Wednesday, December 23, 2015

Mother’s Day

On Tuesday December 8th Panama celebrated Mother’s Day. Panamanians take this day so seriously that it is a national holiday, and offices are closed. Many people take this day off of work to spend time with their mothers and families. On Friday December 11th, the HIV/AIDS clinic I volunteer at decided to celebrate the mothers that come to the clinic. A volunteer from the Peace Corps brought in gifts for them. She gave them things like soap, wallets, and cleaning supplies – all gifts that these women can use in their daily life. All of these women are indigenous women. To celebrate these mothers Dr. Anne Okwuka, the doctor who runs the clinic, organized a lunch at the clinic where these mothers could enjoy a free meal and share their stories. Dr. Okwuka began by reminding all of those who were there that being diagnosed with HIV/AIDS is not a death sentence. As long as people take care of themselves by regularly taking their medicine and maintaining healthy diets, they can live long lives. Surviving with HIV/AIDS is one thing, but living and coming to grips with it is another. Some of these women have been recently diagnosed and some of them have been living with HIV/AIDS for over ten years. Everyone stood up and shared their experience with the group. I will share some of their experiences here so you can understand how this disease spreads, how it is viewed culturally, and why it is such a big problem here.

The first woman who spoke had one of her daughters with her. She began by saying that she has two daughters, ages 10 and 15. Both of her daughters are HIV positive. They were not born infected. In the indigenous community there is a hidden culture of family members sexually abusing children. In this case an uncle, who was infected, sexually abused the children. No one talks about this abuse, but everyone knows about it. This woman did not volunteer the information on how her daughters became infected. She had to be pushed to say what had actually happened. Even as she told her story it was said in a quiet, hurried voice. As soon as she was finished she sat down quickly. I know she felt shame and guilt for what had happened even though it was not her fault.  

The second woman who stood up to talk had been recently diagnosed. As she stood up she began to cry. Dr. Okwuka stood to comfort her, and gently urged her to speak. It soon became clear why this woman was crying – her entire family had abandoned her. Her parents kicked her out of the house. Her brothers no longer financially supported her. She had no job, and no chance at getting one. The rest of her extended family kept their distance. Why? Because HIV/AIDS is not very well understood or accepted by the community. All most people in the community believe is that it is easy to get and if you get it you will die. This is true if you ignore your symptoms, don’t take your medicine, and fail to take care of yourself. A lack of education and knowledge leads to fear. Because this woman’s family did not have a clear understanding of what was happening, they acted based on pre-conceived notions and popular opinion. They shunned her. Unfortunately this is not an isolated incident. Stories like hers spread fast within the community. No one wants to be shunned by their family.  Many people decide to ignore their symptoms when they first notice them. If they do decide to go see a doctor, and even if their tests comes back positive, many people will decide to do nothing rather than be cast out by their family.

A third woman stood up to share her story. She began by sharing how she had been diagnosed. She was married and faithful to her husband. She had been living in David (in the north of the country) and needed to travel to Colón (several hours to the south) to visit her mother and to look for work. She returned to David several months later. Two years later she went to the doctor and discovered that she was HIV positive. She had been infected by her husband. There needs to be some clarification about sex and sexual relations in the indigenous community. While marriage and monogamy are present, a culture of open sexual relationships is common. During parties it is common for people to have multiple partners in one night. While there is nothing wrong with this, when this is coupled with a culture of ignoring or being unaware of sexually transmitted diseases, then they can spread rapidly. So even if people have one sexual partner, much like this third woman, it is still entirely possible for them to become infected. A lack of comprehensive sex education and safe sex practices also allows for the spread to continue.

These three stories are only a few of the thousands that are out there. Dr. Okwuka and the clinic she runs works within this community to help the people. She finds ways to bring people together, like this Mother’s Day celebration, to show the community that there is life after being diagnosed and that there is support for them. But Dr. Okwuka knows that more needs to be done. A culture of hiding and maintaining is not a solution. She envisions a culture of openness and prevention. Once the taboo is conquered and people begin to talk about and attain more knowledge, then we can move forward and work towards eliminating HIV/AIDS for good. It starts by celebrating what we can. So even if it’s not Mother’s Day where you live, I would like to wish you a happy Mother’s Day. 

Thursday, December 17, 2015

Changuinola – A New Home

It has been quite some time since I last blogged. I had planned on updating this blog weekly, but that has not happened. I do apologize for the late update. A lot has happened since I last blogged. In order to avoid one long drawn out blog post I plan on blogging bit by bit more regularly until I am caught up. So, to begin, this post will describe my new home, Changuinola.

Changuinola is located in the northern part of Panama, close to Costa Rica. It is in a province known as Bocas del Toro. People are more likely to recognize the name of the province because it is also home to a very popular tourist destination. However, when people visit this popular tourist destination they are not visiting Changuinola, rather they are visiting Bocas Town on Colón Island, or as the locals in Changuinola refer to it: Bocas Isla (or Bocas Island). It is around an hour and a half to two hours away by bus and then water taxi (or much more quickly by air if you prefer). I was fortunate enough to visit Bocas last month to celebrate Panamanian independence, but I will talk about that in a later post.

Changuinola is divided into Fincas. They are small neighborhoods that are based on the banana plantations that surround the center of town. These Fincas are connected to each other by one main road, called 17 de Abril Avenue (or Main Street), which runs north to south. The center of town is where all the main shopping is done. It is also where the majority of local businesses are. Since Changuinola is spread out, it is necessary to take taxis from one location to another. All travel within Changuinola costs 70 cents, it is more if you want to travel further out of town. There are many taxis as well as local busses, so finding transportation around town is easy. I live five minutes away from the center of town by taxi.

There is a mixture of ethnic groups in town. The majority of the people in Changuinola are those of Afro-Caribbean descent, and those descended from the indigenous population (from the Ngobe-Bugle tribe). There are also a large number of Latinos as well as some Chinsese immigrants. While the main language is Spanish you may also hear English, Chinese, Wari Wari (English/Spanish mix brought by the Jamaicans), and native dialects.

The main source of employment is the Bocas Fruit Company, or the “Company.” It was known as the Chiriqui Land Company and United Fruit Company, but last year the United Fruit Company sold the company to a Brazilian company and it became the Bocas Fruit Company. The Company took care of everything in Bocas. They controlled the water, the power, and even took care of the social and cultural aspects of the area for over one hundred years. The company was truly the caretaker of the people. Beyond just providing jobs the company also helped to take care of the community. For example the Transfiguration in Changuinola, the Episcopal Church, had a parishioner that was a manager with the Company. He would make sure that the company would mend the fence, keep the grass cut and ensure that the building was painted regularly. The Transfiguration was not the only church in the area to be supported.

Around thirty years ago the Company decided that it was much more cost efficient to slowly sell the company to the workers. It was more cost effective to work with new private entities and use contracts to grow and process bananas, rather than manage the process completely. The globalization of the banana market meant that the price of bananas had dropped significantly, forcing the Company to find new ways to save money in order to survive. The Company knew that many of the buildings and machinery were very old and the cost of updating and upgrading would be more than the Company could realistically spend. The solution was the privatization of the various aspects of banana growing, helping the Company to become more financially stable in the Bocas region. While this helped the Company, it also meant that many jobs were lost. More than that, with the slow draw down in the region the Company began to turn over control of things like water and electricity to the government. A community that had been taken care of by the Company for over one hundred years was then forced to depend on a government that would not be as efficient as the Company. Because the people were completely dependent on the Company, this new direction meant devastation for the economy and the people of Bocas del Toro. To this day the old men will still recall the good old days and fondly tell stories of when they worked for the Company.

This is only a brief introduction to my new home. I have based this post on my own observations and conversations that I have had with people around town, in church and at rugby practice. While this is far from a complete picture of Changuinola, my hope is that you will keep this post in your mind as you read about my work here. This post will help you understand the cultural and social experiences of my time in Panama.