Archive for the ‘Uncategorized’ Category

Meet Our New Board Member, Dr. Kim Lam

Monday, December 19th, 2011

We’re pleased to introduce you to our newest Board Member, Dr. Kim Lam!

Kim is serving as an OB/GYN at St. Helena Hospital and the St. Helena Women’s Center in St. Helena, California. A graduate of Texas Tech University Health Sciences School of Medicine, she received her medical degree in 2007. During her residency at Baylor College of Medicine in Houston Texas, Kim was named Outstanding Medical Student Educator and earned the Ben Taub “Service First” award 2009-2010. She received her undergraduate degree in microbiology from University of Texas at Austin, where she was awarded the Lawrence C. Baker Scholarship. In addition, Dr. Lam, who is fluent in Vietnamese, English, and medical and conversational Spanish, has performed volunteer clinical service on two continents, including in Juarez, Mexico; Nairobi, Kenya; and most recently in the Dominican Republic.

Apart from all that, she’s simply awesome – already a valuable contributor and creative thinker among our group. (And, we’re pleased to add, she has a great sense of humor.) We are so fortunate to have her among us!

Exhibit A: Our Supply Room – AFTER!

Thursday, November 10th, 2011

This is our supply room AFTER it was inventoried and organized by CV Super Volunteer Jennifer Owen. (Yes … it’s a thing of beauty.)

This is what it looked like pre-Jennifer.

We love people who get things done!

CV Boaco Update

Friday, October 21st, 2011

CV Legal Rep Rafael Morales, Dr. Armando Incer and the MINSA inspection team in Boaco.

As we work to raise awareness and support in the U.S., a lot of activity is taking place in Nicaragua. Our dedicated team in Managua and Boaco are working hard to keep our project moving forward. Here are some highlights of our progress:

• The American Nicaraguan Foundation inspected the clinic on Oct. 4 to approve us for receiving medications and support through their incredible foundation. Thanks, ANF!

• The Ministry of Health visited Clinica Verde on Oct. 20 to inspect the clinic for approval. Thanks to this great MINSA team for their time and attention. We hope to satisfy their requirements quickly so we can begin the work of serving impoverished Nicaraguans!

• Recommended personnel are being reviewed by our legal rep in Nicaragua, Rafael Morales, and Clinica Verde Board Vice-Chair, Dr. Elquis Castillo.

• Former Minister of Health of Nicaragua and CV Board Member Margarita Gurdian spend time in Nicaragua following an assignment with USAID in Angola, and met with officials and CV team members to review goals and action items prior to clinic opening.

• CV volunteer Jennifer Owen is in Boaco helping with clinic setup. She has been an enormous blessing to our project.

We are moving forward!

Clinica Verde Light Study at PEC

Wednesday, July 20th, 2011

By Bill Bylund

To test the natural lighting effect from the clerestory windows at Clinica Verde, I recently visited  The Pacific Energy Center (PEC) in San Francisco. The PEC is a resource available to people interested in energy efficiency in every aspect of design and construction.  They have a program for testing shading and light distribution in buildings.  To record the data one has to bring a scale model of the proposed building to their laboratory where it is attached to the base of their Heleiodon, a mechanical apparatus that rotates the model to simulate various sun angles.  They take pictures of what occurs inside the model using a special camera.

The model is a scale model of the west wing of Clinica Verde, which was oriented north and south to capture the natural light most efficiently.  We maximized the ability to capture the greatest amount of natural light by employing clerestories facing south and north.  To enhance the effectiveness of the light capturing process we added light shelves.  This device shades the lower windows while directing bounced light through the clerestory windows onto the ceiling inside.  This ensures the light is reflected deep into the interior.  We added a clerestory at the halfway point in the length of the west wing to achieve an even distribution of the reflected light.  We weren’t  certain the north facing clerestories would be effective, which is one reason for the necessity of the Heliodon study.  The clinic site is located 13 degrees north of the equator.  Since the Tropic of Cancer lies 23 degrees north of the equator, there is a potential for capturing some direct natural lighting in the winter time, unlike here in the States, where we are above the most northern path of the sun around the earth (Tropic of Cancer).  Artists like north-facing windows in their studios because they receive a diffused light that does not produce shadows or hot spots.  When you are trying to maximize the lumens (light intensity) in an interior space, to replace dependency on electric lighting, you want to capture direct light from the sun.  To reduce heat gain, bouncing the light into the space using light shelves is a preferred technique.

Our intent has been to have systems that dovetail to provide an even dispersion of natural light throughout the building while selectively protecting certain areas from the intense seasonal sun.  We accomplish this with clerestory windows, strategically positioned skylights, large areas of windows, glass blocks, large overhangs and light shelves, all working in concert with each other to greatly reduce the requirement for electric lighting and heat gain.

You can contact Bill Bylund directly at bill@valleyarchitects.com

Our medical equipment arrives at the clinic!

Wednesday, July 6th, 2011

After a long delay in Nicaragua customs, we are happy to report that our shipment of medical supplies and equipment has arrived at Clinica Verde and is being inventoried by Dr. Armando Incer. Things look good, and we’re eager to unpack it all and get things in their place so that we can continue moving forward!

We’d like to recognize and thank IMEC for organizing and arranging the entire shipment for Clinica Verde. IMEC is a volunteer-based organization whose mission is to provide doctors in developing countries with quality medical equipment to improve health care for the poor. IMEC has worked with over 60 humanitarian organizations to revitalize hundreds of existing, impoverished hospitals with donated surplus medical equipment and supplies that are organized into complete medical departments, delivering them to over 70 countries around the world. They made the job of equipping our clinic efficient and highly organized in ways that helped us to conserve both time and resources. A special thanks also to Clinica Verde board members/volunteers Dr. Mary Huber and Don Farrar for identifying and coordinating with this world-class charitable organization.

More pictures below!

Cumplir Con Uno de Nuestros Medicos Favoritos …

Tuesday, May 24th, 2011

Dr. Armando Incer, Clinica Verde

Vos has trabajado los pasados tres anos con la junta directiva de Clinica Verde. Como fue esta experiencia? Que ha sido los retos mayores – y que ha sido lo mas gratificante?

Ha sido una experiencia muy importante en mi vida, pues he visto como un grupo de personas dan lo mejor de si, y lo mejor de esto es que se entregan por una causa que es noble y que lo hacen buscando como cambiar las vidas de personas que no conocen.

He aprendido que es mejor dar que recibir, que es muy importante en la vida de las personas luchar por una meta y hacer todo por alcanzarla.

Todo ha sido un reto, he estado en el proyecto desde sus inicios, en la formulación, en ayudar a definir la localización, y en ayudar a conseguir el terreno, he estado en cada uno de los pasos y ahora lo siento mio.

Una vez dije que hay una frase que ha marcado mi vida y es:  “SI LAS COSAS QUE VALEN LA PENA FUERAN FACILES, CUALQUIERA LAS HARIA.” Y definitivamente el trabajo que ha hecho la directiva ha VALIDO LA PENA y con su trabajo y dedicación nos han mostrado que la tarea ha sido difícil pero hemos llegado a cumplir nuestro sueno.

Habla un poco sobre tu visión para la Clínica Verde.

Pensar en Clínica Verde se traduce en AMOR a nuestros semejantes, amor a los niños, amor a las mujeres campesinas, amor a los pobres. Este AMOR lo demostraremos con nuestro trabajo, y será gratificante decir que la CLINICA VERDE no solo tiene el color de la esperanza, sino que también trae la esperanza de una vida mejor para nuestros pacientes.

Cierro mis ojos y sueno con una “clínica bonita,” pero no bonita solo por la infraestructura, bonita por que será un lugar en que los niños y las mamas estarán a gusto, sentirán que les pertenece y tendrán la confianza de asistir sabiendo que serán atendidos como nunca lo han sido en ninguna otra unidad de salud. Imagino a los niños en sus citas de control, viéndolos sanos, nutridos, con buen desarrollo físico-intelectual y a las mamas sabiendo que su embarazo esta seguro gracias al esfuerzo de todos los involucrados en la Clínica Verde.

Que quieres decir a la gente en lugares lejanos que han apoyado este proyecto para la comunidad de Boaco?

Quiero contarles que Susan ha sido un ángel para Boaco, y decirles que ella me dio una gran lección en la ultima reunión en Granada. Ese dia le preguntamos: Por que?? Por que?? Por que Susan ha impulsado esta tarea???? Y ella nos dijo: Tengo todo, no me falta nada y para dar gracias a Dios tenia que hacer algo.  Y este algo resulto en la Clínica Verde.

Pienso que igual que Susan todas y cada una de las personas que han ayudado lo han hecho “dándose” por completo a este proyecto y lo han hecho por que sienten que “para vivir es necesario navegar” y ellos al apoyar el proyecto deben sentir que han navegado por la vida.

Mi padre nos decía que en la vida “Es prohibido NO soñar.” Y yo he soñado gracias a ustedes y he visto como gracias a personas como ustedes los sueños se hacen realidad.

Muchas Gracias.

What Makes Canadians Michael and Jason So Cool

Thursday, April 14th, 2011

Awesome Supporters: Michael Sidra and Jason Macdonald
Michael Sidra and Jason Macdonald are environmental health officers in Edmonton, Alberta, Canada. Recently, they entered a competition asking for creative and new ideas to promote the public health field through the Canadian Institute of Public Health Inspectors. Michael and Jason won the competition, and they will receive their award, along with $1,000 in cash, this June in Halifax, Nova Scotia. Michael and Jason have chosen to donate the money they’ll be receiving from this award to Clinica Verde – and to encourage others in their field to donate as well through Give Forward. Below, why these awesome supporters chose to support Clinica Verde.

Why have you taken an interest in Clinica Verde? What about the project excites you?
Clinica Verde appeals to us because the organization is helping build infrastructure that will serve the vulnerable population of Nicaragua.  The innovative environmentally sustainable design of the facility shows the forsight of the Clinica Verde leadership team.  As environmental public health professionals, we are also excited to see and support the efforts of Clinica Verde to offer public health initiatives on top of their primary care focus.

What do you hope to accomplish through this grant/fund-raiser?
We hope that we are able to raise funds, but even more importantly raise awareness of the great work that the Clinica Verde organization is doing to support the vulnerable population in Nicaragua.  Long-term support for their efforts is essential in order to enable them to make a sustainable difference in the community and thus we hope to increase the level of ongoing support/donations that Clinica Verde receives beyond the fund-raiser.

Why do you think others should support Clinica Verde?
Since both of us are proud parents, we have an appreciation for quality health care.  There is nothing worse that having a child or a close family member who is ill.  Clinica Verde provides this essential medical care for mothers and children who need it the most.  They are also providing health education that will enable them to better their own lives such as food safety and nutrition education for visitors of the clinic.  After saying all that the question then becomes – is there any reason not to support Clinica Verde?  We think not.

Help Michael and Jason Give Forward

Clinica Verde, April 2011

Thursday, April 14th, 2011

Here are some photos of the clinic from a couple of days ago. Just a few more things to do to wrap things up on the construction side. Equipment should arrive soon.

Hey, where did he come from … ?

Farewell and Thank You, Sr. Johny Siman …

Wednesday, April 13th, 2011


What has it been like working for Clinica Verde these past couple years?

Being part of the Clinica Verde Team has been a much enriched and challenging experience. With all the ups and downs, natural to any project, we were able to carry out our goals and build Clinica Verde the way it was intended with all its features that will make this project unique.  I would have to confess that when I was presented with the project I didn´t think we would be able to carry it out. Yet, I took on the challenge and the project took its course.

What about Clinica Verde stands out to you?

Clinica Verde has so many things that make it stand out. The holistic approach to healthcare and education, the ecological design, the cooling of the building with natural air instead of electricity, the natural sunlight that illuminates all the areas of the building, the classroom for education on nutrition, prenatal and postnatal care, etc.

But if I have to pick out one thing that stands out the must, it would have to be the people involved in the project:   Susan, Tim, Peter, Vikki, Ken, Kathryn, Dennis, Mary, Bill, Don, Joan, Elquis, Rafael.  I believe that the success of any venture is due to the people that are in charge of making the decisions.  The team of Clinica Verde is much diversified and has lots of experience on social projects. And even though each person is assigned a specific field of the project, everybody is involved on the decisions of the project. John D. Rockefeller once said that an extraordinary person is just an ordinary person that does something extra. I believe that the members of the board of Clinica Verde are ordinary people doing something extra for the people of Boaco.  That’s why I think that this is the aspect of Clinica Verde that stands out the most and the reason Clinica Verde will be a success.

What is your hope and dream for our project?

I hope that once the Clinic opens up, that the people of Boaco understand and appreciate all the effort going into this project from so many people. That they understand that Clinic is theirs.  That they know that we don’t expect anything from them except to help them mitigate poverty by having quality healthcare available to them.  My dream is that this project can extend to other parts of Nicaragua or other countries.

Any parting words?

Even though I’m not physically there, it does not mean that I am not there. Clinica Verde will always be a part of me and I always support the project, whether I am in Nicaragua, El Salvador, the United States or any other part of the world.

Clinica Verde Featured in U.S. Ambassador’s Speech to American Chamber of Commerce

Monday, March 7th, 2011

Ambassador Robert J. Callahan (blue shirt and tie), seen here during Clinica Verde’s 2011 annual meeting of the board in Granada, Nicaragua.

On March 2, U.S. Ambassador to Nicaragua Robert J. Callahan delivered a speech to the American Chamber of Commerce in Nicaragua that generously commended the work of Clinica Verde. The full text of the speech appears below. Thanks very much, Ambassador Callahan, for being such a force for good diplomacy in the world.

* * *

Fact and Fantasy:  the United States and its Policies in Nicaragua

March 2, 2011, Ambassador Richard J. Callahan

Good afternoon and thank you for this opportunity to speak.  The American Chamber of Commerce in Nicaragua has been a catalyst for economic development and a bulwark of democracy for many years.  I salute you for your numerous achievements and wish you many successes in the future.

I’d like to take this opportunity to congratulate Doctor Yali Molina on his election as Amcham president and acknowledge publicly Licenciado Roger Arteaga for his superb work as president and for his forceful and valiant advocacy of democracy in Nicaragua.  You both have the support and admiration of the American Embassy in Managua.

I would also like to take a moment to congratulate our friends at La Prensa, a paper which celebrates today the 85th anniversary of its founding.  Few editors and reporters anywhere in the world, or for a longer time, have shown such courage of their convictions, such determination when confronted with threats and censorship, and such commitment to the idea of free expression as those who have made that paper a symbol of democratic defiance.  To all those who work there, and have worked there, and to the members of the Chamorro family who have guided the paper through many tumultuous decades, thank you for your contributions to freedom.  May they continue for many decades to come.

I just wish that Guillen would make me look better in his caricatures.

Today I want to talk about the United States and respond to some allegations and accusations that I hear, and have heard for over two years, about my country’s policies and intentions in Nicaragua. As the bromide has it, everyone is entitled to his own opinion, but no one is entitled to his own facts.  I want to offer some facts.

I then want to describe what we really do here, which is nothing more than to support those Nicaraguans who seek to strengthen democracy and generate prosperity for their country.

In doing so I will depart somewhat from customary diplomatic language.  I will be candid in my comments and direct in my exposition.  But I offer my views in the belief that we can speak truthfully to each other, as friends and as partners, and by doing so create a more mature and respectful relationship.

Let’s start over 150 years ago, with the inevitable William Walker, who is invoked with such frequency that you might think he was here last month.  It is said that he was sent by the American government to colonize Nicaragua and establish slavery.  The truth is that Walker was an adventurer, something akin to a land pirate, and that President Castellon, a Liberal, invited him and his band of mercenaries to join his side in a civil war against the Legitimists or Conservatives.

It is true that at the beginning of Walker’s campaign, the American government did nothing to restrain or condemn him.  And it is also true that, when his fortunes began to sour and his situation became desperate, he planned to establish slavery in Nicaragua.  He thought that this would earn popular support in the slave-holding states in America, and it did.

But when it became apparent that Walker was indeed a danger to Nicaragua and an embarrassment to the United States, Secretary of State William L. Marcy took measures to discredit and disarm him.  He marginalized the American minister, John H. Wheeler, who was sympathetic to Walker, and ordered American warships to intercept the Filibuster’s supplies and reinforcements.  In fact, when Walker left Nicaragua and returned to the United States, he blamed his defeat on Marcy and Cornelius Vanderbilt.

Walker was clearly crazed, a true megalomaniac, and he caused death and destruction wherever he pitched up.  But he was acting on his own and received no support from the American government.

Those are the facts.

America remained interested in Nicaragua over the next 50 years, especially as a potential site for the inter-oceanic canal, but it was the arrival and lengthy presence of Marines during the first third of the last century that has provided grist for current criticisms.  Although I will not attempt to defend that policy, I do think it fair to recall that the Americans sent the Marines with good intentions:  to put an end to political chaos and help Nicaragua establish a stable democracy.

Of course, the Marines stayed for about 20 years and their presence was a daily insult to many patriotic Nicaraguans, including Augusto Cesar Sandino.  He took up arms and waged an effective guerrilla war against them.  However, following the peace agreement in Tipitapa in 1927 and the promise of national elections, according to a book I’ve read that cites one of Sandino’s letters, Sandino wrote to the Marine commander in Jinotega, proposing to lay down his arms provided the Marines remained to ensure free and fair elections.

Another renowned Nicaraguan figure to emerge from this period was Anastasio Somoza Garcia.  As history would prove, Americans erred in selecting him to lead the newly created and non-partisan National Guard, which was to replace a politicized army, but it would have been impossible to know Somoza’s intentions at the time.  He seemed bright and well intentioned and he spoke English.  He talked of democracy.  He extolled freedom.  He promised elections.  He charmed us, and many others.

Yes, we supported him and his sons for years, tolerating them in the name of national security.  But at the end, admittedly late in the game, we abandoned him.  Many contributed to the defeat of Somoza, but we did play a modest, if belated, role.

Those are the facts.

But no matter our interpretation of history, no matter the prism through which we see the past, it profits us nothing to dwell there.   Yes, acknowledge it, learn from it, but move on.  After all, don’t we have enough problems in the present?  Don’t we have enough challenges to address, as individuals and nations, as neighbors and partners?

We certainly think so, and that is why I have talked frequently over the past years about America’s commitment to the Nicaraguan people.  I would like to think that by now our various bilateral programs – USAID’s work on health, education, and democracy, the MCC’s contributions to infrastructure development and technical assistance, the Peace Corp’s daily involvement with thousands of Nicaraguans – are well known.   Over the past two decades the American people have spent in Nicaragua over 2 billion dollars.

But there are many other, much less visible, ways that America and Americans contribute to Nicaragua’s economic and social development.  Take, for example, remittances.  Although we have no exact figures, we estimate conservatively that Nicaraguans receive at least a half a billion dollars annually from workers and residents in the United States.  The United States has welcomed these workers, many of whom are immigrants, and has never interfered with their desire to send money home.

Take trade.  Since the inception of CAFTA almost five years ago, Nicaraguan exports to the United States have increased by 71%, to a current total of about two-billion dollars.  Think of the jobs this has engendered, the opportunities it has created, the wealth it has generated.

To help in the export of agricultural commodities, the United States Department of Agriculture has worked closely with Nicaraguan ministries and farmers to increase yields and reduce disease.  We have offered training, education, and equipment to the specialists, and then provided motorcycles and trucks to get them into the field.  Over the past decade this has cost 66-million dollars.  Then, just last month, we made an additional 10-million dollars available.

Another program sponsored by the Department of Agriculture, as strange as it may seem, is in microfinance:  providing loans to entrepreneurs in businesses related to farming.  To date, this initiative has made loans available to 9,000 clients in the amount of over 2.2 million dollars at modest interest rates.

And we continue to devote effort and resources in other ways to Nicaragua’s largest economic sector, agriculture.  Through our various USAID programs the United States provides millions of dollars each year to improve farming techniques and increase agriculture production in Nicaragua, especially among the smallest and poorest farmers.  We want to encourage them to move from subsistence farming to become producers who sell their surplus at a profit, making them, their families, and their communities more prosperous, and in the bargain contributing to Nicaragua’s food security.

These are not crumbs.  It is development, and it involves a lot of money, money that comes from hard-working Americans who may themselves be struggling to remain solvent.  We should never lose sight of that.

The programs I just described, and there are many others, are designed to promote Nicaragua’s economic growth, most notably among the needy and indigent.  Along with the prudent macroeconomic policies and a commitment to free markets pursued by this and previous governments, and with contributions from other donors, we have seen significant progress over the past 20 years.  We take satisfaction from that, and also in our social programs.

Like you, I often hear accusations of America’s imperial designs on Nicaragua, criticisms about our evil intentions here.  As I discuss a few of our social programs, I’d ask that you give some thought to how, by any stretch of the imagination, these programs support imperial policies or promote nefarious ends.

Let’s begin with child labor.  When a child works to pick coffee or cut sugar cane, he is not only deprived of a proper education but also jeopardizes his mental and physical health.  He is denied the simple joys of youth, the freedom to play and explore, read and learn.  He grows old while still a child, loses his innocence while still young.

To address this scourge, the United States Department of Labor has created a program called Enterate and has provided 5 million dollars for its execution over three years.  The intention is to rescue five-thousand children engaged in physical work and prevent an additional five thousand from becoming involved.  Now functioning in the departments of Madriz and Jinotega, and in cooperation with enlightened owners of coffee plantations, Enterate is providing quality education to thousands of children who otherwise would be picking beans or coffee.

There is another, equally important, facet of the program that targets children in Managua who have been sold into prostitution or compelled to work in markets or on the streets.  They too now have an opportunity to learn and grow as normal children, free of the fear of forced labor.

An American idea.  American money.  Is this an American plot to subvert Nicaragua’s sovereignty or further America’s imperial ambitions?  Ask those kids in school.  Or their parents.

What of the American military, the very instrument, according to some, of our imperial designs?  By now the annual visit of a U.S. Navy ship, often the hospital ship Comfort, is old news.  The doctors, nurses, and technicians aboard, working closely with Nicaraguan medical personnel and those from other countries, such as Holland, Colombia, and Canada, treat about 10,000 poor Nicaraguans during their two-week stays.  They perform routine and complex surgeries, distribute thousands of pairs of eye glasses, offer health classes, and provide medicines of every sort.  Other crew members undertake civic-action programs, such as building basketball courts or repairing schools.

The arrival of these ships attracts a lot of media attention.  What is less well known, but every bit as helpful, are the humanitarian projects that occur without much fanfare.  For example, our military has built warehouses on the Atlantic coast and stocked them with supplies for use in emergencies, such as natural disasters.  They have dug wells in small towns to provide safe drinking water.  They have donated thousands of mosquito nets in an effort to reduce the incidence of malaria in the RAAN.

To be sure, our military also comes to help train, equip, and work with the Nicaraguan armed forces, but our exclusively humanitarian programs probably cost close to five million dollars a year, more than we spend on military training, equipment, and exchanges.

Why do we do it?  We do it because we are committed to the Nicaraguan people and want to show them, in the most tangible way, our friendship.  Some may find a sinister motive in that, but I do not.

So far and for the most part I have discussed the American government’s many programs in Nicaragua.  Now I’d like to turn briefly to what private American citizens, with little or no reference to their government, are doing here.

Working with their Nicaraguan counterparts, they are engaged in an array of efforts to improve health and sanitation in the poorest communities and bring medical attention and decent housing to the neediest.  They arrive, go to their site, do their work, and return home.  We often don’t even know they have been here.

Let me cite a few examples.  Dr. John Lent and his wife Barbara bring a medical brigade to Rosita for two weeks each year.  They perform surgeries and provide routine health care, distribute medicine they have brought from home, offer training to local doctors, and send dentists to the far countryside, where they treat people who have never seen a dentist before.

Amy Wiza runs the Wisconsin-Nicaragua Partners of America, one of the most active chapters in the program.  Amy’s mother, Sherin Bowen, whom I admired and respected, lost her life in an accident while working on a project in Managua almost two years ago.  Her selfless example continues to animate all those involved in the organization, especially the young Nicaraguans she nurtured and mentored.  Today, under Amy’s direction, the Wisconsin Partners in Nicaragua donate fire trucks and bicycles, provide clothing and sports equipment, repair houses and schools, and sponsor educational and cultural exchanges, among many other endeavors.

Susan Dix Lyons, who came to Nicaragua as a young journalist 20 years ago and who today lives near San Francisco, California, has dedicated herself for the past four years to building an eco-friendly health clinic near Boaco.  To date, she and her committee, including her husband, Dr. Tim Lyons, have raised a million dollars and now have completed Clinica Verde.  They will dedicate it soon.  Once operational, the clinic’s doctors will care for expectant mothers and give them the kind of attention that will ensure a healthy pregnancy and safe delivery.  And the Clinica Verde foundation will assume the annual costs of operating and maintaining the hospital, including the salaries of doctors and support staff, and the purchase of medicines and supplies.

Kevin Marinacci, then a recent graduate of Georgetown University, came to Nicaragua at about the same time that Susan Dix Lyons did.  Encouraged by the Jesuit fathers at Georgetown to go out and help the less fortunate, he decided to volunteer for a while at the Fabretto Foundation.  When Father Fabretto died unexpectedly, Kevin took on the direction of the operation, which he still runs.  He persuaded his father Carl to serve on the board, and together the Marinaccis have raised millions of dollars to feed, teach, and give hope to thousands of young Nicaraguans in eight Fabretto educational centers and fifty public schools throughout the country.

I know these people, and others, and what they do because I have talked to them and visited their projects. But there are hundreds, perhaps thousands, whom I do not know personally.  Some are affiliated with churches or charitable groups.  Some work with medical or dental organizations.  Others come alone.  All of them do good work.  They repair hare lips and cleft palates in Matagalpa, distribute toys to sick children in Leon, deliver medicine to remote villages along the Rio Coco, teach farming techniques to poor campesinos in Somoto.  They do it because it’s the right thing to do.  They do it because it is the American way, embraces American values, shows the American spirit.  They do it because they enjoy doing it.

They do, however, complain about red tape and petty harassment.  They come to the embassy, baffled and often angry, and tell us that they have great quantities of medicine that they cannot get out of customs.  They tell us that they have hundreds of donated wheelchairs, used but in good condition, that the authorities at the airport will not release because they do not have a bill of sale – the equipment, I repeat, was donated.   They tell us that they had toys to give to poor children for Christmas, but that the crates are still locked in an airport warehouse, caught in a bureaucratic snare.  And it is now long after Christmas.

This happens repeatedly to voluntary organizations that are operating on a small budget.  And while their donations are awaiting clearance, they are charged up to a thousand dollars a week in storage fees, something they cannot afford and should not have to pay.  I know that countries need to protect their borders, and can enact their own customs regulations and set their own storage prices, but every consideration should be given to those who have come here not to seek profit, but to offer help.  If this kind of treatment continues, it will almost certainly lead some of these groups to go elsewhere.  The Nicaraguan people, especially the neediest, will be the ones who suffer if this comes to pass.

I have heard complaints from the Nicaraguan government, too, mostly about the amount of our support and conditions we place on our bilateral aid.  Let me take each in turn.

Our bilateral assistance of all types to Nicaragua comes to over 60 million dollars a year.  Yet Nicaraguan officials claim that this is woefully insufficient, especially the part destined to law enforcement.  Well, we have contributed 24-million dollars since 2007 to Nicaragua to help in combating crime, including drug trafficking, and we hope to increase significantly that amount in the years ahead.

Still, certain people find fault with the program.  I therefore find it odd, and not a little ironic, that the Nicaraguan government last year decided not to sign an agreement that would have provided seven-hundred thousand dollars to study penal reform and establish anti-gang programs.

And what about the conditions we place on our money?  What should be the alternative?  Senior Nicaraguan officials have told me that we should simply turn over a check, that they know better than we what Nicaragua needs.  Maybe so, but I somehow doubt that our elected officials will agree to spending the American taxpayers money in such a manner.  It could easily lead to their losing the next election.

Anyway, what are those conditions?   Are they onerous and intrusive?  Are they unfair?

To begin with, we do not condition our humanitarian aid.  If people are suffering, we help.  We have given food to North Korea during famines and offered relief supplies to Cuba after hurricanes and to Iran after earthquakes, and we do not maintain diplomatic relations with those countries.  We have spent over a billion dollars combating AIDs in Africa, and much of that money goes to organizations working in countries governed by regimes that are authoritarian and barely responsive to our diplomacy.

In most countries, though, and on most programs, we do place conditions on our aid.  We insist on respect for human rights and individual freedoms, credible elections, and budget transparency.  We require a regular accounting of how our money has been spent.

Why should any country, especially one identifying itself as a democracy, object to these simple standards?  It is somewhat akin to electoral observation.  If you have nothing to hide, you have nothing to fear.

And that leads me to this:  we have nothing to hide in Nicaragua.  The goals of the United States in Nicaragua have not changed since my arrival over 30 months ago and will not change in the future.  We seek to support those Nicaraguans who are attempting to strengthen their democracy and develop their economy.  We are confident that these are the right policies.  We conduct them openly and without preference for party or person.

When we talk about democracy, we mean more than free, fair, and transparent elections, although they are essential.  We mean rule of law, due process, separation of powers, checks and balances, and respect for those individual rights common to all liberal democracies:  freedom of speech, religion, press, assembly, and movement.

We mean that no one is above the law, that elected officials serve the people by governing, not ruling, and that they owe the people an explanation of their policies, decisions, and spending.  We mean that institutions are more important than individuals and that the cult of personality is inimical to true democracy.

We also mean something a bit more, something amorphous but real, and that is a tolerance for other opinions and a belief that no person and no party has a monopoly on truth and wisdom.

When enough people in any country come to believe and practice this, even when the belief is fragile and the practice flawed, democracy takes root and begins to prosper.  To be sure, the process is messy, often chaotic, and the results mixed.  But if there is a better way to preserve order while ensuring freedom, I have not come across it.

About 20 years ago we began supporting groups and organizations that shared some or most of those beliefs.  We continue to support them.  To my mind, and despite accusations of partisanship, these groups promote values, not people or parties, and have proven their worth through many years.

They have worked to strengthen civil society, protected basic freedoms, monitored elections, and criticized governments of every ideological stripe when they have disagreed with that government’s policies or found fault with that government’s behavior.  That’s responsible.  That’s democracy.

They have defended the handicapped and advocated for minority and women’s rights.  They have lived among the most desperate and given them voice.  They have reached out to the poorest to teach them about disease, nutrition, hygiene, and sanitation.  That’s noble.  That’s selfless.

What they are doing, always and everywhere, whether it involves politics or development, is good for the people and good for the country.  It is to be welcomed, not feared; supported, not suppressed; applauded, not condemned.

This is how countries grow confident and prosperous.  This is how democracies get strong and durable.  This is how people gain dignity and self-respect.  When the people themselves create these conditions and construct these institutions, they secure democracy and promote prosperity.

But however democracy comes, it must come from the people.  It cannot come from without.  It cannot come from another country or an international body.  It cannot be imposed.  It cannot be conjured into existence.

If takes courage, patience, good leaders, and constant vigilance.  It takes tolerance and sacrifice and compromise.  It takes hard work and energy.  It takes the people.

It always comes to that – the people.  Whether in mature and wealthy democracies, those of more recent vintage, or those countries struggling to create representative government, the people themselves ultimately must take responsibility for their own affairs.  The people themselves must fashion their future, determine their destiny.

Here the United States will support the Nicaraguan people where appropriate and their organizations when they advocate those universal values that promote peace, freedom, and democracy.  But it is you, the Nicaraguans, who must carry the burden.

In my two and a half years here I have traveled widely and spoken to thousands of Nicaraguans in schools and city halls, in factories and hospitals, on farms and softball fields.  They have impressed me with their intelligence, determination, vision, and optimism.  They have convinced me that this lovely country, rich in human and natural resources, will inevitably realize its enormous potential, will take its rightful place among the world’s wealthy democracies.

It will be a struggle.  It will take time.  But it will come.

Thank you.