MANOS officially began with a guided readings course in March 2006 during which four students traveled with an NGO on a medical trip to Costa Rica. Later in the spring, MANOS identified “El Mojon” in the northern department of Madriz as a location to concentrate our efforts. A student, Ben Winer ‘08, traveled in August 2006 to collect descriptive information on the site. In the fall of 2006, students decided to provide a medical clinic.
In March 2007, eleven students and Dr. Aday traveled to Cuje and set up a clinic for four days with Dr. Roger Martinez from Managua. In May 2007, four students traveled to Cuje to pursue further research on nutrition and geography. In fall of 2007, students were officially registered for an independent readings course. MANOS adopts two mantras: “good intentions are dangerous things” and “every helping act is a political decision.”
In March 2008, for the second year of the clinic, Dr. Mark Ryan from SOMOS assisted Dr. Roger in providing medical consultations at the outpost and at schools. Team members collected data on distribution of water sources and interviewed brigadistas. In late spring, a decision was made to officially move away from service learning toward a project grounded in social theory and methods. In May 2008, students attempted to map the community but returned to the US without success; another member collected information on nutrition.
In March 2009, MANOS held a clinic and conducted interviews on-site. The team conducted its first round of social network analysis. In May 2009, five students conducted library research on various topics to provide background information. The team decided to focus efforts in Chaguite while still providing a clinic to the other communities.
In March 2010, the team held interviews at the clinic. In Chaguite, we asked about health concerns to better understand which could be solved through partnership with the community and inquired about social structures. CPC interviews were held to ask them about their role in the community. GPS coordinates were taken and relationships with the resident doctor and INPRHU were further developed. In May 2010, eight students returned to Nicaragua to conduct research projects.
In March 2011, MANOS introduced Medical Passports to the clinic and used a roving doctor for the first time. We held household level interviews about participation, leadership, and communication (social network analysis) and updated GPS data. MANOS met with Dra. Tellez from MINSA and toured INPRHU’s facilities. Additionally, Jackie R. pursued a personal research project that focused on plan parto (planning out a birth), contraception distribution, and new brigadistas. In May 2011, the team held the first focus group interviews; four groups created executive boards. Jackie G. conducted research on education.
On the March 2014 trip, MANOS held meetings with each of the five focus groups and two community meetings in which the community reviewed the Five Year Plan, and the community members brought up concerns of communication throughout the community and with the team, especially. Phones were discussed extensively in both community meetings and increasing communication across focus groups, and that central locations for meetings are ideal because it is more inclusive. given the new partnership with EWB. Many conversations revolved around the idea of participation, but the term seemed to be too abstract to effectively resonate so other ways of communicating that same idea were used.
On the May 2014 trip, We arrived in the community with the intention of presenting the map data to the community and receive feedback on what to include on the map as well as how to develop inclusive practices for research within the community. It was also important to address MANOS’ changing relationship with the community, redefine leadership goals and expectations, and establish effective communication between EWB and the community. The community provided feedback on the map and noted to include central point in the community, such as the well, other communal water sources, and clearly marked houses with details indicating roof type, FG, etc.
This was the last March trip that MANOS sent the whole team; we were accompanied by Professor Lamb from EWB. We did not provide a clinic; instead we had medical efforts focused on prevention and distributed vitamins, suero, and chloro. Charlas focusing on water safety were led by a nurse and nutributter was distributed to pregnant women within each community. While the charlas were being held, MANOS roved throughout other communities and held exploratory interviews house to house to get a better understanding of each community’s health concerns and geography. We inquired about any ongoing community projects, partnerships with organizations, and gathered census information (how many households in your community, and people per household). In Chaguite we informed the community that EWB would not be travelling this spring. In focus group meetings we discussed a smaller-scale project and how to make it inclusive. We presented the map updated from community members’ inputs in December.
On our May trip, 5 community members were decided on at a community meeting to accompany 2 MANOS members down the mountain to Ocotal. There was representation from each focus group and emphasis was placed on females because they would be using the tanks more often in the household. We went to a few plastic stores and hardware stores and ended up with two tank options. The blue tank was objectively better but they brought it back to the community in a meeting where everyone voted on it as opposed to a different tank. We then bought the tanks from the hardware store and had them delivered. We used the maps that were created and in each focus group meeting confirmed the list of families so we knew how many tanks to buy.
During the winter trip, community members collected information for EWB about potential water projects and household water usage (data is referred to as the “diagnostico”).
This was the first March trip that MANOS did not send the whole team and the first March with no clinic. Community members listed projects that would increase their access to water and prioritized them in sequential stages at the second community meeting. During our focus group and community meetings we asked community members to list past projects and discuss problems with those projects so that the same problems would not come up in the future. Additionally, we followed up on the materials list that had been drafted during our January trip by reviewing the list at the community level and also by traveling with community members to get price estimates for the different materials. EWB and the community will discuss potential projects in order to make a plan for implementation.
In May, MANOS spoke with individuals at the focus group, community and individual level, and learned that there was not consensus about how limited resources should be allocated. There was a lack of different opinions voiced at FG meetings (only >50% of households in FGs were represented at the meetings), people with opposing opinions did not attend FG meetings. We heard from some voices – but not all – about ways to prioritize the roof project moving forward. The dominant suggestion voiced at FG meetings was to continue with the same resources as were provided in “Phase 1” of the project, only giving them to different families. We began to ask about next steps in terms of financial contribution, but only got suggestions for how MANOS could send further funds to Chaguite, and not about financial contributions of community members. We learned that certain community members understood that our phone calls were decision-making calls; learned that MANOS and Chaguite had different understandings of what had been discussed during those calls.
MANOS completed interview schedules for DTRA, SNA, community banking, and women’s roles. We created a community vocabulary dictionary surrounding water sources and containers. We also got lists of community groups, NGOs, and government projects that are involved in the community or the region. We also implemented another phase of the roof project and clarified the roles of the JD and WC with regards to each other and the community.