One Day at a Time — A Doctor’s Story in Nicaragua

A Note from our Co-founder Sam Talbot: On my recent visit to Nicaragua, I was blown away on multiple occasions. The views were spectacular. We cooked steps away from the Ocean. It was nothing short of a perfect culinary expirence. Wind blowing, waves crashing and also it was the first time I cooked dishes from the menu of Pretty Southern (my new restaurant opening soon). We did elevated organic southern food for everyone staying at Rancho Santana, and we even had a few people say it was the best fried chicken they had ever eaten! Everyone we met along the way was so kind and generous. But the Team over at the Roberto Clemente Clinic, they stood out amongst everyone. They are pushing the boundaries in Nicaragua to make sure everyone in their community has access to healthy, clean food. They offer programs to educate and assist people to live healthier lives. The clinic even has an organic garden, so kids can learn about growing their own food. Not only was I touched by the team at Roberto Clemente, but I was truly inspired and motivated to follow in their foot steps. What we aim to do at Beyond Type 1, is celebrate those who are disrupting diabetes, and, the Roberto Clemente Clinic is doing just that. Buen trabajo!
-Sam Talbot

Doctor Jose Mosquera_2

My name is Doctor Jose Mosquera. I’m a surgeon with 34 years of professional experience. In late 1984, my son, Jose Gabriel, was diagnosed with insulin dependent diabetes (Type 1). At that time, in the city where I lived in Ecuador, there were no doctors who specialized in children’s diabetes. For that reason, along with my wife, who is also a doctor, we came to the National Institute of Health (NIH) to get our little one treated and to also get some training in diabetes care.

The following year, we went back to Ecuador and realized how difficult it was to locally find insulin. We would have to get it imported from the US. We found out that there were many children in Ecuador who had diabetes, but there were no resources to properly treat it. Many children were in a coma or sadly dying due to the lack of resources.

In the late 80’s, along with two 15-year-old American boys, Jesse Fuchs and Nicolas Cutris, we founded Ayuda, Inc. The main purpose of the foundation was to start a diabetes awareness campaign in Ecuador and other countries, as well as establishing free summer camps for children with diabetes. The camps allowed the kids to share their experiences and treatments, as well as creating a record of blood glucose values and dose adjustments. The final reports were sent to their doctors for follow-ups.

At the same time, we initiated a program managed by the children’s parents to ensure insulin and other resources necessary for optimum treatment were obtained. Moreover, in conjunction with other doctors in Ecuador, we started promoting diabetes education to prevent complications from this disease.

Today, I am the clinic director and CEO of The Roberto Clemente Health Clinic. I was inspired to take this position because I particularly enjoy being able to share my experience and knowledge at a clinic which offers health care services to the community. Being an active part of the community through the different projects offered at the clinic which are so beneficial for the public is highly gratifying.

Moreover, I like to follow the example of its founders, looking for community development, not only in health, but also with wellness programs for the community.

Our clinic has to be very conservative with the resources we have; we wait for reliable resources and contributions from generous supporters. But waiting can be very hard when you care so deeply about your job, and about helping people. We advocate good nutrition and a healthy, active lifestyle … one day at a time.

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We started a Healthy Eating Initiative to battle the local high incidence of diabetes, high blood pressure, tooth decay, weight gain and anemia. Not only are we able to produce organic vegetables for the community, but we also produce enough for local restaurants. We work as a teaching community, where locals come to learn our natural techniques.

Training and education are key to support those living with this disease. Diabetes treatment is effective only if you have these three components:

  • Education: educating the patient as to how to handle the medications, perform blood glucose exams, maintain proper nutrition and daily exercise.
  • Complication preventions: educating the patient to take necessary measures to avoid complications through proper use of exercise, diet and daily activities in a healthy way.
  • Make the community aware: health providers, the community and the authorities need to be aware of the importance of providing comprehensive treatment to the population in the case of chronic diseases such as diabetes—with the objective of having a healthy community and optimizing the use of health resources.

Currently in Nicaragua, there are some official programs in place focused on chronic disease treatment, which provide treatment to those with diabetes.

The main problem I see is that patients in rural areas, such as the area where the Clinic is located, do not have enough resources to become educated and there’s a lack of adequate blood glucose control for patients with diabetes. The financial resources to cover medicines, blood glucose testing and proper nutrition are very limited for people living in rural areas. The absence of necessary resources causes severe complications, such as diabetic neuropathy, visual deficit and serious renal and cardiovascular problems.

At The Roberto Clemente Health Clinic, we presently have one doctor who specializes in diabetes. Our future plan is to concentrate on educating patients to better manage this medical condition, raise awareness in the community about the importance of properly dealing with diabetes, and if possible, to extend our current stock of medicines and home blood glucose tests.

I see the need for my medical expertise first-hand and it drives me to keep going, not only in my own work but in developing and training our team to excel every day and help many communities in this impoverished area of Nicaragua.

If you would like to learn more about our programs and how you can help, please visit our website at

WRITTEN BY Jose Mosquera, MD, POSTED 03/14/16, UPDATED 07/25/23

Jose Mosquera, MD, is from Ecuador. His son was diagnosed with Type 1 in 1984, and since then he and his wife have looked to improve diabetes care and access to supplies in both Ecuador and now Nicaragua. Currently, he's the Director and CEO of The Roberto Clemente Health Clinic in Nicaragua and has started the Healthy Eating Initiative there.