From the students’ perspectives

On the last day in Cuje, I asked the students to write about their experiences from the week just finished.  They did, and the results were heart-felt and touching.  Sitting in the courtyard of our hostel in Managua, I asked them to reconsider, this time focusing also on the project and their contribution to our collective effort.  The result follows, and it is a fairly long blog entry.  I hope you’ll read it.  It’s worth the time and effort.

Nicaragua, 2009.   From the students’ perspectives:

Beth Anne Digiorgis (’11; 1^st year)

At William & Mary, I am involved in student organizations that work to protect women’s health.  This trip to Cuje has opened my eyes to a whole new perspective on women’s health.  Issues that I previously accepted as simply basic healthcare became deeply complex when applied to the women of Cuje.  For example, at William & Mary my organization recently hosted an event where we screened a documentary and heard from a midwife from Richmond.  Both the film and the speaker emphasized the dangers of the over-medicalization of birth, including unnecessary c-sections and labor-inducing drugs.  While I was genuinely inspired by their arguments, I struggle to reconcile my new knowledge of American birthing practices to the realities of Cuje.

Through a few conversations with my teammate Jackie Ramirez, I’ve learned that the few thousand women in the community only have one physician. This woman is responsible for the health and safety of all the pregnant women.  For this and I’m certain many other reasons, women are taken out of their homes, sometimes against their will, to give birth in the hospital.  I try to understand how these two opposite trends are both meant to create healthier environments for mothers and newborns.  This trip has given me the opportunity to think critically about these complex, culturally-loaded issues.

Kevin Sethi (’10; 1^st year)

Compared to Nicaragua, William and Mary sucks, for the following reasons:

1)       There is no Tona

2)       The view at W & M was once considered scenic, but after going to Nicaragua, (where the view of majestic mountains is an everyday occurrence), W&M does not even compare.

3)       There are way too many guys at W&M, which will be a huge change for me after being surrounded by the SCH Amazon Tribe, which I have grown to care about due to their overly feminine welcoming ways — as exemplified by my THREE friendship bracelets.

But in all seriousness, traveling to Nicaragua has been so much more than just a service trip; it has been an unforgettable, enlightening experience.  Initially I thought my only true value to the team would be my clinical experience and fluent Spanish skills.  But this was far from the case.  For instance, I was able to explore the heavily mountainous regions of Cuje in my exciting GPS expeditions, conduct fascinating interviews with the residents of Cuje, and expand my knowledge on the inner-workings of Nicaraguan law enforcement.  Lastly, being embraced by the infinite warmth of the Nicaraguan people everyday has made the unwavering dedication required by the team seem effortless.

Molly Copeland (’11; 1^st year)

There’s so much to remember from Cuje:  the smell of overheated vitamins, super sound effects handshakes, the sound of a perfect blood pressure, and unending mountains.  But I know what I‘ll carry with me most when the trip I ended is less tangible because I have learned the value of listening to people you want to help, to understand what is needed and how we can be effective and sustainable.   Like my teammates, I trust myself to complete hard work efficiently and cheerfully, to overcome mediocre Spanish by really listening to what people are trying to communicate, and to diligently observe everything to learn as much as possible.  Seeing how I can help those in need by being part of a team that helps not only one week a year, but year round to find solutions that will last and continue to improve people’s lives.

Soyoung Hwang (’11; 1^st year)

I love Gabi Arias aka Gaba Waba.

I applied specifically for this trip because of the component of sustainability we try to achieve.  As we have often told ourselves, we are addressing water accessibility, but we are not well diggers.  We are not giving band-aid relief and this fact makes even the seemingly simple aspects of our trip require careful attention and thought.  In truth, we do not simply address problems with water; we spend time trying to understand the community and making sure they understand us as well.

I am not a fluent Spanish speaker and this has been an overwhelmingly frustrating obstacle.  So much of how we understand the people of Cuje depends on speaking to the people.  Overcoming the cultural barrier alone is difficult, but adding a language barrier and witnessing my peers successfully have interactions beyond the scope I can achieve, has prompted me to study Spanish when I’m back in the states.

Our trip is unique in that we strive to have real engagement with the community members because it’s not about going to some poverty-stricken area and throwing out solutions for them.  It’s about getting the community to identify for us what their problems are and this implicitly requires that they trust us.  Dr. Aday reminded me today that at any point we could be gone and our true purpose is to spur community interaction that continues, regardless of our presence, making it crucial for us to understand how the community of Cuje works.  Community projects are most successful when they’re led by the community, not by outside forces, which makes our role confusing, but our project is still young and considering the quality of the work we’ve done in our short week, things look promising.

Ruby Langeslay (’12; 1^st year)

On our final day of clinic, we see many familiar faces: Leticia, the nurse from the Ministry of Health; children who stop by before or after school to blow bubbles and take pictures; and a woman who I don’t know by name, but I could recognize in an instant.  She seems to have lived a long life, but is probably no older than 50.  White streaks through her hair, she has blue lips, and her skin is exposed to more sun in a day than I am in a week.  This isn’t her first trip to the clinic this week and she is complaining that she’s about to faint while hyperventilating.  When she goes in to see Dr. Roger, though, she says nothing at all.  She could have mental health problems or she could be a victim of domestic violence, but we won’t find out.  From interviews I’ve participated in with medical and political figures in Totogalpa, we’ve learned that cultural traditions can slow down progress in the health field.

Knowing Spanish has definitely been useful, not only to order dinner and make purchases, but also to connect more deeply with the people of Cuje.  The patients feel more comfortable speaking to you, colleagues find you more relatable, and the interviews can extend much further than a scripted Q&A session.  The clinic we hold helps many, but there are even more left out.  The research we do provides us with great knowledge about the community’s structure and functions.  With this information, we can better figure out a project that can successfully provide a permanent solution to at least one of the many problems we see in Cuje.

Accomplishment, though, isn’t defined by numbers or statistics, but from the mutual gratitude and job shared between our team and all those we’ve encountered in Nicaragua.  This week has allowed each individual to grow and has invigorated all with a new sense of purpose, not only in our work, but also in our own life.  It’s been a short time, but the great love that circulates through our team keeps us forever strong in an unbreakable, yet inclusive bond.

These borrowed words from Shawn Hlookoff are dedicated to my team members:

You’re such a wonderful surprise

I couldn’t plan it if I tried

You turn my darkest day to light

Like a morning sun, you’re such a wonderful surprise.

Emily Matson (’12; 1^st year)

As a Christian, my main motivation for doing community service has been that all people, as children of God, are valuable and should be treated as such.  This means that they should be loved, whether that be through merely listening to them or by taking concrete measures to help improve their lives, such as in sustainable community development.  This desire to love and help people, along with my passion for Latin American culture, led me to apply for this trip.  I figured that my Spanish skills would be helpful, and that I could really make a difference in other people’s lives.  After I was accepted onto the team, however, I really didn’t know what to expect.  Not only had I not anticipated the level of commitment that was required, but I also had my doubts on whether all the sociological theory we discussed in class would actually have a concrete impact on people’s lives.  When we arrived in Cuje and started conducting our medical clinic, however, I began to understand how our project could become reality.  We worked at gaining a deeper knowledge of the community and building relationships with the people there.  My favorite part of the trip was getting to know the Nicaraguans we met.  I talked at length with a girl who routinely hung out around the clinic; she really loved social studies.  I blew bubbles for the kids, and they sang Happy Birthday to me.  I talked with our drivers about their girlfriends and their jobs, and practiced my Russian with the clinic doctor.  It was being able to communicate with and know these people personally that has inspired me on this trip, because now I can see more clearly who we are working for.

Ashley Ingram (11; 1^st year)

On the last day of clinic there was a woman who came after all the consultation numbers were given out, but she stayed there all afternoon asking everyone for a number hoping someone would eventually say yes.  Her wide eyes following me around the clinic — just another reminder that our one week clinic won’t solve any of the underlying problems plaguing this community and that our real contributions lie in our long-term projects based on our research.  I’ve been really involved in the mapping project, pouring over Google Earth and discovering what 4-wheel drive vehicles were made for as we bumped and slid over the mountains, searching for reference points.  With this project, we hope to create a visual that will help geographically coordinate future efforts in the community, but it also helps us see and experience the community as the inhabitants do.  Until you’ve walked the hours up the mountain slopes, you don’t realize how difficult it is for them to have to come back the next day to see the doctor, and once you’ve met these people in the houses, seen their poverty, and felt their kisses on your cheek, you finally understand why they need and deserve to much more than one week.

Margaret Summers (’11; 2^nd year)

This is not always a “feel good trip”.  Don’t get me wrong, I wouldn’t have this experience any other way, but there are so many things we see and decisions we make that are frustrating to the core.  We turn away people from the clinic that clearly need medical attention and we learn about water access problems we don’t know how to solve.  These frustrations are the very reason we do what we do, and connections with people we meet fuel our ongoing project.

A woman approached my teammate, Molly Blumgart, and me at the clinic after we interviewed her, asking us what we will do with the information she gave us.  We sat with her, overlooking mountains that are beautiful from afar and strenuous up close, describing our desire to understand the community to help it create long-term solutions.  The woman, holding her bag of month-long medications with worn hands, reminded me of the urgency of the problems in Cuje and the fact that we are deeply accountable for the work that we do.

Each year, we collect more data to analyze empirically and build a better sense of the community.  Informed by knowledge from last year, the questions we asked this week about communication networks and water issues illuminated the situation in Cuje even more.

In the coming weeks, I will be in Swem meticulously creating and analyzing Excel spreadsheets of data from our interviews.  At the same time, the woman Molly and I talked to will be hiking up inclines that I, even with enough food and water in my system and cushioned running shoes on my feet, find exhausting.  This devastating reality, coupled with the hope brought on by the strength and spirit of the people in Cuje, drives this project forward.

Allison Corbett (’09; 3^rd year)

I first joined SHC because of a discussion I had with a team leader about sustainability in public health.  Though I have little medical background, the project and its mission to provide solutions that respond to real health needs in Cuje intersected with many of my prior interests and experiences.  As a Hispanic Studies major I spend a lot of time discussing power relationships in culture but I had yet to address those marginalized communities in an ethnographic, sociological way.  In my freshman year, I was introduced to critical pedagogy and the work of Brazilian educator Paolo Freire.  Friere’s vision of pedagogy of the oppressed calls upon educators to create learning contexts that promote community action and respond to the real needs of learners.

Though SHC isn’t a pedagogical project per se, our careful ethnographic research works towards a similar goal.  Instead of designing programs to implement (read: impose) based on the problems we imagine the people of Cuje to have, we are spending years, literally, talking to the people in Cuje, striving to reach even the most remote corners of the area in order to understand community networks and issues.  The process has been long and definitely trying, but after this year’s team’s incredible collaboration and effort I’m leaving Cuje and William & Mary with the knowledge that this team will accomplish so much more than we yet have and am so grateful to have the chance to be inspired by each and every member that will carry this team into the future.

Gabriela Aria (’11; 2^ND year)

A cursory glance at the team can easily stereo-type us as a medical mission, helping a poor community in a Third World Country.  And to an extent we do hope to provide some immediate relief to a community in desperate need of any kind of assistance; but that is not our single or most imperative objective.  Our mission lies beyond the short-term help a doctor and medicine provides – it revolves around the sustainable solutions we are trying to form and then implement.  I tried explaining this to Dr. Roger last year but I undoubtedly failed because he was still puzzled why we kept returning to Cuje.  Our second Q&A helped him develop a more thorough understanding of SHC’s objectives in Cuje.  Discovering the community’s fundamental problems is critical in our construction of sustainable solutions.   This is why we’ve spent a week interviewing residents, community workers, NGO leaders, doctors from the Ministry of Health, and the municipality’s mayor.  Each team member contributed valuable insights and perspectives that are instrumental to our mission.  We understand that the people of Cuje need help beyond the medical relief we provide during the week.  In other words, it’s not always about the scrubs.

Sarah Ruth Goldman (’09; 3^RD year)

Ashley Ingram is a new member.   She is sweet, soft-spoken, and sharp.  Mapping the community has sparked her interest.  She enrolled in a GIS (Geographic Information System) class to better her comprehension of the program and has developed a plan to eventually have a map with all of the important points and paths of Cuje.

Gabi Arias is a returning member, but only a sophomore.  Within the past two years she has dived head first into the project.  She is not just our charming fluent Spanish speaker, but also our government major who has difficulty containing her interest in the politics of Cuje and Nicaragua.

Molly Copeland is another new member of the team, but you would never know.  Her contributions are always challenging and force us to think about every interview question and how it will help us better our understanding of the community.

The involvement of my fellow teammates in SHC has made it abundantly clear to me as a co-leader that in order for a trip to be as successful and smooth as this past week has been, we all have to bring something to the table.  We are more inclined to actively participate if we have been truly engaged in the process.  By finding our own special interests in one of the many aspects of our trip, the project has grabbed the attention, respect, and devotion of each member.  I’m looking forward to hearing about how SHC will continue to flourish after I graduate this May.

Molly Blumgart (’10; 2^nd year)

After my first service trip experience in high school, I was left with the uncomfortable feeling that our trip had not done much to help the community and our money would have been better spent if it had been sent to the local church we had partnered with.  Four years later, sitting in class with the rest of the SHC team, it felt so relieving to have my frustrations voiced by the students – and professors – around me.  Our interactions with the Community in Cuje this past week has made my belief in our approach to service even stronger.  There is no doubt our patients appreciate the medical help they receive from the clinic, but it will not change the poverty in which they live or improve their lives in a sustainable way.  As one of the more fluent Spanish speakers on the trip, however, I was able to have conversations with some of our patients about our interviews and plans that enabled me to see a possible future in which, together, we could plan and implement a project.  That prospect leaves me with such hope, a feeling so far from where I started four years ago.

Jacqueline Ramirez (’10; 2^ND year)

Significant progress made this year from the clinic coordinating to the thoughtful and careful interviews with INPRUH, the Mayor of Totogalpa, MINSA, local physicians, and residents of the rural mountainous community that as a returning student to the project this time around I feel a greater sense of ownership and have a solidified understanding of our sustainable development efforts in the project.

From the beginning, I had a sincere commitment to the vision of SHC, but worried about our presence in the community and questioned the impact of our ethnographic research. Seeing many similarities between my parents’ county life in Oaxaca and Guerrero, Mexico with Cuje, Nicaragua sometimes the best solution for some people simply happens to be migration. Yet, I wonder what if they had not crossed over to the US.? How would life be different? In response to a Managua physician’s thought that perhaps Cuje should be inhabitable, I think there must be an alternative to migration.

We now have a greater sense of the community’s resources, potential leaders, and identity. This information in combination with the political and power structures that surfaced has brought us closer to a potential sustainable development project that will address the community’s most urgent and underlying cause of healthcare problems:  water access and quality being on top of the list.  Hopefully, we will move into more concrete action soon that will support the stay and development of communities in Cuje. I envision the day when people stay in their countries of origin not because they don’t have a choice, but because they chose to stay.