A Long Road

We often talk about the six years the women in Adelante Mujer spend in the Intercultural Medicine program at URACCAN University. These women work hard, often beginning their studies in a language that is not native to them. (Women from the remote areas of Nicaragua often speak Miskito or Rama, or another indigenous language. Those who do, will learn Spanish when they start at the university.) These women, most coming right from secondary school, begin studying physiology, anatomy, and medical vocabulary. They then add special medical areas such as the cardiovascular, reproductive, digestive and respiratory systems.  Finally, they study pharmacology, immunology, alternative medicine, and epidemiology. During all of their years, they spend time practicing their skills and seeing patients. When they are finished with the program, they take the Hippocratic oath.  

But that is not the end. They then spend a year doing an internship. They spend two years of required social service in return for the tuition money they receive from the government. Additionally, during this time, they do research and write a monograph on a specialized medical subject. They must defend their monograph to a professional panel. It is only after all of these steps that the women receive their diploma from URACCAN. They will then receive their MINSA code, similar to a medical license in the US. It is a long road, but the women in our program are becoming excellent doctors.

A graduate of the Adelante Mujer program, Dr. Joselyn poses with her new diploma.

~~~ Karen, November 2022 ~~~

We Are Strong

Last week, Adelante Mujer’s Board of Directors met.  The group meets three times a year to review, discuss, and plan the organization’s activities.

Front row from left are Mary Gorske, Sr. Doris Klein, Joan Schilke, Paula Elmer, Dr. Ann Schlaefer (outgoing). Back row from left are board president Barb Senn, Sarah Endicott DNP, RN, executive director Karen Heuberger, Rita Thomas, past executive director Sr. Diane Bauknecht, Dr. Gina Everson. Absent Jane Monahan.

As part of this meeting, we showed gratitude to our outgoing board member, Dr. Ann Schlaefer, who has shared her gifts with the board for the past six years.

 Dr. Ann Schlaefer left and Barb Senn

 We also had a display of all 70 of the women who have successfully completed our program and are now serving the population as medical doctors. It is a reminder of why we do what we do.

At our summer 2022 meeting, we had put closure to our strategic plan, so this meeting included work on our new strategic plan. As part of that process, we did a SWOT analysis. I want to share a few of the strengths we noted. First, we acknowledged the creative passion of our foundress, Sister Ann McKean, CSA, Ph.D. An organization is on sure footing when the mission can be passed on from the founder to others to carry on. Adelante Mujer is now working under its third executive director, demonstrating the continuing strength of the program. Another asset is our students. The women in our program are determined and hardworking. Their success shows the effectiveness of our program. Finally, we acknowledge as a strength, our resources. Not only do we have a committed staff and board, but we have faithful donors. Your generosity makes everything possible and we are grateful to you. 

~~~ Karen, October 2022 ~~~

Welcome to Our Newest Students

In late July, the students at URACCAN University started a new semester.  Seven of those students are new members of Adelante Mujer.  All seven are second-year students in the Intercultural Medicine program. They range in age from 17 to 23, and all have hopes to specialize in different areas of medicine, from obstetrics and gynecology to neurosurgery.

                     Yaritza, Nora, Elena, Verónica, Ashly, Adjanny, Shaimara

The women were very grateful to learn of their acceptance into the program. Here is a message from one of the students. “Thank you very much. I can’t find words to thank you for this great support that you gave me. I will always give my best at all times, thank you very much and blessings.”

Welcome to Yaritza, Nora, Elena, Verónica, Ashly, Adjanny, and Shaimara! May God bless you, your studies, and the people you will serve.

~~ Karen, September 2022 ~~

A Note from our Outgoing President

Dear Friends of Adelante Mujer,

Over the past eight years, I have had the graced opportunity to assist in the mission of Adelante Mujer as a member of the Board of Directors.

When Sister Ann McKean, CSA, asked me to be part of the board, I hesitated a bit to begin yet another task in another country. However, Ann cheerfully allowed me all the time I needed to make a decision to commit to the mission for Nicaraguan women. After some months, I responded affirmatively because of CSA’s longtime commitment to Nicaragua in the services of education and health care. I did not just commit to Ann’s call but to an inner sense of my own life of ministry to the poor whether in Chicago, Nigeria, Mexico, or Israel. Those women were calling me.

The Board of Directors, at the time I joined, needed to organize itself as guardian of the newly incorporated Adelante Mujer. We had a very humble start but we had Ann’s focused vision about whom we were serving and how they would be educated at URACCAN University. Our purpose was not to build another institution but to support women medical students at a university where they were educated to be doctors using western and indigenous approaches to health care on the East Coast of Nicaragua. This mission-in-reverse approach is significant in a country like Nicaragua where systems succumb to the issues of climate change, poverty, and a host of other issues. This requires another way to serve, namely, listening to the needs at the base and work to meet those needs. This mission focus is not on buildings but on people having specific needs. With that in mind, the Board of Directors incorporated in the USA to serve as an outside source of assistance with no incursions on systems that we, or the people we serve, have no control to change.

With our eye on the work to raise funds for women, we established standards that the students are required to achieve in order to succeed in their system. The standards are high. The work of the board has internal expectations that any student accepted into the program be financed fully at the time of their approval. The results are impressive. The mutual commitment of the students and our organization is based on trust and a local support system that helps to understand the need for further assistance. Because we help students for URACCAN University, our organization benefits the university since most of the women medical students who graduate are in the Adelante Mujer program. Within the eight years of incorporation, Nicaragua now has 70 doctors who work in hospitals, clinics and at university level as teachers.  Because of the mission-in-reverse focus on the person rather than the institution, our program is well over 90% successful in terms of assisting students who graduate and serve. All of this has happened in the last 10 years beginning with Ann’s vision and the board’s support.

I am deeply grateful to be able to serve as one of the board members who have helped to design a program that is so successful in its mission goals. I hope that the board will continue its work for many years to come. I fully intend to support their goals with any assistance that I can give. 

Esther Suzanne Hicks,

Outgoing President


Standing Strong Through the Pandemic

Though in the US the COVID pandemic is starting to take a back seat to other world events, it is still very real and current for many. It not only impacts individuals and communities through illness, but through economic setbacks as well.

Natasha Mudhar, founder of the social impact organization The World We Want, reports that “Women and girls have absorbed the brunt of the crisis, with the pandemic’s economic impact serving as just one example. Across South Asia, Sub-Saharan Africa and Latin America, a majority of women work in the informal economy (jobs that are not taxed, monitored or protected by governments), which was the first to be affected by layoffs and pay cuts.” 1 

Additionally, the pandemic has impacted girls’ educational opportunities as well. According to the World Bank, “Girls’ education goes beyond getting girls into school. It is also about ensuring that girls learn and feel safe while in school; have the opportunity to complete all levels of education; acquire the knowledge and skills to compete in the labor market; learn the socio-emotional and life skills necessary to navigate and adapt to a changing world; make decisions about their own lives; and contribute to their communities and the world… But school closures during the pandemic may have put girls at a higher risk of not returning to school, limiting their learning and future opportunities.” 2              

But through it all, the women of Adelante Mujer continue on their journey to making a difference in their world. Graduates continue to treat the sick in remote areas of Nicaragua and add to the nation’s economy. Current students continue their studies and provide medical care to people in their homes, or in clinics and the hospital in Bilwi. Recently, the students have submitted their annual reports on patients they are treating. These reports remind us of the good work Adelante Mujer students do every day.  We share pictures from their reports with you.

1 https://theface.com/life/pandemic-impact-women-girls-developing-countries-lockdown-education-gender-inequality-world-we-want

2 https://www.worldbank.org/en/topic/gender/overview)

– Karen, July 2022 – 

Doctor and Pediatrician: The Journey

This month I want to share my feelings and tell a story, a story of sacrifice, of learning, of friendship, and life lessons: a story that began 13 years ago. I decided to study medicine to relieve the pain of the most afflicted because medicine is a career in which we are at the service of our neighbor as well as our own advancement and self-improvement. Deep inside my soul had been planted the seed of a vocation for medicine. I did not choose medicine, it chose me. I knew I had all the qualities to be a good doctor.

Continue reading “Doctor and Pediatrician: The Journey”

My Soul Friend, Sister Ann











I entered the Intercultural Medicine Program at URACCAN University when it first began in 2009.  I could not afford even the mínimum program fees and had to charge them.  During my second year I was stressed about how I would ever be able to follow my dream to become a doctor.  It was then that I first met Sister Ann McKean, CSA at the convent in Bilwi, Puerto Cabezas, Nicaragua and I told her my problem.  That ángel of mine went to the university and paid my fees and when she brought the receipt to my home, I cried.  That was how I became the first Adelante Mujer student and that was the beginning of my beautiful relationship with Sister Ann Continue reading “My Soul Friend, Sister Ann”

Connecting in a Pandemic









Until December 2019, the director(s) of Adelante Mujer would travel to Nicaragua two times each year. While there, they would interview prospective students, meet with current students, and meet with the on-site coordinator. If the timing was right, they would even attend a promotion ceremony. All of these events are great ways to get to know the women in our program. Then COVID hit. 

Pandemic. Unprecedented. Social distancing. PPE. Quarantine. Virtual. New normal. Since early 2020, these words and phrases have taken on new significance. The world has changed. We have changed. Our ways of connecting have changed.  International travel has decreased by 73%, and until recently, in-person meetings were nearly non-existent. 

So how does a small international nonprofit make it work? Through Zoom, of course! Through Zoom meetings, we are able to stay in regular contact with our on-site coordinator. We can discuss the needs of the women, changes at the university, events that impact the people of Nicaragua. We also interview our prospective students over Zoom. The students at URACCAN often don’t have a computer, and some don’t even have phones. But for those determined to find a way to stay in school and who learn about Adelante Mujer, they overcome the barriers.  

Last semester, we interviewed four students, all using their phones. One had to find a spot to interview between her activities. Another had to go to a relative’s house to borrow a phone for the interview. All four interviewed well. We are only waiting for their grades from last semester to determine eligibility. The new semester starts soon, so please pray for Michayska, Jheymi, Josneira, and Arlen. They may be the next Adelante Mujer students! 

~~~ Karen, February 2022 ~~~



Think about the choices you make each day – what to eat, what to wear, how you will spend your time. Oftentimes, you have multiple options. Here in the United States, most of us have choices between wants, not needs. But in countries like Nicaragua, that is often not the case. Young university women are faced with choices such as, “Do I spend money on a taxi to safely get to my destination or do I walk tonight so that I have enough money for a meal?”  

The students in the Adelante Mujer program do not have to make that decision. Our program offers them funding for transportation to the hospital for on-site training and for a meal when they are on campus. Our program helps relieve some Continue reading “Choices”

In Their Own Words

In July, we shared that our campaign to raise money for computers was a success.  Our onsite coordinator in Nicaragua wrote, “The girls told me to say thanks for this great help and some of them said that they were going to say thanks personally, they are so happy and thankful.”  Many of the women have written to show their gratitude for the computers, and for ongoing financial support.  We would like to share some of that appreciation in their own words.

“I already received the computer and I want to thank you infinitely for the support that you and together with the Continue reading “In Their Own Words”