Post Conflict but not Post Consequences

This week, Larissa and I went to the hospital to talk to one of the nurses there.  I was interested to hear her impression of the young girls in La Merced and their knowledge of reproductive health, as well as her experience with women and what sort of resources the hospital had to offer them.  At the time, I had no knowledge of the unexpected direction that this interview would take.  I was told that Jenny was the head nurse and that she would be the person to talk to.  We met her at the hospital in the morning, and to my surprise she was a younger girl.  As “head nurse”, I was expecting to meet a woman who had been working at the hospital for decades.  Jenny has worked at the hospital in La Merced for the past 6 months.  Apparently, there is a national policy in Colombia, which requires all doctors, nurses, and dentists to do one year of social work as part of their degree programs.  Jenny had been assigned to La Merced for her year of rural medical work, and has 6 more months of work in La Merced ahead of her.  After talking with her for a few minutes, we learned that her role as head nurse was somewhat by default, since she is the only certified nurse working in the hospital.  There are 7 nurse assistants who have not received the same training that she has, and don’t perform the same tasks that a full time nurse would.  Needless to say, Jenny has been very busy for the past 6 months.  She also told us that until recently, there were 3 doctors working in the hospital.  Last week, one of them decided to quit due to “political reasons.”  The two doctors that remain are actually students in the same program as Jenny.  Not only do these doctors have minimal experience, but also they will only be working at the hospital for the next year, before moving back to a larger hospital in the city.  From what she has learned during her time here, she says that this is the normal cycle of staffing at the hospital.  Mostly, the nurses and doctors are working there as a part of this degree program and leave each year, while new interns arrive.  So there is never really a seasoned staff of doctors or nurses to treat the people of La Merced. 

When we asked Jenny why she thought that it was so difficult to keep the hospital sufficiently staffed, she told us about a meeting she had recently attended.  There was discussion about the paramilitary history of La Merced.  La Merced became a center for paramilitary training in the 1990s and early 2000s, and the municipality was strongly controlled by a paramilitary group.  The severe loss of population in La Merced is largely due to this history of conflict that has left its mark on the town.  Jenny told us that up until about 10 years ago, while the paramilitary group was occupying the town, they placed officers in the hospital.  These officers monitored who was coming in for treatment, and told the doctors which patients they were allowed to treat, and which ones they needed to turn away.  After hearing this story, it became clear why it was so difficult for the hospital to maintain a sufficient and capable staff.  Her jarring story reminded us of the very real violence and darkness that the town had been put through.  La Merced’s history is something that we have all been aware of even before coming here.  It’s something that sits in the back of my mind every time I learn something new about the town, or hear another person’s story.  But it’s not something that has ever been out in the open.  It’s not often that you hear people referring to it directly, so it’s easy for the stories and facts that we’ve read to remain intangible notions in my mind.  These facts take on a whole new meaning when they are brought into reality, which is what happened for me that day at the hospital.  The conflict may be over, but there are still very visible consequences that the town endures. 

You Know You're in Colombia When....

My image of Colombia will forever be colored by my time living in La Merced.  After 2 months of life in this quaint and beautiful rural town, here are some things I have learned:

You know you're in Colombia when...

...your 5 year old friend can work a soccer ball better than you could ever hope to.

…an arepa appears on your plate at least twice a day.

…you arrive at a meeting wearing sandals and sit down next to a 58-year-old woman wearing bedazzled 6-inch pumps.

…you tell people you don’t eat meat and they give you this face:

…standing up in a bar or restaurant and creating your own dance party is socially accepted and even encouraged.

…your office is 2 blocks from your apartment, yet you can’t get home without being offered at least 2 shots of aguardiente.

…you are woken up by banging noises at 5 am, and you simply go back to sleep because you figure someone is just setting off fireworks outside of your front door.

…you can never get enough coffee breaks.

…you order a cappuccino and you have to specify if you’d like it with or without alcohol.

…your name becomes obsolete and you are simply dubbed “La Monita.”

…you can’t buy shots of liquor, only bottles or half bottles.

…the street dogs outnumber the people.

 …a horse, a donkey, and the roof of a Jeep are all feasible modes of transportation.

 …"breakfast without chocolate isn’t breakfast.”   – Doña Jacky

…you have a naptime after lunch…like a little baby.

 …a walk through the mountains can quickly turn into a flight through the mountains.

 ...you can't imagine a world where you don't get to wake up to this:

…you are surrounded by some of the happiest and most beautiful children you’ve ever met.

The Tourism Association

We facilitated two workshops with the Tourism Association on July 10^th and  17^th.  After our introductory meetings with them, it became evident that there was a strong need for increased collaboration between members, as well as strategic planning.  So we planned a session using exercises in the hopes of getting to the root of the reasons for the dysfunctionality within the association, while also brainstorming possible opportunities to combat those problems.  The workshops additionally served as team-building exercises, having asked the participants to work in groups throughout the meetings.  I have to thank our fluent teammates, Julían and Larissa, for carrying us through most of the talking of these meetings.  Without them, we all would have just been sitting in a room playing charades.

The focus of the first workshop was to identify the causes and effects of the lack of functionality of the organization.  We split the room of 16 participants into two groups and facilitated an exercise called “The Problem Tree.”  As a result of this exercise, the overwhelming consensus was that the reasons for the lack of cohesion within the association stems from a lack of leadership, communication, and organization.  After identifying the problems, we asked them to turn their problem trees into opportunity trees.  Once the problem of dysfunctionality was changed into the opportunity of “an operational association” it was easy for them to recognize objectives that they would need to accomplish in order to reach success.  The workshop was a success.  People began to think more critically about why they hadn’t accomplished anything within the association this year, and they also began to talk and think with a more united voice.

Th problem tree exercise was a perfect segway into the focus for our next workshop: goal-setting and task breakdown.  The second meeting was off to a shaky start, as only 3 association members showed up on time.  The association is in the middle of a re-election and restructuring of the members, so many members aren’t even sure if they will be continuing on with the tourism association.  But after some time passed, a few more people trickled in and we ended up with 7 participants; not as many as we had hoped, but it was enough to do the exercise we had planned.  We used the tasks that the groups had identified from the problem tree exercise: forming committees, more organized leadership, official notifications of association activities, creation of a tourism booth at the town square, and more marketing of La Merced.  From here, we had the members identify the specific problem and objective that they were addressing.  In addition, they were asked to list what resources they would need to complete the task, and by when they planned to have it done. Our hope was that as a result of this meeting, we could deliver a planned calendar of activities that the association could use to more actively carry out projects.  However, given the currently unstable climate of the association, the members did not feel comfortable assigning participants to each of the tasks.  This was understandable, considering the restructuring that they have been trying to do.  They completed what they could for the exercise, and presented their progress to the rest of the association in a meeting that weekend. 

I really don’t know what will come out of the work we have been doing with the association while we’ve been here.  They are at a pivotal stage where they are changing their constitution and hopefully gaining better leadership.  There is still so much foundational work that they need to do before they can consider projects that they want to work on.  I just hope that they realize how significant strategic planning will be for them.  Despite the frustration of many members and the dormant state that the association has been in this past year, it was encouraging to see those members who haven’t given up on it yet.  They still show up to the meetings, they still participate, and they still try to think of better ways that they could be working together.  I truly hope that these people can take the calendar that they have created with us and put it into action once the association is ready for it.  Unfortunately, I don’t get to be here long enough to see what that will look like.  But we have been here long enough to do our job.  We saw the needs of this group of people, and we facilitated a plan to address the problems that they were encountering.  At this point, it will be up to them to put that plan into action.