a program for children in these underserved communities. LTN is a great way to run around with kids, but to also provide them with a real curriculum that focuses on respect and etiquette on and off the field.

Lastly,  I am very happy to announce that we are opening another clinic in Villa Guadalupe (formerly known as La Chureca). The people living in this area face many health concerns, namely respiratory and parasite issues, as their community is just beside the municipal dump. I am really excited to get involved with health-promotion projects in the community with the local health promotor.

Overall, I have been challenged so far by balancing all the different projects, yet I know all of them are vital to holistic community development and all support each other in special ways. It is important for the community to be well educated, healthy and financially stable. By addressing the triple bottom line the MPI PDs and I are challenging the status quo and hoping to create true change in the lives of many. This is going to be a great year and I am very excited to see how the year will progress. While I face many challenges, all in a foreign language, my heart is in the right place and with that passion and inspiration from those around me, I hope to be a part of the change that so desperately needs to come.

Paz y amor for now and be sure to tune in for more updates!


U.S. Department of State-Designated J-1 Visa Sponsor
Alliance for International Exchange
The International Coalition for Global Education and Exchange
European-American Chamber of Commerce New York
Global Ties U.S.
International Au Pair Association
WYSE Travel Confederation