I'd like to share two separate stories with you this month. One is a brief snapshot of two of our patients, written by Maria Jose Montiel, a Nicaraguan student of Communications who sometimes interviews patients for us. The other is a blog post by one of our interns, Paige Preston, a student at University of Southern California. Both offer perspectives into our work in the world. I hope that you will enjoy the inside view.
Thanks, as always, for making our work possible!
Susan Dix Lyons
12 Hours of Travel
By María José Montiel Castillo
From a far-away community – farther than San Pedro del Norte – in the department of Boaco came Elena Rios and her daughter Claudia. They had traveled a long stretch to arrive at Clinica Verde, arriving with closed faces that made it difficult to read their moods. This bearing is common among women in Nicaragua, who present themselves as humble and submissive according to the cultural roles of women and men in society.
Claudia, 17, had come for a consult: She was extremely thin and fragile, appearing malnourished and coughing frequently. Her mother Elena, 38, also appeared worn and concerned for her daughter, who she said had problems with her blood pressure and ovaries.
“The illness made me come,” said Elena, while her daughter withdrew shyly. Together they had discovered Clinica Verde when they passed the clinic on a bus and they decided they liked the way it looked. And, Elena added, they needed to go somewhere where costs were low. Basic household expenses made healthcare difficult.
Both mother and daughter said they were housewives. Claudia was the youngest of seven siblings. Elena said they were also looking for a psychologist for one of her other daughters because she was often depressed. Concern was etched in her eyes as she shared that she didn’t have options because there is no health center near her community.
For Elena and Claudia arriving at Clinica Verde was an odyssey, taking them 2 hours on horseback and 10 by bus. Elena said she wanted only the health of her daughter – it was the only thing she could offer her. She said her daughter wanted a different life, but she didn’t know how to help or please her. Claudia said she had left school. Her mother showed no emotion. Resignation invaded her.
The two women prepared to see the doctor.
This story is simply a snapshot of some of the patients we have the honor to serve. The names of the patients have been changed.
María José Montiel Castillo is a student in the School of Communications at the University of Central America.
• • •
More than Just the Facts
By Paige Preston
I had all the facts—the first trip, the million dollar fundraising campaign, the number of people seen and served in the first year of operation. I would tell anyone and everyone that would listen about this ambitious vision that had turned into an amazing clinic in a small town in Nicaragua. No matter how much I believed that there was a mighty force for good working behind Clinica Verde, I would see doubt in other people’s eyes. I could only throw more facts at that doubt, and I knew that would never be enough.
In many ways I agreed with them and their skepticism. In their position it would take more than a 16-year-old who had never even been to Central America, let alone Nicaragua or the clinic, to make me believe in what could be perceived as an idealistic mission. I would need more to convince me as well. When I finally did make it to Boaco, Nicaragua two Februarys ago for the annual board meeting, it is quite possible that I spent more time in our van driving to the clinic than I actually spent inside. I had seen the drawings, prototypes, and photos of Clinica Verde, but nevertheless as we drove up to the gate, my breath was taken away.
Perhaps it was the direct contrast between the numerous sheet metal “houses” I had passed on our way, but the clinic looked beautiful. I understood the sense of relief that a patient would feel as they arrived, as well as the hope and security they would feel once inside. For the time I walked around the clinic, I evaluated all that I saw. I am no medical professional, but I tried to objectively observe. I noticed people looking genuinely comfortable in the waiting room. I noticed natural light flooding in from widows and skylights, and fans to keep the temperature cool. I took note of the brightly colored walls that inspired warmth and power. I saw a smiling staff that was Nicaraguan just like the people they served. Seeing it in person, the why care? Why bother? What’s so different? And all the other answers to the questions that founded the doubts I had faced became illuminated.
Clinica Verde does not just treat the symptoms—it heals the person. I was not sick upon arrival at the clinic, but nevertheless I left healed, hopeful, and somewhat relieved that a place like Clinica Verde in all its idealism could actually exist. It is a clinic that could be placed anywhere and would continue to challenge the norm for healthcare. It’s a new model that is not only for those who can pay for the best treatment and care, but for the poorest of the poor as well.
It has been a year since I saw the clinic for those brief few hours. That initial impression has not left me. I believe now more than ever in Clinica Verde. When people ask me now why Clinica Verde matters, I can give more than just facts. I can tell them that mine is not a blind belief in the mission, but that I have seen it and the work being done there will truly change the world. I can tell them that it is a place I would be honored to receive treatment from. For those who doubt it, I challenge them to go see for themselves, see how this clinic is different. Don’t simply rely on my story, but dig deeper, decide for themselves, and then share what they discover.
Paige Preston is a sophomore at the University of Southern California studying Political Economy. She has been an intern with Clinica Verde since her freshman year of high school, volunteering and contributing research.
Julieta came to Clinica Verde from El Jocote, an area that belongs to a municipality in the department of Boaco. To get to the clinic, she woke at 4 in the morning.
"We have to walk 30 minutes, then grab a bus or truck, then take another bus that brings us to Boaco. It takes us over 2 hours to make the journey."
Julieta says she has come to Clinica Verde many times with her mother and children. “The nurses are very friendly, the doctor (Dr. Miranda) also." As a patient at Clinica Verde, Julieta contributes a “donation” to the clinic for the services provided. She says the fee is lower than at other places with medications. Recently, Julieta shared, she had to pay 1,600 cordobas (approximately $62) for exams at another health institution, and she’s still trying to pay the last 450 cordobas ($17). She hopes that Clinica Verde will one day have a laboratory and provide such exams “at a lower cost, because sometimes her family has to go without eating in order to cure our children of their illnesses.”
Julieta has 7 children – 5 girls and 2 boys. On this visit to Clinica Verde, Julieta came with her younger daughter, Mariana, 19 years old. It is her third visit to Clinica Verde, and she arrives with pain in her throat. Dr. Nubia Huete diagnosed her with pharyngitis and malnutrition. Mariana weighs 38.6 KG (aoubt 85 pounds). Julieta’s other daughter, 22-year-old Valeria, had visited Clinica Verde recently with stomach problems.
“I am very grateful to the doctors and Clinica Verde," said Mariana. “My Mom has received treatment here and also much of my family.”
Message from the Founder:
We love to share stories of our patients, which highlight our challenges as well as our triumphs. Julieta and her family underscore our challenge providing transportation to indigent patients, and also our need to expand our services. Clinica Verde is seeking funding to support a van and to begin laboratory services.
The question of patient fees - or, in our case, a requested "donation" - is also something we're always reviewing. In trying to create a sustainable financial model, Clinica Verde experiments with services that produce revenue while not interfering with our primary purpose to serve those in need. How do we reach the most patients, providing excellent care and education, while contributing to our long-term financial health and sustainability? In the coming months we'll continue to explore this, looking at ways we can expand our U.S. student education program, consider occasional specialist services such as dental, and open an in-house laboratory. We welcome ideas and feedback from our supporters!
In other news we'd like to share: Our wonderful clinic director, Dr. Alba Castillo, has breast cancer and begins chemotherapy this week. Our Clinica Verde staff has been coached and trained to help cover her duties while she goes through treatment. Please hold her in your prayers.
Thanks, as always, for your wonderful support! We couldn't do our work without you.
Dear Awesome Supporters:
2013 was a wonderful year for Clinica Verde as we continued to expand our services, strengthen our partnerships and serve our patients. Here are a few highlights:
In 2013, we ...
• Served 14,415 patients.• 37% of our patients were women of fertile age. We increased our number of prenatal controls 30.5% over the previous year; 72% of these patients came to CV in the first trimester of their pregnancies.• 19% of our pregnant patients were adolescents; of these, 48% came from rural areas.• 31% of patients were children under age 5. Of these, 12% of children under the age of 1 were underweight and 27% of children between the ages of 1 and 4 were underweight.• 19% were adults over 50.
As we reviewed the year, it became clear that there's a need for services for the larger community. With that in mind, we're continuing to serve women and children, but we're making it clear that Clinica Verde is a community health clinic that serves all patients in need of excellent care, compassion and health and nutrition education.
In the coming year we plan to continue our cervical cancer screening program, and amp our program to address adolescent pregnancy. We'll be starting Clinica Verde's Youth Club sometime in the coming months. This excellent idea came from CV Administrator David Narvaez, who was shaped by his experiences with a youth club in Nicaragua himself. David submitted his plan as part of our "Great Ideas" contest for employees in 2013.
Lots of good things happening! Below is short story about one of our cherished patients. I hope you enjoy! Thanks, as always, for your kindness, compassion and generosity!
Maria Elena is a Proud Mother
(Note: Names have been changed to protect the privacy of our patients.)
By Maria Jose Montiel Castillo
The mother of 5 came from the region of La Concepcion. She left her home at 6:30 a.m. to arrive at Clinica Verde at 8:15, a long journey to find relief for her children. Her name was Maria Elena.
On this visit she was accompanied by 3 of her children: Francisco, 3, Eduardo, 1, and Nubia, 14. Both boys arrived with a high fever, and Nubia came along to help her mother on the journey. Francisco was excited to start preschool, his mother bragged. He couldn’t stop talking about it “like a parrot,” she said proudly.
It was her fourth visit to Clinica Verde, her fourth time with Francisco and Eduardo, who get sick frequently. Maria Elena explained that Dr. Nubia Huete always took care of them well. “The doctor has a nice way about her,” she said.
On this day, his mother said, Eduardo was suffering with a cold and fever. At 1 year old, he weighs 18 pounds. The previous month Dr. Huete had detected anemia and today the doctor diagnosed him with mild asthma and pneumonia. Maria Elena was given a nebulizer to use on Eduardo three times every 20 minutes, and was asked to come back in 8 days.
Maria Elena said that she learned about Clinica Verde through her mother, who told her CV provided good care to its patients. Also, “if I go to a private pharmacy it costs me much more,” added Maria Elena, and they might not have all the medications prescribed for her children.
Mary Elena and her husband Ricardo had their first child together at 18. She said she had only finished school through 5th grade, which made her sad, but she insisted that her children attend school and follow their dreams, “since we could not.” Her daughter Nubia hopes to study Agricultural Engineering.
“I think I have been a good mother, and I never regret being a mother,” said Maria Elena. “Without my children I would be alone. I would be sad not to hear their laughter, see their games and feel their love.”
Maria Jose Montiel Castillo is a student in the School of Communications at the University of Central America.