Reaching out and working together: The catalyst to health care improvement in Washington State and San Ramon, Nicaragua

January 27, 2016

Taya and family in Nicaragua
Taya (center) and her mother, Alice (right), with a patient in Nicaragua.

Changing payment models and system consolidation. Severe limitations in mental health treatment capacity. Data that show disparate treatment based on race and ethnicity.

The big thorny problems can seem overwhelming to us as health care leaders.

In the past two years, my family has twice traveled to Nicaragua to help run primary care clinics in impoverished rural villages. To give you a sense of the setting, the clinics are often set up on the dirt floor of the community church after shooing the village chickens outside. Without the services of the medical mission — Corner of Love, with which we served — many individuals in those villages would have no health care at all.

Some of the conditions we saw in clinic simply do not occur in the U.S.: deaths and severe illness from preventable conditions such as parasites and Hepatitis B, a sore untreated for 12 years that developed into a deep skin and bone infection, infected contractures on the abdomen of a woman who had a caesarian section performed in the field, and two young women with legs crippled from polio. The opportunity to connect in these clinics with the patients — who are so warm, resilient and appreciative — is deeply humbling.

On re-entry to the U.S., and Washington State in particular, what has been so striking to me is that in both countries the solution to the challenges before us is the same: cooperative action on behalf of the whole community. WSHA has demonstrated that the action of the entire membership, often in partnership with other organizations, rapidly improves outcomes. Our ER is for Emergencies Campaign with the Washington State Medical Association comes to mind as one example where care was improved and costs were saved. In Nicaragua, they are tapping this same secret sauce and are making strides. For example, Corner of Love is completing construction on a leadership school to foster promising children into community leaders who can work together and make things like clean water and routine health care a reality.

These are two different countries, cultures and circumstances, but with a single, powerful approach to improving health.


Taya Briley

General Counsel


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