“How can I prevent pregnancy?” and “What actually is HIV?”. For the rural population of Nicaragua, finding answers to questions such as these is not easy. In the Central American state, education about sexual health is almost an alien concept. Nor is it easy getting access to contraception. Some 20 per cent of women in rural areas have no access to contraceptives. Against this background, it is hardly surprising that many young women experience unwanted pregnancy. The risk of them dying in childbirth is also significantly higher than the national average.
Domestic violence is widespread
Knowing about sexual health and reproduction is vital when taking care of one’s own health and making conscious decisions about family planning. In the second phase of SWISSAID’s project promoting the sexual health of women and young people in Nicaragua, emphasis is also placed on educating participants – both male and female – in regard to their sexual rights. This is a desperate necessity: official reports show that 48 per cent of married women, or women in relationships, have experienced an incident of psychological abuse by their partner or ex-partner, while 27 per cent are victims of physical violence and 13 per cent have been sexually abused.
Instances of sexually transmitted diseases are increasing
Although cases of HIV and AIDS are increasing, the people of Nicaragua are largely ignorant about the risks of STDs. There is no medical screening for breast, cervical or prostrate cancer – check-ups are too expensive, hospitals are too far away and the subject is just too “embarrassing”. Husbands therefore tend to forbid visits to a doctor. But many diseases could be identified and treated early through regular check-ups.
To raise awareness and break down taboos about sexual health issues, SWISSAID works together with nine local organisations to train people as “promoters”. These experts are qualified under this project and impart their newly acquired knowledge to the local population, encouraging people to take responsibility for their own health. They know where victims of domestic violence can get help and also ensure that men are involved in family planning. They encourage men and women to make use of the offer of a free cancer check-up as part of this project – and like 46-year-old Bertha, they themselves set a good example for others.
Life-saving cancer check-up
Bertita, as her friends and family call this fun-loving woman, is a committed and determined activist for women’s rights. But her tireless commitment caused her to neglect her own health. Until she became a promoter for sexual health and reproduction, she had never had a cervical smear test. The positive diagnosis was a real blow and she began to experience feelings of denial, anger and fear. After managing to get the money together, she had a hysterectomy and her diseased ovaries were removed. “If I had not been diagnosed early with cancer, I would have died,” she said with obvious relief. But the operation was not easy for this lively woman to cope with. Bertha was grateful for the support and psychological guidance that the project team also offered her after the operation.
Not a unique case
Giving up her work as a promoter after recovering from the operation was never an option for Bertha. However, she did realise she had to pay more attention to her own health: “I survived cancer. Now, I take better care of myself and live my life by listening more to my own needs.”
Bertha’s story is not unique. Many women have never had a cervical smear test or a mammogram for breast cancer. The situation is even worse for check-ups for prostrate cancer in men. The promoter welcomes the fact that people are now being given the opportunity to have free health checks.
- Project code: NC 2/12/07
- Duration: until 2014
- Costs: 102'493 Swiss francs