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Ownership, Medicine and Trust at Clinica Verde

Daniel Olivieri

Daniel Olivieri, center, at Clinica Verde.

By Daniel Olivieri

“The real question now,” an old Cuban doctor told me, “is looking at what happens when it [universal healthcare] doesn’t work.”

We had just completed 15 interviews in Habana Vieja, when I decided I wanted to work in Nicaragua the following summer.

It will be different, I thought. It should be different, but it should also be particular, fluid, and innovative.

That’s when I found Clinica Verde.

I’m proud to say that Clinica Verde is everything that it looks like on their website, and then some. When you’re at Clinica Verde, in the words of administrator David Narvaez, “eres familia.”

While I came to the clinic to systematically define what ownership means in the context of post-modern development scenarios, I quickly came to realize that ownership and health are only defined by the terms that they are composed of and not the other way around.

In other words, trust, one of the defining characteristics of catchphrases like “ownership” and “patient-centered design,” is what really matters.

What could be more essential that trusting that the services you receive are not only high-quality, but are given with the utmost care, respect, and thoughtfulness?

Healthcare is much more than the medication you receive, the amount of doctors available at a clinic, or if you follow up with your appointments. Health is about the community you live in, the people you surround yourself with, and the way you perceive yourself. Health is about religion, sociology, and governance.

Healthcare is, and will always be, at its core, about justice.

And justice, I’ve learned, is a brutal uphill battle against the current, a unifying cause that brings together doctors from Boaco, patients from Puerto Cabezas, and a researcher from the States.

Just as doctors can be called the lawyers of the poor, clinics should be called on to provide a fair court where the lawyers can work, succeed, and vouch for their patients.

Let me, then, introduce you to Boaco.

In a little over four weeks here at the clinic, we’ve seen patients travel from over eight hours to eight minutes to attend the clinic, always for varying yet valid reasons. Clinica Verde, in convalescing the pieces of a public healthcare system that often garners more skepticism than pride, attempts to toe the line between free and effective care, betting on trust, charlas, and an innovative method to provide a trustworthy alternative to the expensive private clinics and public health posts.

And that’s a bet they haven’t lost yet.

From weekly outreach visits to rural communities surrounding Boaco to cost-sharing for medicine on a case-by-case basis, charlas to consejerias, Clinica Verde’s holistic moxie not only upholds the right to health, but it demonstrates the importance of trust, not money, buildings, or awards, as an effective solution to sometimes ineffective public healthcare.

By framing patients as people and not numbers, the clinic aims to provide Boaco with a more refined approach to care. One day, I hope, holistic healthcare will be tried-and-true, the bread and butter of public healthcare, but until then, clinics like Clinica Verde provide a reprieve from sometimes corrosive systems of care that merely provide biological care without actually “treating” the patient.

Does Clinica Verde have all of the answers? Can they help every patient in Boaco and its surrounding departments? Probably not. (At least not right now, they might tell you).

What Clinica Verde does have is trust.

And as I’ve learned here in Boaco, that can go a long way.

Daniel Olivieri is an undergraduate researcher from the University of Notre Dame in Notre Dame, IN, USA, and was awarded a Kellogg Institute Fellowship to work with Clinica Verde this summer. Daniel has completed research projects in Havana, Cuba, and Rocinha, a favela of Rio de Janeiro, Brazil, and aspires to work in improving the logistics of public health systems in developing countries through a biopsychosocial approach. He welcomes any questions, critiques, or comments, and can be reached at




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