Coffee Farm Workers at Santa Maura
Jinotega, Nicaragua
Fairfield University Nursing Students:
Sarah Hespe, Lia Iacuone, Sarah Roghanian, Megan Cammarota, Danyella Hernandez, Patty Adams, Molly Moran
Faculty advisor: Jessica Alicea-Planas PhD, RN, MPH
Other Project Faculty: Lydia Greiner & Philip Greiner
BACKGROUND
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Nicaragua is a country of just over 5,000,000
inhabitants
Human Development Index: Ranked 129 out of 187
(2012)
About 12% of Nicaraguans live below the poverty
index or on less than US $1.25 per day
Those living in poverty are disproportionately
rural
• 7 out of 10 people in rural areas are poor
Cardiovascular disease is the leading cause of
death in Nicaragua (Pan American Health Organization, 2007).
COMMUNITY OF INTEREST & ASSESSMENT
 Agricultural (coffee farm) workers in rural
Nicaragua who work on Santa Maura coffee farm
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Family owned and operated; located in the northern
central part of Nicaragua; set within the 'Reserva
Natural Datanlí-El Diabolo' nature reserve.
The forest, its fauna and flora are protected and
continuously studied by the Environmental Science
Department of the Central American University (UCA),
which has an experimental station at the very heart of
the farm.
The farm produces its own energy from an
environmentally-friendly hydraulic turbine, thus
avoiding the pollution caused by the use of fossil
fuels.
Much of the fertilizer used to nourish the coffee plants
is produced by a worm farm where discarded coffee
pulp is broken down over a period of several weeks
before being returned to the land.
The parchment from the dry milling of the coffee is
also recycled and is used to provide fuel for the ovens
in the main kitchen.
The family has managed the farm for over 80 years and Santa
Maura employs between 250 to 1,100 people, depending on
the season.
• The highest is during harvest time (October-February)
Workers are provided with room, board, and meals for the
duration of their employment.
• For every large basket of coffee that is picked, a worker is
paid the equivalent of about $1 US.
• The farm provides the workers with school for their
children
The Santa Maura community has access to a nurse seven days
a week
• The closest healthcare facility outside of the coffee farm is
located one hour away via public transportation.
• Medications are also available on-site on a limited basis
and are provided by the Ministry of Health.
RESEARCH POSTER PRESENTATION DESIGN © 2012
www.PosterPresentations.com
OBJECTIVES/IMPLEMENTATION
The purpose of this project was:
• To assess demographic characteristics
• Provide glucose/blood pressure screenings
• Deliver culturally appropriate health promotion
education
RESULTS/EVALUATION
N = 256
• Men - 52.6%
• Females - 46.9%
• Education level- 28.5% none, 48% primary, 18%
secondary, 3.5% university
 76.2% of the workers reported that they had never had
their blood sugar tested previously.
Description
• All adult workers and their family members 18
years or older were encouraged to attend one of
several health fairs.
• A short questionnaire which included
demographics, risk factors and current treatment
information, along with selected items from the
CAMDI project (PAHO, 2011) was administered to
each participant.
• Blood pressure and glucose were measured by
student nurses using standard protocol.
• Height and weight of participants were also
collected
• Those with abnormal results were referred to the
on-site clinic for further evaluation and
management.
• Health education regarding glucose and blood
pressure levels as well as healthy dietary lifestyles
was provided to all participants.
Our primary goal was to provide health education to
agricultural workers on how to maintain and/or improve
their health.
 69.5% of the participants stated that they have had their
blood pressure checked before.
 74.2% reported they do not smoke and only 9.8% stating
they smoke everyday.
 When addressing preparation of meals, 42.2% reported
they never add salt and 34% admitted they always add
salt.
CONCLUSIONS/FUTURE RECOMMENDATIONS
• An assessment of risk factors and prevalence of HTN in a
sample of agricultural workers was done
• There is the potential for decrease in
cardiovascular disease if more screenings and
preventative teaching are done prior to
diagnosis.
• Continued collaborative efforts for health education,
blood pressure / blood sugar screenings and delivery of
culturally appropriate education
• Limited access to screenings/education
because of resources can be improved through
continued collaborations
• Future collaborations with other near-by coffee farms
was requested by the Santa Maura clinic nurse.
• This is can be viewed as an indication of the
need in surrounding farms and also the trust
with the current community partnership.
Effectiveness
 By participating in the screenings, members of the
Santa Maura community were made aware of their
baseline blood sugar, blood pressure, and BMI
values.
 Participants were provided with all of their
screening information on small cards.
 Those members who had elevated glucose levels
or blood pressure were evaluated immediately
and participants left with a follow-up plan
Innovativeness
 The health clinic in Santa Maura was left with
scales and glucometers to allow for further
assessment of the community.
 Educational posters written in Spanish were left
with the practitioner at the clinic to provide
further information.
 Teach Back method was used after the
educational information was reviewed with the
participants. If the concepts were not understood,
it was explained again with the help of a
practitioner.
Challenges
• Space was limited and at times and areas became
very crowded
• Language barrier
• Fear of glucose testing (from the workers)
• Hours of availability
 Glucose testing at 4:30am
 Health fairs late into the evening to
accommodate work schedules
REFERENCES
World Health Organization (2006). Health & development . Retrieved
fromhttp://www.who.int/countryfocus/cooperation_strategy/ccsbrief_nic_en.pdf
Harkness, G., & DeMarco, R. (2012). Community and public health
nursing, 59. Philadelphia : Lippincott Williams & Wilkins.
Blondin, N. A., & Lewis, J. J. (2007). Prevalence, awareness,
treatment and control of hypertension in a rural Nicaraguan sample.
Journal Of Human Hypertension, 21(10), 815-817.
doi:10.1038/sj.jhh.1002225
ACKNOWLEDGEMENTS
Fairfield University would like to acknowledge the
willingness of the Santa Maura coffee farm, the clinic
nurse (David) and la Universidad de Centroamerica (UCA)
for collaborating on this project.