Men´s Health

Over the past few years, Peace Corps Honduras has introduced a Men’s Health Initiative into the Health Project. The project focuses primarily on HIV/AIDS prevention education but also touches on other men’s health topics such as testicular and prostate cancer, smoking, alcohol abuse, domestic violence, etc. In Honduras adult men receive less health care and less health education partly due to the machismo culture. There are numerous NGOs that focus on maternal and child health, but few that focus specifically on adult men. In my site alone there are two NGOs that focus on reproductive health for women, one that does HIV/AIDS education for youth and numerous others with broad health goals but not one that works with adult men concerning issues of sexuality and HIV. Yet, HIV/AIDS education is crucial for adult men because they are usually the ones making the sexual decisions. So even if the woman receives education about how to protect herself there is not much she can do if her partner is not willing to use a condom. Therefore Peace Corps developed a workshop with a complete manual to teach adult men about safer sex practices. Last week I went to a Peace Corps workshop with somebody from my site to receive training on how to lead the workshop. It is really an amazing manual with hours of material ready to go. It is designed for all sorts of groups of men from university students to police to inmates to taxi drivers and uses a very raunchy approach.

Chicas Calientes: Literally means Hot Girls, but has the double meaning of horny girls.
In this activity we in up a bunch of magazine pictures of hot girls and all the participants have to choose three girls that they would want to sleep with at a party. Then we reveal that one of them has HIV and whoever slept with her is now infected and they consequently infected the other girls they slept with who consequently infected the other guys they slept with…etc. The point of the activity is to demonstrate the chain of transmission and that in essence you sleep with everybody your partner has slept with. We also demonstrate that the chicas calientes all look very healthy and that there was no way to tell that they were infected so you have to get a test to be sure.

Dice Game
On each side of the die a bodily fluid is written (semen, blood, saliva, etc). The dice are rolled and we ask the group to first use their imagination to think of a situation (conventional and not) where the two fluids would mix and then determine if this situation could transmit HIV.

Human Knot
Hondurans love dinamicas (fun games) and we throw tons of them into our workshops to break the ice and entertain and sometimes they even have educational components.

Condom Demonstration
We had humongous bananas for our condom demonstration!

¨Spin the Bottle¨
We play spin the bottle where one person has to ask “Why don’t you want to wear a condom?” The other person has to give a reason he doesn’t want to wear a condom and then the first person is supposed to give a rebuttal to why he should wear one. For example, “I don’t want to spend money on them” à “You can get them for free at the health center”. Although the activity sounds good in theory it is hard to make it work, the participants usually just say “I don’t want to wear a condom because I don’t like it” and the response is “But you should wear one anyway”.

I am very excited to start giving workshops in my town because although there is a lot of HIV/AIDS education going on in Santa Barbara, this is an area that is really lacking. Yet, I can’t do it alone, because obviously, I myself am not a man. Therefore I am starting to form a Men’s Health Team to go about the task. One member has already attended the training and will hopefully work with me to give workshops. I hope to train other educators to give workshops as well as network with the other NGOs that are already doing HIV/AIDS education to give us support.

Although I am really excited and have confidence that we can be successful the process is not without challenges. First, I decided to go to the workshop at the last minute and had to find somebody to go with me at the last minute. Somebody I met when I was translating for the medical brigade recommended a friend of his to me. He is finishing school and is the student class president. I was told he was 22 and a good public speaker. It turns out he is only 20 and a little shy in front of large groups. I think I had set my expectations for him a little too high so when he didn’t do an excellent job at the workshop I was a little disappointed. I did learn some valuable lessons though. First, I should be a little more careful about who I decide to work with and should take time to get to know somebody before I commit myself to work with them. Second, I need to accept people where they are and not where I think they should be.

The actual workshop given by the Peace Corps was also a little frustrating. We traveled about 8 hours down to San Lorenzo, Valle, in southern Honduras. It is supposed to be sweltering hot there but luckily we were in air conditioned hotel rooms and conference rooms, so we never really got the full effect. There were about 10 Peace Corps health volunteers and about 20 Honduran counterparts accompanying them. Most of them were respectful and participative. Others were a little too participative..The experience brought me back to when I was teaching for Health Space Cleveland. When I would go to give classes to the little kids, kindergarten and 1st grade, I would often have to explain the difference between a question and a story before I asked “Are there any questions?” because little kids don’t seem to know the difference and would raise their hands when I asked for questions and begin to tell a five minute story about this one time when…Well, unfortunately some people never learn the difference between a story and a question (or they just don’t care). Every time our facilitators would ask if there were any questions the participants would take this to mean it was time for them to stand up and proceed to give their own lectures. Although the air conditioning was cool and I was happy to see some other volunteers I was ready to go home after three days of hearing everybody’s two cents.

Pure Water for the World

Agua Pura para el Mundo (Pure Water for the World) is an NGO that works to provide water filters to people who do not have access to clean drinking water. They are my primary counterpart here in Santa Barbara which means that I spend most of my time working with them. There are currently two employees; Nineth, the Supervisor and Adan, the Health Promoter. There is also a volunteer from Canada working with us for a few months. Overall, they are a great team and we are able to work well together, which isn’t the case for all Peace Corps volunteers.

Chris Green, our Canadian volunteer in the Agua Pura office

Chris & Nineth Mungia diligently working

Agua Pura teams with The Rotary Club to acquire funds in order to function. There is a local chapter of El Club Rotario here in Santa Barbara who partners with clubs in the states. Clubs in the states raise money and donate it to the clubs here to fund our project. Currently we are working with grant money from clubs in Maryland and Maine. We are really very lucky to have such amazing support, the work we do couldn’t be done without it. However, working with El Club Rotario means that everything has to go through them in order to be approved which can be very frustrating when it takes them a month to get some things done. Also, communication can sometimes be difficult when you are trying to involve the club from the states, the club from here and Agua Pura; not everybody speaks both English and Spanish and business is conducted at quite a different pace. As the Peace Corps volunteer working with the project I find myself in an interesting role because I am the only one who speaks English and Spanish and more or less understands both cultures. It is tricky and sometimes stressful. On one hand I have a skill that others don’t so I want to use it to help the program. On the other hand I don’t want to be the only person who knows how to do certain things. For example, the last volunteer from Canada who was here took charge of many things without teaching the Honduran employees how to do it themselves. Now that he is gone nobody knows how to get certain things done. For example, we need to order new lab equipment and nobody knows what to order because the previous volunteer had always taken care of it. It re-affirms the idea that I am not here to do their job for them; I am here to teach them how to do it themselves. After I leave I want the work I have started to continue and I never want anybody to say ‘we don’t know how to do that because Allison always did it’.

The filters are produced by a local workshop; actually my host dad owns it. For the most part they are hard workers, but clear communication and staying on schedule are big challenges.

Chris & Nineth with the Agua Pura truck at the workshop where the filters are constructedFilters ready to go


In order to provide people with water filters so they don’t have to drink contaminated water there are a lot of steps that we have to go through. First, we have to identify communities with contaminated water who don’t have access to clean water. We receive recommendations from the Health Centers based on cases of diarrhea, personal solicitations from community members and word of mouth. Once we identify a community we meet with the community leaders to see if there is an interest in having filters. Then we go to the communities and take water samples from their current drinking sources, such as a well, spigot or stream to determine if the water is contaminated (which it always is). We have a decent set-up of lab supplies in the office which seems to do the job. Although sometimes I think about everything that would need to be done to make these tests “accurate” and then I remember that I am in Honduras and forget about it.

Lab Equipment & samples in fridge (it really smells when you open the door)


Once we have determined that the community does indeed have contaminated and the community leaders are willing to work with us we hold a meeting to talk to the community about our project. We give a basic talk about why water is important and the link between clean water, hygiene and health. We also talk about the logistics of the filters, how they work, how they are maintained and how much they cost. At that point we get a list of people who want filters and start to deliver and install the filters in individual households. When we install the filters we talk to each family about how to use and maintain the filters.

So far we are pretty good at delivering and installing filters but we still need to work on improving other components. For example, once the filters are installed we are supposed to go back to the communities to monitor how they are being used and if people have any questions. This part of the process has been hard for us to do because the emphasis seems to be on producing and installing filters. Although education is really the most important part (if people don’t use their filters properly they won’t get any health benefits) it sometimes feels like we are pressured to judge our progress by the number of filters we have installed.
We also want to add a de-parasiting component to the project. Once people have been using the filters for a few months we want to give them parasite medicine to get rid of whatever they had (i.e. worms) while they were still drinking contaminated water. Luckily we just received a donation of parasite medicine so hopefully that will encourage us to get moving.
Another component we want to add is training community agents to help us install filters, teach about hygiene and help monitor the filters after they are installed. This places less dependence on us as an outside organization and more on the community members.

Me with filter

Agua Pura is actually an international organization with offices in various countries around the world. In Honduras there are six sites including Santa Barbara. Last weekend I visited one of the other sites in Choluteca, located in Southern Honduras. They also have a Peace Corps volunteer working with them and it was helpful to see how things are run down there. I was also able to meet the national director of Agua Pura, which helped me put a face to lots of e-mails. .
Not only does Agua Pura install filters in individual households, but also in some schools and churches. This is a school in Choluteca where they installed a fitler in the kindergarden class
From left: Megan (Peace Corps Volunteer who works with Agua Pura in Choluteca); Kelley (Environmental Engineering Student from Buffalo, NY, here to do a study of Agua Pura); me; Johnny (medical student here to volunteer with Agua Pura for the summer, from Ireland)
The beach


If you want to read more about Agua Pura you can sheck out the following web-sites
www.purewaterfortheworld.org
www.aguapuraparaelmundo.org
www.portlandrotary.org
www.freeport-rotary.org

Eye Extravaganza

A few weeks ago an optometry brigade from Memphis, Tennessee came to visit Santa Barbara and I was able to help them translate. During that week my co-workers from Agua Pura were working in the campo and came across a number of people who seemed like they could benefit from the services of the brigade. So they decided to bring them back to Santa Barbara to be seen by the doctors. They lived about an hour away so they came back with my co-workers at the end of the work day and spent the night at the houses of Nineth, the supervisor of Agua Pura and one of the other Agua Pura volunteers and were seen by the brigade the next day. It turns out that two of the old men had cataracts and needed to have surgery to remove them. The surgery was to be done in San Pedro, the second largest city in Honduras, about two hours away from Santa Barbara. We advised the men of this and took them back to their homes that night and forgot about it for awhile. Then last Sunday my co-workers were out working in the campo and remembered that the men were scheduled for surgery the next day so they should take them in. So that night they brought back Don Justino, Don Chico, Laura and Eve to spend the night in Santa Barbara and take to San Pedro the next day. Don Justino is about 80 and almost completely blind. Laura is Don Justino’s neighbor and supposedly came along to help him because he can hardly see (later we figured out that she just wanted to go get her eyes checked). Don Chico is also in his 80s and isn’t quite blind, but is completely batty. Eve is a teenage girl who got it into her head that she wanted to go to San Pedro to work so she asked Nineth, if she could find her work. Nineth called an old friend who lives in San Pedro and they arranged for the young girl to go and live with her and work as her household employee. So Monday morning we all met and planned our schedule for the week (something that I am trying to get the group to do to improve organization). In the week plan we assumed it would take about five hours to deal with the eye surgery. Two hours to drive them to San Pedro, an hour to get them settled and two hours to drive back. Well, as I am learning about Honduras nothing is ever simple and things always take longer than expected. They spent the day in the clinic doing the initial check-up and trying to figure out who would pay for the surgery and didn’t return to Santa Barbara until 9 pm. While in San Pedro they dropped the young girl off at the old friend’s house to start work. The surgery was scheduled for Thursday so then we had to juggle the three of them for the rest of the week and try to figure out who was going to take them back to San Pedro, who would pay for the surgery, where they would stay and who would take care of them after the surgery. In the meantime my co-workers were housing, feeding and caring for Don Justino, Don Chico and Laura. Eventually we dropped Laura off because we realized she wasn’t really there to take care of Don Justino, she was just there to get her eyes checked, which she did and they were fine. Finally we got in touch with family members of each of the men and explained the situation to them. The initial reaction was to ask us to bring them back to San Pedro and pay for everything and continue to take care of their fathers. The families didn’t seem to have any sense of gratitude for any of the work we had done to take care of their families and seemed to expect us to do everything for them. Eventually we convinced sons of each of the men that it was their responsibility to take care of their fathers both physically and financially and they left with them to return to San Pedro on Thursday for their cataract surgery (hopefully all went well because we haven’t heard back from either of them). Oh, and then the young girl decided she didn’t like the work after two days so came back to Santa Barbara and stayed with Nineth for another two days and then finally went back home.
When my co-workers with Agua Pura first offered to take these two men to get their eyes checked out two weeks ago none of us had any idea what we were getting ourselves into. Overall it was a pretty frustrating week because it pretty much took four days to deal with the mess and meant that we succeeded in doing very little work. It was also frustrating because the families didn’t seem to want to help themselves and just assumed that we should do all the work and pay for everything. When working in the campo we see varying levels of poverty and we all have an inherent desire to help people that need help and often make promises without thinking about the consequences. This experience taught me that you just can’t help every person you see even if they really need help. At the end of the week Agua Pura decided as a team that we need to focus on our primary objective, which is to run a successful organization to provide people with access to clean water. This means that we will have to say no to people who need our help in other ways, which is of course unfortunate. I think this experience was important for me because it has taught me that I shouldn’t make promises to help people before I know what keeping that promise will entail. Also, I have to accept that I can’t help everybody and if I try I’ll drive myself crazy and carry the weight of the world on my shoulders and probably get depressed and decide I’m a failure and drop out of the Peace Corps. I’d prefer not to have any of that happen, so I’m going to focus on my priorities and do the best I can do with the time and resources I have.