Aug 10, 2019

How we could help Loyda to go to the dentist

The majority of people with an intellectual disability, including our core members, have never seen a dentist. Nor are there many dentist who do feel themselves able to help them...

This is not because they have such excellent teeth, but simply because from early on in their lives they never received the same dental care as their family members, no doubt partly because they were not able to indicate when they suffered toothache. Moreover, there are very few dentists who feel capable of handling intellectually disabled persons. So we should count ourselves lucky that the teeth of Daniel, Miguel and Manuel look quite good. Unfortunately, the teeth of Maria Helena and Loyda look less strong, and at their relatively low ages they are already missing several molars and incisors.

Bleeding gums
For several days Loyda was suffering from bleeding gums. We asked her mother, doña Yolanda, to take her to the dentist in the hospital which treats patients free of charge. She came back quite indignant: the dentist had not even looked into Loyda’s mouth and had told her to use a spray to stop the bleeding and to return after one month.

Through a doctor couple, who happened to be on a visit to Juigalpa to get to know our Ruach Foundation, we got the address of a dentist relative of this couple with whom we were able to make an appointment for a check-up three days later. Private dentists have their own practice and their own prices, but dr. Baez, the owner of the Christian Dental Clinic Mana, offered us a reduced fee. So we went, including doña Yolanda. Of course it was difficult to get Loyda to open her mouth wide and long enough for the dentist to properly assess Loyda’s dental status. Loyda had an infection caused by a bad tooth and her teeth needed a thorough clean. Treatment would be easiest if it could be done under a general anaesthetic. So a plan of action was required, because treatment under a general anaesthetic requires the presence of two dentists and an anaethesist and a bottle of oxygen. We were not charged for this visit, and also we came home with a special toothbrush and a spray to alleviate Loyda’s pain to some extent.

Step 1 was to order a blood test for Loyda at the local lab through our doctor-friend. The blood test indicated it was safe for Loyda to have a general anaesthetic, so we could plan a date for the treatment. Step 2 was to deliver a bottle of oxygen from the doctor’s practice to the dental clinic. A female friend was happy to do the driving, but who would have thought an oxygen bottle could be so heavy (see picture above)? We were lucky enough to have manpower around at the right moment for loading and unloading…

So last Tuesday Loyda was back in the dentist’s chair, surrounded by two dentists, dr Baez’s wife, the anaethesist, doña Yolanda, and myself. Before starting the procedure, we got dr Baez on the phone. He was in the US for a week, but he made sure everyone and everything was in place for this procedure: his colleagues who agreed to work free of charge, and the oxygen bottle from another doctor also made it available to us for free. Dr Baez prayed on the phone and asked for a blessing for the operation. It was a special and moving moment which was followed by a one-hour operation.

I had not thought of the transport to get Loyda back home, so I had to arrange this on the spot. But again, ‘good befell us’: Jorge collected her in his car. And because he is also a doctor, he stayed to give Loyda her injections (anti-biotic and pain killer) which we had bought in the local pharmacy. Jorge came back the next day to repeat the injections, saving us the trouble and cost of finding a nurse to do this.

What’s next?
Loyda is still recovering. Three molars were pulled out and her mouth was cleaned quite thoroughly. She slept the first night sitting upright to avoid the risk of choking. For days she only wanted to drink, was tired and weak. Gradually she starts taking solid food again, but she is not yet back to her ‘old self’.

We had to collect money for buying the pills she needed, because doctors are good in prescription of several pills for recovering...We were lucky that, as icing on the cake, the owner of the pharmacy accepted our written request to donate to us the gel that promotes Loyda’s recovery; just another example of together making a difference and t life being full of surprises.

How you can help to support in the needs of Loyda and the others of the community home


Eric writes:

'Since almost the start of the work in Nicaragua I do what I can to support the Ruach Foundation in Nicaragua.   Astrid Delleman, the coordinator of Ruach’s community home and activities centre, is a friend since student days. My plan is, once again, to do a 50 km sponsored run in my home town in the Netherlands on 14th September,  to raise money for Ruach and be a visible amassador of the good work they do. Please sponsor me, donating on the GlobalGiving Ruach page.

When: using the GlobalGiving’s Little-by-Little matching campaign fund.

What is the best time to donate? Monday August 12,  2019, from 2 pm in England, from 3 pm in the Netherlands. In the US  from 09:00:00 ET on Monday, August 12, 2019.

Any donation any time will of course be gratefully received, but a donation on the dot of 2 pm Monday 12 August, or shortly after, will give Ruach a good chance of a TOP-UP of 60% from GlobalGiving’s Little-by-Little matching campaign fund.

This month the Ruach Foundation is ranked 381 out of 5246 members, which means Ruach is a GG Superstar! GlobalGiving will match any donation to their Superstars up to $50 (or roughly £40) by 60%. However, the matching funds are restricted to $60,000, and they will be allocated on a ‘first come, first served’ basis.
Get the point? Your timely donation of £5.00 will become £8.00 due to the GG bonus, or £10 if you are an English tax payer and can claim 25% Gift Aid by ticking the appropriate box on the donation page!

My contact details:; 01935 592185; or mobile 07 4484 95085'.

loyda with the dentist team
loyda with the dentist team


Jul 17, 2019

Together we make a difference in the lives of Loyda and Daniel

Siblings Daniel and Loyda have been with us from the beginning of the community home, and have since then done well. Before they joined us, they were malnourished, were used to sitting on the floor trapped in their own world, and gobbling up their food.

Since they joined us we have been intensively working with them to make contact with others. They now respond to the adapted and simple stimuli we provide; they are toilet-trained, barring the odd accident. Loyda has stopped putting most of her ring finger up her nose and does not lick her arms anymore the way a cat licks its paws.

At first Loyda found it difficult to get from the curb onto the road, but now she can even get up and down the stairs using the banister. Her stamina is improving by the week, and she has no trouble anymore getting in and out of a car. Her responses to others are still minimal, but she will look at people she knows if they appear in her field of vision.

Daniel has made more progress in communicating with his house mates. He can walk up to us and give someone a caress, clumsy as it may be, or put his arm around someone. It does not happen often, but he is definitely more focused than his sister on what is happening around him. All core members, including Daniel and Loyda, can fetch their plate of food from the kitchen and take the empty plate back. That’s a huge achievement, because it makes it easier for us to involve them in other activites as well.

Where is the limit?

The results come, but slowly, especially with Daniel and Loyda who have had no stimulation from anywhere for many years. They do not express themselves verbally. We have to closely watch them to know what they need and to respond to that. Working with them requires a lot of creativity to try out various methods and techniques to find out which ones work best. We hope of course to get to the point that Loyda and Daniel will be able to use a minimal vocabulary. But whether that is feasible? Who knows where the limits lie. Our philosophy is that it’s always wrong not to have tried.

Unfortunately, we are still dependent on generous donors!

On Thursday, July 18th, GlobalGiving is promoting the July Bonus Daycampaign! And we use the campaign to raise funds for our Ruach Foundation in Nicaragua:

  • $ 100,- covers the cost of the meals of one resident of our home for an entire month
  • For $ 75,- we can buy disposable diapers for Daniel en Loyda during the night as they are not fully toilet-trained for an entire monthTogether we can make a difference
  • $ 25,- covers the transport costs to enable Manuel and Miguel to attend sessions at the activities centre for a whole month

GlobalGiving has committed itself to match donations starting at $100 and up to $1,000. The higher the donation, the higher the match. Make your gift count! Through the bonus you make your gift bigger than just what you give! Donating is easy, by pushing the ‘donate’ button on the page: projects/ fundacionruach

               Together we can make a difference! We showed it.

We ask you to make a donation on the 18th of July, between 9:00 a.m. ET to 11:59 p.m. ET (US East Coast time), or between 2 pm on the 18th until 4 am on the 19th of July in the United Kingdom

Thank you for feeling yourself part of our work!


Jun 24, 2019

A summary of Ruach's external evaluation

Our donor VivirJuntos paid the costs of an external evaluation that took place last November. We are existing about three years. So time to look more carfully how we are doing. The general aims of the evaluation were: (i) to find solutions to the weak points Ruach may possibly have in its planning and implementation of certain activities, and (ii) to become financially less dependent on funding from abroad.

To fulfil these aims an independent adviser conducted 14 interviews with Ruach stakeholders. She also visited Ruach several times to observe what was going on and held focus group interviews for Ruach board members, employees, beneficiaries and outsiders.

The highlights of the 30 page report are given below:

To what extent does the Ruach Foundation lives up to its mission and fulfils its targets, both in qualitative and quantitative terms?

Ruach’s current activities are in line with its mission and its targets. Ruach has managed to respond to the needs of the poorest among the poor. The quality of work in the home is very good. Participation of Ruach’s core community members and the two live-in carers is encouraged. There is a positive sense of connection and security. The quality of work in the activities centre is also good, in spite of the fact that the number of participants has declined. The dynamics and participation of the beneficiaries is very good. The intellectually disabled participants irrespective of age feel connected to the centre. They love their activities there and feel they are part of a process. The supervisor of the activities centre is well regarded.

Doing activities should empower both participants and staff. This is best achieved by working in small groups. An increase in number of participants would result in opportunities to offer a wider range of activities better focused on participant’s skills and preferences.

Evaluation of the working methods:

The Ruach Foundation has now existed for 2.5 years. The activities centre started in May 2016, the community home in August 2016. Ruach has gained rich experience in the community home, but the success of the activities is negatively affected by a decline in the number of participants.

The care and stimulation of the core members in the community home has been exemplary as can be clearly assessed by the progress made by the functioning of each of the core members. Likewise, Ruach has given valuable support to the staff working in the Home. These successes are based on the methodology used, the work protocols and the monitoring and evaluation tools used to assess the progress of the core members. In the early stages the core members are closely observed to ensure that they gradually get used to the routines in the home. Videos of Daniel and Loyda made throughout their stay at the Ruach home clearly verify this. The other strand in the success of the work in the home is that two members of staff who work in the home for at least one year have internalized the processes of caring for and paying attention to the core members.

There are big limitations in recruiting staff with specific qualifications. Therefore recruited staff are enrolled in an in-service training programme to tune them in to the needs of the core members, which requires patience, and a focus on repetition of activities and routines. Due to a lack of technical knowledge, training and experience, several employees have struggled to come to grips with these needs, and this initially resulted in a high staff turn-over. Progress has been made in this respect as Ruach now has got two home assistants who work with experience and dedication. Two other staff members only recently joined Ruach, but feel they are working in the right place.

In the activities club the supervisor is a relatively new recruit who works hard to get to grips with the methodologies she ought to use. She is making good progress and relates well with the people who use the activities centre. The key to success is the implementation of the methodology through protocols and work routines.

The decline in the number of participants is difficult. The reasons for this decline are: the limitations in the ability of the families of the participants to take their relatives to the centre; the current political situation resulting in a decrease in perceived safety, and an increase in economic hardship. Personal health issues also play a negative role for some participants


The external evaluation was completed just before the long holiday break. We are grateful for the clarity that the evaluation has given us. As the coordinator of the home and activities centre I am of course happy with the positive assessment of the care we provide. It is clear that there are issues we need to address in order to give Ruach a stronger foundation. Immediately after the summer holidays we started preparing a new work plan.


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