Project #2680

Healthcare for Pregnant Women in Nicaragua

by Clinica Verde
Clinica Verde
Clinica Verde's Dr. Nubia Huete examines a newborn

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 CV

In 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! 

A patient gets clean water @ Clinica Verde
A patient gets clean water @ Clinica Verde


The CV staff with Maria Urbina and her family.
The CV staff with Maria Urbina and her family.

Dear Awesome Supporters:

This year, we've served 11,702 patients at Clinica Verde. That's pretty awesome. But while numbers are important to help us plot our progress, they tell only part of the story. 

With that in mind, we want to share with you 2 short stories that we think will tell you a lot about Clinica Verde. But first: One of our top 3 goals for Clinica Verde in 2012 was to create an organizational culture that reflects our mission. This is both a tough thing to do and a tough thing to explain to supporters. It can't be quantified - but it's vital to who we are and our success. We think these stories will help you understand what that means - and we hope that you'll be as proud of the staff at Clinica Verde as we are. 

A Baby Who Wouldn't Stop Crying

A single mother named Maria Urbina Mendez from the village of El Tule showed up at the clinic carrying her 7-month-old baby, Danilo, and accompanied by her 5-year-old daughter, Maria Jesus. It was clear to the staff immediately that they were all malnourished. The baby, Clinic Director Dr. Alba Castillo reported, appeared to be only 2 months old, and the little girl looked like a 3-year-old. The Clinica Verde nurses and doctors attended to their needs. 

One of our nurses, Jasmina Diaz, noted that the baby wouldn't stop crying. She asked the mother, "Why does she cry?" The mother responded that the baby was hungry. Jasmina suggested the mother give the baby her breast to nurse. The mother said, "I have no milk." Jasmina consulted with Dr. Nubia Huete and they gave the baby some sugared water. The baby stopped crying immediately. Jasmina and Dr. Huete wanted to help this family. They asked the rest of the Clinica Verde staff if they would contribute to a collection to provide the family with basic foods and supplies. They made an appointment for Maria and her family to come back, and when the young family returned the staff of Clinica Verde presented them with all that they had gathered and donated: clothes for the entire family, food, diapers, wipes. "It was a happy and emotional day for the whole staff," Dr. Castillo reported. 

None of the staff at Clinica Verde is wealthy. They all have families and scarce resources themselves. But they understand the mission to serve with love and compassion the poorest of the poor. We were so proud and pleased to hear this story, and feel confident that our staff understands what it means to work at Clinica Verde.

Reaching Out to the Elderly

As a maternal-infant clinic, we can't serve everyone at Clinica Verde. We never turn a needy patient away, but our focus is on women and children. However, practicing our mission in the communities we serve is important to our organization. It's who we are. Recently, we received this story of service in practice: 

From CV Director Dr. Alba Castillo: "This afternoon, the CV team went together to the Boaco nursing home. It was a wonderful experience to share time with our old people and bring not only the healthcare they need, but also to show them affection and respect. Everyone was very happy - both the Clinica Verde team and the elderly we spent time with. Our team showed a lot of compassion and love towards the sweet elderly people. In addition to medical care and love we gave donated adult diapers, medicines and materials they needed, and also brought along a small snack. The smiles on their faces were drawn with joy. We talked and sang together, and they thanked us for our visit. This is not the last but the first of many visits. It was wonderful." 

* * *

So, dear supporters: Thanks, as always, for supporting our work in the world! We wish you the happiest of holiday seasons and thank you for your compassion and generosity.

Local residents at the Boaco Nursing Home.
Local residents at the Boaco Nursing Home.


Dr. Castillo and Scarleth Baca @ Clinica Verde.
Dr. Castillo and Scarleth Baca @ Clinica Verde.

Hola, Amigos!

Checking in with all of our awesome supporters at Global Giving! We continue to be busy at Clinica Verde, routinely seeing more than 1,000 patients per month. From January 2012 until the end of September 2012, Clinica Verde served 9,752 patients, primarily mothers, women and children. 

Having just returned from a visit to Clinica Verde in September, I can report personally that the clinic is operating well, with a dedicated staff and a motivated, ambitious director. All of our staff is Nicaraguan, and our work to share and build on our mission of service with love and compassion to the poor is manifest each day. It's a joy to see.

We continue to focus on developing a culture of service, quality and teamwork among our staff (this work will never end!). In July, Dr. Alba Castillo began as our Clinic Director and quickly moved our team and effort forward. Having worked in leadership positions for the Ministry of Health of Nicaragua and with USAID-funded projects, Dr. Castillo, a pediatrician by training, is well-positioned to professionalize our reporting and data collection. She is excited to be working in the environment of Clinica Verde and has proven both creative and industrious. 

At Clinica Verde, we continue to work on developing partnerships. We’re working regularly with the Peace Corps (volunteers provide education at Clinica Verde each Tuesday), Juan XXIII, Metanoia Foundation, and the American Nicaraguan Foundation, and we are in the beginning stages of working collaboratively with USAID.

Some of our immediate goals include:

  • Upgrading our inventory systems.
  • Develop a plan for continuing education for our medical staff.
  • Create a special area for Oral Rehydration for children with diarrhea.
  • To continue to refine our clinic accounting practices and protocols to integrate with our U.S. accounting and meet best practices.
  • Continue our monthly program with the volunteer dentists who come from Managua to deliver dental hygiene education to children and their mothers.
  • Implement a basic, straightforward medical record system for tracking health outcomes.
  • Hire an OB/gyn to replace our former OB/gyn (who had a car accident and is in long-term recovery).
  • Work with the Board of Directors for the upcoming Annual Meeting to come up with a Strategy for the coming year.

There is much good work to be done! 

Our annual charity fund-raiser takes place on Saturday, Nov. 10 in the Napa Valley. Pray for our success! You can check out our video promo here:

Thanks as always for being the kind of people you are – caring, compassionate, with a global vision of progress. We are so grateful for your interest in our work in the world.



One of our patients.
One of our patients.
A recent visit by USAID.
A recent visit by USAID.


Cony Acevedo and Kelli Stam at Cafetin Verde
Cony Acevedo and Kelli Stam at Cafetin Verde

Clinica Verde was designed with a small cafe connected to the clinic, as a place where patients could relax and buy healthy food while offering a small business opportunity for a member of the local community. Cony de Fatima Acevedo Corrales stepped forward to take on the business. However, we quickly realized Cony could benefit from small business counseling to learn how to manage her costs and market her business. Enter Kelli Stam. Born and raised in Long Island, New York, Kelli attended college at George Washington University in Washington, D.C. After school, she jumped into the world of advertising, developing brands such as the Colorado Lottery, ESPN, Virgin, Sony and more.

But after a while, Kelli decided it was time to use her work to do good and to give back. She hung up her advertising agency career (at least for now) and entered the Peace Corps. She now lives and works in Boaco, Nicaragua as a small business development volunteer. Her primary work is in high schools in the community, training teacher counterparts to teach a kick-ass class called Emprendedurismo to juniors and seniors. In this class, the students learn how to start and maintain a business and the class takes the form of a project in which they form groups and start their very own businesses. In addition, Kelli advises small business owners in the Boaco community.

Kelli was just what we needed to help Cony get off and running. Now, Kelli meets with Cony once a week to help her develop and improve her business. We asked Kelli to tell us about the experience.

Tell us a little about what you're doing to develop Cafetin Verde with Cony.

 Clinica Verde is located outside of the city center of Boaco and while there are many buses and taxis that pass by there is no foot traffic like there is in the city. The Cafetin, located in the front part of the Clinic, is new and was without a name and had no visibility.

Given this situation, Cony and I worked together to present a recommendation to the Clinic for a name: Cafetin Verde. And then worked on getting signage, which is now up!

In addition, we have identified other areas of need for the business and are tackling those issues over the coming months. Our action plan includes more publicity and awareness for the Cafetin Verde (we plan to make some simple brochures), implementation of a basic accounting system in order to track costs and income (which we have already put in place), and the development of a unique food product in order to draw people in for something that they can only get at the Cafetin Verde (we are thinking healthy smoothies).

 What has been the biggest challenge?

Working with Cony has been amazing. She is a dream project for a Peace Corps volunteer since she truly wants the help and truly wants to improve.

The biggest challenge is the lack of disposable income that the communities have to spend on food outside of the home. The communities that the Clinic serves are some of the poorest communities and it is challenging to establish prices that allow us to do much more than cover Cony’s costs.

 What's the goal?

Our goal is to find ways to save costs and increase Cony’s profits so that she can sustain a healthy business for both her clients and for her family’s needs.

 What brings you the greatest satisfaction working on this project?

Generally speaking, I get the greatest satisfaction from the sense that I get that Cony feels supported and empowered, that she has an advocate in me, and someone who she can trust. In terms of specific successes and the resulting satisfaction from them, I am confident that day has yet to come.

Peace Corps volunteer Kelly Stam.
Peace Corps volunteer Kelly Stam.

Dear Global Giving Supporters:

We've been busy at Clinica Verde these past couple months! Since our opening in January of this year, we've seen over 6,500 patients. Under the able guidance of our Clinic Director Jennifer Owen, the staff has been fine-tuning processes and procedures, constantly looking for ways to improve our services. We're so proud of the dedication and commitment of our Nicaraguan staff to our goals and mission! Here are some highlights:

• Peace Corps volunteer Liz Malenk has been providing weekly "charlas" (talks) on Nutrition and the importance of getting Pap tests at the clinic, regularly engaging patients in our waiting room with her visual presentations. Patients are responsive and attentive!

• Peace Corps volunteer Kelly Stam has been proving business counseling to Connie, the woman who rents our on-site cafe, to help her turn it into a successful business. Kelly is working with Connie on marketing, managing costs and growing the business. Connie has decided to call it Cafe Verde!

• HIGHER (Helping in Global Health and Education Reform), our Clinica Verde summer program for teens, is off to a good start. The students have been certified in Basic Life Support, have been practicing their medical Spanish at a local community clinic in California, and learned how to suture on pigs' feet. The students head to Nicaragua for 2 weeks on July 15!

• We happy to welcome two new advisors: Dr. Robert Moore and Jonathan Drewry. Dr. Moore will serve as Chief Medical Advisor to the Board. He is currently chief medical officer at Partnership HealthPlan of California (PHC). Prior to that he served for 13 years as Medical Director of Clinic Ole, a non-profit community health center serving migrant and agricultural workers in Napa, As a medical student, Bob spent time in Managua, Nicaragua at Bertha Calderon Women's Hospital and Lenin Fonseca Hospital studying the primary health care system. Jonathan Drewry is currently finishing his Ph.D. has a Master's in Public Health and is currently completing his dissertation at the University of Alabama on health care organization and policy with a concentration in maternal and child health. He's also worked as Director of Community Health with the US Peace Corps in Nicaragua and as a Community Environmental Health Advisor with the Centers for Disease Control and Prevention. We are grateful for the contributions of both Bob and Jonathan!

• Our awesome (possibly superhuman) Clinic Director, Jennifer Owen, is returning to the States after 6 months in Nicaragua helping to get Clinica Verde launched. Jennifer's work has consistently impressed the Board – we simply could not have made the progress we have without her able leadership. We will miss her dearly – but are heartened by the fact that she'll stay involved with Clinica Verde once she returns to the States.

• We are happy to welcome Dr. Alba Castillo as our new Clinic Director. Dr. Castillo is an M.D./MPH whose specialty is in Pediatrics. She served as a consultant on maternal-infant health to USAID working to improve quality of attention,  developing standards and measurements for quality for hospitals serving women and children and providing data analysis on processes and results from the country's plan to reduce maternal mortality and improve neonatal services. Dr. Castillo also served for 10 years as Coordinator for the Program on Integral Childhood Health focusing on Nutrition for the Ministry of Heath, providing training to staff on new standards of growth and development for children, including early stimulation, lactation, human rights for children and adolescents, family planning, and domestic violence. You will hear more from her in the coming months!

But most importantly, we continue to reach out and touch the lives of the patients we serve. Thanks for being such a vital part of our success! Feel free to email me anytime with questions:



Clinica Verde waiting room.
Clinica Verde waiting room.

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Organization Information

Clinica Verde

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