Monday, July 11, 2011

Ungoodbye

I suppose this could be one of those notorious closing posts where I linger on all my sadness about leaving and review the ups and downs that made this experience life-changing.

On the contrary, I've decided this post should be an ungoodbye. Neither am I willing nor am I required to say my goodbyes to this way of life just yet. 

While sorting through my emotions in the last few days, I came to the surprising conclusion that I am not so attached to Costa Rica as I am to the OTS community that has challenged me, supported me, and given me constant intellectual stimulation for months to the point where I feel a renewed passion for gaining every bit of knowledge to which I have access. Because each answer leads to better and better questions.

And thus I also am fully converted to being a team player in academics. While we all know that having people from 5+ different disciplines talk about the same issue makes for a very interesting, productive discussion, I don't think this is something sufficiently practiced in academia. The curse of having so many specialists is that there's not often much incentive or initiative for interdisciplinary brainstorming to occur until a pressing issue demands it.

I do health, it's what makes me tick. But I hope to work with ecologists, historians, biologists, educators, artists, political scientists, agronomists, linguists, engineers, etc., in the future. 

Ofcourse, you're thinking this is obvious stuff  - but can we do it better? What if we were encouraged in youth to not only define our own interests, but to also never be satisfied with our own perspective even in the very beginning of asking questions about the world around us? Maybe there's a better way to ask.

I like to think that the work being done within a discipline has implications for any other discipline. Perhaps it's irritating to some folks in academia, but I do wish we were all at least giving a nod to the big-picture implications of what we do, because those are the currents that connect our seemingly distant islands of ideas and give us the hope of progress.

So...where I am I going with all of this?

I hope this is a glimpse of my future: this life as a researcher, this intellectual wildfire, this desire to always be surrounded by bright, engaged minds filled with wild ideas to which I never would have independently arrived.

Ciao, San Vito, I'll see you in October with more surveys and a field notebook in hand.





Wednesday, June 22, 2011

A few photos...

Crossing a bridge to get to the house of one of my guides - always an adventure.

View of La Casona while hiking up a mountain to get to another community, Betania.

View entering Betania, a community deeper in the mountains.

Gorgeous forest in Betania.

My guide and I trek to a house for an interview.

Monday, June 20, 2011

¿Mä kä ñö?

 What's your name?
¿Mä kä ñö?


For the last week it has been my goal to start learning words and phrases in Ngäbere, the native language spoken by most people in the Coto Brus Ngäbe teritory. While I'm at it, I should also address a question I've been getting about the name of the people with whom I work and how to properly spell it. Guaymí is the term most often used here by Costa Ricans and it is derived from the Bugle language that is also spoken by many members of the community. However, the preferred names are Ngäbe or Ngöbe - I tend to use the latter.


My guide for this round of interviews is an amazing young woman who speaks 3 languages fluently (Spanish, Ngäbere, and Bugle) and easily can throw out phrases and words in English due to the fact that she is currently taking a course at the OTS Las Cruces research station to become a nature guide. Her husband is also an English professor at the primary school in La Casona and she has two adorable little boys. She is sharp, patient, and analytical, and I expect she is going to be a great asset to the community in the future as a leader who can help to manage and negotiate development and tourism in the community (these are issues currently being discussed and pondered).


One day, while on our hike from one community to another, we were discussing languages and I started to ask her how to say certain things in her language. She started to teach me phrases and nouns as they came to her, and I'm sure she doubted that I would remember any of this by the next day. But I wrote everything down and then decided to do my best to memorize it all, because apart from it being exciting and useful, I wanted to prove to her that it mattered to me.


The next day when we were hiking again I told her that I had practiced and then recited what I had learned. She laughed and was clearly a little surprised. So I asked her to give me more things to practice. And she again started to name things around us and gave me a phrase to learn. 


I hardly have any delusions that I'll be able to learn the basics of this language anytime soon, but I am already excited to catch words so that I at least know the subjects of conversations!


A quick lesson....


(Ng.)     (Sp.)      (Eng.)
brare = hombre = man
meri = mujer = woman
kwi = gallina = chicken
 nu  =  perro  =  dog
 ti    =   yo     =   I
mo  =      =   you
kwe = el/ella = he/she
kwedres =ellos/-as = they
nundres = nosotros/-as = we
chi = pequeño = small
kri = grande = large
ju (hoo)= casa = house
 ji (hee)= camino = road




I cannot believe I'm running out of time here, but I will be doing everything that I can to return in a year.



Sunday, June 5, 2011

To the fincas I go....

http://www.rainforestproperties.com/images/listing_photos/53_coffeestarting.jpg


Tomorrow morning I head to nearby El Roble to visit the finca of the locally famous owner Paco Trejos. This is the finca that produces the brand of coffee called Don Ramon, which can be found in any grocery store in the region. I will interview around 10 migrant Panamanian women who have worked during the coffee harvest and remained on the finca.

While I am excited to begin the interviews that are the crux of this study, I am fearful that maybe I'm going to miss some aspect of the experience of women in these fincas that is important to their health and the health of their infants. Tomorrow is my chance to make sure that I am asking the right questions.

I spent the day preparing questions for the supervisors at El Roble, and stumbled upon newsletters and online videos for the local organization Finca Sana, with whom I have worked to coordinate these finca visits. Associated with the International Organization for Migration and Costa Rica's national health system, Finca Sana ("Healthy Plantation") organizes efforts to improve the working conditions and migrant worker health in the coffee plantations of Coto Brus. They work with community leaders from the Costa Rican Ngobe population as cultural advisors and teachers for health education and other skill-learning workshops given to migrant families working in the fincas.

The organization also works to change the perspective of the coffee plantation owners so that they might no longer view Ngobe migrant workers as primitive peoples who don't require the same living standards as the rest of us.

I am hoping that my results can also help Finca Sana tailor their efforts to improve maternal & infant health on the coffee plantations. Below I've posted links to the YouTube promotional videos for Finca Sana:

Part I: http://www.youtube.com/watch?v=v1YOuccUTyE&feature=related

Part II: http://www.youtube.com/watch?v=qmiQg2Akj_s&feature=related

Wednesday, June 1, 2011

Frustrations, Surprises

No Panama.

It was decided in some 24 hours when everything seemed to be blowing up in my face.

I started the chain of events with my simple email to the Panamanian contacts about initiating the local ethics review process. I had been informed by my Costa Rican liaisons that I would do the same kind of local approval across the border. They, however, were quite wrong. And I, having been inattentive to this one detail, shouldn't have so easily trusted the Costa Ricans to know the Panamanian protocol. We learn from our mistakes, and I surely won't overlook this kind of thing again.

After a long 24 hours of frantic emails and phonecalls, I was informed that Panama's national ethics committee would not even begin to review my study for another 8-12 weeks - this being after I travel all the way to Panama City to present the documents in person to the committee and pay a big fee. And at that, I decided that it was time to regroup.

This is research at its best. Curveballs just when you think you've gotten in the swing of things.

Within an hour of deciding that I would complete the entire study in Costa Rica, I had formulated a plan based on my initial methodology from several months ago: I would seek out migrant mothers still currently working in Costa Rica and do my best to achieve a good sample size.

However, I was still missing a third cohort for comparison purposes. When I described this dilemma to the doctor with whom I had collaborated to design the project, he proposed that I interview a group of mothers from La Casona who had migrated for work in the past year. Thus my three groups would still cover differences in migrant status and any differences based on nationality - success!

Now, almost a week later, I am preparing to start my interviews in the fincas (coffee plantations) of Coto Brus. I was happy to discover that my desired sample size likely won't be so difficult to achieve, and therefore Panama may not have been a necessary move to find migrant women in the first place.

Ironically, I am currently writing from Panama, as I ventured here a few days ago to renew my Costa Rican visa and do some sightseeing in Panama City while I have the opportunity! I am now in David and will continue heading back to the border to cross tomorrow morning.

Funny thing is, being here just makes me miss my new "home" in San Vito.

Friday, May 20, 2011

Part I, Conclusion

As I left the EBAIS (main clinic) of La Casona today, where I had been chatting with Maria the midwife and the indigenous community health worker, I walked towards the taxi that had just pulled up and saw a Ngobe woman with whom I am well acquainted getting out of the car with shopping bags. So I greeted her with a smile and we discussed her trip into town (San Vito), which is unaffordable for most La Casona residents. She told me money had been pooled to buy things for a sick woman and she lifted the bags to show me the purchases. Our goodbyes followed, and I closed the door behind me. Before I could utter my greeting to the driver, he turned to me and said in Spanish with a grin, "Wow, you know alot of people here in La Casona, don't you?"

The truth is, I am getting to know people. Today I found myself stopping in the road to chat with passing women who I had interviewed at some point in the last two months and waving to families sitting in the shade by their homes. Nothing is more warming to me than when a Ngobe woman smiles with recognition as we're walking in opposite directions and actually stops to chat.

My last day of interviews with the women of La Casona thus presents me the answer to a question that I have been asking myself for weeks: where should the year after my graduation be spent?

After all that these women have offered me over the past few weeks, I owe it to them to come back to La Casona and continue working as an advocate. If I can develop my ideas and find the funding, I hope to find myself back here again in a year.

Thursday, May 19, 2011

Videos from the UNFPA Maternal Mortality reduction program in the Comarca Ngäbe-Buglé of Panama

Take a closer look at the work being done in the Ngobe territory of Panama where maternal mortality is comparable with Sub-Saharan African (298/100,000) and only 45% of births are attended...

Video directed to health personnel (Spanish) – 14:01 min

Informative video directed to the Ngäbe-Buglé community (in Ngabere) – 11:11 min

Directed to the general public (Spanish) – 2:32 min

Directed to the general public (with English subtitles) – 2:32 min

Sunday, May 15, 2011

Meditations on Patience

Villa Palacios, Brus Malis, Copey:

The first three days of field work have been equally laden with frustrations and progress. I have trekked over mountains in deep silence, wiped out on muddy footpaths (giving my guide a good laugh), shared stories about myself with strangers, been tattooed by Ngobe children, and heard the echoes of a Ngobe elder chanting far overhead on the mountainside as I wandered through a valley. I have been looking for needles in haystack after haystack, trusting my guide to carry me through a place that feels otherworldy and almost forbidden to find some 40 women with newborns.

Just when I begin to get the queasy feeling that I couldn't possibly know what I'm doing and that these results can never be of any help to anyone, a woman will dare to go off the script of the structured questions and begin to tell me her story. It's always brief, but startling, when a woman stops staring at the ground to avoid eye contact, suddenly looks me directly in the eye, and becomes illuminated with the power of her own voice. And this is how I know that while I feel a questionnaire may never fully capture the nuanced reality of care-seeking for these women, I am the person hearing their voices for the first time about this topic and -at the very least- I am recording their answers so that more questions can be asked.

My guide for the past week is exactly my age; but unlike me, she is a spouse, mother to a four-year-old daughter, and a primary school student in the evenings. She has been wary and slow to trust me, but our fifteen hours of focused, meditative hiking together punctuated by funny little mishaps has brought us to an interesting state of give-and-take. There's the most obvious exchange of her guidance on trails for my money at the end of the day, but even our little spurts of conversations were a chain of revealing ourselves little by little, back and forth. This is not to say that there was a budding friendship at the end of the week, but a mutual acceptance and patience. I could write several pages about the strange relationship that emerges between a guide and a field researcher, as there's nothing else quite like it.


Sunset in Coto Brus.

Tomorrow I go to Caño Bravo (provided that my guide, the local midwife Maria, doesn't decide for me that we should go somewhere else!). Maria is a witty, sharp woman who is widely known and respected in the community. Not surprisingly, Maria is a bit of a local superstar throughout Coto Brus due to her prominence as a community leader and the traditional crafts that she produces - I stumbled upon a professional photo taken of her recently at this link: (kacproductions, OTSmariaphoto). In the photo, she is wearing the traditional handmade dress of the Ngobe women, which is actually based on the dress of nuns who came in previous centuries to Christianize the Ngobe and other indigenous populations in Central America.

The women are primarily mothers and wives in this society, therefore they remain in their homes and do not often receive education unless they are living in the central community of La Casona, which receives the most contact with outsiders and Costa Rican government support in the form of schools and clinics.

Yet even in La Casona, girls often become pregnant at 13 or 14 for the first time and already turn their focus from being a student to being a mother. Family support is strong and women (especially co-wives) share responsibilities and childcare so that some women might take occasional night classes; however, most women in this community remain uneducated and without opportunities to choose their own fate. This is the aspect of the Ngobe culture that I find most frustrating.

Shunning for a moment a central tenet of anthropology, I cannot help but to make the judgment that the future of the Ngobe community will be more promising if women are introduced to the concept of reproductive rights. In this situation, I can see clearly the distinction between cultural relativism and moral relativism, as I do not think that these women should be culturally pressured to repeatedly risk their lives in pregnancy and childbirth unless they are able to choose those pregnancies and can carry them out safely with full access to care and assistance. They have every right to opt out on higher education or a Western-style "career" and choose the future of becoming a wife and mother. But I am making the value judgment that they deserve childhood, basic education, and the freedom to choose partnership and pregnancy at a later stage in life if they wish.

This is my little salute to the critics of cultural relativism (many of whom work in the field of anthropology) who are willing to take a stand on basic human rights issues, as contemporary anthropologists can no longer overlook human rights abuses.

Friday, May 13, 2011

Temblor!

This post is only for me to say that I just felt my first earthquake: a 6.0 with its epicenter somewhere near San Jose. Nothing too crazy down here in San Vito, just the doors and curtains swinging while my jaw dropped as I realized what was happening!

Link to event description:
USGS, Costa Rica Earthquake 6.0

Tuesday, May 10, 2011

Return to La Casona




Entering La Casona (view of primary school).
To enter into the Ngöbe territory of southern Costa Rica in Coto Brus, I drive some 20 minutes from the Las Cruces research station, passing breathtaking mountains and valleys on either side of the highway. Then comes a single turn off the main highway and another 20 minutes on a bonesetting unpaved road that winds into a range of cloud-shrouded mountains. I arrive to the entrance of La Casona (pictured above), to find the primary school and EBAIS (the fully-staffed clinic) of this first community.

La Casona is only one of many communities tucked away in the mountains of the Ngöbe territory. Most people from these other communities come to La Casona for the government-provided health care at the EBAIS and for any important gatherings, as the cacique (the leader of Ngöbe in this region) lives in La Casona.

This is the beautiful place to which I will come every morning to then trek deeper into the territory with my guides to find the women who I will interview.

Thursday, May 5, 2011

Beginnings

End of OTS Global Health Semester; San Jose to San Vito:

Finally the day arrives after months of preparation, and for a brief moment, you forget everything that brought you there. It is an infinitesimal moment in which you know you expected to, are supposed to feel a burgeoning sense of accomplishment, purpose, and vitality. But instead you have suddenly opened your eyes after a long dream and realize you don't recognize anything around you and don't know which move is the correct one that you expected to, are supposed to make then and there.

As I stepped onto a bus in San Jose, Costa Rica, after having stowed away all of my possessions in the cargo hold, I found myself facing rows of unfamiliar faces staring blankly back at me. And I forgot everything. I felt the weight of all my decisions fall into my hands but I couldn't quite comprehend the passage that I was making. I found my seat and dug through my bag to find a notebook. I haphazardly it opened to any page that would look like all of the rest with frenzied, half-formulated notes about my research scribbled in all directions. I read those notes until they became familiar again and I could feel sure that they were mine.

My arrival in San Vito six hours later brought me to familiar sights and sounds. Yet even as I unload the contents of my bags into a cabin at the Las Cruces research station that I came to know so well during the semester, my uncertainty lingers.

Tuesday, May 3, 2011

The Project

The Ngöbe are are a transnational indigenous population of approximately 200,000 to 250,000 who reside in territories in southern Costa Rica and western Panama. While the Costa Rican Ngöbe population is relatively sedentary, a large proportion of the Panamanian Ngöbe population annually migrates across the border into Costa Rica for seasonal employment during the coffee harvests. Both the Costa Rican and Panamanian Ngöbe territories have been formally recognized by the respective national governments; however, the Ngöbe still remain marginalized and underserved in both countries.

Among the most vulnerable members of the population are Ngöbe mothers and children. The national ministries of health and the UNFPA are currently working to reduce maternal mortality rates and make motherhood safer for Ngöbe women. 

While infant mortality rates among the Ngöbe are already higher than national rates, the migrant Ngöbe population has been identified as having a particularly high infant mortality rate. During the next few months, I'll be conducting interviews with Costa Rican, Panamian, and migrant Ngöbe women to understand each group's particular circumstances of care access for infants and their care-seeking behaviors