When Ana Urbina, 47, visited Clínica Verde for the first time in November 2012, she complained of having body aches and pain in her right arm.
She had suspected something was wrong with her heart since the day she experienced a sudden, acute pain in her chest, a feeling “like someone was pressing down on it,” she says. Ana, who washes and irons clothes for a living, noticed that even moderate amounts of physical work were beginning to cause her palpitations.
An electrocardiogram performed at the clinic revealed cardiac ischemia, or an insufficient flow of blood to the heart caused by an obstruction of the arteries. Chest pain, discomfort, and fatigue are common symptoms.
Not long after her diagnosis, Ana received more bad news: her husband had been killed in a road accident. The weeks that followed were what she calls the darkest times of her life. And it was during this time that she experienced strange episodes of anxiety.
“I would start crying out of nowhere,” she remembers. “Anything would scare me. If I heard a phone call my whole body would shake. … I would get the feeling something bad was going to happen to me.” Clinica Verde’s Dr. Varela, who is in charge of her case, believes the stress aggravated the pre-existing condition.
Clinica Verde provided Ana with medication designed to improve blood and oxygen supply to the heart and prevent chest pain. Ana says she has not experienced panic attacks or heart discomfort since she started taking it.
Dr. Varela has also advised her to reduce her workload, given her heightened risk of suffering a heart attack. Ana says she’s been working a lot less but can’t give up the job completely, as she is coping with difficult financial times. “My husband used to help me line-dry the clothes when I got too tired,” she says. “Now I have to find others to help me. It often means I have to pay them,” she says.
Clínica Verde Director Dr. Alba Castillo explains that because the clinic deals primarily with maternal-infant cases, medication for chronic diseases is sometimes limited. Still, the clinic receives all types of patients, she says.
Dr. Varela was able to obtain a similar medication, a drug designed to improve blood and oxygen supply to the heart and prevent chest pain. “It’s nice to see that our doctors still go out of their way to meet their patients’ needs,” says Dr. Castillo.
“I don’t think I would’ve been able to get it otherwise,” says Ana, who has not experienced panic attacks or heart discomfort since taking the medication.
Ana recently moved in with her daughter and says spending time with her 5-year-old grand-daughter Frangie has kept her mind off her condition. “I only wish I had taken care of the problem sooner,” she says. Ana brought Frangie with her to Clinica Verde when she came to see Dr. Varela, and Frangie received preventive pediatric care. Ana said her favorite thing about Clinica Verde is the attentive service.
“The service here is excellent,” she said. “The nurses and doctors are all very welcoming.”
Clinica Verde is honored to serve both cherished patients.
Maria Oviedo is a student at The University of Notre Dame.
• • •
From January through October 2013, Clinica Verde ...• Served over 12,000 patient visits• Performed 120 Pap tests (precancerous screenings) on women• Experienced a 40% increase from the same period in 2012 in growth and development consults of children under 5• Treated more than 175 children under 5 for diarrhea. Globally, diarrhea is the second leading cause of death among children under 5 and the leading cause of malnutrition• Began a census of pregnancies in compliance and coordination with the Nicaraguan Ministry of Health
Thanks for your continued support! We couldn't do our work without you.
Hola, Awesome Supporters!
Do you ever wonder who our patients are? We have so many stories to share. I'd like to share just one, so that you get a glimpse into the world that you so generously support. Meet Eusebia ...
MOTHER OF 17 FEELS BLESSED
IN HER LIFETIME, 74-year-old Eusebia Rodríguez gave birth to 17 children, 12 of whom survived into adulthood. The friendly Boaco native, who never went to school, started her family at age 16 and spent her early years of motherhood working as a food vendor from her home. The job allowed her to be close to her children, but eventually turned dull, tiresome and financially unstable, says Eusebia.
Yearning for opportunity, at age 33 she and her sons moved to Nueva Guinea, a sleepy agricultural town near the Atlantic coast of Nicaragua – almost 140 miles away. The start was difficult, Eusebia says, but she soon purchased pigs, a cow, and grew her own vegetable plot.
At an advanced age, Eusebia began to suffer one of the possible adverse effects of childbirth: a cystocele, or “fallen bladder.” Clínica Verde’s Dr. Haldam Varela explains that a cystocele develops when the supportive tissue under the bladder weakens as a result of straining during childbirth, causing it to sink. Women who have multiple natural births are at greater risk of suffering this condition, Dr. Varela says.
Eusebia recalls that any minimal pressure – coughing, sneezing or even sitting down– would cause her urinary incontinence, so she visited a local doctor to treat the problem. “He gave me injections, pills, but nothing had an effect on me,” says Eusebia.
“I noticed the problem was persistent; and as time went by it only got worse. I had to make diapers out of old rags,“ she says. “It’s one of the most unpleasant feelings in the world.”
Having heard of Clínica Verde through her daughters, who stayed behind when she moved to Nueva Guinea, Eusebia returned to her hometown and visited the clinic, where she was examined and referred to Boaco’s local hospital for surgery. Dr. Varela says he is pleased to see “inter-institutional coordination” between Clínica Verde and the hospital, particularly because he works part-time at both institutions. He also says Eusebia could go to the hospital for post-operatory care, but prefers to come to the clinic.
Eusebia says her favorite thing about Clínica Verde is how clean it appears. “This is a real clinic. Other places I’ve been to shouldn’t call themselves clinics – they’re just filth!” she says.
She is adamant that the most important aspect of a good household is cleanliness. She says she still hand-washes her own clothes despite Dr.Varela’s strict orders to rest, because she believes no one can clean them like she can.
She says she feels much better since the surgery and looks forward to going back to work on her farm as soon as she recovers. “I’ve been so blessed by God,” says Eusebia. “I have my children, my pigs, my chicken – I’m not missing anything.”
By Maria Oviedo, CV intern and a student at the University of Notre Dame.
Thanks for your continued support! Now, below, some info from the first 6 months of 2013:
In the first 6 months of 2013, Clinica Verde served 7,876 patients, an increase of 21% from the same period in 2012. Following are some highlights of that activity: • We performed 1,017 controls for growth and development of children under 5 years old, an increase of 28% from the previous year. • 54% of patients served were first-time visitors, while 46% were return patients, demonstrating that we are growing while developing loyalty among our patient base. • 61% of patients served came from rural zones and 36% came from the urban area (the rest came from other departments) • 30% of our patients were under 5 years of age. • 45% of our patients were women of fertile age. • 61% of our pregnant patients came to the clinic in the first trimester of their pregnancies (a 37% increase in this number from 2012). We’re encouraged by the number of patients who are coming to the clinic for preventative care, and are particularly heartened that 68% of our pregnant women returned for their recommended 4 prenatal visits. We think that's pretty wonderful.
Please email me any time if you have questions about our work in the world. It's always a pleasure to connect with you and share more about our work. Thanks again for your kindness and generosity!
Dear Cherished Supporters:
We want to share with you a few updates since our last report.
• In early May, we held a training and counseling session at Clinica Verde for 30 mothers and young women over dangers and warning signs during and after pregnancy. The session took place, thanks to a partnership with Foundation Juan XXIII and its COMSALUD project, with support from USAID. Clinica Verde nurses Yasmina Diaz and Azucena Narvaez also provided training on proper nutrition during pregnancy.
• Engineers representing the renewable energy company Asofenix and the international nonprofit Green Empowerment visited Clinica Verde on May 8 to perform an energy audit at the clinic. We're working with these excellent organizations to reduce our energy consumption and explore renewable energy alternatives, including solar panels. We're excited about the work. Stay tuned for our course of action!
• Under the leadership of Peace Corps volunteer extraordinaire Kelli Stam, 10 high school seniors from Boaco last week presented their findings from a marketing study for Clinica Verde. We asked the students to survey the local population on their use of local pharmacies and purchasing behavior in order to see what opportunities exist for Clinica Verde. The students did an impressive job, surveying 139 locals between the ages of 16 and 77. We're studying their conclusions and recommendations, which were excellent. We hope and expect that these local students will continue to guide and inform our work in their community.
• Three inspiring Aussies continue to cycle across Europe to raise funds for Clinica Verde! Watch a short video on their trip here: http://youtu.be/SQrIOYntG-EAlso, you can follow their journey here: www.babyonabike.com
Thanks for continuing to be a part of our work in the world!
Hello, Dear Supporters:
Thanks to you and others like you, we continue to move forward and do good work at Clinica Verde! I'd like to share with you some highlights from the first quarter of 2013.
We closed out the year 2012, having provided 13,942 consults at Clinica Verde. It was a great first year, during which we learned a lot. One of the high points for our Board of Directors is the exceptional leadership we have at the clinic. CV Director Dr. Alba Castillo and her dedicated team have exceeded our expectations for providing high-quality, compassionate care, while monitoring and capturing data that will help us evaluate our impact. Having just returned from Nicaragua after our Annual Meeting of the Board, we are flush with statistics and information, and so pleased to see the clinic operating so effectively. Just a few notes of interest: • In 2012, 31 % of our patients were between the ages of 1 and 4 years old. Of those children, 23% were malnourished, which underscores the work we need to do in the area of nutrition education. We are planning interventions and education for 2013. • We're seeing 46% of pregnant women in their first trimester, which is great news. Also, 48% of pregnant women are coming back to CV for the 5 visits recommended by the Ministry of Health. (Woo-hoo!) • Of the pregnant women we served, 306 were identified as high-risk or potential risk. We are honored to be serving these patients through their pregnancies to ensure safe care and delivery. • 57% of the women we cared for in 2012 were of fertile age, so we're succeeding in our efforts to focus on maternal-infant care. • We began our work in cervical cancer prevention by promoting and providing Pap tests, performing 145 screening tests in 2012. We plan to step up efforts to address this issue in 2013, as cervical cancer has the highest incidence of all cancers among women in Nicaragua. There's a lot of exciting work going on, and a lot more to do. If you ever have any questions or would like to see more of our patient data, please don't hesitate to contact us!
Yale School of Business Partners with CVIn other great news, we were fortunate to be selected by the Yale School of Business Global Social Enterprise Club to partner on developing Clinica Verde's long-term plan for sustainability. Through the program, we're matched with a group of 5 MBA students who study and research Clinica Verde, travel to Nicaragua to visit the clinic and make recommendations for our path moving forward. We've already gotten started and look forward to working with them through the spring!
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