Jun 11, 2018

Violence and unrest continues in Nicaragua ...

Dear Supporters – Many of you may or may not be aware of the tense and dangerous situation facing Nicaragua over the past months, which has escalated into the worst civil crisis in the country since the 1980s. Below is an overview of the situation written by Clinica Verde’s Executive Director, Yolanda Paredes-Gaitan. We ask that you continue to pray for the Clinica Verde team and beautiful Nicaragua as this devastating situation continues.

Dear Clinica Verde Friends,

This week, Nicaragua completed 50 days of civil unrest and violence following the government’s response to peaceful protests and demands for change.

The situation began on April 19, when university students protested social security reforms that would increase taxes and decrease benefits. This was the trigger, but the government’s violent repression of these protests unleashed a response from citizenry that has been building over the past decade as President Ortega and the Administration has concentrated power and instituted constitutional changes that threaten democracy and freedom (Amnesty International Report). It is the worst crisis faced by the country since the civil wars of the 1980s. Efforts by the Catholic Church and civil society to create dialogue with the government have failed.

According to the InterAmerican Commission on Human Rights (IACHR), a total of 127 people have been killed, over 1,000 have been wounded, and hundreds have disappeared. These acts of repression continue in the country at the time of writing this report. Any act of social protest or challenge makes citizens a target.

The government acknowledges the deaths of only 10 people. Said the country’s Vice President, Rosario Murillo: “Imagine how low they can stoop ... inventing deaths! That's like making up illnesses, inventing suffering. … They are like vampires, demanding blood to feed their political agendas, to feed themselves, because vampires feed on blood and believe that with it they can advance their political agendas. False news, false people, false beings, false consciences, false propositions.”

In Nicaragua, most of the media (TV channels and radio stations) belong to the government. Those channels are being used to increase negative messages against the student protesters and other actors. Mainly, the government-controlled media plays music and ignores the massacre and the situation taking place in the country.

On April 19, all news channels ceased broadcasting by an order of the Telecommunications Institute. A radio station in León, Radio Darío, was set on fire on April 20. Its owner indicated that government supporters were responsible for the fire.

It has been reported that in some of the protests the police had a direct order to shoot to kill. The report of Amnesty International indicates that between April 19 and May 12 people were arbitrarily deprived of life during the protests through the excessive use of force. This behavior continues. Further, Amnesty International reports that, based on the pattern identified, a considerable number of the causalities could be considered extrajudicial executions, noting that the type of weapons used, and the place and trajectory of the bullets suggests the presence of professional snipers.

Said Nicaraguan journalist Ileana Lacayo: "Most of the deaths that occurred in the country ... are the same. These are carefully aimed shots. A single shot fired with precision at the head or jugular or chest. They are shots that aim to kill, and they are fired by professionals. Not ordinary people; ordinary people don't have weapons. … These were murders. And the pattern was the same all over the country."

Reports indicate that the government has created a pro-government paramilitary who are empowered to shoot at any threat or challenge to government rule. In addition, these groups are destroying and stealing private property with the tacit approval of police, who do not enforce civil law and order.

The state of the health care system is in tatters, and public hospitals are turning away injured protesters. Reports support the claim that the Ministry of Health issued an order to its institutions to not treat people coming from the protests. Several testimonies were given to international human rights actors about the denial of medical attention. One of the most high-profile cases of this behavior was the story of Álvaro Conrado, a 15-year-old youth who, according to the testimony of family and medical staff, was refused treatment at Cruz Azul Hospital. Alvaro died on April 20. Alvaro was shot in the neck for bringing water to student protesters. On April 25, the police tried to prevent Alvaro’s family from filing a complaint for the murder of their son at the CENIDH (Nicaraguan Center for Human Rights) and hours later his uncle's mobile food stall was destroyed. Álvaro’s parents believe these actions were a threat in retaliation for their persistent complaints, which were publicized in the media. Said Edwin Roman, a priest from Masaya, Nicaragua: “We are treating injured people here in the church because we can't take them to the public hospitals anymore.”

Some protesters have been arrested and taken to jail. Hundreds have been unlawfully detained, released days later with bruises and tales of cruelty behind bars.

The ugliest day so far was May 30, Mother’s Day in Nicaragua, when AK-47–toting police indiscriminately opened fire on a peaceful march to honor the dead. It was reported that almost 500,000 people participated in the march, including seniors, children and relatives of the victims plus citizens demanding justice and the cessation of the violence. As police sprayed the crowd with bullets, government sharpshooters positioned on the roof of the national baseball stadium fired with sniper rifles. Before the sun rose, 16 more Nicaraguans were dead, and another 88 were injured.

The government denies all responsibility for the violence and for the existence of the para-police. President Ortega has blamed the bloodshed on foreign agitators, gangs, organized crime, and drug cartels. The Inter-American Commission on Human Rights has called on the Nicaraguan government “to immediately end the repression” and “urgently adopt adequate measures to end the violence,” including the dismantling of all para-police groups.

Nighttime is hell. In some cities, frightened citizens lie in bed or on the floor in fear of stray bullets, listening to the fighting and chaos in the street and praying it won’t come through their front door. I am one of those.

Now, the economy is crumbling, with total losses estimated somewhere north of $600 million, according to the country’s council of business chambers (COSEP). Nicaragua’s economic tailspin is hurting small businesses the most. Looters have ransacked more than 200 small businesses across the country during the past seven weeks, punishing the struggling working class. Meanwhile, roadblocks have paralyzed commerce and transit throughout the country, restaurants are shuttering, and tourists have fled. The most recent calculations of the Nicaraguan Foundation for Economic and Social Development (FUNIDES) are discouraging: FUNIDES estimates that 150,000 jobs could be lost in a country where formal sector employees are estimated at 900,000. Tourism has been one of the hardest hit sectors, followed by commerce and construction.

On June 6, a representative group of bishops of the Catholic Church had a meeting with President Ortega and his wife, Vice President Rosario Murillo. The meeting’s results were very negative. The church gave the President 48 hours to analyze the civil society document suggesting the next steps, providing answers in writing. President Ortega continues to resist the request for change by civil society and church leaders.

Clinica Verde

The Clinica Verde team continues to provide health services and support to our patients in the clinic. Our community outreach services – which have represented the largest volume of care and activity in the past few years – have been canceled due to the insecurity in the region.

Our Prenatal Nutrition program still provides the space for education and support of our pregnant woman, although assistance has decreased due to difficulties of access due to closed roads and a climate of fear. We continue to provide whatever outreach and education possible for our patients.

Our teen program is on standby. Parents are afraid for their children to travel to the clinic or engage in public activities. As stated above, youth are targets for the para-police groups and for terror groups that are mobilizing at any time of the day, randomly shooting.

The Clinica Verde team also decided to volunteer in case of an armed conflict. We recognize that we cannot provide emergency services, but at least we can provide first aid and support to the wounded until they can be referred.

Our team has organized a plan with equipment and supplies waiting for the worst scenario. On May 25 Boaco, where Clinica Verde is located, had an armed confrontation in an area called “El Quebracho.” The government organized a women’s march of workers from the different health centers in Boaco, considered a strategy to provoke the group that was blocking that area. During this situation several people were wounded, including a couple belonging to the Youth Sandinistas, who play a role as a confrontation group. The armed men (pro-government members) mistakenly shot the members of this group, as well as citizen protesters.

At Clinica Verde we received two wounded patients that were treated, with minor injuries. Following that, members of our staff started receiving frightening calls threatening Clinica Verde if they continued to treat the wounded. As the Director, I received a call from the local hospital asking for the identification of the patients (information that by law we are obligated to provide).

After the May 25 event, the Clinica Verde team realized that we are very vulnerable due to our rural location. In addition, serving the wounded could be interpreted like an emergency service that our current license does not allow. We made a team decision to stop providing emergency service but to set up a system to help during armed confrontation. The team decided to activate our Code Red in case a confrontation leads to the collapse of the local hospital. The intention is that we share with local authorities our readiness to serve without discrimination in case of need.

The situation is very tense. Our main concern is our patients and our ability to continue providing services to those in need without being accused of being part of the political opposition.

In this time of crisis, uncertainty and fear, we are even more strongly committed to the mission of Clinica Verde. Not only for the poverty that looms in our communities, but also for the injustices created in this crisis, where the public health institutions have express orders to serve only those who represent a specific political party.

Clinica Verde also has a commitment to our extraordinary team. Their dedication and willingness to help is something that has always characterized our team, and now more than ever we remain committed to this service despite the risks and the emotional stress that persist in our country.

Our Clinica Verde team believes in a new Nicaragua with social justice. They believe this nightmare will end soon. They believe that there is a God who can see all, that He is in charge, and that, God willing, the crisis will soon end.

We are very grateful for your continued support and prayers. Thank you for supporting Clinica Verde, our team, our families, and our country.

Abrazo fuerte,

Yolanda Paredes-Gaitan

Executive Director

Clinica Verde

Apr 23, 2018

How Many Miles Would You Walk for Your Health?

Yamileth, left, at Clinica Verde.
Yamileth, left, at Clinica Verde.

Access to health services is very tough for many in rural Nicaragua. Some – like Yamileth – have to walk miles to find care for their families. Yamileth is one of the moms in our Prenatal Nutrition Group at Clinica Verde.  She's 33 years old, married, with two children. Yamileth became a member of our Prenatal Nutrition Group to learn more about taking care of her body and raising a healthy baby. She lives in a very poor community located miles from Clinica Verde, with difficult paths in poor conditions that make her journey a struggle. And yet she comes. 

Each Wednesday, Yamileth travels to Clinica Verde to receive education and health services provided by our obstetrician and a prenatal nurse. She also receives additional services that she and her family need. Sometimes she comes in the company of her youngest son, who loves visiting the Clinica Verde bio-intensive garden. In fact, Yamileth and her son say that that's what they love most about Clinica Verde: the garden. Because of the work and education at Clinica Verde, Yamileth now has a bio-intensive garden in her own home yard. She believes that learning about the garden and how to raise healthy and nutritious food for her family was the most important part of the education she received as part of our Prenatal Nutrition Group. Yamileth is proud that she learned to harvest her own healthy vegetables rich in nutrients to nurture and protect her family.

As for the travel, we're doing the best we can to bring our services to those of our patients like Yamileth who live in hard-to-reach areas. This year, we have 6 new sites for our Prenatal Nutrition Groups.

We can help Yamileth and other rural moms like her only because of your support. Thanks for helping us change lives.

 More About Our Prenatal Nutrition Program

The Prenatal Nutrition Program that Yamileth is a part of is one of the cornerstone programs at Clinica Verde – and, we believe, a powerful step towards empowering local communities to improve and transform their health and that of their families. Here are some quick stats:

• Our Prenatal Nutrition Program has served 3,543 pregnant women since starting. In 2017, we served 307 pregnant moms
• During the same period, we served 7,154 children 0 to 5 years old. In 2017, we served 553 children
• Upon completion of the program, 80% of moms increased their knowledge about the normal development of a baby and child in the first 5 years of life
• 100% of graduating moms could identify the use of 3 fruits to improve overall nutrition (pretest data showed 83%)
• 80% of moms could identify and use 3 vegetables to improve overall nutrition (pretest data showed 50%)
• 100% of graduating moms could identify signs of malnutrition and obesity

We're now serving and educating moms through this program at additional sites in the region to expand our impact – including in a couple villages in partnership with the Ministry of Health of Nicaragua. Big thanks to you for making this possible!

Please reach out any time with your thoughts, questions and ideas. We're so grateful for your support.

Jan 22, 2018

Meet Corinne Kamrar, whose life was changed

UCSD Pre-Med student Corinne Kamrar
UCSD Pre-Med student Corinne Kamrar

Corinne Kamrar first got to know Clinica Verde in 2015, when she was a sophomore at UCLA. She joined a group of students for our HIGHER education program, and it changed her life. Corinne graduated from UCLA in the spring of 2017 and is now in the Pre-Med program at UCSD. Here, in her own words, is her experience.

Tell us about your experience with Clinica Verde and the HIGHER program.

In a remote community such as Boaco, Nicaragua, Clinica Verde stands out and I’m not just referencing it’s welcoming vibrant green and yellow paint. The clinic’s available resources and care in contrast to other clinics in the area is immeasurable. My experience with the HIGHER program allowed me to get involved with health care in a hands-on way. I was able to take vitals, teach nutrition concepts to children, work in the Clinica Verde garden, and watch a C-Section at the local hospital. This hands-on experience surprised me as I wasn’t expecting to be so intimately involved with the community members of Boaco. I was also surprised at the integral role the local community members had in helping maintain CV and also their role in giving back to other community members with the knowledge they had gained through their education at CV. For example, I noticed that young women who had gained  knowledge on women’s health care presented this information to their peers in  the community. CV and its myriad services and outreach are truly is in place because of the buy in of the local people.

What did you learn?

It takes a village. This applies to not just Clinica Verde but all of health care.  And that even the basic needs and care can make a huge difference in people’s lives.

Is there a story or a patient that lingers with you today?

Although there are many memories I continue to reflect on, reminisce about, and gain wisdom from, there are two specific experiences that put me right back at the clinic.

No words were needed to convey the worry, concern and shame on the mother’s face regarding her inability to purchase the medication seven months earlier.

The first has to do with complexity. An unforgettable experience I had as a volunteer in Nicaragua began with doing rounds alongside a doctor at the local hospital. We were told if there was a birth that day, we would be able to observe. While visiting one of the first patients of the day the doctor was paged and we were told to “scrub up.” I will always remember the feeling of following operating room protocol and putting on my scrubs. Prior to that day I had been in scrubs many times but something about putting on the cap, face mask, and shoe scrubs to observe a Caesarean section operation in an underdeveloped country confirmed the importance of outstanding medical care for everyone. This experience added an additional reason for pursuing medicine through an immense fascination with life itself. I still remember the overwhelming feeling of emotion when I saw the doctor gently remove the newborns from where they had spent the last nine months. Reflecting on the complexity and mystery of the development of a human life is astonishing and has continued to motivate me to pursue my passion to become a physician and make an impact in other’s lives.

The next has to do with emotional valence. Few words can describe another humbling experience I had while shadowing a doctor on my third day at Clinica Verde. I sat in the consultation room with the doctor, a Spanish translator, a returning patient, and her mother. Since the young girl’s last visit, she had been living with a painful yet curable body rash because the family could not afford the prescribed medication. The gestures and emotions in the room overpowered the words being translated. As the doctor examined her face and back the facial expressions of the young girl clearly expressed her pain and symptoms far more than the translated words. Similarly, no words were needed to convey the worry, concern and shame on the mother’s face regarding her inability to purchase the medication seven months earlier.

Other experiences I’ve had working in a variety of health care settings including local hospitals and clinics have consequently allowed me to see how special Clinica Verde is.

Shortly after the consultation other volunteers and I followed the family to the pharmacy to discover that only one out of the two necessary medications had been purchased. As the family was leaving the clinic we asked the pharmacist if we could purchase the remaining medication. The experience of buying the medication and running to the bus stop to give it to the mother was tremendously fulfilling; the sense of relief on her face and gratitude in her eyes were immensely touching. This experience is important to me because it clearly demonstrates the power of body language, gestures, and human emotion as a form of unspoken communication. It made me realize that these universal forms of communication can connect us to one another despite economic and cultural differences.

How did your experience at Clinica Verde affect your opinions and ideas about healthcare?

Other experiences I’ve had working in a variety of health care settings including EMT training and volunteering in local hospitals and clinics have consequently allowed me to see how special Clinica Verde is. My time at Clinica Verde changed my perspective while amplifying my existing thoughts on the importance of health education, understanding cultural backgrounds and empathy to one’s individual health and life circumstances as integral parts of treatment. Furthermore, I can’t help but implement the powerful things I learned and observed during my volunteer experience, not only into my future medical career, but as a compassionate human being. I have become more aware that the lack of money or education should never be reasons we as humans do not give or get treatment. The resources and information that one takes for granted, some might not even know exist. Clinica Verde not only recognizes this, but implements and executes community education, care, and treatment. Clinica Verde promotes not only a health care facility, but a facility that cultivates hope and optimism-two integral aspects of ones present and future well being.

Any thing you’d like to share with others or Clinica Verde supporters?

Clinica Verde continues to not only change the lives of patients in the community, but anyone who is involved with this impactful organization. I know this because Clinica Verde changed mine!

One patient at a time ...

Since opening our doors in 2012, Clinica Verde has provided over 140,000 healthcare services to the community we serve – including prenatal visits, medical consults, vaccinations to children, Pap tests for women, optometry, dental, laboratory services, nutrition counseling and educational talks. Our staff is guided by our compassionate care approach, serving each patient as though he or she were a family member or loved one. We do this in a country where close to 50% of families live in poverty.

One of our Clinica Verde families
One of our Clinica Verde families
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