Project #2680

Healthcare for Pregnant Women in Nicaragua

by Clinica Verde
Students working at our biointensive garden.
Students working at our biointensive garden.

Dear Friends and Supporters:

We're really excited to share with you the launch of a new program at Clinica Verde - Grupo de Bienestar Materno Infantil  (GBMI). This project to promote maternall infant wellbeing is a pilot using interactive lectures, food based approaches and a socio-behavioral change curriculum to teach pregnant mothers about the stages of fetal development, ways to care for the health of their child in the womb and nutrition during the pre-natal, post-natal periods and the first five years of life. There has been substantial evidence that prenatal and under-5 nutrition impacts a person’s health and wellness over their entire life course. Additionally, there is substantial evidence that education surrounding these topics is limited in the city of Boaco, Nicaragua and demand exists to repair the discrepancy. For this, Clinica Verde is initiating a ten-week pilot project for pregnant mothers that will teach fetal development and maternal and child nutrition through presentations, interactive activities, use of our Clinica Verde organic, bio-intensive demonstration garden and cooking demonstrations. 

Pretty awesome, right? 

Here are some of our specific objectives of the project:

  • 80% of GBMI participants give breast milk to their infant within one hour of birth—this is concurrently encouraged by the Nicaraguan Ministry of Health
  • 70% of GBMI participants attempt to practice EBF for 6 months post delivery- practicing EBF can be a challenge for various reasons beyond control; for this reason, this strategic objective is presented as an attempt.
  • In final project survey, 90% of mothers can identify 3 nutrient-dense vegetables, the health benefits that those products confer and a way to cook them in their home that retains nutritional value
  • At 3rd month home visit, 70% of GBMI participants report 2 additional fruits or vegetables in the previous day’s diet as compared to the initial program survey 24 hour recall
  • In a survey of childhood malnutrition/over-nutrition 80% of mothers can identify 3 symptoms of malnutrition or nutrient deficiency and 2 symptoms of over-nutrition
  • Increase knowledge of the internal pregnancy process and fetal development- 8 out of 10 mothers give correct responses to 2/3 development questions during end of reunion evaluations
  • Mothers demonstrate gradual increase in verbal participation; 8 of 10 mothers attend the 4 months post project lunch at Clinica Verde
  • 80% of mothers use Clinica Verde for child’s health and development visits
  • One family member of a GBMI participant attends a CV bio-intensive cooperative gardening session during the 3 month GBMI course

We realize this won't be easy, but our team is excited by the potential for impact among our cherished patients.

We'll keep you posted on how things go. In the meantime, please know that your support is vital to this project - and all that we do at Clinica Verde to bring health and hope to families living in poverty.

We love our supporters!!

One of our sweet patients!
One of our sweet patients!
A mother cooking using an ecostove.
A mother cooking using an ecostove.

Dear Friends and Supporters:

Last year we started a TeenSmart club at Clinica Verde, and we're excited to share with you how it's going. First of all, Our Teen Club is comprised of more than 20 teens from the region we serve. These teens are trained to be peer counselors to other young people in surrounding communities, encouraging engagement, self-esteem, and responsible behavior around smart sexual health and wellbeing. They have a special space at Clinica Verde that they fixed up to be their place for brainstorming, meeting and supporting one another.

Recently, we visited the homes of adolescents in our TeenSmart program. We got to meet their mothers and siblings, and share personally the work we're doing with their young leaders. A couple of our teens also developed the idea to visit an elderly care center. A couple of the students, who are studying nursing, performed blood pressure checks and general health assessments for the elderly in the nearby community of San Nicolas. Other students participated in community service by cleaning windows at the center, served refreshments to the elderly and spent time building new friendships. It was a wonderful day.

This work is guided and overseen by TeenSmart International, a non-profit organization that promotes self care and self-empowerment among teens with the goal of reducing or preventing risky sexual health behavior. Providing peer support and engaging in community service opportunities is key to building self-confidence. We wanted to share photos of some of this work with you. We'll keep you updated as we have more information and data on the program and curriculum. In the meantime, we wanted to share some photos of our teens and action and simply thank you for your ongoing faith and support. We couldn't do our work without you!



In the last 3 months, Clinica Verde has served 2,628 patient visits, including 350 growth and development consults for children under the age of 5. Thanks to the help of Vitamin Angels, we've been able to distribute Vitamin A supplements to 103 children between the ages of 6 and 59 months; provide multivitamins to 150 children, and serve 164 pregnant women with prenatal controls.

In addition, we've performed 15 PAPs and - something we're very excited about - we've opened our own on-site laboratory, allowing us to better serve and diagnose our cherished patients. As always, our top priority is to serve our patients with quality and compassion, promoting the prevention of illnesses through check-ups and regular education talks. In the past 3 months we've delivered 33 talks on themes including nutrition, dengue, maleria, danger signs of pregnancy and family planning. Our biointensive garden managed by Global Student Embassy also receives visits from our patients, teachers and students from both secondary schools and universities, all of whom learn about the biointensive method of farming and how to create home gardens that amplify the nutrition of families.

In the department of Boaco, where Clinica Verde is located, 23% of pregnancies occur in adolescents, and this number is also an area of focus for us. Thanks to the support of the Strachan Foundation and an alliance with TeenSmart International, our teen club has been actively connecting with area teens to provide education talks and equip our teen leaders with information on sexual reproductive health to share with their peers.

Dina, a Boquena woman born in 1968, is one of the women who we've served with honor, overseeing her pregnancy and the delivery of her baby with quality and compassion. She is a blessing to us, and to all.

We wish all of our supporters a very warm, safe and loving holiday season during this time when we are all called to remember that we are born to serve and support those among us living in need.

Mil gracias.

Celebrating the Purisima at Clinica Verde.
Celebrating the Purisima at Clinica Verde.
The Global Student Embassy team at Clinica Verde.
The Global Student Embassy team at Clinica Verde.
Kimberly Smith in Empalme de Boaco, Nicaragua
Kimberly Smith in Empalme de Boaco, Nicaragua

In some families the expectations are for the children to be doctors or lawyers, in our family the expectation was always that we give back to our world and our community. Not that giving was your primary job, just that giving should always be part of anything you choose to do.

In college I studied business and political science and graduated with the opportunity to go work with my husband in a small woman-owned real estate corporate housing business in San Francisco. 

Two years into this adventure my father, who was only 53 years old, was diagnosed with cancer and passed away within a few months. His life story was one of overcoming adversity and giving back. So it was quite a shock that at the young age of 53 his life would end so abruptly. I got angry at our imperfect world, but I also thought if I am here on this earth for 27 years, 53 years or 100 years I better make sure I make a “contribution” to this world. 

I abruptly quit my job, decided to move back to Denver, and my husband and I decided to start our own real estate corporate housing business. Over the years we did better than most, started two more businesses and continue to run those now 15 years later. But the large cash bucket we had originally envisioned never materialized. What I did realize during those years is the importance to give what you can now and not just wait for some big event in the future. So I challenged myself to figure out what I could do to support my community and my world at each stage of my life and not just at some future point in time. 

I came to learn about Clinica Verde and was invited to join the Board for their annual meeting in Nicaragua. As a mother of two young boys my free time was limited, but I decided a 4-day trip to Nicaragua was something I could do and was the best gift I could give to myself. The next challenge for me was what could I do that fit my limited budget but might be helpful. Not a doctor, I didn’t know where to find medical supplies and I thought there had to be something I could bring with me. I learned that in Nicaragua the kids played baseball and there was even a local baseball field and team. As the mother of two boys who played baseball this was something I was familiar with.

When I arrived in Managua, Nicaragua I was carrying over 100 pounds of baseball equipment.

During our trip to the clinic we met with a local baseball team and had the opportunity to share the items directly with the children. We all had a great time tossing the balls, wearing new hats and laughing a lot. It was a great way to get to know the community we served and support their local recreation.

During this time I was traveling with the Board of Directors for Clinica Verde that also included a number of doctors. The meeting site chosen for me to meet with the baseball team was in front of a family’s home in a rural community outside Boaco where the clinic is located. While I was playing baseball, the doctors went inside to meet with the family. In the home there was a young teenage girl who had recently given birth via c-section and the doctors discovered her incision was deeply infected. The doctors we able to help care for the infection and coordinate for her to visit Clinica Verde.

Some time later I was speaking with Clinica Verde founder Susan Dix Lyons and inquired after the girl’s health. Susan let me know the girl was doing fine. She had come to the clinic and the infection was gone. However, Susan went on to tell me the girl had stolen some surgical gloves during her visit. Shocked I was very confused at why someone who had just been given so much would steal something as small as surgical gloves. Susan went on to tell me the girl had stolen the gloves to fill up with clean water from the clinic to take home to the child. Wow, in that one moment I got some glimpse of how important Clinica Verde was to that community, how even a small amount of clean water could make a difference in someone’s life.

What I first was attracted to with Clinica Verde was how they were able, in just a few short years, to conceive an idea, develop that idea and create a vibrant structure, health system, community center and vision for the future. As we progress with the development of the Boaco facility I develop an even greater appreciation for all the details that the founder’s vision for Clinica Verde incorporated from the water system that now waters the organic garden to the open courtyard that supports educational events. I appreciated that the vision for the first Clinica Verde clinic was to create a “prototype” on which to develop a larger system of clinics that can deliver “Heath and Hope” wherever they are built.

I know the Boaco Clinic is the first, but really it is the foundation on which successful clinics and health cares systems and services can be developed. I appreciate now that “contribution” to our world can be done one small step at a time.

Dear Supporters:

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. 


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Organization Information

Clinica Verde

Location: Angwin, CA - USA
Website: http:/​/​
Project Leader:
Susan Dix Lyons
Staff member
Angwin, CA United States

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