My time this summer has mostly been dedicated to conducting a global health research project designed by the four of us Yalies, to investigate the barriers to urban and rural womyn in Leon receiving Pap smears. In addition to open-ended interviews, we also administered our own survey to 321 womyn in three urban health centers and three rural health posts. Since some of our participants were illiterate and most wouldn't know how to use a computer, we had to read every single survey to each person, and then input each of her answers into the computer. This involved a lot of struggles with old Thinkpad computers and Claro internet sticks, but eventually I became one mean, lean survey-collecting machine. This meant A LOT of close, intimate conversations with the womyn of Nicaragua. Occasionally we would have womyn who had never received any schooling at all, and sometimes explaining questions to them would be challenging. And then some womyn just really did not understand the concept of "please rank on a scale from 1 to 6." Some womyn loved to start telling stories in the middle of the survey about their aunts with gastrointestinal cancer and their husbands who sleep around with other people, all while I am trying to keep them focused on their most recent Pap smear. One womyn asked me what the word "probability" meant. When I asked another womyn if Paps contradicted her religious beliefs, she replied,
Creo en el Señor pero también creo en los chequeos, "I believe in the Lord, but I also believe in checkups." I learned that womyn have to provide their own cup for a urine sample, and their own speculum for a Pap smear if they care about having a sterilized one. Most frustrating was when some womyn would just would stop responding or making eye contact when they didn't feel like they knew the answer. And every womyn had a baby. Or five. Not matter what age she was, she had a baby, and she would not be afraid to whip out her breast at any time while talking to you to breastfeed her baby. There is so much social pressure on young womyn here, that until they become a mother they are not considered a womyn. Usually the baby would come before a husband, and before the end of high school. When questioned for the survey, more often than not womyn would say they were "adjuntada" not married, which means they had a partner. I have asked so many people here about that phenomenon. Some say that marriage is just out of fashion. Others says the more underlying cause is that since the culture is for the men to cheat on or abandon their wives anyway, in the end it is not worth the cost of getting married anyway.
An old janitor at one of the health centers sought me out, and we had a long conversation together. She said,
Aquí las mujeres sufrimos bastantes, "Here, we womyn suffer so much." She felt that because of the pervasiveness of machismo in their culture, men are worse in Latin America than anywhere else. She told me of a college girl in Managua who was recently killed because she resisted a man's advances. She said she constantly sees womyn with bruises from their partners beating them. They cannot leave because they got pregnant so young that they wouldn't have money to feed themselves or their children without a man. From when they are little children, the boys and girls are treated so differently. Boys are allowed to play, while the girls are supposed to do all the housework and chores. Later on in a relationship, the husband won't want his wife to work, for reasons of ego, pride, and control. Even if a womyn works, there is such a huge wage gap that they can barely support themselves on their own. Since they are making less than their husbands, the men use this as a reason to control them and make all the family decisions. Womyn feel no other option but to suffer through, because machismo is so pervasive it is the same with most men. Given all this, when I asked the janitor about abortion as an avenue of empowerment, she responded that a womyn would have to be mentally deranged to consider getting one. As of 2006, a national law made abortion illegal in all cases, including rape, child abuse, or if the mother will be killed by her pregnancy.
Nicaragua is so much more accepting of womyn breastfeeding in public. I'm not sure if it is due merely to the abundance of babies or to a different cultural cause, like that womyn are so sexualized here already, people are willing to realize they do have boobs. Ether way, the U.S. has a lot to learn. In her talk last week, Gioconda Belli pushed everyone to imagine what it would be like if the workplace were actually set up for womyn rather than men, if it were a given that mothers should be allowed to work, and therefore they were given adequate maternity leave or areas to breastfeed, and sexual harassment was not tolerated.
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| The mantra of any global health student: exclusive breast-feeding for 6 months! |
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We made posters this week for the health centers to fix misconceptions we'd noticed.
We also gave charlas, or little talks with groups on womyn educating them about the topics and answering their questions. |
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We really felt like we were starting the important conversation about the HPV vaccine among the León health centers;
doctors in the public sector previously had little info about it and wouldn't even offer it as an option their patients. |
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| We got a brief chance today to shadow doctors & med students in gynecology and pediatrics in the one hospital in León |
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| An altar burning in incense in the sweltering waiting room |
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All of the services in this hospital are free.
So crazy for the American that she had to take a picture |
