Integral Health Assistance to Highly Nomadic Indigenous Population

Integral Health Assistance to Highly Nomadic Indigenous Population

Costa Rica
Organization type: 
$10,000 - $50,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Assistance is provided to highly nomadic indigenous population coming from the Panamanian territory, with an integral criterion, mainly in connection with health promotion and disease prevention. The paradigm is based upon respect for human dignity, and full exercise of the right to health with a holistic vision of persons in their physical, social, psycho-emotional, cultural, migrating and labor aspects. These services are transferred to the place where said population is more easily reachable, i.e., the frontier post through which they enter the country. Assistance is provided regardless of their migration status, sex, language, etc. To the contrary, services are given privilege according to their social and cultural condition, encouraging them and adapting services as necessary.

About Project

Solution: What is the proposed solution? Please be specific!

1. “Tailor-made” health pattern for a minority population with very specific characteristics. 2. Initiative making an impact on both sides of the frontier. 3. Respect for and actual exercise not only of the right to health but also respect and reinforcement of cultural identity and human dignity. 4. Guarantee of quality, integral and free-of-charge assistance. 5. Make visible the rest of the institutions of a population which during more than 20 years had never been taken into account except to work without being acknowledged any kind of rights.. 6. The initiative is a catalyst for the empowerment of this population as persons and as workers in an integral way and with all their rights. 7. Awareness of public workers and employers of the rights of these populations. 8. Granting of health services in better conditions compared to the service they usually receive. 9. The assistance activities where planned and consulted by and for the population receiving it. 10. The education activities are delivered in their own language by people of their own cultural group.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

In the individual assistance field: vaccination, de-worming with oral medication, taking of anthropometric measurements to the underage population, specific assistance to pregnant women, privileging their well-being and that of their children to be born as also the reference for their specialized assistance in high-risk cases. , gynecological examinations, distribution and education on ant-conception methods (condoms), detection and reference for treatment of epidemiologic cases, among others. In the group assistance field: education-related activities by promoters of indigenous health on such matters as personal hygiene, domestic violence, alcoholism and drug addiction, labor and migratory rights, human trafficking, etc.
About You
Área de Salud Coto Brus (CCSS)
About You
First Name


Last Name

Ortíz Roses

Facebook Profile
About Your Organization
Organization Name

Área de Salud Coto Brus (CCSS)

Organization Phone

(506) 2773-4001

Organization Address

San Vito, Coto Brus, en el centro

Organization Country

, PU

Country where this project is creating social impact

, PU

How long has your organization been operating?

More than 5 years

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What stage is your project in?

Operating for 1‐5 years

Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.

It is a community with a social and economic condition which makes them travel during the second half of every year to work in coffee grain harvest at the farms on the Costa Rica side, because in the District of Ngöbe Bugle (where they come from) they make a living with less than one dollar per day per person. It is a community with almost intact ancestral customs and habits, they have a local government with indigenous authority with official legitimacy granted by the Panamanian government. It is a young community (23 years old-average ) and with a large number of needs in the development, education, labor and health fields.

Share the story of the founder and what inspired the founder to start this project

The need for a health pattern change was made visible in 2003, when an estimation of the costs arising from the in-hospital assistance of this population amounted to $500,000.oo per year, which was (and is) an exorbitant amount for the health service budget corresponding to the Coto Brus District account. And worse still, in spite of the high investment in health services for this population, the death toll was very high due to totally preventable diseases , mainly in children who had not yet reached their first year of age. For this reason a model was outlined with preventive characteristics, privileging healthy life styles, supported by a preventive health system with an earlier approach to disease assistance, providing accessible services to the population by getting in contact with them upon entering the country, through a “health post” located at the access pathway they use to enter Costa Rica.

Social Impact
Please describe how your project has been successful and how that success is measured

1. Dramatic reduction of infantile death toll indicators.
2. More than a 70% reduction in costs of assistance (in hospital) to the target population.
3. Almost 200 duly educated, aware health workers, who are protectors of the specific rights of the target population.
4. Joint and articulated interaction between health authorities from both sides of the frontier.

How many people have been impacted by your project?

1,001- 10,000

How many people could be impacted by your project in the next three years?

More than 10,000

Winning entries present a strong plan for how they will achieve growth. Identify your six-month milestone for growing your impact

Appropriate population assistance, recording and identification, to replicate the pattern in the rest of the migration route in Costa Rica.

Task 1

Creation and implementation of a web database to be used in the rest of the country.

Task 2

Replicate the successful material used to perform the ad hoc educational activities.

Task 3

Increase in 20 de number of indigenous health promoters in order to provide coverage to the rest of the migration route.

Identify your 12-month impact milestone

Have an integrated, interconnected, online information system to provide adequate assistance to the target population along the whole migration route in Costa Rica.

Task 1

Test the first system prototypes.

Task 2

Reproduce the successful educational material to be supplied to health centers.

Task 3

Start the formation process for candidates to be the new indigenous health promoters.

How will your project evolve over the next three years?

It must be consolidated as a permanent post (not just temporary) of health assistance on the frontier line whose paradigm should have replicated itself in at least three migration points and at least in nine points along the Costa Rica migration route.

What barriers might hinder the success of your project and how do you plan to overcome them?

One of the main barriers lies in the fact that the current installed capacity is not for more than 10,000 effectively assisted persons even though there is awareness in the sense that up to 15.000 persons are entered. However, one of the areas in which work has been carried out is in the creation of the Costa Rica Social Welfare Department (Caja Costarricense de Seguro Social) within the institution – to contemplate institutional budgets more consistent with the different challenges that are present every year (currently the CCSS provides only 50% of the total costs. The rest comes from external financing such as the one proposed by "Changemakers"). We have already obtained a partial budget in an extraordinary period, travel expenses as well as the official acknowledgement and the assignation of a budget code for the frontier post.

Tell us about your partnerships

Since this is an “Integral Assistance” initiative the paradigm requires the vision of an “integral human being” and for this reason an institution such as ours (CCSS) is limited by its legal and constitutional mandate to consider certain criterion of human integrity which are required when referring to an “integrally healthy” human being. Therefore, very interesting strategic alliances have been made, such as:
State-Owned Universities (UNA and UCR): Research and Education.
Advocacy of Inhabitants: Promotion of Rights and handling of specific juridical cases.
Costa Rican Demographic Association: ITS and HIV AIDS.
General Department of Migration and Foreign Affairs and Migration procedures.
UNICEF: Childhood and adolescence.
UNFPA: Cooperation in the creation and reproduction of educational material.
OIM: Massive migrations and subjects relating to human trafficking.
Labor Ministry: Labor – related issues.
Panama Health Ministry: Coordination and direct assistance in connection with prevention and epidemiologic issues,
among others...

Explain your selections

NGOs: external funds (World Bank, German Embassy, Andaluzian Government, etc.
National Government: Regular CCSS Budget.
Other: Contributions in kind of aware persons and enterprises.

How do you plan to strengthen your project in the next three years?

Through the integration of more players and the replication of a successful paradigm. It is intended to incorporate at least nine health areas along the migration route so that it will be a nationwide project, as well as the replication that may be achieved under the Panamanian health model.

Which barriers to health and well-being does your innovation address?
Please select up to three in order of relevancy to your project.


Limited human capital (trained physicians, nurses, etc.)


Lack of physical access to care/lack of facilities


Limited diagnosis/detection of diseases

Please describe how your innovation specifically tackles the barriers listed above.

1. Advantage is taken from temporary resources (university and high school students, medicine trainees, interns, etc.).
2. It is planned to enlarge the start up of the paradigm to at least nine points along the migration route in all Costa Rica, in order to ensure to this population the same assistance pattern regardless the place they are located.
3. Work is being performed with the purpose of having the chance to provide assistance to more complex diseases beyond the level that is permitted to us according to law in order to be able to provide better assistance to more complex disorders.

How are you growing the impact of your organization or initiative?
Please select up to three potential pathways in order of relevancy to you.



Enhanced existing impact through addition of complementary services


Leveraged technology

Please describe which of your growth activities are current or planned for the immediate future.

1. Replicate the pattern of health assistance provided to this population in at least nine additional points along the migration route (already settled CCSS Assistance Centers).
2. The diversity of service offers will be improved, e.g., Laboratory and Image Services for preventive medical assistance.
3. It is planned to propose a multiuser information system in order to interconnect it to all the points of assistance to this population.

Do you collaborate with any of the following: (Check all that apply)

For profit companies.

If yes, how have these collaborations helped your innovation to succeed?

1. With Government entities by encouraging that all institutions acknowledge this population not only in connection with labor but also as integral human beings, subject to all the rights provided by law and the constitution.
2. With employers by accomplishing and ensuring that all individual, family and labor rights be enforced.