This past weekend, Clínica Verde hosted Nicarguan architect Alfredo Osorio for a meeting in the Napa Valley. Osorio is our partner in Nicaragua – a fascinating, elegant man who has stories to tell about many of the greats in his field: Frank Lloyd Wright, Louis Kahn, Calatrava. Osorio recently designed the new U.S. Embassy in Managua, and has designed a plan for the city of Managua that he’s been pursuing with the current Nicaraguan government. His history is long and colorful, and we’re lucky to have him on our side.

Osorio was here primarily to participate in design meetings with our U.S.-based architect Bill Boyd, our project developer Peter Stanley, Nica project manager Johny Siman and other board members. He’s a guy who cuts straight to the center of a problem, with simple, commonsense solutions. Over two days, the design team met to further refine our plans in anticipation of a break-ground date of this spring.

But we also showed Alfredo a couple of highlights in the Napa Valley. The most memorable was a visit to the winery Frog’s Leap. Founded by John Williams in 1981, Frog’s Leap is located among 130 acres of vineyards in Rutherford. They produce 60,000 cases of hand-crafted Sauvignon Blanc, Chardonnay, Zinfandel, Merlot, Cabernet Sauvignon and Rutherford. It’s beautiful, the wine is superb and well-priced, but there’s a lot more to Frog’s Leap that makes it something to applaud and admire.

Frog’s Leap grows all it grapes organically, in addition to cultivating an on-site organic vegetable garden. And, in February of 2005, Frog’s Leap became 100% solar powered. One thousand photovoltaic panels collect sunlight that is then converted to a clean and renewable energy source. Its hospitality center is LEED-certified – green certification that is the gold standard in the environmental building industry. Our tour at Frog’s Leap was excellent, leaving the whole team inspired to work towards our own solutions of sustainability for Clinica Verde.

If you’re ever in the area, be sure to check out Frog’s Leap. You can read more about the winery here: Go to Frog’s Leap.

I’ll leave you with Alfredo’s words upon his return to Nicaragua: “Thank you for having the privilege to know so many noble people and the magnificent beauty and tranquility of Napa. I am so grateful to you that I do not have enough words to express it, but it is deep within me. I will never forget this trip.”

Nicaraguan architect Alfredo Osorio is our “man on the ground” in Nicaragua. Here (right), Alfredo meets with Clínica Verde architect Bill Bylund and project director Peter Stanley. Recently, Osorio answered a few questions for us about his involvement with our project.

Tell us about your career ­– how long you have been working, highlights and major accomplishments.

I have been practicing architecture and engineering since graduation at Tulane University in 1956. Since then I have continued studies obtaining a Master’s in Architecture and Master of Masters, equivalent to a Doctorate. I also studied structural engineering and business administration in Paris, France. I have an ample and large architectural practice, having been the architect for the best buildings in Nicaragua. In this last year I completed the Embassy Building of the Netherlands, and the Embassy building of the United States of America. I have just finished the design for the new American Nicaraguan School. Presently I am the candidate for doing the urban redesign of the City of Managua. So far, I believe I am the only candidate. I could tell you more but I am afraid of sounding a little boastful.

Tell us about your career ­– how long you have been working, highlights and major accomplishments.

I have been practicing architecture and engineering since graduation at Tulane University in 1956. Since then I have continued studies obtaining a Master’s in Architecture and Master of Masters, equivalent to a Doctorate. I also studied structural engineering and business administration in Paris, France. I have an ample and large architectural practice, having been the architect for the best buildings in Nicaragua. In this last year I completed the Embassy Building of the Netherlands, and the Embassy building of the United States of America. I have just finished the design for the new American Nicaraguan School. Presently I am the candidate for doing the urban redesign of the City of Managua. So far, I believe I am the only candidate. I could tell you more but I am afraid of sounding a little boastful.

What attracted you to the project Clínica Verde?

I am attracted to Clínica Verde for being such a charitable and good group of persons dedicated entirely to the welfare of humanity and at the same time the deep concern for the welfare of our planet.

Why is Clínica Verde important in your country – and how can you see it being a model for the world?

Clinca Verde, in my opinion, will be the cornerstone of the type of construction and services very badly needed in our country. It is my hope that it could be a paradigm of new Nicaraguan government construction in the field of medicine and popular health services. Naturally, once an example such as Clínica Verde becomes known, then its influence could spread to other regions of the world.

What is your personal vision for Clínica Verde’s sustainable clinic?

Clínica Verde has all the potential to be a sustainable entity to bring health and care to the poor people of Boaco, integrating local civil leaders to continue with the task of keeping it up and maintaining it.

Support Clínica Verde.

Anyone who’s even marginally involved with nonprofit work knows that an extraordinary amount of time and effort goes into fund-raising. Meeting and cultivating prospective donors, researching and approaching foundations, mobilizing friends and family and, of course, trying to figure out how to best employ social networking with the advent of Web 2.0. As a start-up, this reality especially applies. The funders we approach are more akin to venture capitalists – people who are willing to take a chance on an untested idea because they believe in the vision and thinking behind its model of success.

I love people like this not just because they’re willing to invest in Clínica Verde, but because they tend to be creative, bold in their thinking, and ambitious in their commitment to social change. They’re interesting, fun to be around and – a big bonus for me – generous with their time and experience. They also understand that sustainability in the nonprofit world no longer rests on the capacity to generate financial capital through tireless fund-raising. Make no mistake, we have an urgent need to raise funds to construct our clinic prototype and prepare for operation, but long-term our goals include a funding model with additional streams of income.

One of the most successful models in the field of healthcare is Aravind in India. Founded in 1976 by a physician who decided he wanted to end needless blindness, Aravind’s eye care system is now touted as the largest and most productive facility of its kind in the world. It is also financially self-sustaining. Aravind practices what is referred to as “compassionate capitalism,” essentially a tiered system in which those who can afford to pay do while the very poor receive free care. All clinical care maintains the same high standard of quality. In practice, Aravind says that it supports two-thirds of its patients, while the remaining third in effect subsidizes that care. The money generated covers operating costs in addition to financing expansion. In May, Nobel Peace Prize laureate Muhammad Yunus opened the first Grameen eye hospital in Bangladesh modeled after Aravind’s system.

As Aravind Executive Director Thulasiraj Ravilla tells the story, it was a failure of fund-raising that actually forced Aravind to become sustainable. Concluding that donors were giving more out of “pity than passion,” Aravind’s founders sought an alternate route. Through a combination of what is described as “innovation plus standardization” Aravind developed a model in which much of the care is performed by specially-trained students who support the clinics’ physicians – 4 to 5 trained students per doctor. These specialized workers receive a much lower salary than the physicians. Physicians, meanwhile, are able to focus on their unique capacities – performing surgeries, for example.

Aravind’s high efficiency fuels their margin.  They report that while most private practitioners will perform 20 to 30 procedures per month, Aravind performs 20-30 per day. All while maintaining a reputation for top-notch care. 

You can hear it from Thulasiraj himself in a podcast from Social Innovation Conversations, produced by the Center for Social Innovation at the Stanford School for Business. By the way, Social Innovation Conversations is a really great series that highlights the work of people on the forefront of creating social and environmental change around the world. 

We at Clínica Verde are exploring how we might apply such a model to our clinic prototype in Nicaragua, while remaining true to our goal of serving the poorest of the poor. Sustainability is one of our core values, and it extends to every aspect of our project.