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Neighbors Helping Neighbors: DGH in Managua By Jennifer Perry

Amidst the noisy, dusty streets of Nicaragua's capital city, Managua, exists a small haven where children dance and sing and learn. This place, tucked discreetly off a main thoroughfare, is Barrio Edgard Lang.

The barrio's (neighborhood's) dirt paths and tin homes contrast sharply in comparison to the surrounding brick and cement urban homes. Cars barely pass through the narrow "streets" of the barrio. Bikes and feet are the transport of choice. Chickens roam the dirt pathways and neighbors watch the pedestrian traffic from their plastic chairs set outside their homes. The distant delighted shrieks of children can be heard coming from the green park in the center of the neighborhood.

“The community center's logo is a turtle walking proudly and determinedly, with legs, head and tail all well out of its shell, thinking: "Only by sticking your neck out can you take steps forward!"”

Barrio Edgard Lang was not always a center of positive growth and community. This very poor neighborhood in Managua has about 270 houses, with several families living in each house, for a population of about 2,000.

In 1988 a Canadian nun who was working in the neighborhood helped by raising funds to build a community center on community land (a concept instituted by the Sandinista government), but she did not have title to the land. Over the years the center was pretty much abandoned. As violence and alcoholism in the community escalated, keeping children from playing safely outside, neighborhood residents decided to take action. They formed APROPOCACO (Asociación de Promoción Popular Casa Comunal), a neighborhood "watchdog" group whose aim was to help their fellow neighbors lead a dignified life. One need they saw was for a community center. This project became the focus of their work, so they took over the abandoned community building.

Neighborhood children attend classes in the barrio's community center.

Sometime after the Sandinistas lost power, the local Catholic parish tried to take over the community center, but the community did not agree. They fought back by demonstrating to the government that APROPOCACO had been actively working in it and they then got rights to the land.

Thanks to their hard work, this "C" shaped building now houses a children's library, a preschool classroom, a typing and computer classroom, and a medical clinic. In the adjoining dirt courtyard are benches and chairs for meetings, and swings for play. The center is always bustling-be it mid-week or weekend, morning or late afternoon.

During vacations from school, the center offers youth-led programs on issues such as cooperation, self-esteem, respect and alternatives to violence. High school students take turns teaching the younger children as well as participating in their own self-facilitated group discussions. Although children are the primary participants in many of the center's activities, classes are also held for adults in the evenings in typing, computers, and arts and crafts.

DGH board members first visited Barrio Edgard Lang in October 2001 and were given a tour of the center's services and an overview of how they work. The library is free for anyone who wants to come, but it is not a lending library; books must be read on the premises. The pre-school teaches 50 children in two shifts. They have two teachers (one for each shift) and three grades (1st and 2nd in the morning and 3rd in the afternoon). The children pay a minimal monthly fee, which goes for a small salary for the teachers, but no child is turned away for not being able to pay. The teachers are young women from the same community who are studying at the public university. For income, they also rent out the center for private parties on weekend nights.

During this visit, one of APROPOCACO's board members, a 17-year old barrio resident, proudly pointed to a large drawing of a turtle they have hanging on the wall. She explained that this is APROPOCACO's logo. In the drawing the turtle is walking proudly and determinedly, with legs, head and tail all well out of its shell, thinking: "¡Solo sacando el pescueso se dan pasos adelante!" ("Only by sticking your neck out can you take steps forward!").

Barrio Children playing in front of the community center ask that their photo be taken.

APROPOCACO logo saying: "Only by sticking your neck out can you take steps forward!"

APROPOCACO board members with Father Hébert at the Barrio Edgard Lang Community Center.

APROPOCACO explained to DGH that the community's greatest unmet need was access to affordable health care services. So, with encouragement and assistance from DGH board member and Nicaraguan project coordinator, Dr. George Pauk, they submitted a project proposal to DGH requesting financial assistance and expertise to open a clinic and pharmacy in the center.

Through the joint efforts of Dr. Saul Contreras, DGH's in-country program coordinator, Denis Hébert, a Canadian priest who has worked and lived in the neighborhood for the past seven years, Dr. Pauk, and the barrio's executive board, the clinic opened its doors in July of 2002. DGH has provided financial, material and volunteer support to establish and administer the clinic, making the barrio's goal of providing primary health care to the community a reality.

Currently, the clinic's basic services include consultations with a part-time physician and a pharmacy. Referrals are made to the Ministry of Health or private specialists as needed. Clinic hours are Monday through Friday from 8 am to 2 pm. During these hours of operation, a physician and clinic assistant are available to neighborhood residents. The assistant's role includes that of receptionist, organizing the pharmacy and medical records, housekeeping, and occasional nursing tasks. The clinic is comprised of a front reception area and pharmacy, a consult room, a small area for a future laboratory, as well as two empty rooms, which APROPOCACO hopes to one day make into dental and OBGYN consultation rooms.

There is certainly never a shortage of patients. The waiting room's chairs are usually occupied while others wait standing. When asked what they thought about the clinic's services, an overwhelming majority of the neighbors expressed gratitude for the accessibility to basic health services. They state that public clinics in Managua are often over-booked with patients or simply not open. Furthermore, they often get a prescription for a drug they cannot afford to buy.

That is why the neighborhood asked that the clinic include a pharmacy. DGH listened to their concerns and helped them establish a pharmacy that offers medications at a very low cost-just enough to generate revenue to keep replenishing the pharmacy's supplies.

Future plans for Barrio Edgar Lang include opportunities for DGH volunteers, such as the training of health promoters; teaching classes in the community on various basic health issues; working with the youth in topics such as sexuality, leadership and violence; and organizing a neighborhood garden. Volunteers have the option of a home stay with a family in the barrio.

Barrio Edgard Lang residents have proven that when neighbors take action they can achieve positive results. With a safe space for children to play and learn, accessible healthcare services and affordable medications, the neighborhood has transformed itself into a safe haven.

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