How often do you think about washing your hands?
Probably not that often — it’s a reflex. But for people in rural Nicaragua it’s a basic health skill that’s often overlooked due to a lack of education.
When certified nurse Corrin Berg first visited Los Cardones Ecolodge it was for pleasure, not business. She was taking advantage of the offseason to soak up the sunshine and enjoy great surf, good food and yoga.
“It didn’t take long before they realized I knew something about health care,” Berg said. “You could just see the basic lack of health education. But they just want to learn. They’re like sponges.”
Things we take for granted, like how to wash our hands to prevent the spread of germs, or how to care for a basic burn, are concepts many people in Nicaraguan villages are never exposed to. Because schools are far from many villages and roads are often impassable, fifth grade is a common age to stop going to school.
“I know a little girl who rides her bike probably 4 miles uphill on a dirt road every day to school,” Berg said. “And boys tend to go into the field to work on sugarcane plantations.”
Villagers make do with traditional remedies, like putting mud or cooking oil on a rash. Some treatments work, but others make problems worse.
Before long Berg fell in love with the community and wanted to learn more. After finishing nursing school she returned and eventually founded Salud y Vida, a nonprofit centered on community health workshops. Salud y Vida means “health and life” in Spanish.
Berg is now employed at St. John’s Medical Center in the Living Center and the Primary Care Unit. When she isn’t working overnight shifts at the hospital, she said, the mountains draw her in. In the summer she fishes and hikes. In the winter she skis, and she has recently taken up snowmobiling to get deeper into the woods and hills, something she calls “heavenly.”
Berg leaves Jackson for three weeks in the spring and a full month in the fall for Los Cardones and the surrounding towns. The health clinic participants are all women because they tend to be the caregivers in Nicaraguan culture.
“If you tell these women, it takes a day to get the word out on something,” she said. “They’re always at the town pump, chatting to each other. If we teach one person we hope they teach three more.”
Salud y Vida offers workshops covering basic first aid, illness prevention and treatment, dental health, blood pressure screening and women’s health.
Medical kits are given to the participants so they can apply those health skills in their daily lives. Berg purchases the majority of her supplies at a bulk rate from St. John’s Medical Center so everything is uniform, but some supplies have been donated by local dentists.
Chronic dehydration, which often leads to kidney stress and kidney failure, is something Berg sees often.
“They drink a lot of soda, because it’s less expensive than bottled water,” she said. “It’s common to see a mom with two children picking up a 3-liter bottle of soda for an afternoon snack.”
Berg and her volunteers fill bags of sand to represent the amount of sugar in soda. That amazes the mothers.
“They’ll hold it and say, ‘No!’” she said. “And we’ll nod and say, ‘Si!’”
Something as simple as a plastic water bottle makes a big difference.
“Kids get these water bottles, and it’s like you just gave them a car,” Berg said.
A favorite demonstration of Berg’s is teaching locals how to wash their hands and why. She will mime coughing or sneezing and then use stickers to show how a germ travels. Everyone who gets hit by a germ gets a sticker.
“It really shows that if anyone washed their hands it would’ve stopped,” she said.
Looking for signs of infections is also stressed.
“They’ll get machete wounds from cutting sugarcane and harvesting by hand,” Berg said. “But it’s also used as an everything tool. You scratch your back, you kill an iguana, you make your lunch — all with the same machete.”
Some towns Berg visits don’t have electricity. Many of the shacks have dirt floors, and town pumps provide water. With outhouses behind communal living spaces,“sanitation is always an issue,” she said.
Getting from town to town forces Berg to be creative.
She and her volunteers often travel on horseback because roads are washed out. As a self-described “gringo,” Berg said, she gets pulled over by cops if she’s driving.
In western Nicaragua it’s rare for anyone to own a car. Berg said having a motorbike is a “sign of a higher class,” but some people have bikes, and most get around by foot.
The closest comprehensive clinic is 90 minutes away by car — on good roads. Smaller clinics are about 30 minutes by car, but locals don’t go often.
“To travel by foot to a hospital or a clinic is a whole-day affair,” Berg said. “Everything is based on the condition of the roads.”
Berg has been visiting these towns since 2012, and she’s starting to hear success stories.
“They can’t wait for me to come back to show us what they’ve been working on,” she said.
She remembered one woman who was burned cooking over a fire last year. When Berg returned, the woman rushed over, looking excited.
“She was so proud of her scar and how good it looked,” Berg said. “She ran it under cold water, instead of cooking oil or toothpaste — which takes the burns deeper into the skin — and she didn’t get an infection. She could still take care of her family and she could still use her hand.”
A challenge that Berg and her volunteers face is broaching the topic of women’s health and family planning. Nicaraguans are “very private people,” Berg said, and having these conversations isn’t common.
Berg met a girl who, when she first started menstruating, walked down to the river every day to wash her clothes because she thought she would get in trouble. When she talked to her cousin, her cousin told her she was going to die.
“We’re working on it,” Berg said. “We want to give them the right information and have them talk to their sisters and their daughters.”
Berg wants to continue working with these communities in the future so she can understand their health care needs.
“Some nonprofits in Nicaragua pop in and build a pump or a bridge, and then they’re gone,” she said. “We want to continue to show our face in these communities to build respect and rapport. We started with how to wash hands. Now we are teaching basic anatomy.”
Up next? Tackling chronic disease.
“We have a lot of the same problems,” Berg said. “We all get strep. We all get the flu. We all get pregnant.
“It’s really about empowering them,” she said. “Over time we need to see if there are ways to improve our teaching. How do we get the root of it and education from the bottom up? Shame on us if we don’t.”