By Adrienne Clermont
I am incredibly grateful for my time volunteering at Clinica Verde. Three weeks of shadowing the doctors there left me with a wealth of impressions and experiences that I will take with me as I begin my medical training.
From a clinical perspective, CV provided me with a lot of firsts. Because of my interest in maternal health, I most enjoyed my days shadowing Dr. Baca, CV’s gynecologist. I had the chance to see my first pap spear, my first colposcopy, my first cervical cryotherapy, and my first ultrasound (followed by many more after my first, in each of those categories!). One of my favorite experiences was seeing the ultrasound of a woman who was 37 weeks pregnant with twins. I saw many pregnant women who were happy to be receiving the antenatal care needed to keep them and their babies healthy, but I also saw the more difficult patient interactions that doctors inevitably face – including early pregnancy losses, worries of infertility, and fears of cervical cancer. The compassion, friendliness, and patience with which Dr. Baca interacted with each of his patients was an inspiration for how I hope to practice in the future.
Although I am transitioning to a clinically focused career, I can’t help but keep my public health hat on as well. And from that perspective, CV provided a number of fascinating observations. Perhaps most strikingly, the patients that I saw while shadowing starkly illustrated the “double burden of disease” that afflicts Nicaraguans: while many people (particularly children) still suffer from infectious diseases such as diarrhea, pneumonia, and mosquito-borne diseases, many others (particularly adults and the elderly) suffer from chronic or non-communicable diseases such as hypertension, high cholesterol, and diabetes. I was able to see the environmental issues tied to poverty, such as poor sanitation and use of open cooking fires (which can cause respiratory ailments), that play a direct role in communicable diseases. At the same time, it was hard not to see the link between the typical Nicaraguan diet — which is heavy on fried foods and carbohydrates, increasingly reliant on processed packaged foods and soft drinks, and light on fresh fruits and vegetables — and the non-communicable diseases. This is an issue that CV is trying to address with many of its patients, and I was fortunate enough to observe a consultation between a patient dealing with obesity-related medical issues and CV’s nutritionist. These were all issues that I have long studied as a public health practitioner, but CV allowed me to see them up close, understand what preventive interventions look like in reality, and most importantly connect them to clinical practice with individual patients.
In addition to all this, my time at CV gave me the chance to learn about the history and culture of a new country, improve my Spanish communication skills (particularly in a healthcare environment), and foster new friendships. I am grateful to the CV staff, patients, and community for the welcome they gave me and for all the experiences I was able to take away.
Adrienne Clermont is an international development professional with expertise in the areas of public health, food security, nutrition,and supply chain management. She recently served as an intern at Clinica Verde.