Dad's Role in Health

As a maternal and child health volunteer, I spend a lot of time thinking and talking about mothers and I often make the mistake of overlooking dads. Like moms, fathers provide an incredible variety of health, mental, social, and economic benefits in childrearing, many of which go beyond anything observable or measurable. Having not one, but two incredible fathers in my life, has been crucial in my personal development. My dad and stepdad are positive male role models in my life that have helped sculpt me into a confident, ambitious young woman. They've taught me that I am strong, and that real men love strong women. They’ve introduced me to boxing and scuba diving. They’ve watched countless movies and Monk episodes with me, sampled my ice cream creations, held me when I’ve cried, laughed at my bad jokes, and cheered me on through even my more inspired endeavors.  I can only imagine the beautiful world we would live in if every girl were lucky enough to have them as their dads.

In my Mother’s Day blog post, I spoke about giving women more time by relieving them of some of their familial responsibilities. Now the other side of that coin is helping fathers worldwide take on these newly assigned roles. If you open up a parenting book in the States, you’ll see that it’s written from the perspective of a mother. If you leaf through the piles and piles of parenting pamphlets here in my health center, you’ll find that they’re exclusively directed towards women. If we want men to be more involved in parenting, we have to develop more appropriate resources that implicate men just as much as women. Put changing tables in men’s restrooms. Feature a male in a home appliance commercial for once. Involve men. When we place the complete responsibility of childcare on women, we also deposit the full weight of the blame. I’ve heard many community members and even health workers here in Guatemala disparaging mothers of malnourished kids without a single mention to the involvement or lack thereof of the father. Deconstructing gender norms surrounding parenting helps distribute the obligation, stress, and accountability that come with raising children. Basically we all win, so why aren’t we doing more to include dads?

Research shows that when men are more involved in their children’s wellbeing, they are more likely to share household autonomy with their female partners. In countries like Guatemala where a woman needs formal permission from her husband before seeking medical care for herself or her children, this could mean the difference between life and death. Undeniably, fathers play a unique and important role in the social and mental development of their children, and it has been shown that their involvement is a significant positive predictor of beneficial health and social outcomes that expand even into adulthood.

Unfortunately, there's not a lot of research surrounding the exact benefits of including men in promoting maternal and child health because there are very few organizations in the developing world devoted to including men. But when we as public health professionals exclude men from health initiatives, we isolate women as the sole caretakers of their families. Nearly every MCH Peace Corps volunteer has a club de embarazadas (pregnant woman’s club) or a consejeria de mujeres con niños desnutridos (counseling of women with malnourished children). Including fathers would be a novelty to say the least. In resource-poor settings, actively involving fathers not only increases the socioeconomic capital of every member in a household, it also helps reduce rates of things like malnutrition and under-five mortality. I know that several cultural and social factors can make attracting men to MCH activities incredibly strenuous and difficult, but if we don't continue to try we'll never see change. Dads have the potential to be amazing support systems and their role in health is unequivocally important, so let's give them a place at the table. 

Happy Father’s Day to all the men in my life that have been a positive, norm-breaking role model and have taught me to be tough, to be smart, and most importantly be true to who I am. To my dad that has promised to hate every boyfriend I bring home and then immediately becomes their best friend. To my stepdad who is always willing to smoke a cigar or embark on two-year long carpentry projects with me. 

Tú No Puedes Comprar el Viento

Home sweet home

You can also watch the HD version on youtube here: https://www.youtube.com/watch?v=zdgU4-kY6Bc  

Change is Hard, but Change is Good

“Everyone thinks of changing the world, but no one thinks of changing himself.” -Leo Tolstoy

I woke up this morning to the sound of my wrist watch’s alarm and came downstairs to a breakfast of chow mien sandwiches. I boarded my spray-painted, bass-pumping camioneta and banged my knees against the seat in front of me as we maneuvered over cobblestone streets. For the last two months, this has been an average morning routine for me and it has been nothing like anything I’ve ever experienced in the States. These small changes build up to take the shape of much larger changes in my life. We’re constantly reacting to our environment, to social situations, and to physical stimuli. So when all of those catalysts have changed, we change too. Thanks to my new surroundings, I now know that I’m someone who likes a tablespoon and a half of sugar in my coffee. I’ve also discovered that I love belting out Gloria Trevi lyrics.

Absolutely every aspect of my daily life has changed. Small details have changed – my daily intake of carbs and the pronunciation of my name. And so have the more pervasive details of life- the language I communicate in most often and the people I communicate with. There are days when these changes are invigorating and exciting, just like traveling to a new place or starting a new job. But there are also days when these changes are exhausting and at times even alienating.

All of these small changes are not only induced by my new environment, they help mold me to fit into it. Integration is objective numero uno here in Peace Corps, and I get closer and closer to accomplishing it through systematic change. The question I’ve been struggling with a lot lately is how much change is too much change. At what point do I start to lose what makes up the essence of me in order to start fitting into a Guatemalan context? Back home I never had any problem trying to rock revealing clothes and took pleasure in being proud of my body. Here, I regularly cover up to a Sunday school level so that I can avoid any extra unwanted attention from catcallers. My very type A work style has no place here in Guatemala, where the hora chapina dictates that everyone arrive at least an hour late to a meeting, take another half hour for greetings, and then finally start 1.5 hours late just to break in 20 minutes for the scheduled afternoon snack. And so I am starting to change. This is the first time that I’ve been faced with the challenge of looking inwards at my own personality traits as if they were items in an apartment being packed up for the move. I’ve never before had to categorize my characteristics into boxes labeled “keep,” “throw out,” and “decide later.”

There’s good change and there’s bad change, but are the two always so distinguishable? It’s taken me decades to be at peace with who I am, even the messier parts of me, and now I feel as if I basically have to start all over. How do I do this while remaining true to the daughter my parents raised, the goofball my friends care for, and the woman my boyfriend fell in love with?
One of the hardest parts of coming to Guatemala has been the persistent fear that I’m losing touch with my loved ones back home. Our lives have suddenly become so drastically different that I worry it will drive a wedge between our mutual understanding. Immersed in so much change, I struggle sometimes to hold on to the shared experiences and characteristics that bind me to the most important people in my life. The mutual love for sarcasm and dry humor I share with my stepfather wouldn’t really fly here in Guatemala. My friends’ and my propensity for late night dancing isn’t quite feasible in my new life restricted by a 6pm curfew. If I put these aspects of myself on hold for two years, will they come back to me so easily?

As someone fresh out of my angsty years, I’ve spent the majority of my life trying to define myself in relation to the context I lived in. Now that the context has been flipped, I wonder if I’m required to start over. Which are the aspects of myself that will stay true over the next two years, and which are those that will change? Change is hard, but change is good. I have the unique opportunity to challenge myself on an incredibly profound level; to really figure out who I am regardless of context. I’ve watched two Peace Corps volunteers end their service since I’ve been here and they’ve both said the same thing – the person I am now is not the same person that arrived in Guatemala two years ago. I’m sure that I’ll say something similar at my close of service ceremony, but it’ll only be half true. I am made of the experiences and lessons I’ve shared with my family and friends. The wall decorations and potted plants of my apartment may change, but I will always be built of an indestructible four-walled foundation. One wall for my family that has taught me that passion, a thirst for education, and integrity can get you anywhere in life. One wall for my friends that have lovingly shown me that spontaneous sing-a-longs and uncensored dance parties are the spice of life. One wall for my boyfriend whose endless compassion and kindness have deeply inspired me. And a wall for me, the nature-loving, baby-obsessed, Motown-grooving cat lady I will always be.

Swearing in as official PCVs

Ladies & gents, Bak'tun 7!

Chiles Rellenos

(serving size: 6 people)
6 pimiento peppers          2 large carrots                         1 pound peas

2 large potatoes                 2 tomatoes                               1 white onion

2 cloves of garlic               6 large eggs                              1/4 cup flour

1/4 cup bread crumbs    1/2 cup vinegar                        1 pound chicken or pork

Salt                                  Black pepper

Doña Nury, my host mama, grilling the peppers

1. In a large pan, grill the pimiento peppers until the skin can be easily removed, or for about 2 minutes on each side.

2. Cut the peppers in half, peel the skin off, and take out the seeds. Soak the peppers in a salt and vinegar solution (1/2 cup vinegar:1 tsp salt) for 3 to 4 hours. Make sure they are fully emerged in the vinegar.

3. Finely chop the carrots, peas, and potatoes and boil till cooked. Strain the vegetables and set aside to dry.

Mama Chave, my host abuelita, chopping ehote

4. Boil the meat, strain, and finely chop.

5. Finely chop the tomatoes, onion, and garlic. Fry the three in a large pot using oil. In the same pot, lower the heat and add the vegetables and meat. Add the bread crumbs and mix well, mashing the mixture at the same time.

6. Add salt and black pepper to taste.

7. After the mixture cools a bit, stuff the peppers. Use cupped hands to mold them well so that they don’t fall apart. 

 

NOTE THE APRON! GUATEMALAN WOMEN TAKE GREAT PRIDE IN THEIR APRONS, WHICH HAVE BECOME A BEAUTIFUL FORM OF SELF-EXPRESSION IN A SPHERE DEVOID OF PERSONAL CHOICE

8. Separate the egg yolks and set aside. In a medium-sized mixing bowl, beat the egg whites until frothy (I imagine there is more appropriate culinary jargon, but I don’t cook so…). Once frothy, mix in the yolks and flour, and beat well.

9. Heat a large pan with oil. Take the stuffed peppers and coat them in the egg. Fry the peppers until browned on each side.

10. You can serve Chile Rellenos on their own, but more commonly in Guatemala they are made into a sandwich using French bread, lettuce, and aderezo (aka fancy sauce aka ketchup and mayonnaise).

 

¡Buen Provecho!

Somewhere in Between

Maximón is a Mayan saint influenced by Spanish Catholicism that is both revered and despised. Legend goes that one day in pre-Colombian Mesoamerica while the village men were off tending their fields of corn, Maximón slept with all of their wives. When the men returned, they became so enraged that they cut off his arms and legs. Somehow this turned Maximón into a divine being with an assiduous taste for expensive cigars and fine liquors. During Spanish colonialism, Maximón’s character was hybridized with that of Judas, and nowadays figures of the Mayan god are featured in 18 th century Spanish garb, usually with mysteriously dark sunglasses. It seems that people view him in either one of two ways. Some praise him as a saint and religiously bring him offerings, generally sweets, tobacco, or rum, in return for good health, pay raises, and many many sons. Others view Maximón in a much darker light, and try to harness his powers to curse hated coworkers or cast wicked love spells. Many hate Maximón and believe that he represents a division within their culture. They view him as confusing, disruptive, and bothersome. He’s hated because there is no set way of thinking about him, and this ambiguity can be difficult to swallow.

My home for the next two years is known worldwide for its colorfully and busily adorned shrine of Maximón. In my site-assignment folder, it was characterized as a primarily indigenous town in the midst of rapid modernization. The new has a knack for pushing out the old, and many of the traditional Kaqchikel traits are slowly fading away. As a Peace Corps volunteer, I am myself an agent of the new, and like Maximón, many people may either hate or love me for it. Many in the community may view me as a neo-colonist American come to Guatemala to spread my personal ideologies and beliefs, while others might see me as a social-minded, enthusiastic worker who has come to Guatemala to help provide care to the under-served. The truth is I am not perfect, and due to years of growing up with a privilege and a subconscious uptake of American paternalism, I fall somewhere in between the two. I understand completely how people can view some international aid and health workers as unwanted and detrimental because many are. Our program director here shared with us a story about a non-profit that donated some medications to a rural health post without providing any training on how the medications should be prescribed and failed to even translate the labels from English to Spanish. Because of this lapse in judgment, children with schistosomiasis (a GI parasite) were unknowingly being given schizophrenia meds. Stories like this provide a potent context to the anti-Western sentiment prevalent in many areas around the world.

My studies, previous work abroad, and most importantly Peace Corps training have helped nudge me toward the socially minded end of the spectrum, but I will never be able to leave the spectrum entirely. No matter what I do, there will always be those that view my presence in their country with disdain, and not entirely unjustly. At the same time, there will be those that welcome me with open arms and offer nothing but partnership in our paralleled ambition. And so I am doomed to live the life of Maximón, both hated and loved everywhere I go. Luckily, Peace Corps has been in Guatemala for over fifty years and has a very close relationship with the country. My site in particular has hosted two Maternal and Child Health volunteers before me. Peace Corps teaches us that the main focus of every volunteer’s service should be cultural integration, sustainability, and capacity building. This model serves as a constant reminder that I am here to help empower my community to take health care into its own hands in the most effective and efficient way possible. My work is successful when I am no longer needed.

I cannot convince the entire world that I am good-natured and well intentioned, but I can do everything in my power to continue trying. And to me the best way to do that is to continue learning public health in the field, especially in a real-time context of cultural and linguistic confusion. During the last two months I have grown and learned so much more than over the last six years of my top-dollar education, and have not had to add a single cent to my student loan balance. The majority of my lessons came from on-the-ground experiences and some slightly embarrassing blunders. Peace Corps training has taught me that the next two years of my life are going to be a continual process of challenging my own biases and remaining open-minded, of planning out every detail of a project, and of remaining tenaciously flexible when none of those details matter because the box containing all of your materials got left behind on the camioneta.

 

Public health is a confusing field wrought with contradictions, and I often find myself a bit lost in the fold. There will always be aspects of my work that reflect public health’s history of paternalism and interventionism, just like Maximón will never be able to shake his sketchy reputation. But more often than not there are those willing to bring me sweet offerings of peace and partnership because they believe my presence represents a powerful alliance. So somewhere in between the misguided international aid worker and the socially minded work partner I’ll be; but my place on the spectrum will never be fixed.

My Mother is a Superhero

All around the world mothers are waking up to iron their kids’ school uniforms or cook their families breakfast while others are mopping up the last bit of floor and tucking their children into bed. Morning to night, being a mother is a full time job. Here in Guatemala, I have yet to wake up earlier than my host mom. Even on the days when I wake up before 6am, I always come down to the kitchen to find my madre cooking breakfast or washing clothes. Her typical day consists of cooking three meals for four children (including me), washing all of our clothes, cleaning the entire house, picking her children up from school, helping them with their homework, and bathing her youngest, all while running a private business out of her home – a quaint and lovely gift shop. These familial duties are expected to be done solely by women in Guatemala, and they’re expected to start at an early age. Out in el campo I’ve seen young girls barely as tall as my hip taking care of their younger siblings or grandparents, cooking meals, and sweeping floors.

Obviously these chores are necessary, but in every single country in the world it is girls and women exclusively that are expected to tackle these tasks. Melinda Gates refers to this type of labor as ‘unpaid work.’ In the Gates Foundation 2016 Annual Letter, Mrs. Gates defines unpaid work as falling into three main categories: cooking, cleaning, and caring for children and the elderly. This is work in its strictest sense and every family, community, and society relies on it to function. According to the Gates Foundation, women around the world spend an average of 4.5 hours a day doing unpaid work while men spend less than 2. In the developing world, the chasm is even wider, with women devoting 6 hours of their day to unpaid labor and men less than 1. This is because the daily household tasks in developing countries like India or Tanzania are much harder for women without access to electricity, running water, or modern amenities like washing machines, dish washers, and daycare. Also, gender norms tend to be more rigid and oppressive for women in the developing world.

The incredible amount of time girls and women spend on their daily chores completely distorts their lives. In rural Guatemala the average woman has 6-7 children in her lifetime. Imagine your daily schedule of school or work, and then imagine having to cook, clean, and care for 6 other individuals on top of that. Further, imagine having to do it all by hand with water you had to walk nearly a mile to fetch. There’s simply no time for it all, so girls and women are forced to give up their dreams of going to school or work so that they can fulfill the expectation that they alone are responsible for all unpaid labor. Global economists refer to this phenomenon as ‘opportunity cost,’ or the other things women could be doing if they weren’t expected to exclusively shoulder the burden of these tasks. We talk a lot about encouraging girls to go to school and women to go to work, but do we as a society do anything to help lower women’s cost of opportunity? Picture a world in which men spent 3 hours a day taking care of the household rather than 2. Now think of the incredible things women around the world could accomplish with those extra billions of hours. Young girls could use this hour to do school work and learn more than was previously possible. Women could spend this time doing paid work or starting businesses, unimaginably empowering 50% of every country’s workforce and unlocking exciting potential for social and economic growth. And that’s just one hour.

Growing up I never fully appreciated how busy my mother is. It took me 23 years to even question how, and more importantly why, she does it all. Like my host mother here in Guatemala, my mom is always the first one up. For the entirety of my life, she has been my answer to everything. Who’s taking me to the dentist? Who’s making dinner? Who’s getting the grass stains out of my soccer shorts? The answer has always been her. When I think of all the hours she’s spent caring for me and our family, I’m incredibly humbled. She did all of this for me and my three siblings, all while excelling as a professional with a prestigious and accomplished career. I can hardly imagine where she found the time. My mother is a superhero and her superpower is finding a way to use just 24 measly hours a day to fit in raising a healthy family, maintaining a beautiful home, and breaking glass ceilings in her workplace. There are an innumerable amount of women around the world who are superheroes just like my mom: women who find the time to travel hours on end to access health care for their children, women who work twice as hard and twice as long as men for the same reward, and women who put everyone else’s needs before their own. Their work and their love is the foundation every civilization is built on, every functional economy relies on, and nearly every person owes their own personal success to. Imagine what they can do, imagine the world we can create together, if we just give them more time.

Happy Mother’s Day to all the women in my life that have devoted their precious time to helping mold me into the woman I am today. Words cannot express my gratitude.

A Day in the Life (Pre-Service Training)

Every morning is a toss up whether I’m going to wake up to the loud, ringing bells of the Catholic church just a block away that seem to lack any tune or rhythm, or to the men who walk up and down the streets of Dueñas with their two goats in tow yelling, “leche de cabra” over and over again in a perfected sing-songy way. Waking up like this keeps me from ever forgetting that I’m in Guatemala. It’s impossible to wake up and, in a sleepy daze, momentarily believe that I’m still tucked in my bed back home in the States. Guatemala has a way of keeping you under her spell from the moment you wake up until the second you fall asleep to the sound of music playing from whatever household happens to be celebrating a birthday that night.

There’s a saying here in Guatemala that perfectly sums up my daily morning struggle to pull myself out of bed: “Me pegaron las chamaras.” The blankets grabbed me. After my sluggish morning routine, I head downstairs to join my host mother and little sister for a feast of a breakfast, usually composed of some combination of coffee, fresh fruit, scrambled eggs, frijoles licuados, pancakes, pan dulce, and cereal served in heated soy milk purchased especially for me. Here in Gaute, breakfast is the biggest meal and dinner the smallest. I suppose this makes sense, every meal proportional to the amount of day that lies ahead, but it has been a difficult thing for me to adjust to (I’m more accustomed to barely remembering to grab a granola bar on my hurried way to work and a three-course dinner). After inhaling my lukewarm cup of Nescafe instant-mix coffee, I’m semi-ready to start my day. 

Most days I stay in San Miguel Dueñas for language and culture class. I share a classroom (the transformed kitchen of one of our host families) with two other girls, Gia and Erin, and our amazing profesor Rafael. Gia and Erin are entirely obsessed with Latin American culture and have spent the better part of their young adult lives working, studying, and traveling throughout Central and South America.  We are a goofy bunch to say the least and our Spanish can struggle to keep up with the strange and eccentric topics we find ourselves discussing. Profe Rafa, thankfully, seems a bit goofy himself (he loves saying the word squirrel in English, “esquirrrrrel”) and endures our tangents with nothing but patience and good humor.

 

On Tuesdays, we wake up at the literal crack of dawn, and catch a camioneta, an old U.S. school bus converted into what is basically a party bus with funky paint jobs and loud music that Guatemalans use as their main form of public transportation. Camionetas are magical portals in which over a hundred Guatemalan travelers can disappear into and then reemerge from once they’ve reached their destination. People sit three to a seat and then create a seat out of thin air by balancing on the hips on those seated on either side of the aisle. Sardines in a can. After the camioneta drops us in Antigua, we reunite with the rest of our 14-person bak’tun in the Parque Central where we all take another bus ride to the Peace Corps offices in Santa Lucia Milpas Altas. There we buckle in for an 8am to 4:30pm day of various training sessions punctuated by coffee breaks, which we all use to scramble onto the temperamental Wi-Fi.

After a long day of classes sometimes Gia, Erin, and I muster up the energy to go on a run. Sometimes. Our runs are a great source of entertainment for the community- both for the giggly children who like to chase us and the catcalling men who are too lazy to move anything but their pursed lips. Other days I go straight home after class and join my host brother and sisters at the kitchen table for homework. They too are incredibly patient with me as I bug them relentlessly for help with my language class assignments. Dinner almost every night without fail consists of frijoles licuados served with salsa picante, cream cheese, and pan frances. Afterwards, I gather my shower things as if I were in camp or college again and head downstairs for my increasingly colder and shorter showers. I’m not sure if we have a cockroach problem or a cockroach with a problem, but I swear that every time I enter the shower this one pervy roach comes out of nowhere and watches me bathe, forcing me into the corner farthest from him as possible for the entirety of my 3 minute shower. Clean and sleepy from a long day filled with carbohydrates, Spanish, classes, and bugs, I tuck myself into bed and fall asleep to the words of my Barbara Kingslover novel and the rumbles of the nearby active Volcan del Fuego. Tomorrow waits another full day of unimagined growth.

 

Buen Provecho

A culinary sampling of Guatemala:

A typical breakfast in Guate 

Chile chile chile

Atol de plátano, a heartily thick, warm drink made of rice, wheat, or plantains

Chorizos con arroz, frijoles, y aguacate

So much fresh fruit in this country! 

More fruit (slightly obsessed)

Tamal de cerdo

Christ, carbs, and coffee: the three c's of Guatemala

I'm convinced Guatemalans are 60% tortilla

Tostadas, my favorite snack 

“Little Now”

One of the first things that I noticed while trying to transition my broken Cuban Spanish into ‘chapin’ is Guatemala’s apparent obsession with the –ita suffix. Maybe it stems from the stereotypical stature of the Guatemalan people or from their affinity for the endearing. Either way, it has a tendency to turn things on their head. The three letters have the ability to transform a pulga, a despised parasite, into a pulgita, a Pixar-cute flea. When I’m offered another helping after an enormous meal, my go-to response, “no gracias, estoy bien llenita,” magically puts a cute spin on my grossly engorged belly. But my favorite example of the –ita’s enchanting spell is with the word ahorita: “little now”. As many of my close friends and family members will enthusiastically attest, time has always been a very abstract and difficult-to-grasp concept for me. So when I learned that Guatemalans had completely erased the notion of a now and replaced it with a little now, I thought that they had cracked the code.  See to me there’s really no such thing as a now; there’s just a past and a future. If land is the past and the sky the future, then the horizon is the present. A constant line between two real things. But the horizon itself is not a definite entity; it is a construct of our own, manufactured by our brains to help us grasp the difference between earth and air.

I know that to many people, especially the “live in the now” crowd, this sounds senseless or even depressing. But to me, it reminds me that my sense of now is really just a little part of a much bigger picture. It reminds me to never forget where I’ve come from and to always look forward to where I can go. I am constantly building off my past and simultaneously laying the foundation for my future. Every moment of my little now is part of two much grander things: who I was and who I will be. This has been super relevant for me as I go through PC training. I’m constantly learning new things, and with each new thing I think back on a past experience and a future one. How have I successfully or unsuccessfully done this before? And how can I improve in the future? Sometimes this mindset can be exhausting and overwhelming, and I can admittedly get too caught up in obsessing over the past or crazily planning for the future. But working in health and development, I think that keeping the past and the future constantly on the forefront of our minds is crucial. How else can we build off past experiences and mistakes while beginning to devise a healthier and more equitable future?

Guatemalan time is a very fluid thing. On-time can mean an hour late, and a five-minute walk can turn into a 20 minute tour of “buenos días.” So really here there is no exact now. Guatemalans don’t define themselves like we do back in America (“What do you do?” or “Where do you work?”).Instead they describe themselves by two things: who and where they come from (the past) and their children (the future). Guatemala is a lively mix of the old, represented by the Mayan ruins, the cobblestone streets of Antigua, or the guipils of the indigenous women, and the new of bustling Guatemala City, dynamic political discussions, and exciting development projects. Lost in this confusing swirl of past and future is where I feel most at home. Ahorita is just little now; really I’m part of so much more.