Sunday, November 28, 2010

Backyard mystery

Recently I’ve found a mystery hole in my backyard. It looks like a burrow of some sort, a few feet from my latrine. I’ve never seen any type of animal or insect going in or out of it. I put a rock over it the other day, thinking that if it was a mice or snake hole (do snake even use burrows?) that the rock would keep them from entering my yard. See photo below of rock over hole:

The next morning, I awoke to find the rock moved, quite a few inches from the hole (see photo below of moved rock, with my hand for scale). I immediately placed the rock back over the hole, and the next day found that the same thing had happened.

Now I have become very intrigued as to what is living in this hole and has the capability to move this rock. I really have no idea what it could be. Have any ideas? Help me solve my backyard mystery!

Saturday, November 20, 2010

Our Daily Tortilla

Nicaraguans call themselves “children of the corn,” and for good reason. As I have mentioned in previous blogs, corn – more specifically “maize” – is a large source of income for many rural families and is literally in about every bite of food that Nicaraguans eat. Maize can be used in powdered drinks, main dishes, puddings, desserts, and candy. The most common (and my favorite) way of eating maize is in the traditional tortilla.

Nicaraguan SeƱoras wake up as early as 3:30 or 4:00 AM to start making the day’s tortillas. The more rural the family, the earlier they wake up to prepare breakfast for their husband or sons who go out to the field to work at 5:00 AM. There are certain houses in town known as the “tortilla houses” where you can buy them - my neighbor makes 200 tortillas daily! To prepare tortillas, the maize is cooked the day before, usually in gray ceniza (ash) to help strip off the outer layer. The cooked maize is then set aside to cool until the next morning. Below: cooking with ash (the color isn't too appealing, right?)
The maize is rinsed and taken early in the morning to the nearby mill. There are dozens in the town located in people’s homes or garages, and they start up at 4 AM every day. If you’re up early enough, you can see women venturing out into the morning mist with buckets of cooked maize on their heads, going to the mill which will grind the maize into a smooth pulp for .14 cents/pound. Below: maize pulp ready to make into tortilla.
After grinding the maize, the women trek back home and start up the kitchen fire. A small ball of maize is rolled and a circular sheet of plastic is used to shape the tortilla without sticking to the wooden kitchen table. Experienced tortilla makers can whip out a perfect circular and uniform-width tortilla in less than 10 seconds. People like me take a good minute or so to do the same (although I earn quite a few points for even trying. “You won’t go hungry!” the Nicaraguan women praise me for my oval, misshapen tortilla). As they are pounding out the circular shape, they use the left hand to shape the edge, while the right hand comes down in a repetitive smack, rotating the plastic sheet to continually smooth out the surface (wet your hands first to avoid sticking). If you’re out walking early in the morning, you can tell which family makes tortillas by listening for the radio music, looking for smoke coming from the kitchen, and the telltale “smack, smack, smack” of the tortilla pounding. Once the fire is hot, you can use a ceramic or metal frying pan to cook the tortilla – some have holes in the middle (for air movement maybe?). After the tortilla has been formed, it is thrown on the hot pan for a minute or so, and flipped twice. Experienced tortilla makers use their bare hands to flip it – expertly maneuvering between simultaneously pounding out tortillas and cooking them. Nothing is added to the ground maize, and no oil is used on the pan. Just plain maize + fire = hot and fresh tortilla. My favorite breakfast here (besides oatmeal, of course) is a soft, hot tortilla with boiled red beans. In my community, you can buy tortillas for anywhere from .05 cents to .09 cents/each. Later in the morning (after 6:00 AM) you can observe another exodus of women taking to the streets with cloth dishtowels, on their way to their daily tortilla provider to buy their family’s daily “bread.” My host family, which had about 10 people in it would go through about 40 tortillas in a day. They are served at every meal and accompany soup, beans, meat, cheese, or in a pinch can simply be served with a sprinkle of salt.

After repeated bacterial and parasitic infections, I’ve had to cut down on my tortilla consumption since it isn’t the cleanest food in the world (lots of contact with unwashed hands and dirty water), but they remain one of my favorite Nicaraguan foods. Lucky for me, for most Nicas they are too.

Saturday, November 13, 2010

Leptospirosis Outbreak

Since the beginning of my service, I’ve seen the Nicaraguan Ministry of Health (MINSA) handle several public health emergencies: the fight to prevent swine flu (whose name was later changed to H1N1 Influenza), Dengue fever (a viral disease spread by mosquitoes with symptoms similar to malaria), and Chagas disease (a parasitic infection transmitted by a small bug known in Nicaragua as chinche through its infected feces deposited on the skin and later rubbed into the eyes, mouth or a wound). For each of these outbreaks, MINSA has had to mobilize their community health volunteers, organize educational campaigns and depending on the disease, distribute medicine and vaccinations to those who most need them. Often, those who suffer most from these diseases are the most poor who live in the dirtiest conditions and lack the education to prevent infection. In the past month, a disease already well-known among developing countries and Latin America – Leptospirosis – has surged with 510 cases nationwide, 16 deaths and 17 hospitalized patients. Below: educational posters in the health center about Chagas disease, Influenza H1N1 and Leptospirosis (I made the last one) :) Leptospirosis is a bacterial disease which affects humans as well as a variety of animals – most common in Nicaragua domestic animals (cats, dogs), cows, pigs, donkeys, mules, rats and mice. It is transmitted to humans through contact with infected water, soil or food through an open wound or through ingestion. Because of recent heavy rains due to intense tropical storms, rivers have overflowed, homes have been flooded, and fields washed away. All of this extra water only facilitates the transmission of this disease as wells become contaminated with animal urine and feces and people walk barefoot through rivers. Most diseases increase during the rainy season, such as diarrheal diseases, mosquito-borne illness and respiratory infections – Leptospirosis is no different.

Leptospirosis presents flu-like symptoms (fever, chills, body pain, and headache), also bleeding out of the nose and other orifices, vomiting, diarrhea, and dry cough. If untreated, the second stage is characterized by renal failure, meningitis, and liver damage. Antibiotics are used to treat the disease such as amoxicillin and doxycycline. The latter can also be used as a prophylaxis – when taken weekly, it can prevent the disease. MINSA has been working on educating the public and distributing doxycycline to the entire population above 2 years old. I have been helping in this effort as we go out to every one of the 24 outlying villages of my community walking house to house giving out medicine and explaining to residents what Leptospirosis is. Below: two girls in a village waiting for their medicine. They were VERY interested in me and my tattoo.
The Police, the local cabinets of “Citizen Power” and all the Health Center personnel have been helping in this effort. Every day a group takes off in the Health Center worn-down pick-up to forge rivers and drive down unpaved roads to deliver the medicine to every last house. Since the outbreak began, MINSA has distributed prophylaxis to 2,828,512 individuals and also rodent venom to 167,950 families. The nurses here are assigned to different villages and they know their assignments well. I look out at the hills and see nothing but green, but they can tell me where every house is, how many children live there, and what the best way to walk there is. When we show up at their house, most residents already seem to be expecting us. Although they may not have a television, most families have a radio and have been following the spread of the disease religiously. Everyone dutifully takes their medicine – even the young children. Nicaraguans have come to expect this treatment from their socialized medicine system – healthcare that comes to your door. Below: a baby hanging out in a hammock in one of the communities - what a face!
I give quick talks to the families about precautions they should take (tie up domestic animals outside of the house and do not let them near water sources, avoid walking barefoot or bathing in rivers and pools of water, clean-up debris in and around the house to avoid creating places for rats and mice to hide, and washing hands with water and soap. They nod diligently, but I know that most of these suggestions will go in one ear and out the other. When they have no running water – it is much easier to bathe and wash clothes at the river rather than hauling water from the well, and how can they move the entire herd of cow that is living right outside their front door? Where would they move them to? I see many barefoot children running around the yard, playing with the dog – I tell them they should get some shoes on, but I normally get an odd look. “What is this crazy gringa telling me to do?” but a stern look from their mother usually gets them to do it. Yesterday all the parents were buzzing about something they had heard on the radio that morning – a three year old had recently died in the neighboring municipality from Leptospirosis. Now they knew it was serious.

The community health volunteers of the villages are always willing to help. I have mentioned them in previous blog posts. They are community leaders who have been trained by MINSA to give educational health information, give injections, provide basic first aid and support MINSA activities. They accompany us on the doxycycline rounds and give us the inside information on the community and who is at risk. Although they receive no pay and frankly, very little support from MINSA, they are always at the ready and a valuable asset.

MINSA’s reaction to the Leptospirosis outbreak has been swift, and hopefully prophylaxis will suppress the numbers of people who contract the disease. Most of MINSA’s normal activities have been put aside (as they were in the H1N1 outbreak) to devote all resources to Leptospirosis. Although there have been no confirmed cases in my municipality, people are operating on red alert. Everyone in Nicaragua is talking about Leptospirosis. I do realize the importance of this disease, but at the same time I wish that the same attention could be given to other public health issues, such as HIV/AIDS or teen pregnancy. I have no doubt that if all government, public communications and MINSA resources were mobilized to distribute family planning and educate the public house-to-house, it would make a substantial dent in those high statistics. Of course, swallowing a pill is an easier solution, a less complicated behavior to change, and more culturally acceptable than limiting sexual partners or using a condom – which is what would be required on a national level to cut down on HIV levels.

Friday, November 5, 2010

Camping Trip with Youth Health Promoters

Since the beginning of my service I have been cooperating with a non-profit organization in my community called Plan International. Plan operates in communities in 48 developing countries working to promote children’s rights, and increase the quality of life of the world’s poorest children. They also have a child sponsorship program. Specifically, they focus projects in education, health, water and sanitation, domestic violence, economic security, emergency relief, youth civic participation, and HIV education.

For a year and a half, Plan has been working in my community training youth sexual and reproductive health promoters. They started this project at about the same time I began my Peace Corps service, so it has coincided nicely, especially since one of the Peace Corps community health project’s goals is the education of youth and adolescents in HIV/AIDS prevention and teen pregnancy prevention. Ten youth (ages 14-19) were chosen to be trained in sexual and reproductive health promotion from five of the villages in my municipality – I helped in choosing some of the kids, asking local leaders and teachers about who would be best. Some came from rural areas; others livedin the urban center. All were identified as potential leaders among their peers. Below: the promoters and I at their "graduation" ceremony.
Throughout the training program organized by Plan, the youth have been trained to be competent sexual and reproductive health educators. They go to the departmental capital city monthly with the forty other promoters from nearby municipalities for training from Plan staff in self-esteem, human rights, civic participation, youth development, leadership, HIV/AIDS, STDs, teen pregnancy, anatomy, and condom use. Each promoter has to form their own youth group of ten kids and replicate these learned topics to their group. I help the promoters in perfecting their presentation techniques, helping them research topics, lead meetings, and of course play games.
I have seen the ten promoters from my town grow and learn throughout this project – they have increased their self-esteem and are now more likely to participate in their community and take on leadership roles. One young promoter was so shy at the beginning of the project that she couldn’t even say the word “condom” out loud in public, but after undergoing youth promoter training and being around other self-confident peers that aren’t ashamed to talk about these topics, she has increased her knowledge and self-assurance and those days of shame are long gone.

It’s not all work, however. Plan also gave sports equipment to each of the youth promoters to play volleyball, basketball and soccer at the youth group meetings. Kids won’t come to meetings if they know they will only be working – these meetings are supposed to be different from school – more fun and engaging. The promoters organize energizing games throughout the meetings to keep the kids attentive and interested.

The project is coming to a close now – all of the meetings have been held, and each group has written a community action plan; identifying community needs and how they can meet them using local resources. To celebrate the finalization of the project, Plan organized a four day leadership-building workshop trip to a camp in the mountains of the department of Jinotega (“heen-oh-tay-guh”). Below: "Welcome to Jinotega. The best business for Nicaragua is food production." (Jinotega is an agricultural hub of the country - on the bus I saw cabbages, carrots, potatoes, peppers, coffee, and beans growing and for sale on the side of the road). The promoters from my department came, along with promoters who were doing the same project in the western department of Chinandega. In total, there were 130 kids. Another Peace Corps volunteer from Chinandega and I were invited to chaperone and help facilitate the camp.
I had never been to Jinotega before and was surprised at the cold climate. During our stay, the temperature varied from the low 60s F (perhaps even the high 50s!) to the low 70s F. The showers (unheated of course) were the temperature of ice water. The constant presence of rain, clouds and fog – rather than depress me (as it did to the kids) – actually made me think of my hometown in Alaska. I felt like I had been transported back to Sitka for a few days and enjoyed not sweating for a change.
The retreat was held at the VidaJoven (YoungLife) Nicaragua ranch. YoungLife is an American non-denominational Christian organization that works with youth. YoungLife exists in my hometown, but I was unaware they worked internationally until going to this Nicaraguan camp. A common practice for the youth members of YoungLife is going to a ranch retreat (either in the U.S. or abroad to do a volunteer project) in the summertime to build leadership and spirituality. The ranch in Nicaragua has a small lake with canoes, hiking trails, ropes course activities, a baseball field, basketball court, and auditorium. Needless to say, the Plan promoters were thrilled to be there.

I was in charge of a dorm room of 15 girls – so it goes without saying that I didn’t sleep much. Many of these youth had never left their home overnight before. These kids were very different from one another; some were relatively well-off, living in the urban center – they wore newer clothes, had lip gloss and perfume, and fancy cell phones. Others came from more rural areas and wore patched hand-me-downs, spoke with the rural accent and were more reserved. Some of the boys were openly gay, some promoters were very young (13), others were on the older side (22). However, despite their differences the kids formed a strong bond during those four days. I remember being so amazed at these young leaders – I hardly remember what I was doing at 15 years old, but it sure wasn’t talking about HIV, condoms, and community action in front of my peers! Below: each community made a mural, this one says "Adolescents and youth for a different generation."
The days were busy, but we still found time for fun. During the retreat, a “radio station” was formed by a few kids and they provided the soundtrack for our meals and were DJs at the dance held on the last night. A talent show was held one night and the kids danced traditional as well as reggaeton dances, recited poetry, sang, and did theater. One day we split into groups to tackle the outdoor maze and ropes course leadership activities. I was assigned a group and wore myself out as we raced through the challenges to be the first group to finish: running through the hiking trails, getting lost in the maze, climbing walls, pushing oxen carts, and paddling canoes. None of the kids had ever been in a canoe before and it was entertaining watching them figure out how to steer the boat – bumping into the lake shore and going in reverse more than forward.
The promoters shared ideas, strategies for community action and made fast friendships. When it was time to say goodbye there were several tearful goodbyes and exchanges of e-mails and phone numbers. The experience empowered the youth to keep working, hopefully even after organizations like Plan or Peace Corps leave, and the funding dries up. Looking at every one of those 130 youth, I could see that each one had a special kind of leadership. I am happy to be a part of this project and see each one of the promoters from my town grow and learn. I know I have learned as much from them as they have from me and hope to keep in touch with these kids far into the future – they’re going places!