The Harsh Reality of HIV/AIDS in Nicaragua

In our time abroad, we received many presentations by those making waves of change for human rights in Nicaragua. One of these remarkable folks was Julio Cesar Mena, an organizer working with HIV and AIDS efforts (ANICP + SIDA). Julio contracted AIDS during a blood transfusion while in the army in 1989. Unfortunately he did not realize he was positive until 1993. He shared a powerfully emotional and vulnerable story of also infecting his girlfriend and his daughter, who passed of AIDS at the age of 8 years old. When he discovered he was positive, medications weren’t yet available in the country of Nicaragua. He had to travel to Guatemala and took 90 pills a day for three years… an astounding 30 pills a meal.

Cesar translating for Julio as he demonstates the 5 pills he takes a day now in comparison to 90.  "I want to continue to struggle. I want to continue to live."

Cesar translating for Julio as he demonstates the 5 pills he takes a day now in comparison to 90.
“I want to continue to struggle. I want to continue to live.”

He was given until 1998 to live but has persevered and works every day to focus on the human rights of those that are HIV positive or are living with AIDS, prevention, education, and to alleviate stigma. Six years ago, he weighed 60 pounds and his meds were $800 a month but are now free. Surprisingly, the current Nicaraguan administration is the first to acknowledge the problem and buys 20% of the medications while the rest are supplied by a global fund (Bill Gates is a larger donor). The movement towards greater inclusion on issues of the virus is greatly rejected by the Catholic and Evangelical churches. The stigma is so great that if one enters the hospital and claims to be HIV positive, they will be systematically served last. One can also be fired for being HIV positive, and commonly are. Julio shared that in Nicaragua, 9/10 families would reject those that are positive. On the Atlantic coast, people believe that just looking at or hugging someone can give them AIDS. As you can see, there is a lot of work to be done.

According to the Ministry of Health, 2 people get infected with HIV in Nicaragua every day. The Ministry also claims that about 10,000 people are HIV positive in Nicaragua but Julio estimates the number are closer to 30 or 40,000. He shared, “Three people died of AIDS last week…mostly because of lack of attention and medicine and sometimes people just give up.” The Ministry of Education refuses to take on the task of AIDS education and prevention measures. Historically 90% of those infected with HIV were men but now a change has swept through and those that are positive are predominantly women (those taking care of the home). Julio claims that like the States, gay males and sex worker populations are at a higher risk of contracting HIV. However, I was surprised to learn that most living positive in Nicaragua are heterosexuals. He shared that most straight people were afraid to come out and the gay community falsely keeps the majority of the stigmatization. The main mode of transmission is via intercourse and there isn’t a lot of maternal transmission to child. I also found it interesting to note that an increase in tourism has added transmission to the sex workers.

The organization that Mr. Mena works for is located in Managua with 320 active members. There are 11 people working in the office that go to the hospitals and provide home visits to those that are ill. They also facilitate workshops and support groups every Thursday. There are 6 satellite offices throughout Nicaragua with 1,120 HIV positive members total. Their program also does outreach to hospitals with pamphlets so that people know where to find them and what services are available. They also work closely with sex workers to teach proper condom use and techniques for negotiations to use them during sexual activity. They also try to work to get youth involved in prevention, a task they’re struggling with. A great inspiration, Julio Cesar Menas has been trying to facilitate greater change by requesting to meet with the government for at least 5 years. His goals are to make the government more inclusive of those that are living with HIV and AIDS in the workforce and to allow participation in production of the country.

A Necessary Perspective of Recent Nicaraguan History

After all of the awe-inspiring and exponentially educational involvements I’ve already experienced in my time here in Nicaragua, our first meeting with journalist María López Vigil remains dominant. Maria eloquently outlined the recent history of the Sandinista Revolution that really gave important perspective to my interactions and outlook in this country.

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The university classroom where we received our lecture

 

The Samoza family withheld one of the longest dictatorships in American history (remember, we’re still in America down here!) for more than four decades. The Somoza Dynasty came into power in 1937 backed by a strong alliance with the United States. With comprehensive control of the National Guard (created by the US Marines), alternative political affiliations were violently banned, sometimes by torture and mass executions. In the 1960’s, an opposition military movement was building by the name of the Sandinista Liberation Front. General Augusto Sandino, a national hero who fought with an army of working class farmers led against the United States military efforts before his death in 1934. He is used as a symbol for the revolution. In July of 1979, Nicaragua became the first country to defeat placed military by organized guerilla efforts despite lack of equal technology and resources. Unfortunately in the 1980’s, civil war broke out once again by La Contra. After 1979, the National Guard fled to neighboring countries and received underhanded funds from the United States Government. Maria quoted 50,00 were killed, 100,000 were misplaced, and thousands were orphaned by this civil war. In 1990 during multiple party elections, the Sandinista Party surprisingly lost although it afforded Nicaragua so many new opportunities (such as a focus on a health care system and literacy). “The same generation that overthrew a dictatorship with guns overthrew another with votes… There is a strong collective memory and trauma from civil war here; fighting your brothers, sisters, and neighbors,” expressed Ms. López Vigil.

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Sandino as a symbol for La Revolucion

 

Maria also spoke candidly about the current state of the government by President Daniel Ortega. Nicaragua has moved on to a more neoliberal government where the focus is dominantly focused on the economy rather than the people that make up this beautiful country. There are also strong issues with freedom of the press. The Samoza Family utilized heavy censorship but Maria put it elegantly when describing the Ortega take on information, “They don’t censor, they buy.” The Ortega family has instead bought most of the TV channels, radio stations, and local newspapers. Nicaraguans are also fighting to keep the internet public with great opposition from corporate enterprise that would be directly affected. I asked Maria how people in Nicaragua feel about voting and its effects. Due to election fraud, people are apathetic to voting and therefore don’t bother. “It’s either weapons or votes and votes don’t do anything. Many people in Nicaragua know how to use weapons but that doesn’t get us anywhere. People are afraid war will come back so they are passive.” There is also a huge political struggle against the possible building of a canal via the San Juan River in the south up to Lake Nicaragua, a massive effort that would mark the largest infrastructure in Central America. A Chinese business claims they can complete the canal in just 5 years time and will pay $10 million to the Nica government for 100 years for the business offer. Lake Nicaragua shares the border with Costa Rica and holds the largest biodiversity on this continent. Many international scientists have weighed in on the environmental effects and there have been at least 45 marches and protests in opposition to the building of this canal.

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Another Sandino statue with fresh cut flowers seen later that day near the Managua Old Cathedral

 

When first setting sights on the Nicaraguan landscape of the city, I was alarmed by the amount of gates, fences, and walls I saw creating so many borders. I didn’t understand the use of armed guards in front of buildings and armed men hanging out of jeeps that I couldn’t differentiate between police and military. Without this background of recent Nicaraguan politics, I wouldn’t have had the proper perspective that is imperative for a non-native and especially one from the United States. Maria López Vigil told my classmates and myself that “with your privilege comes more responsibility.” We aren’t coming into Nicaragua to try to help, we are here to transform the country we come from. In this culture there is a great admiration of blanco skin and hair (expressed not only by the residents but by their lack of people of color in their advertisements), denoting extreme cultural power. This has been a message of many of our acquaintances in our time here, to keep the story of Nicaragua with us and to take it home. Hearing these stories sat very heavy on my heart but again, Maria López Vigil laid it out luminously.

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Maria López Vigil

 

“Optimism is optimism because it is lacking information. Pessimism in your mind, optimism in your heart.”