César and Citizenship

I just returned from a meeting at la Universidad Nacional de Bogotá, a prestigious public university in Bogotá.  I went to meet with César, an Anthropologist and Public Health professor there and the author of Itinerarios Burocráticos.  The university had a typical sprawling campus with various squares and greens with students reading, rolling cigarettes, protesting and playing the guitar.  The buildings were all names of well-known revolutionaries with the Plaza Guevara as the central meeting point.

We met in the cafeteria and César treated me to jugo de Feijao (green fruit that tastes kind of like a kiwi).  César looks kind of like my father and has similar mannerisms, so I immediately felt comfortable with him. I wanted to talk to him about researching in Colombia and the ethical questions that pertain to using human subjects.  Unlike the US, there is no Institutional Review Board, but there are different ethical committees depending on where the research is to be published and who the researcher affiliates with.  I have no idea where/if I will publish, but César gave me some names of university and health publications and also intellectual magazines like Malpensante (The New Yorker equivalent) and Nueva Caseta.  I think that the language/style I use for my research will help determine where I will try to publish.  Obviously the important question is: Why publish? For whom? Who does it benefit?  Right now, I would just like to make my research useful for the population I am interviewing. Unfortunately, it will not change their personal situations in any way, but perhaps the article could promote awareness for the NGO’s that are providing them care and help increase funding for these NGO’s.

César helped illuminate one of the central problems of the health system: it assumes that all people living in Colombia consider themselves citizens and understand what citizenship entails.  This assumption forces the subject to play by the rules of citizenship or die.  Legislation, then, is a strategy of social cleansing.  How can street people operate in the health system if they are considered to be outside of the law?  Do street people think they have the right to be attended to at the hospital? Some important questions to ask my interviewees (street people, drug users, sex workers, and transvestites) might be:

“Are you Colombian?”

“What does it mean to be Colombian?”

“Do you consider yourself a Colombian citizen?”

“If so, do you feel like you have certain rights as a citizen?”

“What rights do you feel entitled to?”

“Do you feel like you have a right to health?”

César told me that when he was conducting interviews for his research on barriers in access to healthcare, he sometimes would ask his subjects, “Where are you from? Colombia?” and they might reply, “No I’m not from Colombia, I’m from La Pedrera (little city in Southern Colombia).” In other words, they didn’t have a concept of national, territorial identity, inherent in the concept of citizenship.  Or perhaps they didn’t believe in this notion of citizenship and belonging to the state.

But when people don’t see themselves as part of the system, because they can’t find a job, or don’t vote or engage in illegal actions, they often don’t think they have a right to demand for healthcare (even though it is usually the structure of the system that creates and reproduces their conditions).  If the healthcare system refuses to give an appointment, or pay for necessary post-operational physical therapy, would these street people conceive of taking legal action if they have no concept of citizenship? What type of knowledge does engaging in “legal action” require? In reality, it is not simply a notion of right or wrong, but rather the perception of the individual’s power vis-à-vis the state.   A street person, unaware of the rights of the citizen, feels powerless and stays sick. Slowly the system kills off these outliers. I will try and see if these ideas are consistent with reality in my interviews. Based on the stories I have heard so far, they seem all too true.

Like Dr. T and Timothy, César is yet another inspirational thinker I have been lucky to meet here. I left the Universidad Nacional with an energy I remembered feeling in college after an incredible lecture. In Plaza Guevara, clubs were making jewelry, planning political strategies and selling food and burnt DVDs. To cope with my nostalgia, and feel part of the university world, I bought a buckwheat flour arepa and a copy of SICKO.

 

 

First Day at Work

Today I went to the Parche.  The Parche recently changed locations, so this morning we walked around the neighborhood fetching children who might want to attend the alphabetization workshop.  The people that live in the Santa Fé area, where the Parche is located, generally live in utmost squalor.  

We turned onto cracked streets and knocked on doors inside smelly, dumpy apartment buildings.  The smell was a mixture of excrement and weed. First, a woman answered with a big smile and a naked little boy behind her.  I peered inside her living space and couldn’t understand how smiley she could be when the ceilings were nearly collapsing and the only light peaking into the room came through a greasy, splintered, window.  “Si! Take Miguel Angel!” she exclaimed as her other little boy wandered up the apartment building steps with a notebook and pencil in hand. Today, because the mother had to take care of her youngest one, Miguel Angel could not be accompanied to school, instead, he would come read stories in the Parche.

This boy was truly an angel.  He had huge eyes with long eyelashes and a quiet, innocent demeanor. “Tengo cuatr-lo años,” he said, rolling his r into an l and holding up four wrinkly fingers.  We started talking about the jungle and things you could find in it, like the parrot on his notebook.   I waited outside with him while Dr. T. knocked on more doors.  We headed back to the Parche, passing prostitutes of all sorts, a few cripples and many stragglers. I tried to imagine being this child…what was his concept of safety and comfort? What did his surroundings mean to him? How much does a four year-old understand about danger?   How might this shape his concept of “future” when he grows up?

We headed into the Parche and met the other kids. We split the kids up into mini groups each with a story in hand. I had Johan and Angie, a brother and sister, ten and eleven. “Saben leer?” I asked them. “No,” They answered together. So I began to read about Alice in Wonderland and their new years resolutions, Mickey and his roller skates and Pooh and the lost baby kangaroo. Now and then I’d ask them a word and they would sound it out perfectly. They DID know how to LEARN how to read. They also told me back the stories in perfect detail so excitedly…I had thought that they might get discouraged if they couldn’t read the words. On the contrary, they were eager to sound words out.

After everyone had read their stories we all came together to paint our favorite parts. The kids helped each other; the big kids opened the paints and showed the littler ones how to avoid big blobby drips on the paper. “Ella no sabe nada!” Miguel Angel cried, pointing to the teeny three year-old beside him.  I looked at her smiley face and noticed that all she could say was “Sí!” and smile, like a baby. “Pués, ayúdale y enseñale!” I cried back. But it seemed like she couldn’t follow anything he tried to show her. On our way to the Parche, Dr. T had told me that many of the babies born in this area spend a lot of their babyhood in the hospital with respiratory infections and asthma due to the lead in the paint and the poor air quality in the apartments.  Lack of oxygen to the brain obviously leads to cognitive impairment. How much damage had been done to her cognitive capabilities?  And could she recover if she kept living in these conditions? (picture a closet and then four people living in it. That was her home).  The importance of adequate housing for positive health/development was further illuminated when I went to the Proniño foundation to teach English.

Proniño is in another barrio called Patio Bonito. When I got off the Transmilenio Bus (really effective public transport, but a nightmare in rush hour!), I was hurled backward by the wind and noise. Rickshaws and donkeys sped around me creating clouds of dust.  Proniño was a few dirt roads away, tucked in between a tire shop and a split-level, brick apartment compound. When I walked in, two kids were gobbling up their chicken, beans and rice at the table. They told me with gestures and noises, not daring to open their full mouths, that my class was waiting for me upstairs.

I began to sweat a little, then slowly crept upstairs not knowing who or what was waiting for me…for some reason I had thought that I had taught English before, but as I climbed up each stair, I realized that I had only tutored French and Spanish. How long would I have to draw out “How are youuuuu?” to make my lesson last 2 hours and a half? I pushed open the door and saw six students (three girls and three boys on opposite sides of the room of course) leaning back in their white, plastic chairs. Oh! Six! Not bad at all…but then ten…oh twenty…hmmm. Twenty pairs of eyes staring right up at me!

I had no time to think. Suddenly we were going around the room saying our names, where we were from, what we liked to do and what we’d like to be when we grew up. They were silly and enthusiastic. We played a game that Hannah taught me to learn body parts, sticking colored cards with the English word on each part.  My fourteen year-old volunteer helper, Tatiana, screeched with laughter as she covered her eyes and nose with the cards.  Although my voice had turned completely hoarse by the end, I was amazed to see how fast it went by.

At the end of class, a group of the kids surrounded me, asking questions about the difference between “didn’t” and “do not” and other random vocabulary words. One of the talk-all-the-time boys asked me “how to say, asesino?” At first I kind of shook my head and told him we weren’t learning that now, but then I thought again, why not? How would not knowing the word change anything? It wasn’t that surprising that a teenage boy would want to learn the word for assassin. Then Jason, the oldest and most mature looking of the bunch gave me a hard stare and asked, “Y cómo se dice, ‘gente de la calle’?” I told him “street people” and ended class.  As they walked out, they said, “Bye TEECHER!” and I was left with scattered plastic chairs and empty milk bags on the floor.

One of the other teachers at Proniño walked me back to the Transmilenio and told me about the workshop he was leading for the kids. “Se llama ‘Valores.’” The workshop was inspired by the suicide of a thirteen year-old several months ago. In the workshop, the kids are supposed imagine receiving a phone call from a friend who is saying he wants to commit suicide and then respond to him in a letter telling him why he might reconsider.  The kids need to know their worth, he told me. But we also do this by playing fun games too! Like learning guitar and making art.  We kissed goodbye and I hopped onto to the long red bus, thinking about how learning English might help a street kid feel worth it.

 

Sex-ed Made Fun

 Today was a perfect example of Fenix’s effectiveness and success.  Two of the Fenix girls, in nursing school, led workshop on Family Planning and sexual health.  There were about ten Fenix girls who attended, along with boyfriends, siblings, volunteers and some others (perhaps students or potential Fenix beneficiaries?). 

The workshop started with basic female and male sexual anatomy.  It was a great feeling to be learning along with the other girls. My “elite, privileged” liberal arts education did not make me any more knowledgeable than the some of the girls around me who have had disrupted education due to abuse, displacement, prostitution etc.   My interest in the subject also reassured me a bit more about medschool since this is really the only type of human anatomy study I have done in a long time (aya!).

We discussed contraception and I learned about the Norplant.  I had never heard about this contraception and was so happy to discover D’s (a Fenix girl training to be an orthodontist’s assistant) experience with it.  The Norplant is a form of contraception that looks like two matchsticks and is implanted under the skin on the upper, inner arm.  It works from 3 to 5 years (secreting reproductive hormones) before it needs to be replaced.  D. walked around the room and let us all feel it (it feels sort of like a small scar), while we all asked questions and scribbled down notes excitedly about this option. 

The Norplant (and other contraceptives like birth control) is absolutely free in Colombia. Timothy read the state-written law declaring the Norplant free for Colombians (not sure if this includes minors or not…). Apparently, some employees refuse to offer it for free since it is costly for the hospital. The reading was a way to show the girls that they need to assert their rights to health. In the case where they might be refused the contraception, Timothy encouraged them have a copy of the law with them to pressure the employee and threaten to press charges. The workshop synchronized the key aspects of sustainable outreach: Health, Education, Rights (HER!).

We also reviewed the various abuelita myths about contraception methods. Some of them, like the “Billing test,” I had never heard of.   It is said that when you are most fertile, your discharge is more sticky and can be stretched like a bubble or mucus between two fingers. Of course this is a MYTH, but it is strange/interesting (for some reason this often means the same thing to me…) to think that decades ago, and still people today, might test their discharge and say “OH! We probably shouldn’t do it today honey unless you want to have a baby.” Another one was the idea that when your temperature rises by 1 degree centigrade when you are most fertile.  I wondered how many of these girls had heard these stories or if they had tried these tricks before.  The myths were a great way to lighten up the workshop with humor.

After it was over, one of the girls told my director Timothy and fellow Fenix volunteer Rosie that she didn’t want to leave.  She lives with her “aburrido/abusivo” boyfriend because she has no other home…it was a bitter sweet comment that only heightened the importance of the workshop, but also showed its limitations. Effective family planning requires a positive relationship with a partner…how could she apply what she learned if her boyfriend refused to listen? And might she be afraid that he would throw her out if she tried to assert herself? Her only solution seems to be to move out, but for this, she needs plata… 

Would a sex worker go to church?

Woke myself up again sneezing twelve times. In polluted cities, sneezing is the rousing rooster. Then I took my first shower in my apartment…it called for a “would you rather” question: would you rather have a trickle of HOT water or a strong FLOW of cold water? These are showers that choose to save energy when they feel pooped out, turning off every 3 minutes or so…ah well, still emerged with a clean head.

Today I met with Amy, a PHD Fulbright scholar and Fenix volunteer who is researching everyday lives of street girls. She has become close enough to the some of the street girls here and transvestites to go out dancing with them. Her research is based on participatory observation where she gains insight on the girls’ lives by hanging out with them (in addition to interviews and street outreach).  Amy has been here since 2008 and knows so much on street life function. 

On the bus ride to the center, I asked her some of the burning questions I had.  For example, when I went on the street the other day, I didn’t see any pimps.  Apparently, the type or presence of the pimp depends on where the sex worker is prostituting herself and her age.  Most of the minors that hang around la Mariposa (a huge blue, somewhat cubist, statue of a butterfly in one of the center’s squares) don’t have pimps at all. Some of them are there on their own accord and some are there because their mothers sold them into prostitution.  The minors can charge a lot because they are “fresh.” In some cases the prostitutes have husbands that send them out to the streets and tap into their revenue.  The more commonly known “pimp” tends to be associated with more established brothels.  These brothels run off drug money that is also used to bribe the police. 

We got off the bus at la Mariposa to observe the city’s main site of minor prostitution and see if any of Amy’s girls were there. We passed a tree by the road and Amy told me this tree was called “La oficina.” The office? The lesbian sex workers often congregate here.  We met two girls, not looking so young, and one of them greeted me with an extra polite speech.  We chatted and she started to complain that the “Patio” (a Christian foundation/homeless day shelter offering meals, a space to wash clothes etc.) was forcing the girls to go to church for Easter.  Ha! Amy and I both laughed.  Then I wondered: What is the relationship these girls have with religion?

On one hand, the church chastises them, but on the other, church related foundations provide them much needed help. Furthermore, many of these girls were raised Catholic and believe in god.  Amy explained that god is a part of their everyday lives…many of their expressions end with “Si dios quiere” (But how much does one actually think about god when saying “god willing?”…Still, using “god” in language indicates a sort of socialized relationship with religion).  It must be that this girl does not want to be told what to do, particularly if going to church is an attempt to “save” her as she knows it will not. Has the church ever really saved anyone?

And what about transvestites? The Catholic Church condemns them here and associates them with P y P, “Puta o Peluqueria” (see Amy’s blog). After Wanda Fox, a “trans” activist in sexual empowerment for transgender / transvestites with Zona Trans (here they just say “trans” so I’m not sure they differentiate between transgender and transvestites) was murdered, her trans friends had a priest perform the memorial ceremony on the street at the site of the murder.  Amy reports that they were all praying at the site. In this instance, there is an obvious separation made between religion and spirituality and religion and the state. Religion is called upon in a time of struggle as an all-forgiving arc of support…it is an extra source of energy and inspiration. The trans individual’s relationship with religion is direct; it does not pass through the state.  These are purely suggestions to try to make sense of the contradictions that riddle questions of religion and sexuality…

 

 

 

 

 

Cracks and Crack

We trot down 19th street taking turns tripping over tree roots that bust up the sidewalk: “Nature asserting itself,” Rosie remarks. The farther south we go, the larger the cracks become. Looking down, I see the cracks become dog-size, forming homes for parched beasts and empty corn chips bags. Suddenly, we are there.

            Tim turns left and we follow.  And there, on the corner, is the first prostitute I shake hands with while on the job.  At first, I wonder if she feels like this is an annoyance, that we are disturbing her work. Then, Timothy takes her by the hand and tells her how he remembers her when she was “chiquitica.” How has she been? Her shoulders roll down her back and she smiles. She tells us that, ay si, todavia igual, lo mismo. “You know that you can do something else if you want or you can come talk to us if you want, right?” She answers “Si,” greatfully accepting the condom, lubricant and shoulder squeeze. This is Fenix street outreach: intimacy, honesty, and empathy.

            We pass white boots and painted eyebrows, fried pig ears on oiled bread, and make our way towards “El Parche.” El Parche is one of PROCREAR’s efforts to create a space where the city’s “desechables” (prostitutes, transvestites, street kids) can seek medical consultation and attend workshops (in literacy, art, street activism etc). The word “Parche” comes from “Patch,” as in territory, or patch of land. Instead of referring to the place where they live as a “home,” it is a patch, an understood section of the neighborhood. Patch became “Parche.” “Parchando” became the term for going out as a group in the patch, or doing streetwork. 

A small, smiling lady greets us at the door and ushers us in. This is T. The “wonder woman” doctor who treats anyone and writes amazingly detailed case histories, according to Timothy. The meeting is highly energized. T. is excited about the prospect of conducting research in barriers in access to healthcare amongst the population she sees.  My case histories will be perfect for your work! She says. How many times has she seen patients who say that they will no longer try to go to the state hospitals because of the endless lines, or the unhelpful employees who refuse to treat them because they are missing some particular insurance paper that they have never heard of.  Timothy jumps in: This is the perfect question for your research! This is what you have to ask the people who come to El Parche: “Why are you here and not at the state hospitals?” This question inevitably raises the point of barriers. I need to find out exactly what are the conditions that these vulnerable populations are subjected to when they try to seek medical care. How do these barriers contribute to an increase in HIV transmission?  Timothy showed me a frightening article in EL TIEMPO (the main newspaper here) from February 2010 stating an increase HIV cases from 1 to 50 in minors over the past year. We want to figure out why…

T is in a rush and leads us over to the Procrear base a few blocks away. Some of the Fenix girls (check out Fenix website, it’s the main organization I am working with http://fenix.org.uk/), are organizing for street outreach.  The flyers they distribute are hilarious. They use word plays on vulgar street language to get sexual/anti-drug messages across. For example: "Pichas por Bichas? Pilas con el bicho!" translation: a fuck for crack? Beware of the bug (HIV)! This translation seems STRONG and crass, but this is exactly what catches the street workers eye; these flyers speak THEIR language. They are also written in soft, attractive and warm colors, such as orange and blue, as opposed to aggressive, fear-inspiring colors like red and black. Condoms, KY, and flyers in hand, we head out to 16 and Santa Fe, some of the major prostitution zones.

We pass a young man H. who nods at Timothy and waves him over. Hmmm…is he trying to deal drugs to Timothy? I wait a couple of moments and suddenly, H exclaims: aqui esta mi bebe! H’s girlfriend strolls over to us with a responsive and healthy looking baby. I can’t believe that we are meeting a baby and parents while prostitutes/drug dealers hang around us! As we wave goodbye to them, Timothy tells me about the mother. S. was a highly active prostitute, “The baby might be the one thing that saves her.” I start to realize some of my own judgments…I couldn’t imagine a sweet-faced, young, mother to be a prostitute.  But this must be exactly what Timothy wants me to see: prostitutes have babies and boyfriends. They are human (this may sound obvious, but I think that when people think of “prostitutes” they don’t imagine a person, but rather an object for sex. This is not to say that I think this, but rather I hadn’t imagined a potential life a prostitute might have outside her profession.)

Meanwhile, across the street, 4 bombshell transvestite prostitutes, more beautiful than the surrounding born female prostitutes, shake their bodies (mostly plasticized) in front of SUVs that roll by. A., a transvestite that does outreach with us watches them and quietly compares her small breasts to theirs…Could you give me some sunblock? she asks, “I just got my laser treatment done.” Does A. envy these transvestite prostitutes who have attained the ultimate contemporary image of “female” beauty (big breasts, tight booty, flat stomach, long legs, voluptuous lips, curly lashes and long, soft hair)? How much is the body part of transvestite identity? If body=identity, then does a price tag on the body make the identity more straightforward, particularly if it is a high price?

Up to here, I feel strangely comfortable (considering the circumstances)…I haven’t seen any clients approach the prostitutes and more and more smile at us. They seem to all know Timothy and appreciate the work Fenix is doing. I turn to my left and there is a girl, probably 18 years old just getting a fresh tattoo in the street. Hepatitis anyone? She walks over to us while Timothy is talking to minor and seeing if she might want a different option than prostituting herself. The freshly tattooed girl’s eyes wander about as she sniffs glue out of an old “DETOX yogurt” cup. This is the moment when the reality of the place, of the lifestyle hits me. I feel something break inside me and start to tear up. This is the misery here. The girls prostitute themselves for drugs, and the vicious cycle continues…

Walking out of the 16th I see a chicken’s head dried up on the sidewalk. I am ready to go to my colleague Rosie’s cozy apartment and have some tea. This has been a lot in one day. 

Here I Am

Perhaps a first blog entry is meant to be introductory; I’ll try. I have only been here for a week and already feel as if a month has gone by. Along with a felt month of time is a felt month of information/experience I've been exposed to since I've arrived. In a nutshell, I am working with Fenix (http://fenix.org.uk/). Fenix aims to prepare vulnerable young women (victims of sexual abuse and/or neglect, former sex workers etc.) to enter social and health science professions. This organization works side by side with Procrear, another Bogotà based NGO that focuses on health/social intervention through outreach in vulnerable populations (prostitutes, transvestites, street people). My involvement in these NGO's is a developing process.

Here I sit in the studio I just moved into, thinking this is probably the nicest studio I'll ever live in!  I lived the first week here with my supervisor/director Timothy who showed me the ropes (i.e the best antique/junk shops around Bogotà and where to find organic artichokes) and shared some incredible stories about covering the drug war (he was a photojournalist in the 80's, making the cover of Newsweek and Time before becoming a nurse and a million other things).  Mainly, by living with Timothy, I understood Fenix’s central value: care.

I wrote the next entry last week after my first day observing street outreach.