Tuesday, December 4, 2007

Joining the Effort

Door to Door in Rural Nicaragua

Nothing prepares you to face poverty. Everywhere you go, you are surrounded by flies and the smell of burning dried leaves. You turn a corner on a dirt road and you have a 3yr old boy with no shirt and no shoes by himself staring at you in bewilderment because of your complexion or presence in his tiny town. I walk up to him, smile and rub his head. A group of kids 8 - 11 in age come prancing along smiling ear to ear as I start with an hola amigos. Their smiles and laughter roll back my memory. The CISAS clown troup had dotted my nose and cheeks with red paint before I began my rounds with the Ministry of Health workers and CISAS volunteers.

House to shack, door to rusted metal leaning over the opening where the door should be, we go distributing a pamphlet that tells the bare bones of what HIV is, how it is transmitted, how we can protect ourselves, and how to properly use a condom. Along with the paper comes a pair of condoms. After doing 3 houses in pairs, I am told to take a pack of both and start down a 4 foot wide path that is lined with fences on both sides made of barbed wire or cactus. I´m with Oscar, the most well built and tall Nicaragua I have met thus far. A bartender by night and a community health intern by day. As I walk the path, making sure not to step in the stream that resides in the middle, my mind goes back to Mountains Beyond Mountains and the story of Dr. Farmer doing just this, but instead of only providing awareness and 2 condoms, he brings life saving medicine and years of medical expertise.

I struggle through my first house. The 20 year old male would rather talk about the Bronx and whats up on MTV then Sexually Transmitted Diseases. I get him back on track when I tell him about the free condoms. Mission accomplished - he asked for 2 more pamphlets for his brothers and extra condoms. My next house, like many here, are little shops in the front to get drinks, snacks, candy etc, and then the living room behind the counters. I turn to the older gentleman and Oscar turns to the woman selling him an egg and dry rice. I try to explain the science behind how the elderly man should not be using two condoms at a time. As I talk, the woman laughing says, give him all he needs he sleeps around too much with girls that are in their 20s. His leathery and worn skin smiles displaying only a handful of teeth. Is this the face of a man that a 20 yr old woman is going to give herself to? Do I dare mention the rights of women? I spend extra time telling him how a condom is really the only protection if you are going to be sexually active. He smiles again, asks for 10 condoms and thanks myself and Oscar for the advice.

On the half hour ride back to León, Oscar and I discuss how there just weren´t enough pamphlets and condoms, but that doesn´t mean there is no hope. We over hear one of the women from the ministry of health speaking about a 20 yr old girl who actually told her how HIV is transmitted and told her to save the condoms for others in the neighborhood that will need them; in her own words, "I have plenty of those trust me".


Graham said...

Condom distribution has always seemed like such an effective attention holding preventative/educaiton technique. I mean, after all, the abstanance lectures in Catholic school pale in comparison to learning how to use a new piece of material culture!

Your story was reminding me of the man, I beg pardon for forgetting his name, in A Closer Walk standing on the corner with a handmade sign "Free Condoms" What would the community reaction be if someone set up a shop like this outside a gated community? I don't mean to pick at the poverty gap here, but rather how people assume the poverty gap is synonymous with the education gap. I know plenty of rich people with little to no knowledge about HIV or AIDS. Many even still subscribe to dangerous and malevolent sterotypes.
But getting back to what the "Free Condoms" sign guy was sayin in a Closer Walk. He said that this isn't a battle to be fought from behind a desk...or keyboard...but in our communities. So will would I dare go do what I teach other to do? Go hand out condoms to the self-described rednecks that live on either side of the house I grew up in? I need to do that. At the very least I would have their undivided attention.

Ashley said...

Right now I am serving in the Peace Corps in Peru. I have found your blog especially interesting as you have now entered Latin America. In Peru, the Catholic church has a huge influence over sex education, as I'm sure that it does in Nicaragua. However in Peru, the government operated posta medicas which are located in many small, rural communities are allowed to teach family planning and promote contraceptive use. If you could please elaborate on the situation in Nicaragua in terms of the relationship between the church and the state on this subject, I would really appreciate it.
Thank you,

Marco Ambrosio said...

Well from my experience whether its door to door in the rural countryside or a festival in a packed public location, people here eagerly accept the phamplets and the condoms, especially the condoms.
I also agree with you that the best way to make deep strides is through getting into the community and making them part of the solution. It really coincides with the Farmer method of making change from within and the multiplier effect. For example, the clowns are all teenage Nicaraguans who now a great deal about HIV prevention and methods of transmission. Also, they wear shirts that read " I am informed, I care about myself, I always use a condom". It is only a tiny example, but getting these 15 teens involved has affected their parents, friends, and themselves in a positive manner and according to them the difference is easily noted.