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Preparing food for the church´s Christmas celebration |
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Finishing making the piñata for another Christmas celebration in the community |
The piñatas were a smashing success, both of them, in two separate Christmas parties. After 8 days of work, we finished the house. Party to come this Friday, complete with traditional dancing that some older community members are putting together. I hope to get my wooden latrine seat put together tomorrow so that part of the facility can be open to inspection and use!
The next task, something I´ll be working on in the next 2 months, is to do a survey of the community, all 28 households. The survey I´ve designed should provide some baseline data before we start any programs, as well as start more conversations about community health. I´ve also got a checklist (standardized with the other Environmental Health projects) about things I´ll just observe. For example, in their house I´ll look for how they store their drinking water.
Some example survey questions and my thinking behind them:
What are the names and ages of household members?
Most community members are children and teenagers, with a sprinkling of grandparents. One person pointed out what the presence or absence of elderly indicates for health. Average family size is likely around 5 kids. In the earlier generation, polygamy was common. The two main family groups, upper and lower sections of the community, are each originating in a patriarch with several wives. There are a few complicated situations with second marriage in the present day, and one man with two wives. Due to the influence of outsiders, in the form of increased education and efforts of Christian missionaries, few women are interested in a polygamous marriage nowadays. They used to get married early in the old days, and quite a few still do. One friend got hitched at age 15 and had her first child at 16, with a man 15 years older. I don´t know how she could have had discretion at that age to make a good choice but she seems to have made it- the father is a hard worker and devoted to the family. I need to look past my own prejudices and filters to understand and empathize with people in a situation very new to me. Many volunteers teach seminars for teenagers using a PC developed curriculum about life choices and sex education, to start addressing these important issues. The sheer numbers can speak to how many people a latrine or aqueduct project could serve in the present day, and make projections about the growth of the community.
For what reasons might you go to the health center? The curandero (traditional healer)? What do you treat in the home?
Community members will often treat things in home that I would go running to a health center for- an infected pus pocket on a child´s face, a nasty two week long cold, persistent diarrhea and lack of appetite. I don´t understand this, but I think it has something to do with keeping power in the home vs taking them to an outside source where any of the following may happen: absent doctor (come back later), they may have to wait in lines, spend money, or experience disrespect from staff. Many people will wait an illness out and see if it worsens. Not so bad in our site where an ambulance can drive up at midnight to evacuate if need be, but in more remote communities waiting to seek treatment may have disastrous consequences.
How many cases of diarrhea has your family experienced in the last 3 months?
Often caused by unwashed hands or dirty water. As far as I can tell, they think all diarrhea is caused by foods that don´t agree with the stomach, or don´t mix well together.
Where do you go to the bathroom?
The most sensitive question on the survey, and one that some other Volunteers have found easiest to have an accompanying community member ask. I am expecting, for the most part, one of two answers: in the monte (hills or fields) or the quebrada (creek). Many Ngabe communities prefer to wash rather than wipe, which has been an obstacle to latrine introduction. There are some water based (pour flush) latrines used in the developing world but they are much more expensive. I am feeling out the attitude of the people in the community; several disused latrine pits speak to the complexity of the issue.