Health
 Nicaragua
Project #2680

Healthcare for Pregnant Women in Nicaragua

by Clinica Verde
Vetted
Eusebia Rodriguez
Eusebia Rodriguez

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!

Saludos,

Susan


The Waiting Room of Clinica Verde.
The Waiting Room of Clinica Verde.
Young mother at Clinica Verde.
Young mother at Clinica Verde.
Teens taking a health pregnancy class at CV.
Teens taking a health pregnancy class at CV.

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-E

Also, you can follow their journey here: www.babyonabike.com

Thanks for continuing to be a part of our work in the world!

Saludos,

Susan

Mic & Amaya riding for Clinica Verde.
Mic & Amaya riding for Clinica Verde.
Local teens in Boaco who led our recent survey.
Local teens in Boaco who led our recent survey.

Links:

Greywall Sanchez, one of our cherished patients.
Greywall Sanchez, one of our cherished patients.

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.

 

• From January through March of this year, we experienced 3,473 patient visits
* Of these patients, 63% came from rural areas; 35% urban; and 2% from other departments
• 47% of these patients were visiting Clincia Verde for the first time; 53% were repeat visits. This looks very good to us, since it means that we're both growing and retaining patients, who are returning for their recommended wellness visits. In fact ...
• 65% of our pregnant women are realizing the 4 or more recommended prenatal visits at Clinica Verde. This is great news!
In addition to the important work at the clinic, this semester we've been working with a group of students from the Yale School of Management, who have been helping us examine opportunities in our business model and strengthen our plan for long-term sustainability. The group traveled to Clinica Verde in March to meet with some of our key partners and do research. We are so grateful to these students for their time and expertise!
And ... CV Chief Medical Advisor Dr. Bob Moore attended the Global Health and Innovation Conference at Yale in April to present a social enterprise pitch on Evidence Based Design and how Clinica Verde's sustainably designed clinic is having a positive effect on patient behavior. 
We continue to make positive steps forward in our work. I'm writing you now from Managua, where this morning I'll be meeting with a representative of Green Empowerment to discuss partnering on solar at the clinic; will present to the Board of the American Nicaraguan Foundation; will meet with a local President of Rotary to discuss opportunities for working together; and will catch up with the excellent people of Cafe Don Paco, who have been partnering with us in our work. 
Thanks for being a believer! Your support inspires us to work harder and smarter every day.
Saludos,
Susan

Links:

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

Links:

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.

Links:

 

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Organization Information

Clinica Verde

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

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