Sunday, June 29, 2008

What the #%$@ AM I doing in Nicaragua? Part II.........Lunch Lady

Let’s say that you are a kid living in La Chureca or Acahualinca (area just outside of the trash dump). The idea is that you would go to school and get some type of education, right? I mean the school is right down the street……and it’s FREE. So why would you NOT go?

Well, let’s start with this. Sure the school is technically free……..except for that a few years ago, there was suddenly this new rule from the government making it mandatory for every kid in Nicaragua to wear a nice little school uniform……a nice uniform that ISN’T free (but quite nice I have to say……blue and white…..really quite lovely). And then there are those other little things that aren’t free…….like any “supplies” you may need for your reading, writing, and arithmetic. And then there is the whole OPPORTUNITY COST of attending school. I like to call this one the “hey, I know that you’re only 7 years old…..but you’re a part of this family and we need EVERYONE to contribute…….so as terrific as going to school would no doubt be, we need you to go spend your day digging through trash or begging in the street……we’ll pool our resources at the end of the day…..who knows, maybe there will be dinner tonight” factor. Oh, and let’s not forget the concept of “School? Why would I want to do THAT? I’m young (like 10). I’m hip…….cool…… tough. I have unlimited freedom and friends in the neighborhood. Nobody’s going to make me go? Uh….yea…I don’t think so.”

Enter El Comedor. The MAIN idea was two-fold. First, since malnutrition is such a problem in the area, they wanted to provide the kids with ONE good meal per day. Second, by providing these kids with this one meal per day, that’s all many of them get. If they come to school, they get fed. Put another way, if they sit through classes each day (hopefully getting some sort of education in the process), they are rewarded with lunch. School=Food, and it’s a great way to bribe kids (or their parents) into getting an education.

So with these ideas in mind, NicaHOPE (in partnership with various other NGO’s) built “El Comedor” (i.e. the dining hall) about a year ago. The dining hall has a large seating area, a small kitchen, an even smaller area to store food, and a little sink out back to wash dishes. The staff consists of a lady named Hazel and….well…..Hazel. There are supposed to be “mother’s from the neighborhood” that show up and volunteer their time with the program. Unfortunately, only one of them comes on a regular basis. That means LOTS of work for a VERY FEW people. As for the food, it is donated collectively by USAID, the government of Nicaragua, and a couple of small NGO’s.

The good news? Well, the good news is that the program IS functioning and 300-600 kids per day receive a plate of relatively nutritious food (no frozen pizza or tater tots for THESE guys). The other good news is that after the implementation of the feeding program, registration at the beginning of the year was UP (i.e. initial success)! We’re hoping it stays that way.

So remember that lady from the school cafeteria? The one who was older, heavier, less than attractive (probably at least one large facial mole…with or without hair…….on the mole that is……the hair on the lady was anyone’s guess), ALWAYS clad in white, and NEVER caught without her crown (that would be the hairnet)? Four days per week, I am she…….she is I…..we are one. Yep, in addition to being the nurse’s aid in La Chureca, I’m the LUNCH LADY (self-titled, of course) at Acahualinca Elementary. Four days per week, I cook, I serve, I visit with the staff and kids, and I wash a LOT of dishes……like a LOT of dishes.

But in reality, one can only stay in the mailroom (or in this case, dish room) for so long without finding opportunity for advancement. At least, that’s what I’m finding with my lunch-lady duty. So despite the fact that I’m perfectly content chopping vegetables, pouring soy beverages, and getting pruny digits in the sink out back. there are often times bigger fish to fry (yes…pun intended). For example, what happens if you have 500 kids in a school with no water? I mean not being able to cook or drink anything is one thing. Even 500 kids doing the old #1 can be manageable on a good day. A few hundred….uh…..#2’s? Now we have a problem. So what do you do? Cancel school! Ah, but wait a minute! Wait a minute! There’s actually NEVER any water during the day (one of the little inconveniences of living in a third world city). The water is only on for a few hours in the night and early morning! So what do you do? Well, you install a large storage tank that can fill each night and then be used during the day. What do you do when the pipes break or the tank doesn’t fill due to lack of water the night before? Like I said before, you cancel school! But wait! Wait! Wait! Before we do that, there may be one other option. Let’s call Jason!

Yea, the water problem has certainly become one of my main projects at the school, and I seem to be finding different solutions on different days. My best one involves “borrowing” water from one of the neighboring storage tanks by running a system of hoses a couple of hundred feet across the road and then directing (at times, quite vigilantly) traffic around the hoses. I’ve also been meeting with contractors to come up with a better solution for the long term. That being said though, I do wear a number of hats around Acahualinca Elementary besides the stylish hairnet (OK, so I don’t ACTUALLY wear a hairnet either….standards are a bit different down here), and I’m finding it increasingly difficult to maintain a low profile behind the endless mounds of plastic wear. AND, when I’m not running around the kitchen or solving the daily water crisis, I’m loading a pickup truck with large sacs of beans and rice (I seem to be the only guy around with a drivers license), picking up cleaning supplies from the Ministry of Education, and answering to “Hey Gringo” from all sides.

As for the future? Well, I have a meeting with the official boss tomorrow. I’m learning more about the ordering procedures, the menu planning, and how things magically get done behind the scenes. There are also attendance records to analyze, that whole water problem to solve, the current infestation of flies in the kitchen(think PLAGUE), and the guys who want me to teach them how to watch porn on the school’s only computer. I’m swamped, I tell you……absolutely swamped.

Sunday, June 22, 2008

What the #%$@ AM I doing in Nicaragua? ........Part I

I got an email last week from a friend that I haven’t talked with in a while. I told her that I was down here in Nicaragua and planned to be here until the end of the year. Her response?

Hey Jones! What the #%$@ are you doing in Nicaragua?!

“Excellent question”, I thought. “Excellent question”.

The medical clinic in La Chureca (if La Chureca doesn’t ring a bell for you, check out the Blog entry from January) has been in operation for just under five year, and although it was originally constructed and funded by a charitable organization from Belgium, it is now operating through a group of physicians from Austin, Texas. The staff currently consists of two doctors, a nurse, and a pharmacist, with a dentist and an OB on the way (all Nicaraguan). The structure itself is simple but adequate, with a couple of exam rooms, a small office, and a separate small room that functions as a pharmacy. The porch in front acts as the waiting area and is relatively full most every morning from 9 to 11 AM.

Who are the patients and why are they coming? Well, the patients are the people of La Chureca, and the clinic is a “free” resource for the community. As for WHY they are coming, I think it would be comparable to the average Primary Care Physician’s office in the US. Due to the environmental factors associated with living in smoke and garbage, skin conditions and respiratory ailments abound in the community. There is also the occasional “trauma” associated with “machete fighting”, the burns or lacerations that result from walking through smoldering garbage without shoes, and a few AIDS patients that call La Chureca their home. The most common ailment though? La Gripa…the word that seems to refer to your general cold and flu symptoms. So after waiting on the porch for a few minutes and then having a short “consulta” with one of the docs, the average patient gets a shot or nebulization from the nurse (along with vital signs, etc.) and then walks out of the pharmacy with a small bag of antibiotics in hand.
In addition to the daily operation I just described, the clinic also acts as a “base of operations” for numerous other programs in the area. There is a child-sponsorship program, there are weekly health talks, and there are English classes taught several days per week. Want to have a “de-worming-drive” for the area (yea, parasites are quite popular as well)? Care to vaccinate the entire community? Have a medical “brigade” from the US that wants to set up shop for a day or two? Everything flows through this clinic. In fact, the clinic really isn’t even called a “clinic” but rather the “Casa Base De La Salud”……..or Base of Health.

Perhaps the obvious question then is………“what in the world does a gringo paramedic from Denver do in the medical clinic of La Chureca”? Well, the answer to THAT question would depend on the day. The good news is that I’m realizing more and more that the clinic really doesn’t NEED my help. They are functioning quite well on their own, and seem to be on a continual path of improvement. When I AM there though, I basically just fit in where I can. Sometimes I act as a nurse. I administer various medications through injections or nebulized breathing treatments. I clean and treat wounds. Sometimes I act as the “nurses AID” by weighing patients, taking temperatures and vital signs, etc. Sometimes I act as the janitor. I sweep the floor. I clean and organize the exam room. I try to keep the place tidy. And sometimes I help out in the pharmacy with the monumental task of taking pills from the BIG bottle and moving them to the SMALL bottles. Brilliant……I know…..brilliant. Beyond that, I chat with the folks coming through, hang out with the staff, and run the occasional errand.
And that’s pretty much my life at the clinic. In the earlier part of the year, I was spending as many as five days per week over there. I’m currently down to one. And as for the other days of the week? ………………to be continued.

Thursday, June 12, 2008

It's Good To Be Back

1993. It was the fall of that year. I was returning to San Diego after spending the previous three months working on a ranch in the mountains of Colorado. I was playing tennis again (this time for the university), my girlfriend of the summer had just broken up with me (for the FIRST time), I had recently discovered this NEW WORLD of outdoor recreation, and I officially declared myself to be an “all of the above” guy. I say “all of the above”, because as I read the logic behind it all…..the environmental degradation, the numerous health concerns, the countless ethical questions, etc. etc. etc., the way of the vegetarian just started to make sense. “OK”, I thought. “I think I’ll really give this thing a shot…..we’ll see how it goes”.

15 years later, I found myself sitting in an open-sided restaurant in Nicaragua. Mangoes were falling from the trees, the heat of the dry-season was at the peak of its intensity, and I had just completed the first week of what was to be my new life for the next year. There were probably 10 of us in the restaurant that day, and we had been brought to a very SPECIFIC place to experience a very SPECIFIC food by our host. The idea of the meal was to honor his guests (i.e…..US). To turn down what had just been placed in front of me would have been a significant insult, something I had always sworn against. So there it was……perhaps the largest plate I had ever seen, containing perhaps the largest slab of beef ever intended for a single individual. And as I stared at the enormous CHURASCO before me, I found myself uttering those familiar words from a decade and a half earlier. “OK”, I said. “I’ll give it a shot…..we’ll see how it goes”.

Another three months has passed, and I’m sitting in a small town in the mountains of Panama. I’m essentially taking a vacation, as I needed to leave Nicaragua to renew my travel visa. The rainy season is now in full swing, and the avocados are the current fruit falling from the trees. A new season…….a new world. So as I sit here on a porch, watching the rain, I’m ending my little hiatus from the Blog. In the next few entries, I’ll be filling in a few gaps as to what the last three months have entailed. I’d like to explain what I’m doing in Mangaua, a bit about why I’m doing it, and some of the high’s and low’s of it all. I do hope you enjoy it. It’s good to be back.