Sunday, March 15, 2009

HIV/AIDS breaking down my reservations

Before my Peace Corps training here in Nicaragua, I wouldn´t have been able to summarize with much eloquence what HIV/AIDS was. Thanks to hours of training in just that topic however, I have made leaps and bounds in my comfort level in talking about these subjects and have even done things, (in the name of education) that I would never thought I would do in my life.
When Human Immunodeficiency Virus (HIV) enters the body, usually through unprotected sex (at least here in Nicaragua), it begins attacking the body’s immune system. The white blood cells are overtaken and slowly killed as the virus multiplies, and over the years debilitates the immune system and develops into Acquired Immune Deficiency Syndrome (AIDS). Once a person has developed AIDS (it can take anywhere from 5-15 years from the initial infection date), they are easily susceptible to opportunistic diseases such as tuberculosis and pneumonia, or even the flu, which attack the greatly weakened state of the immune system and cause death.
The past week, my training group was immersed in five days of intense HIV/AIDS training. We began learning about NGOs present in Nicaragua and their diverse target audiences and mediums. Some NGOs were funded by USAID and had different agendas from, for example European, or World Bank-funded organizations. We saw NGOs using soap operas and radio shows to get out the information, youth groups, conferences, health care worker trainings… For all of this training, my group traveled to the Department of Chinandega, which is in the north of Nicaragua and due to its border with Honduras and port location, this department has the highest rate of HIV/AIDS in the country. Despite being in the north, it is also famed for being the hottest department of Nicaragua, and after sweating constantly for the entire time we were there even after taking two showers a day, I can now attest that that is true.
Our training group was split up into teams of 3-5 and we gave educational talks at high schools on STDs and HIV/AIDS prevention, and also to a much more intimidating audience; sailors at a naval base. Men are the “target” audience here in Nicaragua to talk about HIV/AIDS since they are the transmitters of the virus. They are the ones having extramarital relations and bringing HIV back to their wives. They are the ones who refuse to wear condoms, and don’t believe in getting tested. At the naval base, the sailors were full of machismo, scowling, wearing their uniforms, and not excited to hear what we had to say. Needless to say, it was a tough crowd.
Talking to these men about the difference between HIV/AIDS and how to avoid infection is one thing, but then there is the practical application piece of the presentation. Could I stand up in front of a group of people and show them how to use a condom on a wooden dildo? No thank you… However, it’s not really a choice in Peace Corps. This is practical information that these people need to have. If they saw embarrassment or unwillingness on my part, they may be less likely to use one themselves. We have been told that many Nicaragua men and women simply don’t use condoms because they don’t know how to use them, and they are too embarrassed to ask. If these demonstrations will help reduce the number of STDs, HIV/AIDS infections, and unwanted pregnancies….well, then I guess I can do it.
After observing quite a few demonstrations by other volunteers and staff, and memorizing the “seven steps to using a condom,” I finally felt ready during our Chinandega trip to give it a try. What the heck, I’ll probably never see these people again, right?
The first one I gave was actually an impromptu decision I made to get it over with while we were at a billiards tournament aimed at increasing HIV/AIDS education in older men. It was held at a billiards hall (picture this: florescent lighting, smoke, beer, rum, and men of all ages yelling and laughing over pool. No women in sight.) Sort of like an Alaskan bar actually… All of us trainees were gathered there to observe a pool tournament that a current Peace Corps volunteer was organizing. He would give talks about HIV/AIDS in between the rounds of pool, and when the final two players were left, they had to answer questions about the previous presentations in order to win. A local NGO had agreed to donate the prize money, which was USD $100 - more than most people make here in a month. Needless to say, the men were all riled up about the tournament and really engaged in the talks that were being given and in the games that were being played. During the last round you could hear a pin drop in that room of 100 drunk men as they stopped their yelling and listened intently to as the Peace Corps Volunteer asked “What are the four fluids that transmit HIV/AIDS?” The winner was hoisted on men´s shoulders and the noise was audible for blocks, I´m sure.
At a nearby table, there were some representatives from a Nicaraguan NGO helping younger men learn how to put on a condom using a wooden dildo (an integral part of our Peace Corps tool kit). I walked over to observe and realized that they were doing it “wrong.” After a minute or so, I guess they noticed my puzzled expression as I watched them, and they asked me if I could show them how to do it better (in a sarcastic tone of course). I don’t know what got into me, but all my fear about working with machisto, cat-calling, intimidating Nicaragua men disappeared as I proceeded to go through each of the seven steps. From what I hear from the other trainees who were watching, it got quite a bit of attention, and surprisingly, the men didn’t give me a hard time, but they actually gave me a big round of applause when I had finished the demonstration and the NGO representative turned to a few of them and challenged them to do it as well as I had.
Sometimes, I wish I was a male volunteer here since they get more respect, people are friendlier, they are gossiped about less, and women come over to cook for them and do their laundry. However, this past week of HIV/AIDS education and practical application helped me not fear being an American woman and attempting to work with Nicaraguan men. I realized if you are professional and confident, they will listen to you, and with time, maybe respect you as well.
As our week of training went on, I could feel my reservations and nervousness about these intimate topics being broken down slowly with the support of Peace Corps staff, my fellow trainees, and hands-on experiences. As I acquire these skills, I also feel more self-confident, sure of myself, and empowered to facilitate behavior change in others. If I would have been told I would be doing a condom demonstration in a smoky bar, or talking about the female reproductive system in front of a group of middle school students before I came here, I probably would have laughed at you. However, I am in the second poorest country in the western hemisphere, surrounded by different problems, and I have realized that these problems are bigger than my embarrassment. If the end result will help this country to improve their health situation, then that’s my job as a health volunteer. Soon, I too will be the proud owner of a wooden dildo to give condom demonstrations to women and men, and will be talking about other embarrassing or sensitive topics such as puberty, spousal abuse, sexual rights, and adolescent pregnancy. If I can do all these things without blinking at the end of two years, then I will be ready for anything. Wish me luck!

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