All That Is Bitter and Sweet (51 page)

Passing defunct cars riddled with bullet holes, we pulled up in front of a stark building and entered a large warehouse space where dozens of prostitutes were playing games with U.S. taxpayers’ money. At least that’s the way Republican senator Tom Coburn from Oklahoma tried to characterize one of PSI’s most successful education programs in a letter to President Bush in 2005. “The project which has been funding these prostitute parties is up for renewal,” Coburn wrote. “There is something seriously askew at USAID when the agency’s response to a dehumanizing and abusive practice that exploits women and young girls is parties and games.” I wholeheartedly agree that prostitution is dehumanizing and abusive. It is gender violence. That is where our agreement ends and the senator’s grave shortsightedness begins. PSI’s initiatives, which are often funded by USAID, do not always represent the social ideal, which is that someday all girls and women will have sufficient education, empowerment, and opportunity to support themselves with dignity, free from violence. In the meantime, while we work toward that dream, the health needs of exploited populations should be addressed. Otherwise we are complicit in their abuse and misery.

What Coburn—who is a doctor, no less!—specifically objected to is a bingolike game called La Lotería, in which prostituted women are given cards with a grid of symbols that represent concepts about their bodies, HIV prevention, and pictures of venereal infections. Peer educators hold up the pictures one by one, explaining how to recognize the symptoms of AIDS and other infections and how to prevent them. The players check to see if they have a match. The first to cover all nine squares with tokens wins a small prize, such as a T-shirt or a strip of condoms. La Lotería and other approaches like it convey serious, essential information in a lighthearted, understandable, and practical format for the undereducated and illiterate. Life is hard enough, and studies show that instruction in these settings is not effective when it is grim and heavy-handed. Plus, one study showed that those who had participated in the program reported 96 percent condom use versus 78 percent for nonparticipants. USAID cut off funding anyway.

I had made that spur-of-the-moment trip to El Salvador the previous November to lobby for this aspect of our programming at a regional AIDS conference. Our efforts there and in Washington persuaded USAID to renew funding for La Lotería throughout Latin America, including the sessions taking place in this crumbling building.

Salma and I took seats at a table with about twenty prostituted women from the rough red-light district who come together for a few moments of relief and fellowship. In addition to La Lotería, they played a game that involved rolling dice and moving around a ragged game board, asking and answering questions about reproductive health. I’m a fanatic about any kind of board game, and Salma and I dove right in and rather hijacked the play, competing to win. Before long, our new friends were telling us the now familiar stories about how the ubiquitous circumstances of extreme poverty, lack of education, and gender inequality had put them on their backs and knees. When I asked them about their dreams, one immediately said she wanted to be a mechanic. Many wanted to have jobs sewing. So much for Senator Coburn’s delusion of carefree “partying prostitutes.” But in spite of the grimmest lives imaginable, they had retained their sense of humor, were outspoken, and had managed to find sisterhood and camaraderie in their ranks.

After a bloody early flight to Managua, during which Salma let me go through her purse, a quirky thing I find really soothing (I do that to my mother and Moyra, too, and it works great at Kentucky basketball games that become too exciting), we cleaned up superfast at our hotel to turn around for a meeting with the president of Nicaragua. We were met by the head of protocol at the National Palace, who escorted us to President Enrique Bolaños’s office, which overlooked a humongous volcanic lake stretching for miles to the hazy horizon.

I was pleased to see that many of Bolaños’s ministers were in attendance, which underscored Nicaragua’s proactive and bold attack on HIV. Although the country is desperately poor, they have the lowest seroprevalence in Central America—less than .2 percent—and seemed determined to keep it that way. Kate, Salma, and I spoke at length with the president, a courtly, white-haired gentleman, about PSI programs and how they impact citizens exponentially when governments cooperate in serving vulnerable and at-risk populations. The government was just inaugurating a five-year strategic plan to step up its response to AIDS in the health care sector and to coordinate programs such as HIV and tuberculosis prevention as a smarter and more efficient use of scarce resources. After we signed a declaration formally and publicly enshrining the administration’s seriousness on the issue, the conversation drifted to more light-hearted topics, such as baseball—a huge sport in this part of the world. I used the opportunity to tell the president about the YouthAIDS mission and how in particular we used local stars from sports, music, film, and television to send out positive, upbeat messages about behavior change and empowered gender dynamics. In fact, our itinerary included a visit to the studios of one of Central America’s most popular TV shows, produced in Managua, where we would join the cast to film a public service announcement.

The meeting with President Bolaños was a huge success, as serious as the meeting with Guatemala’s president Oscar Berger had been farcical. Next, I was eager to put my feet down on Nicaraguan soil and absorb the history of tragedy and redemption that has marked this country’s path into the twenty-first century.

This was a big visit for me, because I came of age politically in the late 1980s, when the end stages of Nicaragua’s Sandinista revolution were playing out. And now I had a chance to walk around and breathe the air at the epicenter of the Sandinista revolt.

While they were in power during the 1980s, the Sandinistas began a countrywide literacy campaign, expanded education, and implemented universal health care programs. In spite of its formidable obstacles, the country still displays benefits from those wise social policies—particularly in the area of HIV education and prevention. For example, prostituted women here have the lowest HIV rates and highest condom compliance in the region. And during our visit we were able to see a remarkable program that educates local and national police about reproductive health. Salma and I witnessed a typical peer education session in which police cadets played their own version of La Lotería. There were quite a few women cadets, just as there had been several women involved in our meeting with the president.

It was heartening to see uniformed service members take their first, baby steps toward gender equality. Men in uniform constitute a cohort that is well known for reinforcing unhelpful notions of what it means to be a man. I believe that it is as equally abusive to men as it is to girls and women to constrain and confine them to behavior and roles dictated by social constructions of gender. I was reminded of the old feminist saw, “For every girl who wants to play football there’s a boy who wants an Easy-Bake oven.” In Nicaragua, women could join the police and win presidential elections, but I wondered if men and boys would ever be able to break out of
their
traditional roles of hypermasculinity in the new Nicaragua.

After years of strife, the country still has a long way to go to realize the open, equal society that seemed so deliciously possible in the early days of the revolution. Human rights abuses have occurred across the political spectrum, there have been reports of corruption, not all of the government’s policies have been beneficial to the people it serves, and patriarchal values still dominate norms. Teen pregnancy is shockingly common, and motherhood, even for girls as young as twelve, is considered the feminine ideal. An equally disappointing development in Nicaragua was a draconian law passed by the national assembly just months after my visit that criminalizes all abortions, even to save the life of the mother. Because of this cruel law, there have been widespread reports of doctors refusing to treat pregnant women with life-threatening complications for fear of being prosecuted if the fetus dies. According to Human Rights Watch, politicians pushed through the law to gain political support from the Catholic Church, which maintains a rock-hard line against all abortion and contraception.

But I was able attend a Catholic mass in Managua that showed another side of the Church, one that embraces the social justice gospel of Jesus known as “liberation theology.” The congregation met in a broad, airy, simple room, filled with a few dozen kids from PSI/Nicaragua’s youth groups, many of whom were HIV-positive. The service reminded me of the Pentecostal churches I so loved at home: charismatic, with joyous singing and clapping and participation from the congregation. Hymns lifted up the little person, the disenfranchised person, who maybe is sleeping on a park bench, or is selling used shoes from a wheelbarrow, or is being beaten by her husband. The songs said that Jesus was coming for that person. I was rapt. When the priest brought me up to speak—a feature of these modern masses—I shared from the pulpit that even though they might regard their church as modest and humble, for me it was awesome (in the true sense of the word). Jesus has always been my favorite radical, and my life is infused with the values they celebrated; in fact, my Christian faith demands I work for social justice and human rights. I still consider that mass one of the highlights of all my work abroad.

Way too early one morning, Salma and I visited the set of
Sexto Sentido
(
Sixth Sense
), a hugely popular television social soap opera that creates thirty episodes a year. The studio was a poured-concrete building, very tidy, the interior walls lined with small painted sets built for each character. They had craft services and were especially proud of their modern air-conditioning. The dressing room was equally neat and shared by the entire large cast. It was a cheerful, sweet experience.

Each of
Sexto Sentido
’s intense story lines revolve around social issues. There is a gay male couple, a girl who has been sexually abused, a hero character who becomes HIV-positive, a virgin who is betrayed after marriage, and more. The stories are forthright and dynamic, and they present both real problems and real solutions, along with dispensing medically accurate reproductive health information. We were there to make cameos and film a public service announcement about HIV prevention. They filmed a bit of an episode, and after the director yelled, “Cut!” (a woman director, unusual even in Hollywood) the camera pulled back to reveal Salma and me sitting with her at the monitor. We then addressed the cameras, trading lines in Spanish, saying that it’s a lot easier to talk about safe sex on TV than it is to practice it consistently in real life, but it’s critically important. The only bad part of the morning was seeing my tired face and that one huge pimple in such close shots on TV and wincing every time I flubbed an especially hard word in Spanish.

I speak Spanish fairly well, and pick up momentum after a few days’ practice, but for some reason I kept tripping over the same words on every take. It was embarrassing to hear the director yell, “
Otra vez!
Again!” over and over. There was a time when I might have been flustered, but the new tools of my recovery helped keep me from overreacting. It was a perfectly imperfect performance. I remembered I could make a mistake without being a mistake, and we all had a good laugh when it was over.