by Seth Kolker:
The glistening latex of the condom stretched thinner and thinner up Alfredo Ocampos’ arm until it turned white around his thick knuckles. The condom reached from his fingertips to his elbow, covering his entire arm.
A dozen Nicaraguan teenagers standing in a half circle around Ocampos exchanged glances. The boys’ crossed arms and uneasy chuckles betrayed nervousness. The girls’ eyes wandered away from the scene and upward to the foliage of the matapalo tree. They seemed to understand the point that Ocampos was making, though: Any young man who refuses to use a condom because he is “too big to fit” is just plain wrong.
In Nicaragua, people have a lot of babies, and they have them young. Teenage girls in Nicaragua have the highest fertility rate of any country in Central America: According to a 2008 report by the Guttmacher Institute, half of Nicaraguan women had their first child before turning 20. More than half of those births were unplanned. And although data from the United Nations (UN) show that Nicaragua’s adolescent fertility rate has fallen over the past decade, more than one in 10 teenage girls still give birth every single year.
For the past two decades, Nicaraguans could not learn about sex in school legally. In response to this policy, social activists like Ocampos have formed an extensive network of advocacy organizations. These private groups have sought to provide what they see as an essential education for Nicaragua’s youth, despite political and religious barriers.
The state did not always ban sexual education. In 1980, a socialist government came to power with Daniel Ortega as its president. Ortega lambasted the recently ousted Somoza dictatorship for keeping the country uneducated as a means to preserve power. In a highly publicized reversal of this policy, the new administration put in place successful literacy campaigns across the country. Sexual education became part of the public school curriculum as well.
Dr. Auxiliadora Marenco designed the first of Ortega’s reform programs. “I started to teach [sexual education] in the psychology department of the University of Central America, and that was the first time it had ever been taught in Nicaragua,” she said. Soon after, the Ortega administration introduced more basic sexual education programs to the country’s primary and secondary schools as well.
But the new developments were short-lived. By 1990, discontent with the Sandinista government prompted a woman named Violeta Chamorro to run against Ortega. Chamorro beat Ortega and instated a new conservative government that appealed directly to the Catholic Church.
At the time, Marenco helped run the government’s program for youth. Doing so required a special grant. “When the government of Violeta Chamorro won, the Ministry of Health took [our funds] and put them who knows where. What matters is that the program disappeared. Everything that had to do with sexual education, they ordered burned,” Marenco said.
No other sources could confirm “Everything that had to do condoms over his Marenco’s allegation that the new administration took to extremes such as burning books and pamphlets on sexual topics. Regardless, all sexual education in public primary and secondary schools stopped when Chamorro came to power.
Soon after, family planning in Nicaragua disintegrated even further. The Guttmacher Institute reported that the rate of unplanned adolescent births jumped from 34 to 54 percent between 1998 and 2001 alone, and condom use remained exceptionally low. Even leading figures struggled to get their voices heard: Marenco retreated back from the front lines to a post at her old university, which she still holds today.
Yet Nicaraguans did not sit idly by during the 1990s. Even as government officials buckled under pressure from religious leaders to keep sexual education out of schools, independent programs began to take root.
Most of these groups fought for women’s rights, gay rights, or an end to domestic violence. But in order to achieve these goals, the activists focused their efforts on teaching young people all about sex. It was in this newly privatized movement that advocates like Ocampos found their calling
Ocampos is unconventional and bold. Disgusted by how hierarchies “tear apart” social relationships, he refuses to be called the formal “usted” and asks that everyone refer to him as “tú” or “vos” instead. He can rattle off acronyms of dozens of local and national sexual rights organizations, but he especially loves talking about a group called Young Agents of Change (YAC).
Ten years ago, Ocampos co-founded YAC in the province of Matagalpa. His organization focuses on preventing violence against women and promoting civil rights for Nicaraguans who are gay, lesbian, bisexual, or transgender. Like the women’s groups of the 1990s, YAC tries to make comprehensive sexual education programs a reality for the country’s youth as a way to improve Nicaragua’s sexual climate from the ground up.
Ocampos pulls condoms over his arm in rural villages, distributes literature on pregnancy prevention methods, and answers questions about physical abuse in relationships. His efforts do not stand alone: Some organizations promote safe sex by having men face off in condom inflation competitions. Others pass out condoms from ubiquitous “Eskimo” ice cream carts. And educational pamphlets are becoming more available every day Few scientists have taken up Ocampos’ fight. Still, some researchers hope to learn whether the efforts of decentralized organizations such as Ocampos’ are really working. In 2000, a group of European and Latin American researchers reported in The Lancet that leaving condoms in motel rooms in Managua increased the frequency of condom use during sexual encounters. But leaving pamphlets promoting sexual health actually lowered that frequency.
Dr. Danilo Medrano was the Nicaraguan sexual health expert that the research team brought on board to provide local know-how. “Maybe they don’t show up to read, but only have sexual relations,” said Medrano of the motels’ clients. He admits that changing sexual behavior through education is a challenge: It goes against a long history of cultural machismo that discourages safe sex and fails to condemn sexual violence. And he claims that Nicaragua’s single biggest morally influential institution, the Catholic Church, has never addressed these topics.
Yet Medrano remains optimistic that real change is still possible. He turned his pamphlets into posters and hung them on motel walls, and that innovative presentation successfully increased condom use. “We’ve been able to achieve some changes in the law. For example, domestic violence is now actually a crime in the penal code. Even the conservative culture of the Church has been affected,” he said. Some sermons now tackle controversial issues such as machismo and violence against women.
In 2008, the UN partnered with Nicaragua’s Ministry of Education to develop a comprehensive pamphlet on sexual health for distribution to schoolteachers nationwide and use in the classroom.
But within days, the Catholic Church was in an uproar over the documents. “[The government] withdrew the materials even before they could reach teachers’ hands,” said Marenco. A new pamphlet took its place, one that Marenco called “more moderate” and that the Church was willing to accept. It explained the biological basics of sex but was silent on all major hot-button topics—homosexuality, virginity, and abortion.
Still, misunderstandings about these controversial topics are what lie at the very root of Nicaragua’s sexual health crisis, according to activists like Ocampos. He teaches comprehensive sexual education as a means to ending sexual violence and intolerance; Marenco does it to help couples see sex as healthy and pleasurable. Even if students learn about the biological mechanics of sex, their conceptions of these deeper social issues might remain unchanged.
“Now, the old government and all that was done in the ’80s has been left in history,” said Marenco. Since Ortega rose again to the presidency in 2007, this time as a more moderate candidate, he has not heralded any major developments. The current administration still maintains close ties to the Catholic Church and provides public sexual education only grudgingly. In 2008—the same year as the scandal over the education pamphlets—a total ban on abortions took effect in Nicaragua.
School instructors now teach the biological basics of sex to Nicaragua’s youth, and adolescent fertility rates are trending downwards. But the tough questions about sex are still being addressed only through spectacle.
Back in that little community, under the matapalo tree, the half circle of young Nicaraguans huddled close around Ocampos as he delivered his concluding speech. The students were interested to learn. But after years and years of setbacks in their education, learning through this kind of hit-and-run performance is simply not enough.
The group broke and a dozen teenagers turned to go home, back to lives of schoolwork and fieldwork. Some of them seemed quiet and reflective. But already, a few of them were cracking jokes about the presentation, laughing off its lessons.
Ocampos hopes to return to this community next year. When he does, chances are that at least one of these kids will have a new baby of his or her own. Maybe Ocampos will have better luck with that one.
Seth Kolker ’14 is a Global Affairs major in Jonathan Edwards college. Contact him at seth.kolker@yale.edu.