Bridges’ Health Program takes preventive care and health infrastructure to the people living in isolated rural communities. Our projects range from workshops to the construction of health facilities and potable water systems. Our hygienic latrines and high-efficiency indoor stoves improve sanitation and reduce chronic illnesses. Our volunteers provide medical and dental care, with the goal of ensuring the health and well-being of all ages and providing sustainable management of water and sanitation to the in need.

If your organization is interested in sending a group to serve in Nicaragua or the Dominican Republic, please contact us today. Medical service trips open to the public may be viewed here.

Our projects range from workshops to the construction of health facilities and potable water systems. Our hygienic latrines and high-efficiency indoor stoves improve sanitation and reduce chronic illnesses. Our volunteers provide medical and dental care, with the goal of ensuring the health and well-being of all ages and providing sustainable management of water and sanitation to the in need.

  • 2,750 Nicaraguans annually benefit directly from Bridges medical brigades
  • In 2014, Bridges built a maternity clinic that provides over 9,000 women safe and pre- and post- natal care
  • Bridges provided running water, flush toilets, showers, and medical waste disposal incinerators to the Siuna regional hospital that serves 80,000 people
  • Bridges has constructed and donated to the Ministry of Health 4 medical centers throughout rural Nicaragua
  • Bridges educational workshops help train hundreds of medical professionals
  • Bridges volunteers annually build over 60 latrines and smoke reducing stoves
  • In the fall of 2017, Bridges began construction on a regional clinic in a remote area of Nicaragua that will service 18,000 residents with 24 hour care.  Construction is due to be completed in March of 2018.

Medical Brigades – In the Autonomous Region of the North Atlantic (RAAN), in the northeast region of Nicaragua, communities are very rural and spread out, making a trip to a health clinic a serious challenge for the majority of people who have to travel on foot, sometimes for days.  Bridges brings health brigades made up of global health students and doctors to these communities, and they work closely with Nicaraguan doctors.  While there they hold primary healthcare clinics – lasting one to four weeks – that see up to 50 patients a day, currently benefitting over 2,750 Nicaraguans annually. In the coming year we expect to have eight medical brigade team members in Nicaragua for eleven weeks. The Ministry of Health’s data shows significant increase of patients each time a BTC Medical Brigade comes to assist the Nicaraguan doctors. Our longer-term goal is to increase the frequency of these clinics by 4-5 weeks in each of the coming years, so there will be a high level of patient support over time.

Hormiguero Clinic – Bridges to Community has been asked by residents of the RAAN department of Nicaragua and the Ministry of Health to improve health care services by building a new clinic, which will provide consistent access to medical care. This clinic, on which we expect to begin construction this coming year, will be the model for regional rural clinics in Nicaragua.  It follows plans that the Pan-American Health Organization has been advocating for Nicaragua to implement to properly coordinate and provide health care to 51 hard-to-reach rural communities with a total population of approximately 18,000 residents. This new clinic will:

  • Operate 24 hours per day and refuse no one, providing consistent access to care that will generate long-term health benefits and create a model for the region’s health program.
  • Offer critically-needed medical services, including: preventative treatments, care for women and children, immunizations, medication and mosquito-borne illness information.

Hygienic Latrines and Biodigestors – In Nicaragua and the Dominican Republic, latrines are an essential aspect of health and sanitation for rural families. In most of the communities that we work with, several families will share a latrine in poor condition, or may not have access to a latrine at all. This can lead to contamination of water sources and the spread of disease. Bridges to Community constructs hygienic latrines where pits can be dug deep enough to not effect water sources, or biodigestors in areas where pit latrines are unsafe. Biodigestors break down organic waste to produce a renewable energy called biogas that can be used to fuel stoves, and the run-off water from the process can be used for irrigation and fertilization of community farms.

Reforestation– Deforestation and drought are the two largest environmental problems facing Nicaragua and the Dominican Republic. We work with a number of communities in each country to promote reforestation, agro-forestry and diversification of crops. One example of our work: In El Portillo, a rural community about 90 minutes south of Managua, Bridges is helping the community grow over 750 seedlings in its nursery, and has planted over 350 trees, including Mahogany, fruit trees, and Central American native timber trees.  The land was overgrown with shrubs and weeds, but this terrain is being transformed into a farm that produces vegetables and fruit, and is surrounded by large shady trees. One of the project’s most important contributions is the training of over 150 families in the art of diversified agriculture, small scale irrigation, conservation and small subsistence farming method and design, using the two acre plot as a teaching model.  With this training, individual families will be able to replicate the reforestation project on their own land on a smaller scale.  This will provide much needed healthy food for families, with the potential for extra income through the sale of fruits and vegetables, as well as reducing the carbon dioxide output. Going forward, we will maintain comparable projects in Nindiri, Siuna and Caimonial, and will replicate this model in at least three new locations.

Bridges to Community to build regional medical clinic in Hormiguero.

In the RAAN region in remote northeastern  Nicaragua, most people are indigenous farmers living on about $1 per day. Currently, people walk up to 10 hours to reach a two-room medical outpost in the rural town of Hormiguero. For 15 years, Bridges to Community has sent volunteer healthcare professionals to this clinic to collaborate with local doctors and nurses. Volunteers see on average over 50 patients per day .

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Now, Bridges to Community Bridges has been asked by residents of the entire region to help improve health care services by building a new clinic, which will provide consistent access to medical care.

The new clinic will:

  • Give needed medical attention to 7 health territories, 51 communities, and over 18,000 residents.
  • Provide access to health services 24 hrs/day and refuse no one, providing consistent access to care that will generate long-term health benefits and create a model for the region’s health program.
  • Offer critically-needed medical services, including: preventative treatments, immunizations, medication, mosquito-borne illness information, and care for women and children.

New Medical Brigade Part of Bridges Long Term Health Program Goals

This November five medical professionals led by Dr. Michael Lahn, an emergency physician at New York Presbyterian/Lawrence Hospital, will be participating in a medical brigade in Nicaragua with Bridges to Community. The group will provide care and engage in cross-cultural exchange in rural communities where Bridges to Community works, and contributes to Bridges’ goals to expand its health program.

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Dr. Lahn, who has participated in many Bridges to Community service trips with his family and friends, decided to form the group after being involved in a medical emergency with a local teenager in the Dominican Republic. Dr. Lahn accompanied the youth to the local clinic. “I walked away from that experience wondering if I could have taught the local doctor some things that could have helped him be a better physician, and vice-versa,” recalls Dr. Lahn.

When he returned home, Dr. Lahn spoke with Bridges to Community Executive Director John  Hannan about the possibility of a medical brigade: “John explained Bridges’ goal of increasing their medical presence in rural Nicaragua, especially in the northeastern region. It seemed like both my interest and Bridges’ plans could come together easily.”

“These brigades make up the human component of the large plan we have to help build a regional health center that will ensure people in the area receive the basic human right of health care,” Mr. Hannan explains, referring to the Hormiguero Health Clinic that Bridges will begin constructing in 2017. The clinic will provide 24 hour medical service for over 18,000 in northeastern Nicaragua.  The clinic is now under construction and scheduled for completion in March of 2018.

Bridges to Community’s goals for their health program echo those established by the United Nations in the new Sustainable Development Goals, which include “ensuring healthy lives and promoting well-bring for all at all ages.”

The group is made up of physicians that cover a large breadth of medicine, including pediatrics, obstetrics, orthopedics, and emergency care.  They will go down with the goals of treating local residents with acute problems, as well as screening and identifying some underlying chronic problems such as diabetes and hypertension and getting them started on long-term treatment plans.

Dr. Ingrid Mudge, also from NYP/Lawrence Hospital and who has practiced medicine for over 15 years and is no stranger to ensuring healthy lives, had always aspired to do international medical brigade work, but it always seemed out of reach. Now, with the shorter time frame and affordability of this brigade, she is finally able to.

“This is a great way to begin exploring the experience of international medical work,” states Dr. Mudge. “I have always thought that it is important for those of us who have access to high quality medical training and equipment to use those means to support communities who are not so fortunate. Having the opportunity to improve and prolong life is one of the greatest privileges of a medical career.”

The trip will be going down from November 11-19, 2017. For more information on how to get involved with Bridges to Community’s trips or programs, contact us at

Marietta College Volunteer Reflects on Bridges Trip

On the evening of New Year’s Day 2016, I was sitting in my room in McCoy Hall feeling palpably both uneasy and excited, already unpacked for a semester which was not to start for another 10 days. In a few hours, I would be departing for Nicaragua with six other students for the Office of Civic Engagement’s (OCE) annual International Alternative Winter Break trip.

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Though I had been out of the country and done a service trip before, I was uncertain about what I had gotten myself into, and the effect the journey would have on me.

Contributing to my uneasiness was skepticism. The trip seemed to have twinges of the much-derided practice of so-called “voluntourism,” in which relatively wealthy travelers couple their vacations with some service on the side, not so much out of genuine feelings of good will but rather to reduce their feelings of guilt. Was what I was about to do actually good? Would it help mend the wounds inflicted by my government, the United States government, through our direct support of the ruthless Contra guerrillas during Nicaragua’s Civil War in the 1980s? Was it a furtherance of the all too often dependent relationships that developing nations have with the developed world? Notwithstanding these doubts, I had committed to going, and after three weeks of winter break laziness I felt I needed some excitement in my life. So onward I went, piling into a van in the McDonough parking lot at 2 a.m. with the rest of the group.

Upon arrival in the capital of Managua, two employees from Bridges to Community (BTC), the organization we were partnering with, were at the airport to greet us. According to BTC’s website, the organization’s mission is “to improve the lives of impoverished communities in developing countries through volunteer service trips, and to simultaneously educate and transform those volunteers to be more aware of the connections we all share and the ways we can all impact our lives for the better.”

We flew in a tiny plane, reminiscent of a 1980s model car with wings, to Siuna and then took a bus to the community of Tadazna where we would spend most of the week. Both these communities are in the North Caribbean Coast Autonomous Region. We were told this predominantly rural area is one of the most neglected parts of Nicaragua. My initial observations seemed to confirm this. The roads were unpaved, full of jagged rocks and ruts. Due to a lack of trash infrastructure, community members have to pile up and burn waste. The hospital in the city of Siuna, about an hour away from Tadazna, would be considered small by United States standards yet serves a population of over 100,000, and operates only two ambulances that are in constant need of repair due to the poor road conditions.

But if there is an impoverishment of economic resources in Tadazna and the surrounding area, the same cannot be said of human talent, resources and kindness. We were lodged in the cleared-out bottom floor of the house of one of the community leaders. When we arrived and immediately began setting up the mosquito nets I was a little put off by the chickens, dogs, and cats running through our living space, but over the course of the week I grew used to it. Workers from the local community would arrive every morning long before the sun came up to begin making breakfast. Their children would come along, frequently urging us to chase them around or play thumb war. I think it’s probably true that kids everywhere have an insane amount of energy. I could barely keep up, but you always wanted to play with them because their smiles were worth all the exertion.

Over the week we helped to build two latrines and two stoves, but it was local masons spearheading the projects, with assistance coming not only from our group but the families that were to benefit from the work. One of the things that stood out to me the most was the great teaching ability of many in the community. Not being a particularly handy person, I was thankful to be given assistance when I was given a task I couldn’t quite get at first. They also tried their best to teach words to those of us who did not know Spanish, and openly shared opinions and details of their lives. At least on this small scale it was the gringos who were the dependent ones, not the other way around.

Every night we had a reflection with the two BTC staff members. One evening we discussed an article titled “Service Learning to Learning Service” ( In short, it argued that instead of viewing service trips merely as trips to go help those less fortunate, we should rather view them as opportunities to learn from the culture, perspectives and history of those who live in the communities we serve in, with the goal of gaining an enhanced perspective that allows us to better understand how to effectuate long-term, sustainable changes to support developing areas. To me, this idea rang extremely true for our experience in Nicaragua. We were truly students who were allowed to become temporary members of a community, and learned much more than we served. And what I learned is something I already suspected; that people and communities in the less fortunate parts of the world are just that-less fortunate. Tadazna has an excellent group of community leaders and ordinary people who work hard the whole day. They are incredibly kind, hospitable hosts, and have that quiet human dignity and decency that makes the world work. But a lack of adequate access to resources, rooted in exploitation and neglect that dates back to the days of the Spanish conquistadors of the 16th century, keeps the community in an unacceptable state where access to clean water can be precarious and minor ailments can end up being fatal.

As I gazed out the window flying back to the U.S., I thought about how to turn what I learned into action. We were 40,000 feet over the Caribbean Sea, in a sea of blue air far above cotton cumulus clouds. Seeing the earth from this height and remembering the conditions that those in Tadazna and communities like it daily face, I silently laughed at myself for some of the small personal worries I’ve ever let get to me. I considered how lucky I am to be one of the relatively privileged few in history to attend an institution of higher learning. I thought about how much the kids I had met were just like any little ones I’ve ever met in the U.S., how connected we are all no matter where we live or how we’ve grown up or what language we speak. Though the question is still open ended and complex, I know we can do our part in correcting in the injustices of the world by telling the story of Tadazna and the people we met there, by maintaining or at the very least remembering the relationships we formed. With this in mind, we can also make decisions both as consumers and especially as citizens that will bring about a more just world. Nine days in Nicaragua has me committed to doing just that.

For more information on the OCE’s International Alternative Winter Break, click here:

Bridges to Community Maternity House Exceeds Expectations

The idea for the Siuna Maternity House came unexpectedly during a community meeting in Hormiguero to discuss a proposed health center. “As we were talking about the health center, the focus shifted to a maternity house, and in the diagnostic study that we conducted, it was mentioned by almost everyone in the community.”

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The nearest hospital to Hormiguero is a 15 to 16 hour walk away, making it very difficult for pregnant women to receive the care they need during and after childbirth.

For that reason, community members prioritized the construction of a maternity house.  A maternity house is a place where women can go and stay a little before their due date, that has access to vehicles to transport women to a nearby hospital when they go into labor.

Bridges to Community volunteers began construction on the maternity house in March of 2014 with the DC-IT Professionals Group. Hugo Gonzalez, International Volunteer Coordinator in Siuna at the time, remembers that group well: “There were only four people in the group, but you could just feel the excitement. That first day, we began the foundation–digging, mixing cement–it was very difficult, but we saw that it was possible. At that moment, the passion that would continue for the rest of the project was born.”

Even on that first day of construction, community members were out in strides helping with the construction. Men, women, and children all came. “The children were helping to pass out water to everyone working.  No one asked them to do it. They just did it,” remembers Apolinar. And they came from all over, not just Hormiguero. “We realized then that the project was going to benefit more than just the community members of Hormiguero, and it has.”

Since its opening in August of 2014,  120 women have stayed at the maternity house. What came as a surprise, however, was that more than just pregnant women close to their due dates have been receiving care. Women have been coming in after giving birth to receive care before returning to their faraway homes; non-pregnant women have been coming to get their check ups done; and now, even children have been coming in with their mothers to see the doctor. Apolinar believes that this is because the closest health center can get very overcrowded and is rather small, while the maternity house has extra rooms for consultations. Plus, there is a doctor at the maternity house every day, thanks to Nicaragua’s Health Department ensuring that the maternity house be fully staffed.

Another great unexpected outcome of the project has been that community midwives are now accompanying pregnant women from their communities to the maternity house.  Since the women trust these midwives and know them well, they can help to communicate better with the doctors and ensure that the women feel comfortable and safe. One midwife from Hormiguero, Francisca, has been attending to childbirths for over 30 years. She now visits the maternity house frequently as a volunteer, and her daughter, Yadira, is now studying to become a nurse and also volunteers at the maternity house.  Both of them have received valuable trainings over the years from the medical brigades that come down with Bridges to Community, and this has been very helpful at the maternity house.

Overall, the Maternity House has exceeded all expectations, and continues to grow as a center for women’s health. Today, the soon to be mothers in Hormiguero will never have to experience a two day walk to get to a hospital when there are complications in their pregnancies and childbirths. They now have a place to go where they will be cared for and treated well.  All of that is thanks to the incredible supporters, volunteers, and donors of Bridges to Community and this Siuna Maternity House project.

Furnishings to be Donated to Maternity Center!

Masaya – Bridges Nicaragua Country Director Kenia Ramirez has announced a wonderful donation from the Nicaraguan Ministry of Health that will help us stock and furnish our Maternity House in Siuna! “Bridges will complete construction of the Maternity Clinic by July 10th and is excited to see its great impact on the people of Siuna. Thanks to the Ministry of Health, the clinic’s effect will be amplified and accelerated,” stated Director Kenia Ramirez.

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In partnership with the community, City Hall (alcaldía), and the Nicaragua Ministry of Health, Bridges chose to build the Maternity House in El Hormiguero, a rural community with limited access to health treatment. The concept of the Maternity House is a key strategy in global health planning to ensure pregnant women in isolated rural areas can receive proper treatment throughout their pregnancy.

This lack of treatment and medical attention for pregnant women is a big problem in this region of Nicaragua, where more than 18,780 people live in a very remote and diffuse set of 28 communities. Most pregnant women either give birth at home or must travel very far to reach a hospital, both of which can be extremely dangerous. We are building the Maternity House to offset this issue by providing mothers a facility with sufficient resources. Its purpose is to have a place for women to go in their last months of pregnancy where they can have access to a doctor and nurse prior to giving birth. The Maternity House will allow more consultations, faster emergency care, and greater access to medicine. Additionally, workshops will be held at the clinic to inform people of safe practices during pregnancy and birth. The before and after treatment offered is to reduce the chances of death due to things like complicated births and infections in both mother and infant.

As we neared completion of the facility, the Ministry of Health was eager to contribute to the project. They will donate 15 beds, mosquito netting, bedding, towels, chairs, a large stove, kitchenware, and a water tank. Executive Director John Hannan thanks the Ministry of Health “for providing these necessary items that will help to increase maternal and infant health.”

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