One Cow at a Time
"The poor health situation here is a result of poverty in the families," said Reyna Cordero, coordinator of Acción Médica Cristiana (AMC) in Matagalpa, Nicaragua. "Out of a total of 163 municipalities in the country, we are number 99 in terms of poverty. The further we are from number one, the poorer we are." In the mountainous central region of Nicaragua, away from the volcanoes, lakes and beaches, is the town El Tuma-La Dalia, one of the focal points of the AMC programs.
Acción Médica Cristiana and United Methodist Women responded to the needs of poor women in the mountain community of El Tuma-La Dalia who wanted to better their lives and improve the health of their malnourished children. They received cows and were taught how to care for the animals, and they learned new farming techniques and improved nutrition and sanitation. As a result, they strengthened their self-esteem and empowered themselves and their families and communities.
Nicaragua is the poorest country of Central America, where 46 percent of the population lives below the poverty line, and 30 percent is age 14 or younger. The local economy in this mountainous region is supported by the cultivation of export-grade coffee, which pays laborers $2.50 a day or less. This scant sum often supports a family of five to seven people.
The drive to El Tuma-La Dalia from the provincial capital of Matagalpa City is along a curving paved road through green forests and mountains, with stunning vistas of hills, covered in grassy fields, creeks and clumps of trees. It is beautiful, but also remote, impoverished and deforested. A small dirt track leads across a river and up into the hills to San Joaquín, a community in the Aguas Amarillas district, where 263 women and 208 men are organized and receive support from AMC staff and volunteers.
For the past 23 years, AMC has worked in this mainly agricultural region, in the communities of San Miguel, El Coyolar No. 1, La Ceiba, El Granadillo and Yale No. 2, with a priority in health and community development. Today 1,267 women and 1,251 men participate in the projects, and more people come to receive medical attention at the Santa Luz Health Clinic. The clinic is next to the AMC community center, which doubles as a sleeping space for volunteers. There is also a filtered water distribution center provided by AMC.
Clean, green and healthy
The main problem in the community is poor hygiene and lack of access to clean water. Only 35 percent of the people in the municipality have a piped water supply. Even worse, only 55 percent of the population has latrines, and the rest just go to the toilet in "el monte," as the locals call the surrounding hills. "As you can imagine, this situation is the reason why the water is contaminated," Ms. Cordero said. "The population is drinking dirty water, and [as a result] the main health problems are diarrhea and parasites. However, due to the climate and malnutrition, respiratory diseases are also widespread, such as common cold, pneumonia, bronchitis and asthma."
In 1995, AMC encountered serious malnutrition among children in El Tuma-La Dalia. "We counted 51 children, and 17 of them were malnourished," remembered Zayda Reyes Mendoza, AMC educator and trainer for 15 years. "Then, in 2000, we had a cholera epidemic, and one adult and two children died." At that time at least one person per family was sick, and some had to be transferred to the nearest hospital to save their lives.
Cholera is primarily transmitted by fecal contamination of food and water, a result of poor sanitation, and causes diarrhea and vomiting, which can be fatal.
María Emilia Escorcia Hernández, 33, mother of two, remembered that time. In 2001, she had just moved to San Joaquín, and the AMC volunteers were coming to weigh and measure infants. She recounted, "At the beginning, they were treating malnourished children, giving them soya milk. All the women that had children participated in workshops on how to prepare food for their malnourished children and how to treat diarrhea, because we had a big cholera epidemic here."
Since then, Ms. Hernández has been an active volunteer and is now one of the leaders of the group.
Women were also trained on how to diversify crops, create family gardens and prepare and handle food. "All the women who had children participated in workshops on how to prepare green vegetables for their malnourished children," Ms. Hernández said. "AMC taught us how to make compost and prepare the land and grow nutritious vegetables." Worm composting has been a big success since it offers a natural fertilizer.
The construction of sanitary infrastructure was also necessary to promote health. Latrines were built and three water treatment systems constructed to provide clean water access for the communities of Aguas Amarillas and El Tuma-La Dalia, initially serving 150 families and serving more people every day. All these initiatives were done with the participation of community members and volunteers of AMC.
Cow Bank is born
During AMC trainings women started sharing concerns, needs and wishes and began looking for ways to improve their situation: Could they sell some of the produce they were growing? Start a small business? And what about having access to milk? For a poor peasant in Nicaragua, owning a farm animal is a synonym for wealth - and for a woman it is life changing.
Responding to these women, AMC contacted United Methodist Women, and the first 15 cows were provided in 2001. The groups agreed that the cows would be owned only by the women members, who would attend trainings to learn how to care for the animals and "pay back" the cow with the first offspring, which would be given to another woman of the group.
"We want the woman, not her husband, to own the animal," said María Ruthbeli Pérez, 35, mother of two and coordinator of the project in San Joaquín. She explained that the norm was that the man owned all family property and had single-handed decision-making power. "During one of our visits with a family, the husband noted that when the cow gave birth the wife decided to sell the calf to buy a bull to use for breeding, and now she has more cows. Women have learned how to negotiate with their husbands, and husbands have recognized the value the women have for the sake of the family."
"It has been a pleasure to meet the people from Acción Médica Cristiana," said Emerita Garcia Mairena, 54. "I used to think that being a woman was not that important, that women did not have a chance to develop or own things. I thought that men were the only ones to own cattle. Now I know women also have rights. I used to think that because I was a homemaker, my job had no value. But now I know my value. I feel I am important."
She and her husband have seven children and five grandchildren. Her first cow came in 2007, and now she owns three animals. "The original cow, another cow and a calf," Ms. Mairena said, with a smile on her face.
Everybody in her house drinks the milk and eats cheese with their meals; whatever is not consumed is sold. The extra income makes a big difference. "I use the money to buy medicines for the cow and to buy chickens which give eggs for our food. I buy food for the chickens, and I also help my daughter who is in school. Before, only my husband would bring money to the house, but with the cows this has changed."
A new community
Ms. Pérez remembered the first years participating with AMC. "One of my challenges at the beginning was that I did not know how to coordinate, but with the training, I have learned," she said.
Born and raised in the area, Ms. Pérez recognized the impact of AMC trainings: "Other groups tried to organize us before but without any success. Now we have learned how to follow up and how to maintain an organization. I have also learned financial administration. There is more communication between women. Though we lived in the same community, before there was no communication, no friendship. Now we are more united, we are aware, we have knowledge, and when we have a meeting we are confident expressing our ideas."
For some of the women the change is significant. "I have seen a great change in our group's treasurer. Her name is Rosa," Ms. Pérez said. "I give classes to adults to teach them how to write and read, and I taught Rosa, and now she is the treasurer. It is like a new world has opened for her."
In addition to nurturing the people and unifying women, the Cow Bank project has strengthened the bond in the families of these communities. Ms. Pérez explained, "The project is for women, but it integrates all the family, working together."
During the trainings, AMC also encourages women to discuss and learn about many other topics that impact the community at large, revealing the variety of challenges that Nicaraguan women face: domestic violence, women's rights, family planning, and prevention of HIV and AIDS and teen pregnancy.
AMC also supports initiatives born in the communities, such as a land bank that provides loans to help families buy land; community-administered microloans for women; community centers; radio programs by youth to promote good hygiene, responsible sexual behavior and care for the environment; scholarships for students in a place where most have attended school only until second grade; community first-aid programs; community kitchens where participants learn how to cook the new crops they are growing; seed banks; reforestation projects; and other programs to empower women and improve community health.
AMC's constant presence in these communities has made the organization a trusted institution for the people it serves. "I feel very good; no other organization has helped us more than Acción Médica," Ms. Hernández said. "I feel they are like a mother, like a father to us, because they are always looking after us, supporting us."
Ms. Hernandez spoke of the various ways AMC helps. "We go to the Santa Luz clinic when we need medical attention. AMC helped us to rebuild a suspension bridge. They gave us a community house where we receive medical attention when doctors come to the area. And most of all, we have received a lot of training, which is the best, because in this way we learn how to take care of ourselves," she said.
Ms. Mendoza recounted, "Some of them almost cried before when they were going to talk publicly, because they felt pressure in front of other people. Now, you interview them, and they talk, and talk, and talk. As you can see, the women's self-esteem and confidence is much higher now."
What is next? Ms. Garcia answered for herself: "I wish to enlarge the place where I keep the cows. [I would also like] to have my own chicken coop and pigpen, to have each type of animal in its own space to keep them away from the children and avoid any type of epidemic."
Ms. Pérez voiced the strengths and wishes of the group. "We support one another," she said. "We get together to identify our needs and seek help. The desire of the women is that we continue to work together, to get more animals and to get involved in more projects. All these give you an idea of the identity of the group." And she is confident they will have the ongoing support of AMC to achieve their goals.
Loreto Rojas is a Chilean journalist currently living in California. Nile Sprague is a photojournalist based in Mendocino, Calif.