We currently operate an elementary school in the town of Jalapa, Nicaragua. The Jalapa Valley is near the northern border with Honduras. It was a battle field during the 1984 war. The valley is very fertile, and tobacco is grown in the area. Unfortunately, tobacco farming practices cause illness and declining levels of health in the area. Nicaragua is one of the poorest countries in Central America.

HHHE has been involved with helping people in this region since 2006. The president of our organization, Mr. Narayan Shrestha, was introduced to this area by a retired professor, Dr. Paul Jedamus. Ever since Mr. Shrestha’s first visit, he fell in love with the people and wanted to do something for them. Thus far, we have brought 11 temporary dental clinics and 3 temporary medical clinics to many different parts of the Jalapa valley. Our elementary school, The Sreejana Bilingual School, provides English language and quality education as we have done in Nepal. We also have a good relationship with the local government and the people of this valley welcome us.

Scholarship Program

We have recently started a Scholarship Program to help the children of Jalapa attend the Sreejana School. We want to make the excellent education of the Sreejana school available to families for whom the cost of attending school is prohibitive. Click on the button below to find out how the program works and to contribute to it. 

We can organize trips to Jalapa throughout the year. Please inquire if you’re interested.

Basic Itinerary for Jalapa trips:

  • 2-week trip, including travel time
  • 9 days in the village
  • 4 days in surrounding cities and tour of Ome Tepe (an island within Lake Nicaragua)
  • Total Cost = $2,200 (all inclusive, including international airfare)

Healthcare information about Nicaragua:

Health in the Americas: Nicaragua
WHO Statistical Profile: Nicaragua
Equity, Access to Health Care Services and Expenditures on Health in Nicaragua


Nicaragua occupies a landmass of 129,494 square km. Close to 20% of the country’s territory is protected as national parks or biological reserves. The country is bordered by Costa Rica on the south and Honduras on the north. Nicaragua’s economy has historically been based on the export of cash crops such as bananas, coffee, sugar, beef and tobacco. At present agriculture constitutes 60% of its total exports which annually yield approximately US $300 million. Nicaragua ranks among the poorest countries in the Western Hemisphere. The reduction in inflation, economic growth and privatization has not helped with Nicaragua’s many social issues. 48% of the population in Nicaragua live below poverty, unemployment is 38%, and another 46.5% are underemployed.

The health sector encompasses both the public and private sectors. The public health sector consists of the Ministry of Health; the Nicaraguan Social Security Institute; and the health services operated by the Ministry of Government and by the Ministry of Defense. The divisions of the Comprehensive Local Health System (SILAIS) represent the Ministry of Health in technical and administrative matters at the departmental level. The private sector includes hospitals, clinics run by health insurance management companies, and nongovernmental organizations.

The general mortality rate was 26.5 per 100,000 population in 2000. Infectious diseases fell from fourth to fifth place among the leading causes of death in the last two years, with the number of deaths attributable to this cause down by nearly 50% from 1996. Acute respiratory infections were the most common noticeable disease with an incidence rate for the 1997-2000 period of 2,658 per 10,000 population. Children under 5 years of age were the hardest-hit, accounting for 57% of all treated cases of the disease. The mortality rate was 6.47 per 100,000 population, with the hardest-hit group that of children under 1 year of age, which accounted for 55% of all fatalities.

The equipment is insufficient and its use is limited by lack of resources for operation and maintenance. In 2000, of all available equipment, 73% was used for diagnostic and treatment purposes and in direct support of medical care; 82 % was in hospitals but only 73% was in proper working order. The health centers and health posts had 18% of equipment.

The percentage of children in rural areas suffering from some degree of malnutrition was 32%, compared with 19% in urban areas. The mortality rate for all forms of malnutrition was 11 per 100,000 in 1998. Though iodine deficiency is not a public health problem in Nicaragua there are still high-risk groups in the South Pacific region where the prevalence of goiter in certain communities is over 20%.