10 things to know about life in Nica

this is for my loves who are coming to visit very very soon!


above, nicaraguan public transportation

1. Gallo pinto. It’s a way of life.
2. Time is just a completely different dimension here. Things start late and end on time. A meeting scheduled for 9 starts after 10:30, a store that closes at 4 closes after lunch, and if you need to be somewhere on public transportation, make sure you are there a half hour before your bus leaves but be prepared to wait an hour after it is scheduled to leave.
3. Waiting in “line” is really a race to the front. Always be ready to cut! Nica strategy: watch the person who is at the register then no matter where you are in the line, bumrush to the front to get try your chance at being next.
4. Personal space means NOTHING. If you’re not the touchy feely type, don’t come to this country. Touching, hugging, bumping, grinding is not just restricted to discos. Get ready to get close everywhere.
5. Don’t get flattered when the cute waiter calls you “amor” or “amor de mi vida”. In this country, these terms can be equated to “dude”. How can you not love a country that addresses a stranger as a lover ?
6. Cuts, scrapes, aches, Everything. . . According to Everyone. . . can be cured with either lemon or bean soup.
7. 80 degrees is “frio!”
8. There are no street names, addresses are hard to understand , and they often reference where landmarks once were, but are no longer. 2 blocks north and one west from where the national bank used to be behind the house where the lady who sold chicken feet lives. Its very easy to get lost but don’t worry! Just ask someone in the street and no matter where you are, they’ll give you the same answer. The directions to anywhere are “aqui no mas” (just over there!)
9. Its not meat, its just pork! You’re a vegetarian, oh great, just eat this fried chicken!
10. Alarm clocks are sooo the developed world. Who needs an annoying ringtone with when you have the cries of vendors selling honey at dawn fruit at noon and the tortillas at dusk !
..... to be continued

Millions of children die each year from diarrhea, a preventable disease.It is the leading killer of children under the age of five in Nicaragua. The Rotavirus that causes the disease is borne in contaminated water.

Number of people worldwide without access to drinking water: 884 million
Number of people worldwide without adequate sanitation: 2.6 billion

Percentage of Nicaraguan population without improved sanitation facilities: 52
Percentage of Nicaraguan rural population without improved sanitation facilities:66

Monte Fresco
One village. 520 people. 140 families. 120 latrines. $60,000 materials cost.

I expressed my fears of not getting the funding to my father. He reminded me that the US spends 255 million dollars a day in Iraq.

"Imagination is more important than knowledge. . .Imagination encircles the world."
-Albert Einstien


One village. 520 people. 140 families. 120 latrines.
Rotary Club. El Porvenir. FSD.

here we go.

Donations disappeared

It’s a culture of hand outs and you are a gringa. What you are going to do, how you are going to help, but more importantly what are you going to give. “What can I have when you leave? Those sandals i like? Your computer? Can your project buy us a new air conditioner? A little laptop for me like yours?” After months of your donated time and resources, you give something a bit more tangible. Desperately needed supplies. Sphygmomanometers. Measuring tapes for pregnancies and child head circumference. They are received joyfully by the personnel. The materials are not yet distributed for use, but put in a pharmacy closet by the administration to do some preliminary “inventory”. Finally you are able to provide the tangible donations that are expected of a foreign aid worker while still adhering to your values of sustainable development. You are overcome by the, too well known, good vibes resulting from the act of giving.
Then you get pulled aside by several nurses. “Watch where those materials go.” A week goes by. Still no sign of the new tools. You’re in the field doing vaccinations and your coworker pulls you aside. “We used to be able to do a lot more out here in the rural areas. We had medicine kits that were donated by someone from your organization but when she left they disappeared with the administration.” You ask the administration for the materials you donated. When can you disburse them to the various clinics? “Everyone already has one for now,” they say. You decide to see for yourself. In Clinica 2a/b, where the rooms for general consultations and pap smears are separated by a sheet, Doctora Martina and Licencia Chepita share a sphygmomanometer. Fatimah in Tuberculosis doesn’t have one either and the excuse for the one that Doctora Tellez uses in Clinica 3 is ancient.

What’s going on here? You are confused, then angry, but above all heartbroken. Just when you start to feel that nothing can come in between you and your hope for humanity, it does. So this is what discourages most westerners from doing developmental work. CORRUPTION. Shameless, guileful, grimey corruption.
Discouraged and helpless, you despair. You cry for the world. For Nica. For your meagerness to it all, your inabilities and limitations. For the lack of centers, doctors, materials, and medicine. For the kids with no vaccines, the women who can’t read, the barrios with no latrines, and the babies with no milk. You grieve the unfair triumphs of depravity over good deeds. For the hard work and good intentions that lie in vain beneath supreme systems of cruelty and greed. So much for Sandinismo. Beyond the gleaming red flags of the romanticized revolution now lies a tarnished idealism of breeched trust and greed. Somewhere between theory and practice lies viability.

Somewhere between your pessimism and idealism is hope.

Snapshot

Its been a while since I've updated. Been working alot at the clinic and in the fields and now im working on an educational film covering the prevention of various endemic diseases to be shown in the overcrowded waiting rooms of Masaya health centers. Without anything that is especially deep/funny/poetic heres a snapshot from my daily work journal. Look what I've been doing mom and dad!

20-5-10 (Thursday)
Went to La Reforma, one of the roughest Barrios in Masaya, with Chepita. Normal stuff, Door to door looking for kids to vaccinate. I did polio; she, DPT. We are also making appointments for women to come in and get their pap/screening for HPV. All the women are so scared of getting done any gynecological procedure. We have been coming across so many mothers who do not know their own or their children’s birth date. One of the kids we vaccinated was a 5 year old who recently lost his eye in an accident I didn’t really understand. I noticed that many of the kids in this barrio weren't in school, running around with their bare feet and inflated stomachs.

24-5-10 (Monday)
Got firsthand experience of how shitty it is to have to wait to be seen by a doctor in the Nicaraguan public health system.I had a dermatologist appointment at the Masaya hospital at 7. I arrived at the hospital at 645 am and wasn’t seen by the dermatologist until 10. I understand now why people don’t keep appointments. After the 3 hour wait in the dismally lit crowded room lacking ventilation, my 2 minutes consultation with the doctor consisted of her telling me to get a blood test before she could prescribe me medication. A blood test for skin cream is hardly necessary but simply a matter of protocol. Blood tests scare the shit out of me. Even the thought of drawing blood from myself or a patient leaves me feeling uncomfortably queasy. This is a very serious fear I know I will struggle with given the path I have chosen for my future and all. . .
25-5-10 (Tuesday)
In the morning, I made a display for tomorrow’s bi-annual health fair with visual representations of the characterization and prevention of Leptospirosis and Dengue. In the afternoon, I went to the Collectiva Para Mujeres (women’s center) to film and interview a Psychologist about options for women in situations of domestic violence. When I first arrived, she didn’t remember who I was and brought me into a room for a consultation. I like when people confuse me for a local.

26-5-10 (Wednesday)
Feria de Salud!
The Feria de salud is a bi-annual event in which the clinic goes to the heart of the hood, and sets up shop in the street, offering everything from consultations to prescriptions. It was pouring rain, but under the tarps people gathered to see a doctor and receive their free medication in a festive atmosphere of balloons, music, and dancing. Our epidemiologist was the MC and encouraged kids to dance to receive a prize bag containing soap, a toothbrush, and a little game. It was really very festive, at times hard to hear the patients over the blaring meringue. I worked at the pharmacy table in the morning handing out medicines to those who received prescriptions from consultations. I quickly learned what a lot of the meds were for as a couple of the old ladies who had multiple medications and due to their illiteracy needed me to explain for what ailment each med served and how often they needed to take it. A lot of Albendazole (for parasites), Ibuprofen, hypertension pills, amoxycillin. We caught one woman who was going from table to table receiving consultations and prescriptions from as many doctors as she could to load up on her free medications.
In the Afternoon, I worked with Dra. Tellez at one of the consultation tables. In the kids, lots of bronchitis, pneumonia, parasites, and skin issues due to fungi, herpes, and other bacterial infections. In adults- lots of hypertension, gastritis, arthritis. Besides prescribing medication, we explained to each and every patient the importance of certain hygienic practices. With the recent rain, Tis the season of diarrhea and dengue. Wear shoes , wash hands, bathe yourself and child more frequently, use latrines, don’t have stagnant water. Besides our Centro de Salud, two women's organizations and the city division of environmental health were present. I got some great footage of the some young women working with one of the women’s organizations talking about aids prevention including a demonstration on how to put on a condom.

27-5-10 (Thursday)
edit. edit. edit.film. edit.film. edit.

Minsa Survey

I spent most of the last week in Nandayuri, a comarca (rural barrio) of Masaya just above Monimbo. We went door to door doing a MINSA (Ministerio de Salud) survey to catalogue people’s health and living conditions. Nandayuri is only a short walk out of the downtown Masaya area but it feels like a different world. In contrast to brightly painted homes in downtown Masaya, the shacks of Nandayuri are plain and simple, hidden amidst seemingly unmaintained groves of mango and banana trees.

We surveyed things like the number of people per household, their occupations, type of sheltering they occupied, their method of garbage disposal, presence/absence of latrines, pets, light, running water. Most people were living 6-12 per household. This usually consisted of small distinct but connected shacks sheltering the family’s different generations, their spouses, and their kin. The people of Nandayuri were shoemakers, woodworkers, small scale farmers, bicycle repairs men, bakers and seamstresses. Many of the older generation couldn't read or write. Others, including a lawyer we met, had higher education but were simply out of a job. Many households did not have latrines, running water, or electricity but all of them had a chickens, a dog or two, or ten.

Most people received us in their warm and friendly Nicaraguan spirits. They pulled out chairs for us, made us drinks of pinolillo and gave us gifts of mangoes and jocotes (My favorite part of working in the rural areas is all the delicious fruit!). They were eager to talk and jest about their family, their lifestyle, and their problems. Sometimes people had TVs and we would get sucked into the dramatic undertakings of telenovella characters, an entertaining respite from the mid day heat.

There were also those that were not as inviting to our white coats and clipboards, greeting us with cold shoulders and skeptic eyes. One particularly obstinate 78 year old woman made sure we knew about all her qualms with the government and the public health system in Nicaragua. She angrily chastised us for conducting such surveys in vain, recalling the many doctors and brigadistas who have passed through only to make minimal or no improvements to her family’s health. Despite my efforts to distance myself from the messy politics of a developing country like Nicaragua, the association of public health and the political sphere is inevitable. Monimbo, the area of Masaya that our clinic serves, is especially known for its hotheaded Indian Sandinista community. During the revolution, with machettes, women throwing boiling water, and a few rare rifles as their only weapons, they led a memorable and successful insurrection against the well armed National Guard.

The heat has become more sweltering, but the epic tropic rain has started. I am looking forward to more greenery and less dust. I am enjoying Masaya more and more, discovering the many charms the city has to offer. Quiet backyard coffee shops with hammocks and rocking chairs, the best and panaderias and fruit stands, an uphill running trail that leads up to a Somoza era prison fortress with a view of the entire city. I am writing a lot and reading a lot of Latin American revolutionary poetry and literature-Ruben Dario, Roberto Bolanos, and my current favorite Gioconda Belli. I can't find an English translation of this online, but I love it because it reminds me why I'm here:

Uno no escoge el país donde nace;
pero ama el país donde ha nacido.

Uno no escoge el tiempo para venir al mundo;
pero debe dejar huella de su tiempo.

Nadie puede evadir su responsabilidad.

Nadie puede taparse los ojos, los oidos,
enmudecer y cortarse las manos.

Todos tenemos un deber de amor que cumplir,.
una historia que nacer
una meta que alcanzar.

No escogimos el momento para venir al mundo:
Ahora podemos hacer el mundo
en que nacerá y crecerá
la semilla que trajimos con nosotros.

-Gioconda Belli


Adios

Semana Santa

Semana Santa is hardly the holy week that its namesake translates to. During this holiday break, meant to commemorate the death of their savior, people flood to the beaches to drink, party, soak up the sun, and engage in reckless activities often at the cost of lives. Along with two other interns, Kara from Brooklyn and Karen from Canada, I chose to take my week long vacation in the less populated and Caribbean coast in hopes of a scene that was more tranquilo. In the end, we did in fact get that, but we had to go through our share of chaos and near death (by sea) to reach our paradise.

Getting there was an arduous yet adventurous journey including an array of different transportation mediums. Chicken Bus, Micro Bus, Panga, Taxi, Boat, Mini plane. Masaya to Managua on microbus, Managua to El Rama on overnight bus that left at 9 pm and got to El Rama at 2 in the morning where we had a 3 hour layover in the middle of the night outside on a bench waiting for the first panga to leave at 5 am to go down the entire length of the Rio Escondido, get to Bluefields, take another panga to a town called C-------, miss the bus going to Pearl Lagoon because it decided to leave a half hour early, take a taxi to Pearl Lagoon, another panga to and from the village of Awas, and finally a night's rest back in Pearl Lagoon.

It is quite hard to still feel like one is in Nicaragua on the Atlantic Coast. The spoken language was English and the vibe was very west indie. It was such a stark contrast to the Spanish speaking, traditional catholic Latin American ways of the rest of the country. On the Atlantic coast, we ate Coconut Bread in place of tortillas and listened to more reggae than salsa or marimba. For an area so geographically isolated from the rest of the country, it has a unique mesh of different cultures including Mestizos, Creoles, Garifunas, and different Amerindian tribes. Most people are bilingual in English and Spanish and some people speak an additional language that is indigenous to their tribe. When conversing with locals, their heavily accented English was so difficult to understand and we had to switch to Spanish to understand what was going on. In Awas, we met one man who spoke 5 different languages- Mestizo, Creole, Suma, English and Spanish. The contras snatched him from his parents when he was sixteen and he proceeded to fight in the counter revolution of a country he barely associates with. From Pearl Lagoon, we went to a village called Oronoco. Oronoco is the home to a population of Garifuna people, a group with West African roots indigenous to areas in Belize. Karen also seems to think that it is the namesake of that Enya song that goes "sail away sail away sail away", because its actual title is "Oronoco". For years, their Garifuna language and culture was suppressed in Oronoco. Now there is a revival movement that includes teaching Garifuna in schools and reviving traditional Garifuna music and dance. The Garifuna music I experienced was the percussion and voices of a group of young men bringing the vibrant and passionate Afro-Caribbean beats of their ancestors to life. Our new friends took us to the homes of two women, one who sold us cassava bread, and the other who sold us a homemade moonshine comprised mostly of corn and sugar.
After a night in Oronoco, we headed back to Bluefields hoping to catch a ferry to the Corn Islands. What we didn’t know was that there are only ferries to the corn islands on certain days, so we had to stay in Bluefields for a night. Despite the guidebook’s warnings of Bluefields as a dangerous crack ridden city, the girls and I liked Bluefields, and its feeling of a true city. There was a central park, two story buildings (very rare in this country), and a feeling of laid back kind of hustle, but a bustle nonetheless. Something about the city’s raw Creole vivaciousness with its scene of dark and sinful pleasures, made me think of New Orleans (though I have never been, only heard). The hostel we chose, however, did embody all of the stereotypes and warnings. There was a single dark hallway with tiny rooms. Our room had no windows to the outside, but a window that overlooked the dark creepy hallway. The owner of the place was an old man who hobbled around on crutches because of an ailment that left him with a completely skinless, raw underside of one foot and the absence of one toe. My diagnosis is that some weird parasite was eating away at his flesh. Besides its “bargain value and convenient location” The Moon Nicaragua Guide failed to say that one should only go there if they intend to evoke feelings of a Caribbean version of the Shining. To avoid the hostel, we walked around the city all day and even tried our luck at a Casino, where I won just enough to buy us girls a healthy handle of Flor de Cana for the next day’s journey to Little Corn Island.
We had grand plans for the six hour boat ride from Bluefields to Little Corn. It would consist of sunshine, Caribbean ocean Breeze, rum, and deck tanning. In actuality, it was overcrowded, uncomfortable, and by the end, drenched in vomit, saltwater, and sick people laying in all of it. One crew member’s job was to hand out barf bags and collect used ones. Everyone in the inside area had their heads in their laps. Outside on the deck, people were lying down, heads overboard, as waves continually and violently crashed on them. In my corner of a bench squashed between two helplessly immobilized grown men, my stomach endlessly churned as a layer of saltwater slowly accumulated on my face, burning my eyes, and forcing them shut. After witnessing a mother throw up all over her daughter who was already lying down in her own spew, I decided to just keep my eyes closed for the rest of the ride. Together, the girls and I have come to terms with the trauma we underwent. We have acknowledged the impossibility to convey to others the dreadfulness of the experience, and can only look back and laugh at our initial preconceptions.
We finally reached Big Corn, where after all that, we had to take another 45 minute Panga ride to little Corn. And now for the happy ending. It seems almost inappropriate to talk about the rest of the trip in the same post. White sands, turquoise waters, waking up hearing the waves, eating fresh seafood and all day everyday, wearing bathing suits not clothes, coconut bread, Flor de Cana, reggae, vast beaches with no one else on them. It was pretty much that for the next 5 days...On the way back, we paid for a flight in a tiny plane that flew directly from big corn to Managua.
Freaky Warrior.

El Trabajo Comienza!

Alas, after two weeks of cultural immersion and orientation, I have started my work at the Centro de Salud Monimbo. For my first week in the clinic, I did a different rotation each day getting to know the different staff and programs. There is a staff of 12 doctors, around the same number of nurses, an epidemiologist, and 3 women who run the lab. A large portion of the clinic’s patients are referred to the lab by the doctors they see to get tests for pregnancy, stds, different parasites, dengue, tuberculosis, and aids. In the morning, the tiny one room lab floods with people carrying their excrement samples in match boxes and plastic bags and others who are waiting to get their blood tests. Due the scarcity of materials, these blood tests consist of using capillary tubes instead of needles to transfer blood into a small glass test tubes. There are only three women who work in the lab and every day they process all kinds of tests manually for every patient who needs it. For preparing the blood samples, these brave women use their own mouths to siphon samples that potentially contain deadly diseases!
One of the programs offered by the clinic is called “Trabajo de Terreno” and provides basic health services and education to communities in rural areas surrounding Masaya that do not have the funds or means to access traditional health clinics and hospitals. For two days of my first week, I traveled with a team of doctors and nurses to different areas to discover completely impoverished communities. I met many families with several children and children’s children living under rudimentary tin shacks. Right now, the Trabajo de Terreno program is focused on decreasing mortality rates of the H1N1 flu virus, as it has been very high in recent months in Nicaragua. Pregnant women are the most susceptible, so we have been going from village to village, door to door, looking for pregnant women to vaccinate. Even after finding those who were pregnant and instructing them to come to a nearby house, where stationed doctors and nurses were giving the vaccines for free, there was a lack of attendance and we had to hunt down many women and give them the shot at their house. I can already see that these visits mean more than just administering vaccinations. Simply having contact with health professionals who are positive and encouraging reminds people about their health and to make better choices. For example, we encountered one pregnant woman who was very sick. She had seen a doctor in the recent past, but had failed to follow up with any appointments for her or for the routine vaccinations of her child. We encouraged her to come in and bring her kid and also explained to the husband the importance of these future appointments. The visits to these communities are about more than disease control, they are about disease prevention through outreach, encouragement, and education.
The lack of resources is made up for by the presence of so much hard work and so much heart. The clinic is open every day so that those that work during the week could access services on the weekend. All of the doctors here are very young because here in Nicaragua you do not need an undergraduate degree before going to medical school. Their enthusiasm, energy, and optimism are really quite inspiring.
My host family is awesome. They are artisan shoemakers who sell their work in both the local artisan market and the larger local Mercado. My room is on the top floor and has a balcony overlooking the top of the San Geronimo church. Last week was Semana Santa, work was off, so I went to the Carribean coast with two other interns from Managua. So many crazy adventures, but I must save that for another post!
adios

HOLA from Nica!!!

After living in a small pueblo in the mountains for a week, I am back to internet and running water! I was living in a community of Sandinista campesinos called Lagartillo. Lagartillo is in between Esteli and Achuapa in the mountains. They grow corn and beans and this year they are trying to grow coffee as well. All my meals were variations of corn tortillas, beans, rice, and Cuajada (farmer's cheese). There is no variety to ingredients, but I was surprised by the creativity of my host mom to prepare different meals! Every morning I woke up at 530 to the screams of chickens and children and really loud Spanish radio. Every day in Lagartillo starts with grinding corn, which is really hard work. The women there are so strong! After a couple days, I got pretty good at it and would also help grind the ingredients to make fresh Horchata to sell to kids.

The community is definitely living in poverty, but no one is starving. They live minimally in a quite tranquil way. The houses are made of brick, with a tin roof and dirt floors, and showers consisted of using water from a tin trashcan. Everyone in the community is family, and no family lives out of sight. My host mom was the grandmother of 14 grandchildren in the community and she cooked for all of them so during the day there were so kids from ages 2-25 coming in and out of the house to get fed! They have no possessions besides their house and their land. Everyone in the community has bikes or horses, and there is one communal truck for emergencies. ano one is starving, as they are able to sustain themselves on a diet of mostly corn and beans. Within the community, there is a small association called ¨Hijos del Maize¨ that runs a spanish school. No one in the community spoke English, not even the teachers. It was really hard at first, but after a few days, I began getting into the swing of things. I talked to everyone I could and heard some crazy strories about what happened to these revolutionaries during the war. (For those of you who need a quick brush up on Nicaraguan History, Sandinistas=socialists who started the revolution in late 78, FLSN, Che Guevera lovers. Contras= counter revolutionaries backed by US govt. and Reagan machine to topple the revolution, a success in the end. For years they fought a gnarly guerilla war in the mountains and elsewhere.) In 1984, Lagartillo was attacked by the Contras. My host Mom lost her brother and her 15 year old son. She showed me pictures of him as a young kid dressed in full on Sandinista gear with the FSLN headband and all. After the war, the Swiss helped rebuild their community and they returned after a year in exhile.

My favorite night of course was when I got a chance to hang out with the village musicians. I learned the music terminology in Spanish and we played the couple songs that i knew in spanish together. Otherwise we took turns leading , accompanying, and learning each other´s music. It was awesome! The kids in Lagartillo are really talented and on my last night, a of traditional campesino folk music was organized and held in my house.

After a long journey from the mountains back down to the south, stopping for one night in Leon (awesome city with the Nica´s prestigious UNA university), I am now in Masaya. My week long internship orientation started yesterday and already it is really intense! Today I had two workshops, a Nicaraguan history workshop in the morning and my public health workshop with a doctor/professor who works in Managua in the afternoon. I can´t beleive I am going to be here for so long, but I already love Masaya so much! It is bike nation here, like everywhere in nicaragua, and a people with instruments on their back are never out of sight. There is a lovely boardwalk overlooking the lake, street fruit stands for dayyys, and the weather is fantastic! Right now it is 5 pm and still 95 degrees. The nicas are a wonderfully welcoming people and i love telling them about home California and all my loves who reside there! I must go take my third shower today, before dinner. Hasta Luego...
Raquel

Help Me Do Clinical Volunteer Work In Nicaragua!

Hello Family and Friends,
As you all may know, I have just finished my undergraduate degree in Neuroscience at UC Santa Cruz. Here is some exciting news about my upcoming endeavors. I have recently been accepted to participate in an internship program with the Foundation for Sustainable Development. In a few short months, I will be going to Nicaragua to volunteer with a local clinic called Centro De Salud Davila Bolanos. I will be researching epidemiological issues within the community as well as assisting the clinic staff with health care. I am very excited about this opportunity to learn and serve in this community before applying for Graduate School. Getting there will not be easy as the cost of volunteering internationally is significant. The training, placement, family homestay, host organization grand, field support, airfare and insurance for 20 weeks costs roughly $6000. I am trying to meet this expense through fundraising so I need your help. Your generous contribution will give direct support to the Clinic by providing them with an enthusiastic, trained and hardworking volunteer-me!

I will be sending newsletters to all of my sponsors and I plan to hold a presentation describing my experiences when I return. If you choose to help me out, you’ll be pleased to know that all donations are 100% tax deductible. You can click the Donate Now button or send a check. Please make checks payable to Foundation for Sustainable Development, and put my name in the memo area so you can receive a letter from the Foundation acknowledging your contribution as tax deductible, and that the funds will be directed towards my project. Mail checks to me at: 110 Campbell Street, Santa Cruz, Ca. 95060.

Please get in touch with me if you have any questions, ideas, or if you know anyone else or any organization that might be interested in supporting this project. Thank you for helping me make this experience possible.

-Rachel