We heard stories from 8 different "promotores" groups from all across the country as to how health care went in 2012. Each group shared their accomplishments, challenges, suggestions and aims for the future. One man gave a short presentation on the signs and symptoms of Brain Hemorrhages and the importance of early medical attention. Another community had recently obtained an ambulance and a public health volunteer told the story of how his son still died of diarrhea because of how long the trip was to an emergency room (due to the floods during the rainy season). This experience gave him the desire to help save other lives and so he joined this group. Yet another woman from the island of Ometepe (where I live and work) told her own story of how she would have died of peritonitis were it not for a small wooden boat that brought her across the lake to the larger town of Rivas for emergency medical intervention.
Omar, a volunteer of 20 years who lives 12 hours North of Managua in Bonanza, shared with me how he helps his community. He has a first aid kit with the following medications: Amoxacillin (antibiotic), Metronidazole (anti-parasitic), Acetominophen (fever reducer), Oral Rehydration Solution (important for kids with diarrhea) and another that I've since forgotten. He does the best he can in distributing what he has to the folks that come to his doors at any hour. He also has some plants which he picks leaves from and sends home with community members when they are sick for teas. We talked about basil for colds, lime leaves for itchy skin, fresh lime juice for diarrhea, garlic for parasites and much more.
Some of the challenges the groups had were as follows:
-The ministry of health is not involved in many of the groups and the groups lack funding for medicine, equipment, training and organization
-The monthly meetings for each group have been decreasing to bimonthly due to funding
-lack of basic medical equipment like blood pressure cuffs
-lack of training manuals for new health promoters
-shortage of basic medicines
The only thing that was "off" so to speak about the day was an interesting "cultural activity" during the lunch hour, where a group of pre-teen boys and girls put on a performance for our group. The young girls, heavily laden with makeup, flowers, bright flowing dresses and fake long braided hair, danced for us to traditional Nicaraguan music. They were frequently interrupted by the boys who stumbled in with painted clown faces teasing the girls, referring to their bodies and dancing with sexual gestures to hip hop music. After about 10 minutes I left fairly disturbed. The group of Nicaraguans was laughing, clearly entertained by this skit and dance routine but I was not. I couldn't help but think of my young female patients who were pregnant without the father of the child involved in their lives or couldn't tell me if their husband was faithful to them as I treated them for yet another sexually transmitted infection. One of my first days working at the NDI clinic I treated a 16 year old girl in a high school uniform for an STI whose partner was over 40 years old and likely re-infecting her. In this "machismo" culture, men and women are treated very differently. Just as in the lunch hour entertainment, men in any culture can be permitted to disrespect women and appraise them for only their bodies. It was just difficult to see it so blatently in a rehearsed youth performance.
I am looking forward to the conference resuming tomorrow, where I will meet with the group of about 8 health promoters from the communities on the island of Ometepe. I hope to hear about their goals and needs... especially how I and Natural Doctors International may collaborate with and support their excellent and devoted work promoting public health.