John and Deb in Nicaragua: What I actually do as a Peace Corps volunteer in Nicaragua.

Peace Corps has three big goals for its volunteers:

1. To help the people of interested countries in meeting their need for trained Volunteers.

2. To help promote a better understanding of Americans on the part of the peoples served.

3. To help promote a better understanding of other peoples on the part of Americans.

Mainly I write about goals 2 and 3, in hopes of presenting a more nuanced view of US citizens to Nicaraguans and to inform people back home about this wonderful, little country. Goal 3 is especially important to me, because the political history of our relationship to Nicaragua is so despicable.

However, I actually spend about 20 hours a week, sometimes less, sometimes much more on goal 1; my actual work as a public health educator in the Peace Corps in Nicaragua.

I’m spending two years of my life trying to convince Hispanic guys to use condoms when they have sex. (Actually, it is another two years, because I did the same work in Honduras ten years ago.)

The project I’m part of, health, has three objectives:

1: HIV/STI (Sexually Transmitted Infection) Prevention

2: Teenage Pregnancy Prevention

3: Improved Maternal and Infant Health outcomes

I don’t do much on the third one.

Nicaragua has a relatively low rate of HIV infection. Unfortunately, it seems to be steadily growing and there are some risk factors that make it worth paying attention to from a public health perspective. These include a culture of machismo in which multiple, simultaneous partners is the norm for men, acceptance of men visiting prostitutes as part of their sex life, often including their first sexual experience, an uncircumcised population, high rate of other sexually transmitted diseases, a concept of homosexuality that only defines the receptive person as gay, and much resistance to condom use. Likewise, unplanned pregnancies at an early age are very common.

So, yeah, its all pretty much about promoting condom usage, with a pitch for abstinence - meaning delay of first sexual experience and abstaining from sex if you don’t have a condom available - and mutual fidelity thrown in. More on how “mutual fidelity” goes over in Latin America later.

Here are some examples of what this work actually looks like:

I am introduced to a young Nicaraguan man named Cesar Torrez who is a volunteer health educator in a small town, Puerto Morazan, about 20 miles outside of Chinandega. He has a youth group he meets with two afternoons per week. He invite me to come to his youth group. The forty minute bus ride to Puerto Morazan is through cane fields with mountains in the distance. The village is on an estuary. Fishing and shrimp farming are sources of employment. I get directions to the high school and walk a half mile through the village, across a rusty bridge, and arrive at the school. A while later, Cesar arrives and slowly his youth group begin to trickle in. Eventually, there are five boys and three girls. They are between 15 and 18 years old. The young people sit in a row and Cesar stands at the front of the room and gives them a lecture about sexually transmitted diseases. Their attention wanders. They whisper to each other. There is some flirtation going on. They check their cell phones. After about a half hour, Cesar says to me, “Will you show them how to use a condom?” I had thought the invitation had just been to observe the group, but I’ve done this so many times, I don’t mind. Cesar has condoms, but nothing to use as a penis. The first thing I do is get them to move their seats into a circle. Next, I get them to introduce themselves by saying two true things and one lie. I say I have seven kids, twelve grandkids, and four tattoos. I actually only have three tattoos. They have to guess which is the lie. When it is their turn, it is almost impossible to come up with a credible lie. They have all lived together in this small town, all of their lives. However, they have fun with it and laugh a lot. I give them each a condom and get the broom from the corner. Indicating the broom handle, I say, “This is a very long, but very skinny penis. I think it will work to practice on.” I have their attention. We go through the steps for using a condom: check the expiration date, make sure the package is sealed, open the package with your fingers, don’t use your teeth, make sure the condom hasn’t dried out, put it in your palm with the right side up, it should look like a sombrero, pinch the nipple between your finger and thumb to get the air out. Place it on the end of the erect penis (A.K.A. broom handle) and roll it all the way down, have sex, while the penis is still erect, hold the condom around the base and withdraw, slip the condom off the penis being careful not to spill the semen, throw it away. Everyone takes a turn. They are animated and interested, they tease each other and give advice and corrections. After the demonstration, I blow up one of the condoms and tell them to stand up and form a circle. I put the inflated condom between the first boys knees and give them the task of passing it around the circle without using their hands. Nicaraguan kids are very shy and easily embarrassed, but they will basically do anything you tell them, especially if you are an old gringo. They get into it. Boys pass to boys, boys pass to girls, girls pass to girls. It is boisterous and erotic. Nicaraguan kids have the information. Almost anyone can tell you to prevent HIV you should use a condom when having sex, but they don’t do it. My job, then, is to present in a manner that does more than just impart information. I’m trying to change behavior. I think a lot about, and Peace Corps gives a lot of training about how to do this. It is a big question, but one part of the answer is give practice during the presentation of the behavior you want to see. I don’t know how many of these kids have touched or tried to use a condom before, but now they all have. Additionally, they have had a fun time doing it. The bet is that when it comes time to have sex they will be somewhat more likely to use a condom. Who knows? I plan to go back to Puerto Morazan and continue working with Cesar.

Across the street from my house there is an apartment rented to some itinerant construction workers. Some are from León and some from Managua. Most go home for the weekend, but others live full time in the apartment. There are always six to eight guys there, ranging in age from their mid twenties to their late fifties. I talk to them in the street the way I do to all my neighbors. I’m particularly close with one of them, a young guy named Jonathan. He has a wife and kids in Miami, but got deported because of a minor run in with the law. This is a common story in Nicaragua. Jonathan speaks just enough English that it is harder to communicate with him than it would be if we stuck to Spanish. Usually, I talk to him in bad Spanish and he answers me in worse English. One day when Deb is away, I accompany Jonathan and an older guy to get soup and beers for lunch at a neighbourhood restaurant. I have a really good time with them. I tell them about my work and then I pitch them the idea of doing a presentation to all the guys in the house. I had been thinking about this for awhile because itinerant workers, guys away from their families and home for extended periods are at high risk for infection with sexually transmitted diseases. Jonathan and the older guy say, “Sure.” We set a day and time. A couple of days later, I cross the street with my materials and give an hour and a half presentation to eight of them. I get them involved. We do some ice breakers and some games. I get them talking about their opinions and experiences. When the conversation is really flowing, fast and slangy, I only get about 50% of it. It is clear that they are not buying my ideas about prevention: condom usage, abstinence - in these guys case settling for a blow job if you don’t have a condom -, and especially, fidelity to one partner. The group is teasing and pointing the finger at one guy in particular, a bulky, good looking guy of about thirty. He has a wife and family in Managua and also seems to have quite a reputation as a lady’s man. At one point he offers the standard reason for not using condoms: “Carnita a carnitas es mejor!” (Actually, I love this phrase. There is a lot of poetry to it in my opinion. “Carnita” is the diminutive of carne or meat. So, how would you translate it? “It is best when you got the darling, little meat against the darling, little meat!”) I end up saying, I’d like to invite you to think about your wife and family. It doesn't matter to me who you do it with, but consider doing it in a way that you don’t bring a disease home and give it to your wife. Of course the conversation goes on and nothing is resolved. I leave them with a bunch of condoms. The other day, Jonathan said to me in the street, “ ‘ey, man. You got condoms? Yeah, da guys want more, you got ‘em.” Who knows what that means? I am more than willing to supply those guys with condoms. I can get all they want for free from the health department.

Another volunteer, a young woman named Rosalyn Zock, whom I’m very fond of calls me. She tells me she is organising a pool tournament in her town as an HIV education event. The participants will receive information between games of pool and later they will have to answer questions about what they have learned. Rosalyn asks me if I can do a poster for her. She says she would like a picture from the point of view of someone who is about to take a shot. She wants to show his hands holding the cue, getting ready to shoot the cue ball and break up the other balls, only its not a pool cue he is using its his penis. I say, “Whoa, Rosalyn! That’s a bit graphic.” This is something of a role reversal, because in the past I have a history of saying things that are a little too explicit for Rosalyn’s tastes. Could it be that Peace Corps is changing one or both of us? I tell her I will try to do a poster, but it may take a week or more. She says no hurry. I get an image stuck in my head so I finish it up in one sitting and send it off to her. She says she loves it. I keep looking for ways to make sex education in a public health context sexy and funny. I’m pretty sure scare tactics don’t work. “Wear a condom or you’ll get a fatal disease and die!” Nobody wants that thought in their head when they are getting ready to make love. Maybe though, if condoms are funny, playful, and a little sexy, it will increase the likelihood of putting one on when the time comes. Who knows?

I like this work. I do it a lot, in many different contexts, with many different people. It is complicated and challenging, especially doing it in my second language and in a culture different than my own.

Here is a gallery pictures to go with these thoughts:

My poster for Rosalyn Zocks Pool Hall tournament.

A sticker design I did, but decided not to use. Some people loved it, but others thought it was too "political." I'm not sure how it registers culturally.