A Clinic Sees Success Amid Chaos

by Emma Halper, Program Assistant, Latin America & the Caribbean, PSI

Carlos lives in Nicaragua, which has been embroiled in continuing conflict since early 2018. Carlos doesn’t like the noise and chaos this life brings; he’s a country boy at heart and misses his home town of Chontales. He grew up with his six brothers and sisters surrounded by livestock and open skies.

In Nicaragua’s busy capital of Managua, Carlos operates a clinic where women of reproductive age and teenage mothers come to seek family planning methods and counseling services. But when civil unrest broke out in April 2018, Carlos and his employees couldn’t safely continue doing the community outreach that had sustained the clinic since its opening.

Carlos needed to find an alternative. The clinic was experiencing its most significant decrease in users to date.

Carlos has been with the clinic since its inception. A few years after moving to Managua, Carlos had the opportunity to collaborate with PASMO, PSI’s network member in Central America, while working on an HIV prevention project. When a position opened to spearhead the opening of a Red Segura clinic, PASMO’s network of socially franchised clinics in Latin America, Carlos led in building the foundation of a place that has become a source of comfort for many of its clients. One young woman, Grethel, was so moved by her experience at the Red Segura clinic that she decided to become a volunteer promoter to help others feel the same warmth and support that she did.

So it’s no wonder that Carlos is determined as ever to keep his clinic open, even with thousands of businesses closed in public opposition to the conflict.

“Health is a priority”, he emphasizes.

Carlos knew innovation was necessary to increase the clinic’s demand amid the unrest. The clinic now relies on cyber-educators who conduct online interventions through social media sites such as Facebook, which allows the clinic to keep its employees safe, since it’s sometimes dangerous to go outside to gather in groups for on-the-ground outreach.

Despite the danger of traveling to the clinic, clients remain determined to access the health services they need and deserve, traveling individually to the clinic to avoid attention. In June and July, clinic attendees skyrocketed after May’s decline. In July alone, the clinic saw 90 new clients, 65 of which reported that they learned of the clinic’s services through Facebook.

As the conflict persists in Nicaragua, Carlos and his team remain determined to keep the clinic open, continuing to provide reproductive health services and a sense of normalcy to their clients.

“The present is hard, the future is very uncertain, but we come from tougher situations,” says Carlos. “This is something that we have lived through…I know that we are going to return…[to] tranquility.”

Carlos is devoted to his work with PASMO, to expanding the clinic programs and to serving the Nicaraguan people. He plans on staying with PASMO for the rest of his professional career—until the day he returns home to Chontales.

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