I would just like to begin today’s post by saying I had the most delicious lunch today. It was a hearty soup/stew called “Indio Viejo.” According to my research [bonus points to anyone who gets that reference], this traditional dish might be one of the oldest and richest of Nicaragua, dating back to pre-Columbian Nica. Thus, its name tiene sentido (makes sense) as it translates to “old Indian” and uses native ingredients typical of Nica’s indigenous people. The soup’s base is maiz (corn), a staple food then and now in Nicaragua. The soup is a brilliant orange color and had the most interesting “bite” and zing! to it. Upon further research for this little blurb, I now know it’s due to the bitter orange/mint (the zing! factor) [that explains the and achiote paste (the orange color) of the recipe.

Indio Viejo, image by Cocinemosjuntos.com via YouTube

I feel like there’s an elegant way to incorporate my journal prompts into my blog posts that would befit a blog that’s attempting (key word: attempting) to be narrative in style and inspired by the masterpiece of the Spanish Golden Age, Don Quijote. But alas, I’m just going to plop down my prompt and move on with the writing: Take one hour today to talk with a community member (NOT a non-local staff member from your host agency) about the social issue you are addressing. Take the time to listen to their point of view, without imposing yours. What do they have to say?

These past two days, I’ve been with Nurse M. She works in the gynecology clinic and is a one-woman band in that hot rectangular room. I’ve loved the past mornings with her because she has to put on the AC while disinfecting the room for the day. She’s left it on until 12 pm when we break for lunch, and it’s absolutely blissful compared to the muggy waiting room and hallways of the clinic. I confess: I am a child of the AC.

I enjoy the mornings as well because that’s when all the patients arrive, and I can observe the most consultations, listen for areas I can work within and platforms to build upon. In the afternoon, patients sprinkle in here and there so there’s plenty of time for conversation. Today, I asked Nurse M about her opinion on cervical cancer in Nicaragua. Specifically, why is it that it’s such a preventable cancer, yet cervical cancer is leading cause of death for Nicaraguan women. With regular screening (a PAP smear every year once a woman begins sexual relations) and early detection via acetic acid and PAP smears, I believe/she believes/I believe todo el mundo would believe that these numbers would go down. So I asked her why? Why weren’t women coming in to receive free PAP smears? I’ve seen that it’s quick, less than 15 minutes from consultation to being right back out the door. The women I’ve observed thus far have commented, with surprise, that it’s painless. And did I mention that it was free at CS Monimbo? Ok, now I’ll suspend my opinions and point and view and recount what Nurse M told me.

She said: Machismo. Vergüenza. Poor Propaganda. Fear. were the reasons why so many women die from cervical cancer and don’t get an annual PAP smear.

Machismo. Vergüenza. Poor Propaganda. Fear.

were the reasons why so many women die from cervical cancer and don’t get an annual PAP smear.

During our discussion, a friend of Nurse M walked in, Dr. Rodriguez. I asked him the same question and he answered with the following that correlates strongly to what Nurse M stated earlier:

  • women simply don’t want to  – fear, vergüenza
  • women don’t view it (cervical cancer screening via PAP smears) as important – poor propaganda
  • their partner doesn’t want them to – machismo
  • fear of the procedure – fear, vergüenza
  • the false idea that if they don’t have a husband, they don’t need to – poor propaganda

They both urged me though to go out to the community (not even to the women they were sitting outside in the waiting room) and directly ask women if they had their PAP smear done this year, and if they haven’t and weren’t planning to, to ask why. I believe they’re right, and I’m in complete agreement with their suggestion. I also believe I have two possible mentors to guide me if I choose to focus my internship on this significant subtopic of Nicaragua’s public health.