Nicaragua 2009 - Safety is in the Eye of the Beholder (or, 6-year olds with Machetes); July 12, 2009.
It’s interesting to be in Nicaragua as a Public Health student. At home we take for granted the kinds of safety measures that are part of our daily lives; that are part of health promotion and prevention efforts — wearing bike & motorcycle helmets, using lights on our bikes when we ride at night, the list goes on and on. Regularly here we see people riding motorcycles without helmets, often with small children riding along with a parent. Cars pass other cars at high speeds on corners and people walk along and into the street as cars speed by, seeming not to be concerned at all about traffic.
Today, as Alden was treating someone with a run-of-the-mill cold in the living area of the house, we noticed Robert, one of the farm workers, carrying his 6 year old son up the hill towards our house. I immediately thought it strange that he would be carrying the boy up hill in the heat and figured he must be sick and be coming to see Alden.
When they arrived at the house we noticed the blood. Roberto’s 6 year old son had been helping him cut grass, which is commonly done here using a machete. He was wearing a flip flops and sliced through his big toe. Luckily, his wound was not deep enough to even require stitches, and Alden expertly cleaned and dressed the brave little guy’s toe and sent him and his grateful Father off with instructions on how to care for the wound. From the perspective of someone like me who’s been raised to follow certain safety precautions (some might argue TOO many safety precautions - ha) this event was thought provoking, if not surprising. From my educated, health -care worker perspective I could ask “Why the hell would you let a 6-year old who doesn’t have fully developed muscle control hold a machete, much less work beside you cutting grass with it, in flip flops??”.. Well, of course its very common for kids to work at a young age, his Dad probably learned in much the same way, and this is how things are done on the farm (No fancy lawn mowers here). But it got me thinking — I thought about SCHOOL.
This quarter in school we talked about the time orientation of people’s beliefs about health and their own lives. Communities where there is a lot of poverty or where disease prevalence is high and life expectancy is low, may have a more present-oriented view of health versus one oriented towards the future, which then guides their health decisions and behaviors. Life is quite simply focused on getting through the day to day stuff, not about leading a long life into the future. In addition, where there is poverty (or lack of education or racism), there is a decreased sense of control over one’s own life. If you don’t have a strong sense of the future being yours to live and something you have some degree of control over, the idea is that this effects your everyday health behaviors and choices. I don’t know if this is at play here; there are many reasons people do what they do, and it’s not to make a black and white statement, like developed countries are one way and developing countries are another (we need only watch the daily news at home to see numerous examples of people making choices we would consider unsafe where their health in concerned); at least this theory would assert, it has more to do with the characteristics of your specific community, than what country you’re from - in developing countries there is simply more poverty and less education.
The ideas of prevention in health sort of assume that people have a future-oriented view and a sense of control about their lives. I wonder how this effects public health work in these areas and how we can change messages to take that into account. With the diabetes program that Federico and Alden hope to promote, how many people in this area will actually buy into the idea that by controlling your diet and exercising you can have an effect on the health of your future?
Just a thought…
Posted by jennie on July 12th, 2009