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Dialogue and Diarrhea in Nicaragua

This winter break, 11 Haverford and Bryn Mawr students from Professor Kaye Edwards’ “Reproductive Health and Justice” course journeyed to the sweltering green tropics of Nicaragua as part of a 10-day educational delegation.  The students visited several women’s support centers and community clinics in the rural countryside and in cities such as Managua and Matagalpa, where they spoke with local community leaders, activists, healthcare providers and other students.  As described by Edwards, the purpose of the delegation was “to give people a sense of what peace and health justice is like on the ground in other countries.”

The delegation was the result of two years of planning by Edwards, who acquired funding for the trip from The Provost’s Office and from the Center for Peace and Global Citizenship.  The trip was partly coordinated through ProNica, a Florida-based Quaker non-profit—of which Edwards is a board member—dedicated to socially responsible economic development in Nicaragua.

The students, whose academic backgrounds stretch across the disciplines, were united by an open-minded desire to learn firsthand about healthcare systems in developing countries.

“They told us at the pre-departure meeting to come to the country with an open mind and an open heart,” said Manahil Siddiqi BMC ’15, who is working on an independent major in global health.  “So I really just tried to do that and I was very open to all various experiences and foods, meeting new people, things like that.”

Behind Haiti, Nicaragua is the poorest country in the western hemisphere, and while recent reforms have made health care more accessible, its citizens still struggle to treat diseases like the human papilloma virus (HPV) and cervical cancer, as well as social maladies like domestic violence and gender inequality.  The country’s rough landscape of jungle and mountains make it difficult to administer PAP smears and contraceptives, while the country’s rigid adherence to Catholic tradition and male machismo have prohibited abortions and made wife-beating acceptable.  But understanding these complex cultural and political circumstances was the reason why Edwards led her delegation to Nicaragua in the first place.

“I really appreciated [Edwards],” said Siddiqi.  “She emphasized that we’re not tourists here, this is a student educational delegation and it’s a learning experience.  We’re not saviors but we’re also not tourists.”

After a six-hour flight from Philadelphia, the students were greeted in Managua, the country’s capital, with warm weather, warm people and delicious food.

“The food was a big thing,” said Jay Garcia ’16, a Haverford biology major who was born in the Dominican Republic.  “They do it in a different manner but they use the same stuff that we use…rice mixed with beans, plantains, coconuts, passion fruit.”

Unbeknownst to the students, the unfamiliar food and the climate would hospitalize several of them mid-way through the trip.

“We had this community meal and a bunch of people, including me, got sick,” Edwards said.  “They got dehydrated and some people needed IVs.  That was definitely the low point, but that’s traveling.  Even the tour guide who lived in the country for nine years got sick.”

Unavoidable or not, the crisis was made worse by the lack of amenities present in rural Nicaragua. The delegation stayed with local families in houses that had no running water and little more than a hole in the ground for toilets.

“You have diarrhea and vomiting and you go out to a latrine; it’s like the way a lot of people around the world live,” said Edwards.

Yet despite the harsh conditions and sickness, the Bi-Co students toughed it out and still managed to have a great experience.  “It was a bummer but we got over the hiccup pretty quickly,” said Ruben Monarrez, a Biology major.  “People kept a positive attitude; they still made an effort to go to the meetings, go to the talks and actively participate.  It was a good group of people.”

Edwards joked, “I actually called it our ‘loose bonding experience.’  We developed a kind of dark humor about it.”

Amidst the hardship of their circumstances, the students were repeatedly amazed by the tenacity of certain Nicaraguan women who were determined to change their society.

“We met this one community health worker, her name was Rosybel,” said Monarrez.  “She’s done a lot of community work, she approaches families door-to-door and helps them learn about birth control, PAP smears, all that stuff.  She goes out into clubs and hands out condoms and in Nicaragua that’s not something you can do feeling safe.  She’s been doing this since she was 18 years old back in the ‘80s.  She was just sitting on her front porch, pregnant, and then this mobile clinic showed up and she was like ‘this is really interesting, this is what I want to do.’  And so just like that at 18 years old she’s in the field, and she’s been doing that ever since.”

Melena was another such woman from Managua. When death rates among women in Melena’s neighborhood started rising rapidly, the solution proposed by male leaders was to create business by building more coffins and bigger cemeteries.  Melena and ten other women decided to take matters into their own hands.

“She saw that women’s cervical cancer rates were increasing and women were dying so she organized with Amnesty International and they worked together to bring doctors to the community to combat the rise of cervical cancer,” said Siddiqui.

“One of the things she emphasized was that they didn’t have a formal designation of ‘community leader,’” said Hannah Klein ’15, a Haverford anthropology major who met Melena at the Women’s Clinic that she helped start in Managua.

“You don’t need to have the papers and the requirements, you just need to go and take action,” added Klein.

All of these inspirational figures couldn’t have made Kaye Edwards happier for her students.

“I hear students say this often;” she explained, “‘When I get my M.D., or when I get my law degree, I’m going to do this stuff,’ and these women just took charge.  They eventually got those degrees but they started the work without it.  This was in the ‘80s.  There was something really inspirational about the way these people saw this problem and then they did what they could do to solve it.”

The conversations that the students held with Nicaraguans about reproductive health issues also informed their perspectives.

“I think it’s important to get all these different views on the issues,” said Monarrez. “I did struggle at times to hold back my thoughts and not argue with them.  Like there were some men who didn’t believe abortions should be legal or some people who thought that it’s important to let God do his will.  At times I would try to explain to them that it was a health and a human rights issue, but I guess you can’t really change that.”

Despite the foreign food, diseases, and opinions, the students reported having a great time in Nicaragua.

“One time we went out to a waterfall,” said Monarrez.  “It was a pretty rough hike, super muddy, super slippery, people were losing shoes, sliding down this hill.  Once we got there the water was cold but it was a lot of fun to hang out a bit.  Some of the locals from the community led us out there so once we got there we could talk with them, hang out and share a good time together.”

The students spent the last day of their delegation swimming, kayaking, and eating mango-flavored sorbets at The Monkey’s Hut, a hang-out on the shore of a volcanic crater filled with warm blue lake water.  It was here that Jay Garcia had a sublime experience:

“I got a real coconut and I got to open it!” said Garcia.  “I hadn’t done that in like, six seven years.  It’s my favorite fruit.  I used a corkscrew actually, like a wine opener, one on the top and one on the bottom.  Then you start stabbing it with a knife to actually open it.”

Coconuts and volcanic craters would have been unfamiliar to the original Quakers, but the Bi-Co students of Edwards’ delegation and ProNica maintained tradition nonetheless.

“We would sit around a circle in a silent Quaker meeting and then if someone had something to say they’d stand up and say it and we’d let that message sink in,” said Sidiqqi.  “It was really important to reflect and go through what we’d been learning and listening to.”

“There was so much learning that was going on,” said Edwards.  “It was incredible, really incredible.”  The delegation has helped inspire many of its students to continue pursuing careers in health and social justice.

More information in the students’ own words can be found at this wordpress blog site  .

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