By Fiona Whitton
It is easy for us to forget how important the environment is in our daily lives. We don’t see where our food, water or clothes come from, and often forget to ask or even think about how they got to the stores we buy them from. In Nicaragua, we saw a daily connection to the land; a constant partnership between the people and their environment. Each morning, my home-stay mother and sisters would pound tortillas for the day, made from corn harvested by a neighbor. Community children would trot house to house selling baskets full of aguacate, plantains and bananas, bread made by their mothers that morning, or fresh milk from a local cow. Water was fetched from a nearby well, fresh from the earth. This purity of life and was beautiful to see, but after a few days we began to notice that even such an unadulterated use of natural resources came with its fair share of problems.
As a One Health project, we wanted our community assessment to dig deeper than the most obvious, surface level health issues. We needed see the problems from every perspective, be it medical, ecological, economic or otherwise. By creating this unencumbered lens, we began to see how complex many of the issues we were facing were.
The first realization we had to acknowledge was that although we were standing in a lush, prolific community where no person seemed to be going hungry, the reality was very different. This area had suffered through not only a war that left them limited resources, but 2 acute famines over the past 15 years. So, although we were seeing abundant land for now, we knew that moving forward, the idea of sustainability would be even more important taking into account the history of the area.
The crops grown in the local fields were mainly corn and red beans. They were doused, sometimes daily, in highly toxic pesticides. Agricultural workers were dying from renal failure by age 45. Working oxen seemed to tire and have shorter lives than other bovine in the community. Upon interviewing the director of the nearest hospital, he agreed that the connection to pesticide use is undeniable, but the health system is so overwhelmed that they have neither the man power nor resources to attack the problem. Returning to the community, we spent an afternoon with Julian, an influential local man with boundless knowledge of the land. He showed us countless plants on the mountain that can be used as medicines, health supplements, birth inducers, and yes, as natural pesticides. We hope to explore this area further as we move forward with our project.
The fresh milk obtained every morning throughout the community was thick, creamy and delicious - but was it clean? One morning Brooke and I went to help a local woman milk her cow. She showed us the whole process, and did it fact have us rinse our hands, and the udders, in soapy water. But we couldn’t help but notice the contamination that occurred throughout the milking process. A few days later I asked a local veterinarian, Dr. Freddy Guerrero, to look over our assessment survey and make some suggestions. The first thing he said was to ask more about the milking process, because that the contamination of milk, and lack of proper storage, leads to a significant percentage of diarrheal illnesses in rural Nicaragua.
Although the well water was pure (by local standards), and safe to drink, we saw that many households used storage methods that ultimately led to water contamination and mosquito breeding grounds (see our Public Health article!).
That said, we were inspired every day by the connection the community had to their environment. They are reforesting a nearby mountain that had been cleared for timber, slowly adding tree by tree. We joined them for a morning, lugging 4 baby trees (well, Rennie took 6!) up the mountain on our heads, sweating profusely and nearly stumbling with every step, while the incredible local women carried 8, balancing them effortlessly, laughing and chatting the whole time. They would make 4 trips up the mountain every morning.
These few observations and ideas only graze the surface of what we saw, and of the complexity of the health of a community. The importance of viewing health from a multidisciplinary perspective cannot be overstated, especially in a place where the people rely so heavily on their environment and the natural resources at hand.