2017 Annual Report:
The Journey Towards
Health for All



Letter from the Directors



Dear friends,

For the past 10 years, AMOS has been guided by the dream of Health for All. For us:


Health means the ability to follow our dreams.

Health means the chance to live long enough to see children grow up.

Health means the opportunity to serve our community and make the world a better place.


The phrase “Health for All” was coined 40 years ago at the World Health Organization’s Declaration of Alma Ata – the groundbreaking international conference which recognized the importance of the participation of communities in primary health care. “Health for All” means that health care is about more than just hospitals and clinics and the absence of disease. Health care is integral – physical, mental , socioeconomic, emotional, and spiritual – and should involve communities themselves.


Community-Based Primary Health Care (CBPHC) is the strategy we use at AMOS, which builds partnerships with communities to train health promoters who can reach every mother, every child and every baby in remote areas with appropriate and effective health care. This year, we will be joining thousands of other organizations, leaders, and advocates to celebrate the 40th anniversary of the Declaration of Alma Ata. At the same time, we recognize that millions of people around the world still do not have access to health care, because poverty and long distances from health facilities make health care beyond their reach.


In Nicaragua, our programs now serve over 69,000 people and we continue to work to decrease health inequities suffered by the poorest people. AMOS has trained a network of 630 community health workers who help to bring health closer to the people. Last year, we continued to see great results: In 2017, there were no maternal deaths and there was a low rate of neonatal and deaths in children under age 5, in the 22 rural communities where we work.


For more than fifty years, starting with the pioneering work of AMOS Co-founder Dr. Gustavo Parajón in rural health, so many people have come together to be a part of this ministry and journey. With your help, our promoters and staff have been inspired to overcome challenges, encouraged to reach out to more people, and have worked together to improve our impact on the lives of people most in need.


Over the next ten years, our vision is to replicate the model of community-based care that AMOS has been developing so we can make an even greater impact on a regional, national, and international level. We are honored to share this report with you as we celebrate our collective accomplishments over the past year. Thank you for joining us on this journey as we share God’s love and work together towards making health for all a reality.


With much gratitude and love,






Dr. David G. Parajón

Executive Director







Dr. Laura Chanchien Parajón

Medical Director




Where We Work

69,800 people served in 6 regions




2017 Impact: A Year in Review




Rural health promoters are trained to focus on the health of the most vulnerable people in their communities – primarily pregnant mothers, newborns, and children under the age of two. They receive intensive training and support from AMOS. Through their hard work and sacrificial service, we have seen a decrease in the number of child deaths since 2012, and there were no maternal or neonatal deaths in 2017. We will continue to work in the most remote areas to reach the most vulnerable, because we believe no child should die of a preventable cause.




Our motto is that every person counts and every person is counted. Through a community census, promoters know where the most vulnerable patients live, and make sure they do home visits to check in on them. In the case of pregnant women like Ubencia, (above,) it is especially important that they get at least 4 prenatal care visits and give birth in a health center or hospital (also known as an institutional birth) and not at home, where life-threatening complications can arise.






Community clinics in remote areas are an important part of access to health care, but prevention of illness and promotion of health is just as important. This is why we also work to improve access to clean water, sanitation, and hygiene, to prevent water-borne illnesses that cause diarrhea and contribute to child malnutrition.







Saving Lives in Rural Nicaragua


It was the middle of the night in the remote community of La Danta, in the RACCS region, and María began to bleed very badly.


María was a new mother. She didn’t know it then, but she was having a postpartum hemorrhage (bleeding after delivery of a baby), and her life was at risk.


Five weeks before, she had gone to the health center to deliver her baby, and she had been hospitalized for a month due to some complications during labor. After a week of being back at her home, everyone thought she was out of danger.


The health committee in La Danta organizes their community to be ready to respond in case of emergency.

For any woman this would be a life-threatening situation, but María’s situation was even more perilous. She lives in a community located 2.5 hours away by truck from the nearest health center, where houses are miles away from each other in difficult terrain, with no paved roads, and no public or private transportation available, especially at night. For someone who is injured and can’t walk, if there is no vehicle to transport them out of the community, they would need to be carried in a hammock for 8 hours on foot.


In rural Nicaragua, cases like these are not uncommon, and many times preventable tragedies happen.

Fortunately for María and her family, AMOS works alongside the community of La Danta and has trained community health workers who know what to do during emergencies.


Even though it was midnight, “the transportation committee was able to quickly move into action to help María. They placed her on an improvised stretcher made up of a hammock and wooden sticks. On the way, they got bruised, wet, and ended up very tired, but they made it. They reached the road, where they had arranged for a truck to wait for her, and the health center staff was ready to see her”, says Lester Suárez, a community health worker in La Danta.


The emergency transportation committee in La Danta is made up of 5 people. They are a highly committed team responsible for coordinating the transfer of a sick or injured person to the nearest health center. Their volunteer service to the community is invaluable.


María survived and is now back at home with her baby and family. Thanks to the generosity of AMOS supporters, La Danta community health workers were prepared to face this challenge and prevented a baby from losing her mother. It is our privilege to walk this journey together to help save lives and promote community health.



2017 Finances

As a nonprofit, AMOS depends on the generosity of hundreds of individuals, foundations, churches, universities, organizations and corporations. We are committed to good stewardship of our resources. In 2017, 78% of AMOS’ income went directly to programs.





Our three main program areas include Rural Health, Urban Health, and our three sustainable programs: our Delegations and Volunteer programs, as well as our Guesthouse in Managua. Each sustainable program covers its own expenses and contributes funds to support AMOS’ ongoing mission. Delegations and volunteers support community projects in our Rural and Urban Health programs.



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