The term has quickly come to an end and I would like to reflect on all that I have learned in this class. This class has been more that just being lectured about Nicaragua and then writing papers. This class has been very practical in that we have delved into the issues surrounding Nicaragua and discussed them. We’ve interacted with Nicaraguans in person and through skype. We’ve had guest speakers with experience in Nicaragua. We’ve had workshops and educational sessions. This class has been more than just a grade for me. I’ve really put forth a great effort in learning about Nicaragua in all facets in order to be prepared for when I go on my trip in December. Our professor, Douglas Moody, was amazing. He was not only knowledgeable, but he also facilitated great discussion. Also, knowing that he will be on the trip with us made me feel assured that he truly cares about Nicaragua.

I want to highlight some of the most influential experiences that I had in this class. By far, the experience that influenced me the most was when the Daughters of Corn dance troupe along with Compas de Nicaragua came to visit us in our class. I will never forget the discussion we had. They told us that they would never live in the United States because they are proud of where they come from and here in the U.S. we have an emptiness inside of us that they don’t have. After learning about all this issues that Nicaraguans face and all the adversity that they have overcome, it astonished me to see their energy and pride. Also, I was also very touched by the fact that despite their limitations, they do whatever they can to help one another. Through the Women in Action initiative facilitated by Compas de Nicaragua, microloans have been made available to families and these loans have truly made a difference. In addition, they spearheaded a soy food program to grow and cultivate soy which is an inexpensive and nutritional alternative to more expensive foods.

Another experience in which I learned a lot was when Dr. Jim Saunders came to speak to our class about the seven sins of humanitarian medicine. Even though I am not going to be part of the community health team when I go to Nicaragua, I feel like his advice is applicable to all those that volunteer on service trips. He addressed not going into the underdeveloped countries thinking that we are the saviors because we can indeed cause harm. Throughout the entirety of this course, I have realized that service is something that can harm if not done correctly and this is the last thing I want to do when going to Nicaragua. Dr. Saunders, also addressed not leaving a mess behind and not being bad guests. We have to remember that these countries are hosting us and just because we are going to help doesn’t give us the right to look down upon them because most of the time they know more than us. Something that a lot of in class speakers have addressed is learning a lot more than they would have thought from service trips. They thought that they were going to go to their respective countries and provide life-changing services. In reality, they made small contributions, but learned so much more than they gave.
I am very excited for this service trip to Nicaragua in December. I joined this trip because of my love for service. Obviously, that’s always a requirement, but many well intentioned people like me end up causing harm. I have received 10 weeks of training and I went from not knowing where the country is to knowing so much about the culture, the people, and service in general. I am ready to go on this trip and give my everything. I’m looking forward to interact with the local Nicaraguans and learn much more from them than I could ever teach them. I am completely humbled and I am ready to serve and listen to one of my brothers in god.

This week in our class we all presented on a subject matter relating to Nicaragua that interested us. There were so many interesting topics presented along with great proposals for solutions. In my group we analyzed three separate international development projects including their successes and failures and provided a form in which this formation can be useful to the Nicaraguans. Many groups explored topics related to problems in Nicaragua and gave excellent proposals and solutions.

One presentation that I truly enjoyed was that of Patricia and Rocco. They addressed the issue of poor Dental Hygiene in Nicaragua. They made it clear that dental hygiene in Nicaragua is abysmal due to the lack of dentists available in the rural regions and in order to prevent the need for dental care, preventative care is essential. It is not that the Nicaraguans don’t understand the necessity of dental hygiene, but they are just simply not encouraged to follow these practices and do not have reinforcing structures to do so like here in the U.S.

The aspect of this project that I enjoyed the most is how a tangible project will be implemented when we travel to Nicaragua. Patricia and Rocco created a toothbrush holder with dental hygiene cartoons on the front to distribute to young children in Nicaragua. They really put a lot of thought into creating this toothbrush holder from what material would be used to create it to how to make it last. Once their prototype was created, they created a three step implementation plan in order for the holders to have the best possible impact. These three steps being motivation, ability or education, and the presence of a visual trigger. I think it was very important how Rocco and Patricia understood that their project was not a revolutionary change but rather a small-step towards long lasting change. They admitted that they knew this toothbrush holder wasn’t going to completely change dental hygiene in Nicaragua but it would be a strong step in reversing the vicious cycle of bad dental hygiene. I also think it is important to note that they will be using their own funds to create 50 of these toothbrush holders as well as devoting out of class time to the project. This project clearly reflects the steps that need to be take in order to make changes to the problems in these regions. We need to make small changes to ultimately end the problem.

Another project that interested me was Kira and Kayuri’s. They discussed mining in Nicaragua. I particularly enjoyed their project due to the questions and discussion that it incites. They presented facts about the mining industry in Nicaragua. For example, it produces $460 million annually for the economy and provides jobs for working class people. Families depend on this industry and it is an industry that is currently booming due to the interest of mining companies to settle in Nicaragua. A case study of a mining company, B2 gold, was provided and it was shown that the company praises Nicaragua as a great place to do business due to relaxed laws that make exploiting the Nicaraguan resources easy. Obviously, they create confusing jargon to explain this reason.

These mining companies promise to provide safe working conditions and provide benefits and resources in the communities in which they are established. However, as we can observe throughout history this is not the case. We were shown a video of a protest by a small mining community against B2 gold because of the destruction of their community. Is this an example of a community that enjoys the presence of a mining company? At the end of the day the government benefits from mining and the mining companies benefit from mining, so there is no reason to change the system. There is no reason to stop exploiting local communities. However, Kira and Kayuri made an interesting point as to how mining is not a logical way to sustain the economy. Gold veins are finite and eventually all natural resources will be exhausted. What will occur then? The country’s economy will spiral out of control. This also bring up an important question which is should mining be abolished even though for most it provides the only form of income. This is where one weighs the pros and the cons which is impossible to do. What is more important,  safety and the economical success of future generations or your short-term survival. This is an impossible question to answer and the Nicaraguans shouldn’t have to. The government has to step up and provide ways in which the Nicaraguans can thrive without the exploitation of their resources and the endangering of their health.

 
This past class Dr. James Saunders attended our class and gave a presentation on healthcare. He is  an otolaryngologist, specializing in ear, nose and throat disorders. He has a lot of experience in healthcare specifically in Nicaragua due to his work there with an organization he helped to co-found: Mayflower Medical Outreach

I  really enjoyed his entire presentation but I was most interested by his explanation of the seven sins of humanitarian medicine. This is something that we had learned about a while back in our class, but it was nice to hear it from someone who has actually been part of many humanitarian health brigades to Nicaragua. He began by talking about #1: leaving a mess behind. He gave an anecdote about arriving in Nicaragua ready to do ear surgery  with his team after being there 6 months prior. Him and his team were received very coldly due to the fact that a different health team had just been in the area fixing cleft lips and right after they had departed the wounds began to open. The children were then left much worse off than before. Dr. Saunders emphasized the importance of having a plan in case things do go wrong and not taking on more than you can handle.

Next he talked about sin #2: failure to match technology with local needs and abilities. He discussed the use of cochlear implants with people with very bad hearing loss or deafness. These cochlear implants are not only very expensive but they require a lot of upkeep which is certainly not feasible in Nicaragua. Dr. Saunders then compared the situations of 2 girls in Nicaragua with profound hearing loss. One girl lives in Managua and comes from a middle class family and the other lives in a very rural part of Nicaragua. The one in Managua was able to get a cochlear implant because the technology was available to do so, but the other didn’t have the same resources so a low-tech solution was more realistic for her situation. This made me reflect on how sometimes as Americans we believe that our technology and our ways of doing things are universal, but we have to take into account the locations in which we are helping because high-tech solutions in some cases can prove disastrous.

Sin #3 is the failing of NGOs to cooperate and help each other. There are many charitable organizations out there that do wonderful work in countries like Nicaragua. However, when they don’t cooperate, they don’t make the biggest impact that they could make. Dr.Saunders discussed how in places like Nicaragua communities will never reject service because they are grateful. Nonetheless, there are time when they get the same services over and over which is not really beneficial to them. An organization that provided an already provided service could have allocated those funds for an other purpose that the community could have benefited from.

Sin #4 is failing to have a follow up plan. This sin corresponds with leaving a mess behind. When a medical service is provided there is no guarantee that there will be no complications. Thus, Dr. Saunders stressed training people in the communities to address those complications because realistically there won’t always be an American health professional available. He made the wonderful analogy of not only teaching a man to fish but also giving him a fishing pole. So, Dr.Saunders’ organization is not only training people to handle these complications and to do other general medical work, but it’s also providing the proper equipment to facilitate god medical care.

Sin #5 is allowing politics, training, or other distracting goals to trump service, while representing the mission as service. In certain occasions, political parties within some countries want to use these service missions to their benefit in order to make themselves look better. Dr. Saunders emphasized that you can’t always ignore the politics going on around you, but you just have to along with it and not get sucked into it. In my opinion, I think its very easy to get sucked into politics and very controversial issue when doing service work. I think the best plan is to do work that benefits the masses and that doesn’t take a stance on an issue. For example, one wouldn’t  go into a developing country and start facilitating abortions.

Sin#6 is going where you are not wanted and being poor guests.

Coming from the first world, we tend to think that we are the saviors of the third world and we know what’s right for them. Hence, we impose our will and feel entitled because we are providing “service.” Sometimes our help is not wanted or needed and just being poor guests. Dr. Saunders said that in countries like Nicaragua the people are very polite and won’t refuse your help. However, I think it’s essential to really reflect and ask ourselves if we are helping and making the situation better rather than worse. The medical student that spoke at the end of the presentation spoke about needing to test babies’ hearing for her research. She didn’t simply go into hospitals with the expectation to be able to test these babes because she was from America and providing service. On the contrary, she established relationships and didn’t see herself as above the Nicaraguans. So I think part of being poor guest is having a feeling of entitlement and looking down upon those that we are trying to “help” when in reality we might not even be helping.

Lastly sin #7 is doing the right thing for the wrong reason.

This sin is essential especially in my case because  I have frequently questioned myself as to why I’m going to Nicaragua. The worst thing would be going to pad my resume or to have a travel experience. After a lot of pondering, I realized that I’m doing it out of a love for fellow mankind. When I go to Nicaragua I’ll do my best to serve whole heatedly and taking into account that just because I’m there to serve doesn’t mean I can’t cause damage.

Dr.Saunders was great and provided a lot of insight into not only medical service, but service in general. I know that I used to think that simply because I’m volunteering means that I’m doing a good deed but Dr. Saunders has shown that damage can be caused and we always have to  take into account the seven sins of humanitarian medicine. I want to take it further and say that these sins are applicable to all humanitarian service.