Volunteer Nicaragua
Internships - Spanish - Experiential Learning Programs in Nicaraguahttp://www.nicaraguainternships.com
Health Care Program
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» Comparative Health Care Program
Health care internships in both Costa Rica and Nicaragua

NICARAGUA AND COSTA RICA : Two very different countries with different levels of development.  Learn first hand how each country’s different histories, development paths, cultures, health-care systems, and socio-economic conditions influence access to health care and epidemiological profiles. 
This program not only provides students with practical clinical and/or health-care experience, but also demonstrates to them first-hand how socio-economic conditions influence health and the provision of health care. 

The program begins in Costa Rica, working through Costa Rican Internship Institute (CRINI).   Upon arrival in Costa Rica, interns will receive an extensive orientation that includes readings and lectures on the Costa Rican health care system and epidemiological profiles.  Participants will then spend one month interning at a health facility.  Interns will have the opportunity to work at either a rural or urban clinic, a children’s nutrition center, a school for disabled youth, a nursing home, or other health-related facility.   We match your skills, field of study, interests, and experience with those of the health facilities we work with.   

After completing the Costa Rican internship, interns will then travel by bus to Granada, Nicaragua.  Upon arrival, interns will also receive an extensive orientation to the health care system in Nicaragua and its epidemiological profile.  They will then spend one month working through Viva Nicaragua!
at a facility in either the city of Granada or rural areas in the south-west of the country.   Internship work will be similar to the work done in Costa Rica, and includes work in hospitals, clinics, children’s nutrition centers, schools for disabled youth, women’s health clinics, health education facilities, NGO’s, nursing homes, or other health-care facilities.  Upon completion of the internship, interns will return to Costa Rica   for their return flight.   






Participants must be currently studying medicine, nursing, public-health, or other health – related field.  Proof of enrollment (transcripts) is required.  Medical professionals are also welcomed.

Interns must have an intermediate or advanced level of Spanish.  If upon arrival it is determined that participants do not have the required level of Spanish needed to complete their internship, they will be required to study Spanish
at one of our partner Spanish schools. 

Proof of international medical insurance





Included in the program fees: transportation to and from the airport, orientation, lectures and readings on each country’s health care system and epidemiology,
internship placement based upon careful review of the intern’s application, family stay with all meals and laundry included in both Costa Rica and Nicaragua, bus transportation to and from Nicaragua, pick-up in Granada, project support in both countries, written evaluations in each country, and 24-hour assistance for any reason.

Not included in the program fees:  Airfare, border crossing taxes (approximately $15), Spanish lessons (if required),  and personal travel expenses (US$400 monthly in Costa Rica , $200 monthly in Nicaragua )





There are several social and economic factors which influence health.  These include: unequal access to health services, lack of education, and poverty.   Costa Rica and Nicaragua are very different countries with different histories and levels of economic development.  They are perfect locations to observe
first-hand how these socio-economic conditions influence the provision of
health care and  health.

Having the opportunity to experience the health care systems of Costa Rica and Nicaragua back-to-back helped put everything in perspective for me. After I worked with a health care outreach worker in Costa Rica, I was able to fully appreciate the challenges Nicaragua faces in bringing its health indicators up to the level of Costa Rica's.
-Jessica Gould, 2006, Pitzer Unviversity

Venturing into Latin American, I never expect to see such dramatic differences between bordering countries. Traveling from Costa Rica to Nicaragua remarkably demonstrates the effects that political and economic differences have on regions.
-Greg Contente, 2007, University of Michigan

Studying the public health care system of Costa Rica and observing the effects of an impeding private sector highlights the positive aspects as well as the pitfalls of the two systems. And once compared side by side to the private/aid funded hospitals of Nicaragua, the differences between the two systems becomes drastically apparent.
-Samatha Feeld, 2006, Pitzer University .

Costa Rica is one of the most developed countries in Central America.  It is well known for being a country of peace and democracy.  It has never experienced extended wars, as in other Central American countries, and because of its geographic location is not prone to natural disasters. This has allowed the country to devote more resources to economic development and improving socio-economic conditions.

Costa Rica abolished its army in 1948.   With no military spending, it has been able to devote more resources to social programs such as health care, housing, and education, as well as infrastructure, such as potable water and sanitation systems.

Costa Rica has a universal health care system, meaning that the entire population is covered by the health care system.  The State, employers, and employees pay into the system  in order to provide health care for all, including the unemployed, informal workers, and non-residents (many Nicaraguans) who do not pay into the system.  The system is divided into health-care outposts in rural areas, EBAIS (primary care facilities with teams that go out into communities to educate and provide primary care), clinics, hospitals, and specialized hospitals. Costa Rica’s universal health care system, combined with higher levels of education, greater socio-economic development, and improved infrastructure has resulted in improved access to health care and improved health including  lower infant and mortality rates, greater life expectancy, fewer infant deaths from diarrhea and respiratory infections, and lower incidences of infectious diseases. 

Costa Rica’s health care system, while rated as one of the best in Central America, and number 36 in the world (the United States is rated 37), has faced many challenges in recent years.  There is limited access in some rural areas, especially indigenous communities.  The number of non-contributors, including migrants and employers who do not pay into the system, has put a strain on the system, and made it difficult to require modern equipment, certain medicines, and improve infrastructure.   Additionally, a greater gap between the rich and the poor allows the wealthy to use private health care facilities, and complain about the fact that they are paying into a system that they do not use and are subsidizing the poor, unemployed, and migrants. 

Nicaragua, in contrast, while currently politically stable, has a long history of dictatorships, wars, corruption, and natural disasters.  These factors have impeded the country’s economic development, making it the poorest Central American country. Years of military spending and government corruption have limited the ability to invest in social programs and infrastructure. Most of the population has limited access to health care facilities, education, and potable water and adequate sanitation.  This, combined with high unemployment rates (with approximately 75% of the population unemployed or working in the informal sector) low salaries (a minimum wage of under $100 per month), and high birth rates has resulted in limited access to health care facilities and poor health indices including lower life expectancy, high infant and maternal mortality rates, malnutrition, and higher rates of morbidity and mortality from infectious diseases and illnesses including diarrhea and acute respiratory infections. 

The health care system in Nicaragua is provided by the State (the public system), insurance companies, private health care facilities, and non-governmental organizations. A majority of the population (over 60%), including the unemployed and informal workers, have access to  the public system.  Because they are unable to pay into the system, it is funded partially by the state but primarily by international donations.  Access is limited, especially in rural areas. Resources, equipment, and medications are often scarce.  Workers pay for health insurance and are able to use clinics for insured workers (about 10%).  Those with greater economic resources (about 15%) are able to use the private system which has better equipment and no waiting lists (which are a common problem with the public system).  NGO’s fill the gap, providing care to many communities without access to health care services.  Some Nicaraguans travel to Costa Rica for health care, where because of the universal system, they are able to receive better care at little to no cost. 

Nicaragua is trying to improve the system by improving primary care.  They have formed teams to visit rural communities and to educate the population on hygiene and the importance of pre-natal care in efforts to reduce infant and maternal mortality rates as well as infectious diseases. They have managed to lower birth rates, increase life expectancy, and lower infant and maternal mortality rates.  While faced with many challenges,  Nicaragua is a country that, despite its numerous problems, is working to improve the health and access to health care of its population. 





1) Download and submit your application to apply@nicaraguainternships.org  

2) Submit your resume and two original or scanned copies of recommendation letters. 

3) After receiving your application material, we will send you a confirmation letter  begin the application review process.    

4) Upon careful review of your application, we will notify you if you have been placed. You are not officially accepted into the program until you receive a placement confirmation letter. This process usually takes one week to ten days.

5)  If accepted, you will then receive a placement confirmation and letter and an invoice for the program deposit.

6) Mail a signed copy of your application along with your deposit to:
Viva Nicaragua!
P.O. Box 210
Granada, Nicaragua
Central America

7) There will be no refunds after the program has begun. In the event of a personal emergency, we will review the situation and may issue a partial refund.

8) Complete payment is due on or before your program start date.




Questions? Contact us!


“The support was great! Whenever I had a question or a problem I felt very comfortable asking for help or advice from Carrie and Marion.” – Jessica, Public Health/Nursing, 2011

“This program allows you to see the context of the people you are serving and really see social justice issues as multifaceted and interrelated while making tangible contributions to the community.” – Cristina, 2011

“Viva Nicaragua is a great opportunity to view the reality of the world. ...At the end of the day, you learn so much more on your own and you feel like you YOURSELF, have made a difference. “ – Mary , 2011

“It (my homestay) was amazing! Martha (my homestay mom) made the effort to sit down and talk with me…and the entire family made the effort to make me feel comfortable”. – Jessica McFadden, 2011

Nicaragua Internships
The opportunities are endless and you are really given the freedom to bring all of your skills, abilities, life experiences, etc. and creatively contribute them to your project  A beautiful and unique opportunity.
Morea Steinhauer
- July 2009

Voluneering NicaraguaIt (the program) is such a life changing experience.  You learn a lot about what you are capable of achieving, your ability to adapt to different cultures and environments and potential career opportunities.  Living, even for just a short time, in a developing country places a whole new perspective on the world and the conditions that many people live in everyday.  It really is an amazing learning opportunity and overall a fantastic experience.
Kathlyn Parr
- Summer 2009

Volunteer NicaraguaIt is great because you receive a cultural experience with a built in network of peers going through the same things and your work is tailored to meet your interests.
Graham Robertson
-Summer 2009

Volunteering in nicaragua!
"I received more than enough support from Carrie.  Whenever I needed any assistance or help, she was always there with resources and helpful ideas.  It is actually amazing how much she devotes to the program.  Her time, life, mental and physical health, are at the disposal of Viva! Nicaragua interns.
Trista Budzynski,
- July 2008

Nicaragua Internships
“Most mornings we work on micro loans for youth; in the afternoons we plan workshops, visit neighborhoods, or do random errands.  At night, we teach English classes in the outskirts of the city.  Our classrooms are dirt roads between houses.  Students drag out plastic chairs and we teach as dogs run by…After class we often gather in a circle and they tell us myths and legends, or we play games in the road.  Since many kids can’t read or write in Spanish, our teaching style has become increasingly more creative.”
Viva Nicaragua!  Interns,
- July 2008

Viva Nicaragua!
Working with a Nicaraguan NGO, I accomplished more than I ever would have been able to back home. My college leveled skills were greatly
appreciated and I was quickly given responsibilities and respect. I proudly watched my individual work have a direct affect on the people of the local communities. I even had someone stop me on the street to thank me for volunteering in Nicaragua.
Greg Contente,
- August, 2007

Volunteer Nicaragua
“Yesterday  we piled in a jeep and drove down the packed sand beach of Lake Nicaragua, past coconut trees and wooden boats to spend  the day in a remote village providing health care, armed with only a  stethoscope, bathroom scale, and duffel bag full of cough medicine and antibiotics.” 
Viva Nicaragua! 
- Intern, June 2007

Carrie also has cooperative relationships with many Nicaraguans running charitable efforts in the area of Granada and often works closely with them in providing opportunities for students.  Many of these are women running cooperatives, orphanages, clinics, and food programs and are remarkable people.  We very much admire Carrie's approach, in that she works hand-in-hand with the Nicaraguans' efforts to help themselves and each other, and doesn't "overrun" their efforts with her own.


Carrie is approachable, careful, thoughtful and professional in all her dealings with students and those in the community; she is well-respected there.


It’s a wonderful program for anyone who is looking to be creative, independent, and integrate into a community and society.



Nicaragua Volunteer