Guatemala
FEBRUARY 11, 2014
“You can disagree with another person's opinions. You can disagree with their doctrines. You can't disagree with their experience.” Krista Tippett, Speaking of Faith
On Wednesday, February 5, I went to the Cafe' Condesa in the main square to meet Rev. Ricardo Frohmader, the Episcopal priest of St. Alban's congregation in Antigua. Just as he had previously described, he was wearing his clerical collar and seated at a table in the first room.
With him were two men: Carlos, a Guatemalan - American who has homes and business interests in both countries, the proceeds of which make him smile a lot.
Juan, a Guatemalan whose family history includes a past president of Guatemala and an ambassador to a European country, and who spent time in the US obtaining a pilot's license which led to his flying for government forces during the civil war.
Along with Ricardo, who has been in Guatemala since 1973 with only brief interludes elsewhere due to the Guatemalan civil war, whose father was Swiss and mother was half Swedish-half Canadian-American, who grew up in Mexico, worked in a variety of supervisory positions for a variety of fruit export companies (including the famously powerful United Fruit Company of the US) in Guatemala, Miami, and Honduras, whose wife is Peruvian-Okinawan, and who became a priest at the age of 70, I was in the midst of a mini United Nations.
What was clear to me in their responses to my questions was that each man's answers, while expressing many of the same thoughts, took on a separate slant according to their past and/or current experiences..
I asked them the following questions:
What are the three most difficult problems holding the country back?
What, in your opinion, are the solutions to those problems?
What are the prospects of those solutions being put into action?
What are the obstacles to the solutions being put into action?
Here are their answers, exactly as they gave them:
Rev. RIcardo - "...in my personal and private opinion the three biggest problems are:
Exclusion of 40% of the population (indigenous) from most of national life (such as it is) ;
Poor education systems. There is no program to ensure kids are educated in their own language and no incentive to keep them in school until 6th grade if not longer;
Totally corrupt system of government.
What needs to be done?
End exclusion and discrimination.Transform education. Clean up politics
Will it happen? Not in my lifetime.
When I say "not in my lifetime" I am of course aware of what Lee Kwan Yu achieved in one generation in Singapore. It was not very democratically done, but my goodness it was effective."
Juan - 1-Corruption and over population.
2-There is no solution.
3- Narc and political corruption is so deep and no one does anything. I mean an outside power, the U.N or U.S.A, to bring the country back to a new beginning. Years ago a movie with Peter Sellers and Peter Ustinov, The Mouse that Roared, about a European country with the problems of that time decided to invade the U.S.A and then be defeated and given money to reconstruct as happened to Japan and Korea.
Carlos - "...this has been my experience of the last 20 years: Guatemala is and will continue to be an underdeveloped nation. The ingrained culture and genetic buildup does not permit people to change and learn and it is worse among the wealthy. If we were to use the "7 deadly sins" as a guide I can say that the motivators here are envy, sloth, lust and gluttony.
Aid should not continue unless it is medical: all people here are corrupt or corruptible and given the chance they WILL stab you in the back and find a way to justify it (liquid morality). People will use religion to commit the most heinous acts against you and hide under the skirt of religion. The worst part is that the people that supply the information for policy decisions are not prepared and have no interest in doing their job so policies are bad... I still work the way I learned in my early adult life and this has gotten me enemies, death threats, etc."
All three men see Guatemala as a vortex of corruption of the personal, professional,and politcal kind, and each doubts the possibility of solutions, yet each presents a different possibility if such an ulikely event of probelm-solving were to occur.
Ricardo speaks to the social justice actions of ending racism, transforming education, and overhauling the political system - an admirable and ambitious agenda of reversing entrenched, racist, socio-economic and political institutions.
Juan believes that Guatemala is incapable of reforming itself and looks to outside intervention, as happened in the days of his youth and his family's politcal influence, and even a Hollywood movie.
And Carlos, who blames the wealthy class (although some might include him among them), and religion, and who wants to see all foreign aid except medical aid end, although, (and I don't think for a minute that he intends this result) that would punish the poor more than the wealthy.
Three men. Three life experiences in Guatemala. Shared opinions. Three differing perspectives on what should happen if any of it could happen.
None of it likely any time soon.
Marianne
“You can disagree with another person's opinions. You can disagree with their doctrines. You can't disagree with their experience.” Krista Tippett, Speaking of Faith
On Wednesday, February 5, I went to the Cafe' Condesa in the main square to meet Rev. Ricardo Frohmader, the Episcopal priest of St. Alban's congregation in Antigua. Just as he had previously described, he was wearing his clerical collar and seated at a table in the first room.
With him were two men: Carlos, a Guatemalan - American who has homes and business interests in both countries, the proceeds of which make him smile a lot.
Juan, a Guatemalan whose family history includes a past president of Guatemala and an ambassador to a European country, and who spent time in the US obtaining a pilot's license which led to his flying for government forces during the civil war.
Along with Ricardo, who has been in Guatemala since 1973 with only brief interludes elsewhere due to the Guatemalan civil war, whose father was Swiss and mother was half Swedish-half Canadian-American, who grew up in Mexico, worked in a variety of supervisory positions for a variety of fruit export companies (including the famously powerful United Fruit Company of the US) in Guatemala, Miami, and Honduras, whose wife is Peruvian-Okinawan, and who became a priest at the age of 70, I was in the midst of a mini United Nations.
What was clear to me in their responses to my questions was that each man's answers, while expressing many of the same thoughts, took on a separate slant according to their past and/or current experiences..
I asked them the following questions:
What are the three most difficult problems holding the country back?
What, in your opinion, are the solutions to those problems?
What are the prospects of those solutions being put into action?
What are the obstacles to the solutions being put into action?
Here are their answers, exactly as they gave them:
Rev. RIcardo - "...in my personal and private opinion the three biggest problems are:
Exclusion of 40% of the population (indigenous) from most of national life (such as it is) ;
Poor education systems. There is no program to ensure kids are educated in their own language and no incentive to keep them in school until 6th grade if not longer;
Totally corrupt system of government.
What needs to be done?
End exclusion and discrimination.Transform education. Clean up politics
Will it happen? Not in my lifetime.
When I say "not in my lifetime" I am of course aware of what Lee Kwan Yu achieved in one generation in Singapore. It was not very democratically done, but my goodness it was effective."
Juan - 1-Corruption and over population.
2-There is no solution.
3- Narc and political corruption is so deep and no one does anything. I mean an outside power, the U.N or U.S.A, to bring the country back to a new beginning. Years ago a movie with Peter Sellers and Peter Ustinov, The Mouse that Roared, about a European country with the problems of that time decided to invade the U.S.A and then be defeated and given money to reconstruct as happened to Japan and Korea.
Carlos - "...this has been my experience of the last 20 years: Guatemala is and will continue to be an underdeveloped nation. The ingrained culture and genetic buildup does not permit people to change and learn and it is worse among the wealthy. If we were to use the "7 deadly sins" as a guide I can say that the motivators here are envy, sloth, lust and gluttony.
Aid should not continue unless it is medical: all people here are corrupt or corruptible and given the chance they WILL stab you in the back and find a way to justify it (liquid morality). People will use religion to commit the most heinous acts against you and hide under the skirt of religion. The worst part is that the people that supply the information for policy decisions are not prepared and have no interest in doing their job so policies are bad... I still work the way I learned in my early adult life and this has gotten me enemies, death threats, etc."
All three men see Guatemala as a vortex of corruption of the personal, professional,and politcal kind, and each doubts the possibility of solutions, yet each presents a different possibility if such an ulikely event of probelm-solving were to occur.
Ricardo speaks to the social justice actions of ending racism, transforming education, and overhauling the political system - an admirable and ambitious agenda of reversing entrenched, racist, socio-economic and political institutions.
Juan believes that Guatemala is incapable of reforming itself and looks to outside intervention, as happened in the days of his youth and his family's politcal influence, and even a Hollywood movie.
And Carlos, who blames the wealthy class (although some might include him among them), and religion, and who wants to see all foreign aid except medical aid end, although, (and I don't think for a minute that he intends this result) that would punish the poor more than the wealthy.
Three men. Three life experiences in Guatemala. Shared opinions. Three differing perspectives on what should happen if any of it could happen.
None of it likely any time soon.
Marianne
Nicaragua
FEBRUARY 7, 2014
NICARAGUA - The Hope of a Nation
Any country is all about the people. How they prosper or live in poverty. How they are educated or remain unschooled, and for what reasons. How they perceive themselves as helpless victims or as striving survivors. How they continue to hope against the odds, or become resentful pessimists. How they find ways to work at something, or give in to lethargy. How they carry themselves with dignity, or not, when all the negatives of the above list are the stuff of their daily lives.
Such are the circumstances of the Nicaraguan people.
I could write here about my final experiences that got left out in prior posts. But I won't. There is a better way to explain the hope of Nicaragua, and the struggle to turn that hope into reality.
The hope of Nicaragua, like any country, is in its children. Their parents have the same hopes and aspirations for their children as do parents of children in developed countries. In the US the goal has always been that our children would "do better" than we did, meaning be more educated in order to be more financially successful.
That would not be hard in Nicaragua, the second poorest country in the Western Hemisphere, after Haiti. But that measure would mean only a slight up-tick in the level of their poverty. Poor is still poor. Without access to resources still means uneducated, without utilities in the house, the house which itself is little more than nailed together scraps.
To show you the mountain the children in the Pathway to Change program have to climb to break the cycle of poverty, I will let images of where they come from and who they are do the talking.
Take a walk through their neighborhoods. Then look into their faces. Applaud their determination.
NICARAGUA - The Hope of a Nation
Any country is all about the people. How they prosper or live in poverty. How they are educated or remain unschooled, and for what reasons. How they perceive themselves as helpless victims or as striving survivors. How they continue to hope against the odds, or become resentful pessimists. How they find ways to work at something, or give in to lethargy. How they carry themselves with dignity, or not, when all the negatives of the above list are the stuff of their daily lives.
Such are the circumstances of the Nicaraguan people.
I could write here about my final experiences that got left out in prior posts. But I won't. There is a better way to explain the hope of Nicaragua, and the struggle to turn that hope into reality.
The hope of Nicaragua, like any country, is in its children. Their parents have the same hopes and aspirations for their children as do parents of children in developed countries. In the US the goal has always been that our children would "do better" than we did, meaning be more educated in order to be more financially successful.
That would not be hard in Nicaragua, the second poorest country in the Western Hemisphere, after Haiti. But that measure would mean only a slight up-tick in the level of their poverty. Poor is still poor. Without access to resources still means uneducated, without utilities in the house, the house which itself is little more than nailed together scraps.
To show you the mountain the children in the Pathway to Change program have to climb to break the cycle of poverty, I will let images of where they come from and who they are do the talking.
Take a walk through their neighborhoods. Then look into their faces. Applaud their determination.
Where They Come From |
Who They Are |
JANUARY 31, 2014
NICARAGUA Healthcare – Part 2
Medical care in Nicaragua is a complex yet simple situation.
Complex because three different entities, two of them governmental, and the third being the private element, provide facilities and services. Simple because if a Nicaraguan is wealthy, or at least upper middle class, that person can be served in a private hospital or clinic with up-to-date equipment and amenities by a private physician with high-level, often international education and training. These are also the places where expatriate residents and visiting tourists go when they need care.
Everybody else is relegated to a public clinic or hospital where the equipment, physicians, and lack of nurses create a treatment level of mediocrity at best, and negligence and ignorance at worst. These are the places serving the working class and the poor.
Poverty is the leading cause of illness, disease, and death in Nicaragua.Only 5% of poor people have access to medical insurance. Of those, 8.01% are indigenous populations, 3.4% are rural/agricultural populations, and 2.3% are in the bottom quintile on the earnings scale. The 5% with no insurance access are in comparison with 12.3% of poor people who are not indigenous, but who do have insurance access.(From a report on access to healthcare in Nicaragua commissioned by the World Bank, 2008)
Lack of insurance access is not the only factor contributing to sub-standard care. Poor people typically live in areas where there is no healthcare provider at all, or live too far away to get to care, or have no means of transportation, or can't afford to give up a day's pay to see a doctor, or can't afford to pay for services and treatments if they could get to them because healthcare is cash on demand payment.
A further disparity is the proportion of health care costs that the poor pay versus the costs to the well-off. The poor spend 80% of their healthcare expenses on medications versus 41% for the populations upper-middle class and above, for example. In a country where the average income is $1,031.62 per year, it is clear that the proportion spent is out-sized in comparison with the 41% of higher income people.
The result of these obstacles is that poor people tend to self-diagnose and self-medicate (which is easy because almost all medications (except narcotics) can be bought without a prescription), or pray for a cure. Neither of those choices can be considered a viable healthcare option.
The most common causes of illness in Nicaragua are: Upper-respiratory infections (59%); dengue fever (no cure; kills approximately 30% of infected children); and severe diarrhea, a common result of polluted water and unclean food/food-handling. Upper-level and expatriate populations know to wash fruits and vegetables with soap before eating. They have the financial means to buy the soap and have clean water to wash the food in.
The lack of proper nutrition and the fall-back tendency to eat high-fat, high sugar, low protein diets mean that the poor population does not have the physical strength to fight disease.
Everyday realities for a person needing healthcare in Nicaragua are:
1. Only one hospital in the country is approved by the Joint Commission International, an international certifying organization for healthcare facilities and programs. That hospital is in the capital of Managua, a 45- to 90-minute trip from Granada, the second largest city, and 90 minutes from Leon', the third-largest city.
2. Western standards of hygiene cannot be expected. Injections are given without the injection site being swabbed with alcohol, nurses and doctors do not typically wear gloves, sheets on exam tables are not usually changed for each patient, mops used to clean the outdoor steps are casually carried into the clinic/hospital to clean floors.
3. Monitoring equipment such as adult and fetal heart monitors are scarce due to cost.
4. Equipment that is available is often used although it is defective or gives imprecise readings.
5. Private practice doctors are not allowed to practice in public hospitals.
6. All available antibiotics in North America and Europe are not available in Nicaragua. Some are not available at all outside a hospital.
7. A hospitalized patient will need a family member or friend bedside 24/7 because of the shortage of nurses. Families must also bring food because hospital food is neither adequate nor nutritional.
8. There are only three medical schools for the entire country, and they are of questionable quality compared with medical schools in North America and Europe.
9. Simple items like thermometers, blood-pressure cuffs, stethoscopes, surgical masks, glass slides for tissue samples, and sheets are in short-supply.
10. In some hospitals/clinics patients are two-to-a-bed because of bed shortage.
In the midst of this grim reality for the general population there is a movement afoot by private doctors to spend tens of millions of dollars to create a medical tourism market specifically for foreigners seeking elective surgeries and treatments at prices severely discounted from the going rates in their home countries. This market is already gaining traction in the country.
The proponents of a separate tourism healthcare market look to their neighbor country, Costa Rica, which reportedly netted $400 million in 2011, and Panama, estimated at even more, from their medical tourism patients. The three top requests are for cosmetic, dental, and orthopedic procedures.
The significant difference is that both countries, particularly Panama, have modern medical institutions and equipment and the infrastructures to support them, a high percentage of their medical doctors and surgeons graduated from North American medical schools or took training in them, and they have affiliations with US institutions. In Panama City, a new hospital is affiliated with Johns Hopkins University Medical School.
More important, their local populations have more access to a higher level of healthcare which is more available.
There are increasingly opposing opinions about medical tourism. As reported in The Nicaragua Dispatch - Nicaragua bets on medical tourism:
"While Nicaragua’s top doctors and medical facilities cater increasingly to foreign patients, some wonder about the impact on the average Nicaraguan hospital and the type of services available to those who can’t afford to be medical tourists.
According to Perez, (Arlen Perez, manager of medical tourism at Managua’s Hospital Metropolitano Vivian Pellas) medical tourism will increase tourism revenue and encourage other local hospitals to “try to be better and keep higher standards to compete with us.”
But studies from other countries with medical tourism industries show the opposite can also happen. A study funded by the World Health Organisation entitled “The effects of medical tourism: Thailand’s experience,” found that “foreigners’ demand for health-care services could undermine local patients’ access to quality health care” by luring highly skilled physicians and specialists out of the public and teaching hospitals and relegating most Thais to “health-care services of lesser quality.”
Another study, published in 2010 in the International Journal for Equity in Health, reached similar conclusions.
“The argument that destination countries should view investment into technology-intensive infrastructure for medical tourists as beneficial is undermined when the types of services being offered by hospitals are contrasted with the pressing health care needs of the local population,” the report said. “This contrast is all the more troubling when public money that could be used for wide-reaching, inexpensive primary health care initiatives is used to incentivize private investment into expensive tertiary care with a more limited impact.”
TIme will tell whose medical needs Nicaragua decides deserve priority - Improved care and services for its own population; or the desires of foreigners for cheap elective procedures.
NICARAGUA Healthcare – Part 2
Medical care in Nicaragua is a complex yet simple situation.
Complex because three different entities, two of them governmental, and the third being the private element, provide facilities and services. Simple because if a Nicaraguan is wealthy, or at least upper middle class, that person can be served in a private hospital or clinic with up-to-date equipment and amenities by a private physician with high-level, often international education and training. These are also the places where expatriate residents and visiting tourists go when they need care.
Everybody else is relegated to a public clinic or hospital where the equipment, physicians, and lack of nurses create a treatment level of mediocrity at best, and negligence and ignorance at worst. These are the places serving the working class and the poor.
Poverty is the leading cause of illness, disease, and death in Nicaragua.Only 5% of poor people have access to medical insurance. Of those, 8.01% are indigenous populations, 3.4% are rural/agricultural populations, and 2.3% are in the bottom quintile on the earnings scale. The 5% with no insurance access are in comparison with 12.3% of poor people who are not indigenous, but who do have insurance access.(From a report on access to healthcare in Nicaragua commissioned by the World Bank, 2008)
Lack of insurance access is not the only factor contributing to sub-standard care. Poor people typically live in areas where there is no healthcare provider at all, or live too far away to get to care, or have no means of transportation, or can't afford to give up a day's pay to see a doctor, or can't afford to pay for services and treatments if they could get to them because healthcare is cash on demand payment.
A further disparity is the proportion of health care costs that the poor pay versus the costs to the well-off. The poor spend 80% of their healthcare expenses on medications versus 41% for the populations upper-middle class and above, for example. In a country where the average income is $1,031.62 per year, it is clear that the proportion spent is out-sized in comparison with the 41% of higher income people.
The result of these obstacles is that poor people tend to self-diagnose and self-medicate (which is easy because almost all medications (except narcotics) can be bought without a prescription), or pray for a cure. Neither of those choices can be considered a viable healthcare option.
The most common causes of illness in Nicaragua are: Upper-respiratory infections (59%); dengue fever (no cure; kills approximately 30% of infected children); and severe diarrhea, a common result of polluted water and unclean food/food-handling. Upper-level and expatriate populations know to wash fruits and vegetables with soap before eating. They have the financial means to buy the soap and have clean water to wash the food in.
The lack of proper nutrition and the fall-back tendency to eat high-fat, high sugar, low protein diets mean that the poor population does not have the physical strength to fight disease.
Everyday realities for a person needing healthcare in Nicaragua are:
1. Only one hospital in the country is approved by the Joint Commission International, an international certifying organization for healthcare facilities and programs. That hospital is in the capital of Managua, a 45- to 90-minute trip from Granada, the second largest city, and 90 minutes from Leon', the third-largest city.
2. Western standards of hygiene cannot be expected. Injections are given without the injection site being swabbed with alcohol, nurses and doctors do not typically wear gloves, sheets on exam tables are not usually changed for each patient, mops used to clean the outdoor steps are casually carried into the clinic/hospital to clean floors.
3. Monitoring equipment such as adult and fetal heart monitors are scarce due to cost.
4. Equipment that is available is often used although it is defective or gives imprecise readings.
5. Private practice doctors are not allowed to practice in public hospitals.
6. All available antibiotics in North America and Europe are not available in Nicaragua. Some are not available at all outside a hospital.
7. A hospitalized patient will need a family member or friend bedside 24/7 because of the shortage of nurses. Families must also bring food because hospital food is neither adequate nor nutritional.
8. There are only three medical schools for the entire country, and they are of questionable quality compared with medical schools in North America and Europe.
9. Simple items like thermometers, blood-pressure cuffs, stethoscopes, surgical masks, glass slides for tissue samples, and sheets are in short-supply.
10. In some hospitals/clinics patients are two-to-a-bed because of bed shortage.
In the midst of this grim reality for the general population there is a movement afoot by private doctors to spend tens of millions of dollars to create a medical tourism market specifically for foreigners seeking elective surgeries and treatments at prices severely discounted from the going rates in their home countries. This market is already gaining traction in the country.
The proponents of a separate tourism healthcare market look to their neighbor country, Costa Rica, which reportedly netted $400 million in 2011, and Panama, estimated at even more, from their medical tourism patients. The three top requests are for cosmetic, dental, and orthopedic procedures.
The significant difference is that both countries, particularly Panama, have modern medical institutions and equipment and the infrastructures to support them, a high percentage of their medical doctors and surgeons graduated from North American medical schools or took training in them, and they have affiliations with US institutions. In Panama City, a new hospital is affiliated with Johns Hopkins University Medical School.
More important, their local populations have more access to a higher level of healthcare which is more available.
There are increasingly opposing opinions about medical tourism. As reported in The Nicaragua Dispatch - Nicaragua bets on medical tourism:
"While Nicaragua’s top doctors and medical facilities cater increasingly to foreign patients, some wonder about the impact on the average Nicaraguan hospital and the type of services available to those who can’t afford to be medical tourists.
According to Perez, (Arlen Perez, manager of medical tourism at Managua’s Hospital Metropolitano Vivian Pellas) medical tourism will increase tourism revenue and encourage other local hospitals to “try to be better and keep higher standards to compete with us.”
But studies from other countries with medical tourism industries show the opposite can also happen. A study funded by the World Health Organisation entitled “The effects of medical tourism: Thailand’s experience,” found that “foreigners’ demand for health-care services could undermine local patients’ access to quality health care” by luring highly skilled physicians and specialists out of the public and teaching hospitals and relegating most Thais to “health-care services of lesser quality.”
Another study, published in 2010 in the International Journal for Equity in Health, reached similar conclusions.
“The argument that destination countries should view investment into technology-intensive infrastructure for medical tourists as beneficial is undermined when the types of services being offered by hospitals are contrasted with the pressing health care needs of the local population,” the report said. “This contrast is all the more troubling when public money that could be used for wide-reaching, inexpensive primary health care initiatives is used to incentivize private investment into expensive tertiary care with a more limited impact.”
TIme will tell whose medical needs Nicaragua decides deserve priority - Improved care and services for its own population; or the desires of foreigners for cheap elective procedures.
JANUARY 31, 2014
NICARAGUA Healthcare – Part 1
Among the at-risk youth in Granada that Donna Tabor, the expat community activist, was frequently in contact with, was a 14 year-old boy, Miguel. This is his story, as told to me by Donna.
Miguel's Story
Miguel used to hang out with the other street kids around the Cathedral and the Parque Central. A nice enough kid, but not open to asking for help to change his situation. I would talk to him from time to time to find out if there was anything I could do that wouldn't scare him away. Sometimes, yes, sometimes, no.
One day I saw him and couldn't believe my eyes. He was barefoot, of course, and his one foot had ballooned up to four times its normal size. It was discolored and showed all the signs of obvious infection. He could barely hobble. Putting any weight on it was impossible.
I said, "Miguel, what happened to your foot?" He didn't know. It had been that way for some time, he said. "Why didn't you go to the clinic?" I asked. No, that was not something that street kids think is possible, let alone likely for them. I told him that I was taking him to the public hospital immediately. It was clear to me that a course of antibiotics would clear up the situation in a matter of weeks.
We made our way there and waited for a doctor to see us. There is no emergency set-up, so people are seen in the order they arrive. That means a heart attack has to wait until the cough, cut finger, and headache are seen first if that's how they came.
When the doctor came out he was a mess - dirty white coat, disheveled hair, and a cigarette with a long ash hanging from his lips. I explained the situation. He took Miguel into an examination room. A very few minutes later he came out and said "I can take care of this." I assumed he meant the antibiotics, so I asked which ones Miguel would be taking.
"No antibiotics. We do it this afternoon," he said.
"Do what?" I asked.
With a chopping motion of his hand he said "Cut it off!"
I was stunned and outraged. I hollered at him, "You can't cut it off. He's only 14 - and he lives on the street. How will he move around? All he needs are antibiotics."
"No, here we cut it off."
"Oh, no you won't," I told him, and I went into the exam room to get Miguel.
We left the hospital and went to my house. I called a retired MD in the expat community. He came to the house to see Miguel. He agreed to treat him with antibiotics through however much time it would take for the boy to heal.
So there you have it, the state of medical care for poor and vulnerable people. Chop off body parts so they don't have to provide any on-going care, even of the simplest kind. Shameful.
NICARAGUA Healthcare – Part 1
Among the at-risk youth in Granada that Donna Tabor, the expat community activist, was frequently in contact with, was a 14 year-old boy, Miguel. This is his story, as told to me by Donna.
Miguel's Story
Miguel used to hang out with the other street kids around the Cathedral and the Parque Central. A nice enough kid, but not open to asking for help to change his situation. I would talk to him from time to time to find out if there was anything I could do that wouldn't scare him away. Sometimes, yes, sometimes, no.
One day I saw him and couldn't believe my eyes. He was barefoot, of course, and his one foot had ballooned up to four times its normal size. It was discolored and showed all the signs of obvious infection. He could barely hobble. Putting any weight on it was impossible.
I said, "Miguel, what happened to your foot?" He didn't know. It had been that way for some time, he said. "Why didn't you go to the clinic?" I asked. No, that was not something that street kids think is possible, let alone likely for them. I told him that I was taking him to the public hospital immediately. It was clear to me that a course of antibiotics would clear up the situation in a matter of weeks.
We made our way there and waited for a doctor to see us. There is no emergency set-up, so people are seen in the order they arrive. That means a heart attack has to wait until the cough, cut finger, and headache are seen first if that's how they came.
When the doctor came out he was a mess - dirty white coat, disheveled hair, and a cigarette with a long ash hanging from his lips. I explained the situation. He took Miguel into an examination room. A very few minutes later he came out and said "I can take care of this." I assumed he meant the antibiotics, so I asked which ones Miguel would be taking.
"No antibiotics. We do it this afternoon," he said.
"Do what?" I asked.
With a chopping motion of his hand he said "Cut it off!"
I was stunned and outraged. I hollered at him, "You can't cut it off. He's only 14 - and he lives on the street. How will he move around? All he needs are antibiotics."
"No, here we cut it off."
"Oh, no you won't," I told him, and I went into the exam room to get Miguel.
We left the hospital and went to my house. I called a retired MD in the expat community. He came to the house to see Miguel. He agreed to treat him with antibiotics through however much time it would take for the boy to heal.
So there you have it, the state of medical care for poor and vulnerable people. Chop off body parts so they don't have to provide any on-going care, even of the simplest kind. Shameful.
JANUARY 17, 2014
Below is a personal story told to me by community activist Donna Tabor in Granada. Early in her community outreach in Granada, Donna became involved with at-risk youth, primarily street children. This is a sad tale, and a cautionary one.
ANNA’S STORY
“There was a nine year-old street child named Anna that I used to see and talk to from time to time. She was dirty and ragged like all the others who live on the sidewalks, but a gentle soul. One day I was walking through the Parque Central, when I suddenly saw Anna coming down the outside staircase of the Alhambra Hotel, the most expensive hotel in the city. She was being led by a well-dressed, obviously affluent man. Anna looked as she always does – street worn and dirty.
As I walked toward them the man turned away and walked off. I was angry and upset at the same time. “Anna,” I said, “what were you doing with that man?” She looked down, then back up at me. She held out her small hand and opened her fist. In her palm were three one-Cordoba coins, about 12 cents.
“Look what he gave me,” she said, with an expression that was sad, yet satisfied at the same time. With those three coins she could probably buy a piece of bread. It would likely be her only food for the day.
I held her shoulders and looked straight in her eyes. “Anna, you must never do that again. It’s not good for you. Please don’t do that again.”
Anna said nothing. She just walked away from me.
It stretches the imagination for some people who wonder why a man of his status, though he is a horrible pervert, would choose to exert his perversion with a child who most people would consider disgusting and wouldn’t want to touch. I can’t answer that. Maybe part of the attraction is because she is so totally opposite. Or maybe it’s just because poor children are hungry, which makes them vulnerable, which makes them easily available. And what about the hotel personnel who saw this moneyed guest taking a street urchin to his room and did nothing to stop it? Aren’t they just as guilty?
I couldn’t just pick up Anna and take her home with me. I have taken in other children, but they came to me and asked for help. It was their idea. To take her off the street unwillingly could mean trouble. So she had to ask me to come. She never had.
I never saw Anna again. I don’t know if she moved on to a different neighborhood. Or if she was abducted by a pimp, and entered into child prostitution. Or if she was grabbed by a child trafficker and sold to a pedophile elsewhere. Or if she’s dead. She’s disappeared at the age of nine.”
Anna’s story is a learning moment for all of us. We can never assume that a child is safe just because the parents are friends of ours, or the youth group leader is a pillar of the community, or the child is always with a child caretaker.
And we must always remember that every child, girl or boy, regardless of how dirty, how obnoxious, or how seemingly undeserving, is worthy of a true childhood - sex-free, abuse-free, unexploited, unsold, not chained to a bed servicing a string of degenerate customers, whether in a grimy motel or the most expensive hotel in town, whether they are in our own town or a thousand miles away, because all children are vulnerable to the possibility of being abducted and sold as a flesh product.
So if you ever have a moment of wonder about the safety of a child whom you know, or one that you don’t know, but who seems to be in a curious situation with an adult, don’t turn your head because you “don’t want to get involved.”
Remember Anna and the man.
Remember her pathetic three coins.
Remember her piece of bread.
Remember her unknown fate.
Then try to do what that child cannot do for her- or himself.
Below is a personal story told to me by community activist Donna Tabor in Granada. Early in her community outreach in Granada, Donna became involved with at-risk youth, primarily street children. This is a sad tale, and a cautionary one.
ANNA’S STORY
“There was a nine year-old street child named Anna that I used to see and talk to from time to time. She was dirty and ragged like all the others who live on the sidewalks, but a gentle soul. One day I was walking through the Parque Central, when I suddenly saw Anna coming down the outside staircase of the Alhambra Hotel, the most expensive hotel in the city. She was being led by a well-dressed, obviously affluent man. Anna looked as she always does – street worn and dirty.
As I walked toward them the man turned away and walked off. I was angry and upset at the same time. “Anna,” I said, “what were you doing with that man?” She looked down, then back up at me. She held out her small hand and opened her fist. In her palm were three one-Cordoba coins, about 12 cents.
“Look what he gave me,” she said, with an expression that was sad, yet satisfied at the same time. With those three coins she could probably buy a piece of bread. It would likely be her only food for the day.
I held her shoulders and looked straight in her eyes. “Anna, you must never do that again. It’s not good for you. Please don’t do that again.”
Anna said nothing. She just walked away from me.
It stretches the imagination for some people who wonder why a man of his status, though he is a horrible pervert, would choose to exert his perversion with a child who most people would consider disgusting and wouldn’t want to touch. I can’t answer that. Maybe part of the attraction is because she is so totally opposite. Or maybe it’s just because poor children are hungry, which makes them vulnerable, which makes them easily available. And what about the hotel personnel who saw this moneyed guest taking a street urchin to his room and did nothing to stop it? Aren’t they just as guilty?
I couldn’t just pick up Anna and take her home with me. I have taken in other children, but they came to me and asked for help. It was their idea. To take her off the street unwillingly could mean trouble. So she had to ask me to come. She never had.
I never saw Anna again. I don’t know if she moved on to a different neighborhood. Or if she was abducted by a pimp, and entered into child prostitution. Or if she was grabbed by a child trafficker and sold to a pedophile elsewhere. Or if she’s dead. She’s disappeared at the age of nine.”
Anna’s story is a learning moment for all of us. We can never assume that a child is safe just because the parents are friends of ours, or the youth group leader is a pillar of the community, or the child is always with a child caretaker.
And we must always remember that every child, girl or boy, regardless of how dirty, how obnoxious, or how seemingly undeserving, is worthy of a true childhood - sex-free, abuse-free, unexploited, unsold, not chained to a bed servicing a string of degenerate customers, whether in a grimy motel or the most expensive hotel in town, whether they are in our own town or a thousand miles away, because all children are vulnerable to the possibility of being abducted and sold as a flesh product.
So if you ever have a moment of wonder about the safety of a child whom you know, or one that you don’t know, but who seems to be in a curious situation with an adult, don’t turn your head because you “don’t want to get involved.”
Remember Anna and the man.
Remember her pathetic three coins.
Remember her piece of bread.
Remember her unknown fate.
Then try to do what that child cannot do for her- or himself.
JANUARY 16, 2014
Pedophilia in Nicaragua
The man who replaced Osama Bin Laden on the FBI's Ten Most Wanted List was Eric Justin Toth, a third-grade teacher from Washington, DC.
Toth had been fired from a prestigious private school in D.C. after pornographic child photos that he had taken with a school camera were discovered. But before he could be arrested, he disappeared. Police followed clues through seven states, including a fake suicide note in Minnesota, and a search in South America, before Toth's trail went cold.
Toth had landed in Nicaragua.
For five years there was no trace of him, despite continuing efforts of US and foreign officials. It took a US female tourist who encountered Toth in a social setting in the Nicaraguan highlands tobacco-growing region and recognized him, to break the case. Upon her return to the US she notified the FBI who alerted the Nicaraguan police, which led to Toth's arrest in April of last year.
At the time of his arrest Toth had in his possession multiple fake documents of many countries, including passports, driver's licenses, ID cards and visas. He was evidently prepared to escape elsewhere at a moment's notice.
It was also determined that Toth had left a trail of child victims behind him as he went.
In the world of business development, child sexual abuse is a growth industry. It has surfaced and spread from family confines to religious institutions to community groups to US interstate trade to a global industry. Children are now trafficked internationally as commercial products from country to country and continent to continent.
The most recent horror story broke just this week when the three-country cooperation effort of the US, Great Britain, and Australia broke a porn ring in the Phillipines that took money from global customers to watch child sexual abuse online, happening in real-time to victims from six to 15 years old. The investigators identified 733 suspects, with 29 arrested in 12 countries, and the process continues.
Unfortunately, Central America has become a favored location for perpetrators, especially North Americans, because of its close proximity to the US and the usually lax attitude of police officials in Central American countries. In too many situations, officials are "on the take" from perpetrators to ignore their criminal activities.
According to a report in The Huffington Post, and confirmed by other sources, Nicaragua has become "a playground for sex offenders," surpassing the infamous reputation of Asia.
There is a further heartbreaking aspect to this trade. Poverty is a major force in the national and international sex abuse industry. Pedophiles will often go into the remote villages, as did Toth in a highland town close to the Honduras border, because the people there are impoverished and ignorant. The perpetrator might tell the parents that he will take the child to educate so the child can earn a good living and send money back to the parents.
Poor people in third-world countries typically live at subsistence or less than subsistence levels. There is no birth control information, and even if there were, it is culturally rejected. So people have many children, each succeeding one being a burden. Consequently, it is not unusual for the parents to sell their children for one or two hundred dollars to child sex abusers. What happens to the children after the sale could be one of many things - re-sold again and again, abducted and trafficked elsewhere, prostituted, or used up and killed.
The Nicaraguan couple who own the hotel where I stayed in Granada put a real face on the issue. They said that everybody knows the Scandinavian man in Granada who has become a millionaire by advertising in Europe a "charity" for supporting "the poor children" of Granada. He's taking in money by the millions from unsuspecting Europeans who want to do good and will never travel this far to see the supposed good they've contributed to. In the meantime, the man lives lavishly, there is no charitable program, and the money supports the known pedophile activities of himself and his conspirator network.
Another known pedophile in the city was so bold as to want to rent a room in the hotel and told the wife that he would be "entertaining" young friends, for which he would pay a hefty fee for them to look the other way. When she ordered him out of the hotel, he pulled out a wad of cash and insisted that she was making a mistake, because he would continually pay big sums for the privilege. He was tossed out.
The link between global poverty and child sex abuse trafficking cannot be ignored. Until we begin to recognize and understand how poverty in one place links to criminal activity in our own communities, no one's child is safe, including abandoned and run-away American children who end up poor and vulnerable to exploitation and abduction on American streets.
My own city of Philadelphia is identified as a stop on the underground highway of human trafficking operating on the US East Coast. Where the children come from and where they will end up, in which city, country or continent, is only important to the traffickers as a financial transaction.
We are all connected, for good or for evil. We need to ask ourselves "Is this one of the situations in which I might find a way to individually or as part of a group help put an end to the human misery created by the Eric Justin Toths of the world?"
Pedophilia in Nicaragua
The man who replaced Osama Bin Laden on the FBI's Ten Most Wanted List was Eric Justin Toth, a third-grade teacher from Washington, DC.
Toth had been fired from a prestigious private school in D.C. after pornographic child photos that he had taken with a school camera were discovered. But before he could be arrested, he disappeared. Police followed clues through seven states, including a fake suicide note in Minnesota, and a search in South America, before Toth's trail went cold.
Toth had landed in Nicaragua.
For five years there was no trace of him, despite continuing efforts of US and foreign officials. It took a US female tourist who encountered Toth in a social setting in the Nicaraguan highlands tobacco-growing region and recognized him, to break the case. Upon her return to the US she notified the FBI who alerted the Nicaraguan police, which led to Toth's arrest in April of last year.
At the time of his arrest Toth had in his possession multiple fake documents of many countries, including passports, driver's licenses, ID cards and visas. He was evidently prepared to escape elsewhere at a moment's notice.
It was also determined that Toth had left a trail of child victims behind him as he went.
In the world of business development, child sexual abuse is a growth industry. It has surfaced and spread from family confines to religious institutions to community groups to US interstate trade to a global industry. Children are now trafficked internationally as commercial products from country to country and continent to continent.
The most recent horror story broke just this week when the three-country cooperation effort of the US, Great Britain, and Australia broke a porn ring in the Phillipines that took money from global customers to watch child sexual abuse online, happening in real-time to victims from six to 15 years old. The investigators identified 733 suspects, with 29 arrested in 12 countries, and the process continues.
Unfortunately, Central America has become a favored location for perpetrators, especially North Americans, because of its close proximity to the US and the usually lax attitude of police officials in Central American countries. In too many situations, officials are "on the take" from perpetrators to ignore their criminal activities.
According to a report in The Huffington Post, and confirmed by other sources, Nicaragua has become "a playground for sex offenders," surpassing the infamous reputation of Asia.
There is a further heartbreaking aspect to this trade. Poverty is a major force in the national and international sex abuse industry. Pedophiles will often go into the remote villages, as did Toth in a highland town close to the Honduras border, because the people there are impoverished and ignorant. The perpetrator might tell the parents that he will take the child to educate so the child can earn a good living and send money back to the parents.
Poor people in third-world countries typically live at subsistence or less than subsistence levels. There is no birth control information, and even if there were, it is culturally rejected. So people have many children, each succeeding one being a burden. Consequently, it is not unusual for the parents to sell their children for one or two hundred dollars to child sex abusers. What happens to the children after the sale could be one of many things - re-sold again and again, abducted and trafficked elsewhere, prostituted, or used up and killed.
The Nicaraguan couple who own the hotel where I stayed in Granada put a real face on the issue. They said that everybody knows the Scandinavian man in Granada who has become a millionaire by advertising in Europe a "charity" for supporting "the poor children" of Granada. He's taking in money by the millions from unsuspecting Europeans who want to do good and will never travel this far to see the supposed good they've contributed to. In the meantime, the man lives lavishly, there is no charitable program, and the money supports the known pedophile activities of himself and his conspirator network.
Another known pedophile in the city was so bold as to want to rent a room in the hotel and told the wife that he would be "entertaining" young friends, for which he would pay a hefty fee for them to look the other way. When she ordered him out of the hotel, he pulled out a wad of cash and insisted that she was making a mistake, because he would continually pay big sums for the privilege. He was tossed out.
The link between global poverty and child sex abuse trafficking cannot be ignored. Until we begin to recognize and understand how poverty in one place links to criminal activity in our own communities, no one's child is safe, including abandoned and run-away American children who end up poor and vulnerable to exploitation and abduction on American streets.
My own city of Philadelphia is identified as a stop on the underground highway of human trafficking operating on the US East Coast. Where the children come from and where they will end up, in which city, country or continent, is only important to the traffickers as a financial transaction.
We are all connected, for good or for evil. We need to ask ourselves "Is this one of the situations in which I might find a way to individually or as part of a group help put an end to the human misery created by the Eric Justin Toths of the world?"
JANUARY 14, 2014
What I learned today: That the phrase "You may be only one person to the world, but to one person you may be the world" is not just a cliche.
Last Friday, before I left Granada, I met with Donna Tabor, the woman referred to me by the American Legion fellow I'd met a few days earlier. He gave me her name because I told him I was in Central America to do mission work. "Donna is the one in Granada who makes things happen," he said. If you're lucky she'll invite you to her house."
I was lucky. When I called her she invited me immediately.
So two days later I was at the front door of her house, which held an array of 14 cats and 4 dogs. She welcomed me in.
Donna is a small, slight woman of mature age with short, solid white hair. She moves casually yet caringly among her four-legged friends, always looking to shoo this one, or scratch that one. The house is sparse, and clearly the pets are in charge. No space is too special for them to lie down on.
I explained that I'd heard that she is the local instigator of all things community-minded. "Oh, I don't know about that," she protested. Yet she received a National Award for Citizen Diplomacy for her full-time volunteer work with the Pittsburgh-based foundation Bringing New Hope. It is given to people who advance the cause of inter-cultural relations and was awarded at The Smithsonian Institution.
Donna writes an entertaining blog at donnatabor.wordpress. com. A fasciniating article about one of her exploits can be found at http://www.nicaraguadispatch.com/news/2013/06/prison-break-escape-from-monkey-island/8022.
What follows are excerpts from our almost two hours of conversation.
Me: When and why did you come to Nicaragua?
Donna: I'm from the Pittsburgh area. I was a mother of two, a journalist, a school teacher for eleven years, then a TV producer on the Mr. Rogers' Neighborhood Show. Got tired of that, TV is not as glamorous as it sounds. So I hired on as a documentary film-maker. Very interesting. Then, at about 50, when my kids were grown, I decided I wanted a real change and joined the Peace Corps. They sent me here in 1996. At the end of that, in 1998, I had a break for a bout with breast cancer, then decided I wasn't finished with Nicaragua yet. That was 15 years ago, and I haven't left.
Me: How was it then? Before it became trendy with expats, especially Americans and Canadians.
Donna: Rough. Mostly dirt roads. Not a lot of plumbing. Forget restaurants and cafes. There were maybe 10 of us expats in the whole city of Granada. But you don't come to a third-world country looking for comfort. I came back because I saw things that needed to be done.
Me: What was your first challenge?
Donna: How about a hurricane? Mitch was his name. Came in and wiped out whole cities and towns. We heard that there were people stranded on the islets, which were leveled. Went to the Red Cross, but all the guys there did was walk around cataloging the supplies on the shelf. How was that going to help anyone? So a group of women got together and gathered everything necessary for a disaster, water, bleach to disinfect, rope, clothing. You name it, we had it. Within hours a gigantic Sandinista (political rebels) truck arrived. The tires were six feet tall. The kind of thing that knocks down fully-grown trees in the jungle. They loaded, literally threw us bodily in the truck, and off we went. Through mud three-feet deep, with decomposing animal carcasses hanging from the trees. The people were on the beaches screaming for help. And we gave it.
Me: Wow! How do you follow that?
Donna: Sometimes you find something that needs to be fixed, and sometimes it finds you. Like one rainstorm day a little boy I knew came running to me. "The roof, the roof, it blew off the house and the baby is all wet!" he screamed. Now, these were poor people, so the roof was metal. I immediately ran to the Alhambra Hotel. (Oldest, most expensive in Granada.) The expat fellas used to hang out on their roof terrace. Four were there. I yelled at them "We gotta go! A roof blew off and a baby's soaked through." They jumped up, came running, we ran around buying supplies, and by the end of the day that house had a new roof.
Me: I heard that you founded the city animal refuge. How did that happen?
Donna: Well, it was never meant to be a refuge where the animals stayed. At that time there were hundreds of stray dogs in Granada. And they kept breeding. It seemed to me that the process of rounding them up was useless. There were always more to take their place. I figured that neutering and spaying was in order. So I harnessed a retired veterinarian who was here, and we started with one dog being neutered right here in my house on a table in the back. And we just kept on going. Then opened a small clinic and the locals started bringing their dogs. We had to move to a larger space, which is Casa Lupita today. The ones I have here were either dropped on my doorstep, or are too old to be anyplace else. I try to discourage the drop-off action, but it keeps happening.
Me: And you wonder why?
Donna: I guess not.
Me: So far you've battled a hurricane, built a roof, done surgery in your house, and started the city animal clinic. I'd say you deserved that award.
Donna: It's just a matter of somebody's gotta do it, and you can't count on the locals or the government. The locals are poor, they have to work at something to stay alive, so they don't have the time or money. The wealthy Nicaraguans just don't care. It's not like in the States where rich people donate because it's expected, or they actually believe they should. Here the rich people don't even acknowledge the poor. They have maids that they never speak to except to give orders. Don't even look at them when they do it. And the federal government is the most corrupt in Central America. So they're busy taking care of themselves.
There's no such thing as food stamps or welfare or children's shelters or pre-schools or nursing homes or elder care or any other social service option. You're on your own here. Somebody's gotta do it. So it's the expats and volunteers who come who make it happen.
Me: When you start these things, like Casa Lupita, do you need a license or permit or any kind of documentation from the city government?
Donna: Nothing. They couldn't care less. If you want to do something, just do it. They're glad to have the problem taken care of.
Me: So foreigners are a critical part of making a difference in Nicaragua?
Donna: Absolutely. The problems are huge. But that's what you get in a third-world country. That's one reason I stay. Because there are still needs to be met and changes to be made. Besides, where would I go now? This is home.
What I learned today: That the phrase "You may be only one person to the world, but to one person you may be the world" is not just a cliche.
Last Friday, before I left Granada, I met with Donna Tabor, the woman referred to me by the American Legion fellow I'd met a few days earlier. He gave me her name because I told him I was in Central America to do mission work. "Donna is the one in Granada who makes things happen," he said. If you're lucky she'll invite you to her house."
I was lucky. When I called her she invited me immediately.
So two days later I was at the front door of her house, which held an array of 14 cats and 4 dogs. She welcomed me in.
Donna is a small, slight woman of mature age with short, solid white hair. She moves casually yet caringly among her four-legged friends, always looking to shoo this one, or scratch that one. The house is sparse, and clearly the pets are in charge. No space is too special for them to lie down on.
I explained that I'd heard that she is the local instigator of all things community-minded. "Oh, I don't know about that," she protested. Yet she received a National Award for Citizen Diplomacy for her full-time volunteer work with the Pittsburgh-based foundation Bringing New Hope. It is given to people who advance the cause of inter-cultural relations and was awarded at The Smithsonian Institution.
Donna writes an entertaining blog at donnatabor.wordpress. com. A fasciniating article about one of her exploits can be found at http://www.nicaraguadispatch.com/news/2013/06/prison-break-escape-from-monkey-island/8022.
What follows are excerpts from our almost two hours of conversation.
Me: When and why did you come to Nicaragua?
Donna: I'm from the Pittsburgh area. I was a mother of two, a journalist, a school teacher for eleven years, then a TV producer on the Mr. Rogers' Neighborhood Show. Got tired of that, TV is not as glamorous as it sounds. So I hired on as a documentary film-maker. Very interesting. Then, at about 50, when my kids were grown, I decided I wanted a real change and joined the Peace Corps. They sent me here in 1996. At the end of that, in 1998, I had a break for a bout with breast cancer, then decided I wasn't finished with Nicaragua yet. That was 15 years ago, and I haven't left.
Me: How was it then? Before it became trendy with expats, especially Americans and Canadians.
Donna: Rough. Mostly dirt roads. Not a lot of plumbing. Forget restaurants and cafes. There were maybe 10 of us expats in the whole city of Granada. But you don't come to a third-world country looking for comfort. I came back because I saw things that needed to be done.
Me: What was your first challenge?
Donna: How about a hurricane? Mitch was his name. Came in and wiped out whole cities and towns. We heard that there were people stranded on the islets, which were leveled. Went to the Red Cross, but all the guys there did was walk around cataloging the supplies on the shelf. How was that going to help anyone? So a group of women got together and gathered everything necessary for a disaster, water, bleach to disinfect, rope, clothing. You name it, we had it. Within hours a gigantic Sandinista (political rebels) truck arrived. The tires were six feet tall. The kind of thing that knocks down fully-grown trees in the jungle. They loaded, literally threw us bodily in the truck, and off we went. Through mud three-feet deep, with decomposing animal carcasses hanging from the trees. The people were on the beaches screaming for help. And we gave it.
Me: Wow! How do you follow that?
Donna: Sometimes you find something that needs to be fixed, and sometimes it finds you. Like one rainstorm day a little boy I knew came running to me. "The roof, the roof, it blew off the house and the baby is all wet!" he screamed. Now, these were poor people, so the roof was metal. I immediately ran to the Alhambra Hotel. (Oldest, most expensive in Granada.) The expat fellas used to hang out on their roof terrace. Four were there. I yelled at them "We gotta go! A roof blew off and a baby's soaked through." They jumped up, came running, we ran around buying supplies, and by the end of the day that house had a new roof.
Me: I heard that you founded the city animal refuge. How did that happen?
Donna: Well, it was never meant to be a refuge where the animals stayed. At that time there were hundreds of stray dogs in Granada. And they kept breeding. It seemed to me that the process of rounding them up was useless. There were always more to take their place. I figured that neutering and spaying was in order. So I harnessed a retired veterinarian who was here, and we started with one dog being neutered right here in my house on a table in the back. And we just kept on going. Then opened a small clinic and the locals started bringing their dogs. We had to move to a larger space, which is Casa Lupita today. The ones I have here were either dropped on my doorstep, or are too old to be anyplace else. I try to discourage the drop-off action, but it keeps happening.
Me: And you wonder why?
Donna: I guess not.
Me: So far you've battled a hurricane, built a roof, done surgery in your house, and started the city animal clinic. I'd say you deserved that award.
Donna: It's just a matter of somebody's gotta do it, and you can't count on the locals or the government. The locals are poor, they have to work at something to stay alive, so they don't have the time or money. The wealthy Nicaraguans just don't care. It's not like in the States where rich people donate because it's expected, or they actually believe they should. Here the rich people don't even acknowledge the poor. They have maids that they never speak to except to give orders. Don't even look at them when they do it. And the federal government is the most corrupt in Central America. So they're busy taking care of themselves.
There's no such thing as food stamps or welfare or children's shelters or pre-schools or nursing homes or elder care or any other social service option. You're on your own here. Somebody's gotta do it. So it's the expats and volunteers who come who make it happen.
Me: When you start these things, like Casa Lupita, do you need a license or permit or any kind of documentation from the city government?
Donna: Nothing. They couldn't care less. If you want to do something, just do it. They're glad to have the problem taken care of.
Me: So foreigners are a critical part of making a difference in Nicaragua?
Donna: Absolutely. The problems are huge. But that's what you get in a third-world country. That's one reason I stay. Because there are still needs to be met and changes to be made. Besides, where would I go now? This is home.
JANUARY 9, 2014
As the agitation for a higher minimum wage continues in the US I wonder not only about how US workers are expected to subsist on $7.25 an hour before taxes, but how that situation is connected to foreign workers, like the people in Nicaragua.
Are the Nicaraguan maids and janitors, the cooks and waiters, the shop clerks and porters able to live a sustainable life on the wages they earn? What about the street vendors and open-air market sellers?
In Nicaragua the government puts jobs into categories and assigns a wage to the category. Construction is the highest. Hotel and restaurant workers are next. Factory workers earn half of the hotel and restaurant category. Everybody else is in economic oblivion. There are no pensions for factory workers, regardless of tenure or output.
I wonder about the US-Nicaragua connection because as I was riding from the airport in Managua to Granada the driver proudly pointed out to me a huge factory for the Hanes brand underwear sold in the US. When I asked if the workers could afford to buy the products they were making he answered "No, because the pay is very low." This information was validated by the Nicaraguan owner of the B&B where I'm staying.
It's not as if we're talking workers building Mercedes Benzes. If that were me in the US building such a car I wouldn't expect to afford one anyway. But It's underwear, for heaven's sake, and not even the high-end kind. They aren't earning enough to buy the shorts and undershirts they cut and sew for Americans.
How can that be right?
It can't be.
For years I have purposely made an effort to "buy American." For years I have been stopped cold in that effort because the US is no longer a manufacturing country. Everything that I need that I find in any store where I shop, and they are not high-end stores, is made outside the US. The reason is clear - US manufacturing includes livable wages and benefits, which cut into the profit margin. Brand owners can pay sub-standard wages in foreign countries to make super-standard profits.
I am firmly on the side of profit-making, especially since I have been responsible for my own as a self-employed person for 95% of my working life. But profit-making does not have to happen at the expense of populations - the one chosen to work below subsistence level outside the US, and the Americans who lost their manufacturing jobs because they earned a living wage, which moderated profits, and motivated manufacturers to send the jobs to foreign countries.
But take the question one step further and we have to ask ourselves if as Americans we have become so dependent on the lower prices we pay for foreign-made goods because of the lower wages to foreign workers, including for high-end brands, that we aren't willing to make the other choice? That we aren't willing to pay something more for goods and services, including to people who earn the US minimum wage, in exchange for working people to earn a true livable wage?
And one step again - What would happen to the foreign workers if they lost the low-paying jobs they do have because their manufacturing jobs came back to the US? Would we then be responsible for contributing to a continuing cycle of poverty in other countries? Is that justified to return jobs to American workers?
This is not only an economic dilemma, but a moral one as well. How will we resolve it? With actions like letter-writing to companies and politicians? By joining the minimum wage protesters on the picket lines? By refusing, as some determined folks have, not to buy anything other than food and health necessities for a year or more?
What will be the outcomes on the dilemma by any of those actions?
Or will we not reflect on the dilemma at all?
Marianne
As the agitation for a higher minimum wage continues in the US I wonder not only about how US workers are expected to subsist on $7.25 an hour before taxes, but how that situation is connected to foreign workers, like the people in Nicaragua.
Are the Nicaraguan maids and janitors, the cooks and waiters, the shop clerks and porters able to live a sustainable life on the wages they earn? What about the street vendors and open-air market sellers?
In Nicaragua the government puts jobs into categories and assigns a wage to the category. Construction is the highest. Hotel and restaurant workers are next. Factory workers earn half of the hotel and restaurant category. Everybody else is in economic oblivion. There are no pensions for factory workers, regardless of tenure or output.
I wonder about the US-Nicaragua connection because as I was riding from the airport in Managua to Granada the driver proudly pointed out to me a huge factory for the Hanes brand underwear sold in the US. When I asked if the workers could afford to buy the products they were making he answered "No, because the pay is very low." This information was validated by the Nicaraguan owner of the B&B where I'm staying.
It's not as if we're talking workers building Mercedes Benzes. If that were me in the US building such a car I wouldn't expect to afford one anyway. But It's underwear, for heaven's sake, and not even the high-end kind. They aren't earning enough to buy the shorts and undershirts they cut and sew for Americans.
How can that be right?
It can't be.
For years I have purposely made an effort to "buy American." For years I have been stopped cold in that effort because the US is no longer a manufacturing country. Everything that I need that I find in any store where I shop, and they are not high-end stores, is made outside the US. The reason is clear - US manufacturing includes livable wages and benefits, which cut into the profit margin. Brand owners can pay sub-standard wages in foreign countries to make super-standard profits.
I am firmly on the side of profit-making, especially since I have been responsible for my own as a self-employed person for 95% of my working life. But profit-making does not have to happen at the expense of populations - the one chosen to work below subsistence level outside the US, and the Americans who lost their manufacturing jobs because they earned a living wage, which moderated profits, and motivated manufacturers to send the jobs to foreign countries.
But take the question one step further and we have to ask ourselves if as Americans we have become so dependent on the lower prices we pay for foreign-made goods because of the lower wages to foreign workers, including for high-end brands, that we aren't willing to make the other choice? That we aren't willing to pay something more for goods and services, including to people who earn the US minimum wage, in exchange for working people to earn a true livable wage?
And one step again - What would happen to the foreign workers if they lost the low-paying jobs they do have because their manufacturing jobs came back to the US? Would we then be responsible for contributing to a continuing cycle of poverty in other countries? Is that justified to return jobs to American workers?
This is not only an economic dilemma, but a moral one as well. How will we resolve it? With actions like letter-writing to companies and politicians? By joining the minimum wage protesters on the picket lines? By refusing, as some determined folks have, not to buy anything other than food and health necessities for a year or more?
What will be the outcomes on the dilemma by any of those actions?
Or will we not reflect on the dilemma at all?
Marianne
Guatemala
Coming in February 2014
Belize
Coming in March 2014