02.05.2008 Nicaragua

Re-location versus Dislocation

30 years' Medico work in Nicaragua: An interview with the outgoing regional Medico project coordinator, Walter Schütz

Before retiring in January 2008, Walter Schütz had been project coordinator for Medico International in Central America since 1981and during this time had coordinated and carried out many Medico projects, particularly in Nicaragua and El Salvador.

Walter, you worked for almost 30 years in Nicaragua for Medico. How did your work change in this period?

Medico began its work in Nicaragua in the 1980's at the start of the Sandinista Revolution, soon after the fall of Somoza. It was a period of upheaval which affected the whole of Society. At that time large-scale changes were viable in a very short space of time. We supported the creation of a network of health care facilities in the country's poorest province, the Río San Juan department. Starting from scratch, within a few years we managed to create a working, de-centralised, democratic health care system. It was a different perception of health. We did not rely on curative medicine, but followed the "Health for All" concept, developed in 1978 by the WHO in Alma Ata, of participation, prevention, improvement of living conditions and education. Projects like these can only be carried out in times of radical change, i.e. when people and Society as a whole are willing to abandon deep-rooted ways of living.

How did that change in the 1990's?

When the Sandinistas were voted out of office we continued the work in Río San Juan. When I went back recently, I could see that almost everything was still there and had even been expanded in order to uphold the democratic experience and the social ideas in both political culture and in practice. We also supported the creation of Nicaraguan NGOs.

One pivotal event in Central America was Hurricane Mitch in 1998, which took the lives of many thousands of people and exposed the social vulnerability of this impoverished region. How did this affect the work of Medico?

We worked with survivors of a landslide on the Casita volcano caused by the hurricane and which claimed the lives of 2,500 people. With almost 140 families from different villages we built a new village on the edge of the volcano, in El Tanque. This integrated community development programme was a very enlightening experience for me. What was it all about? These were people who had not only lost countless family members, but their home, both literally and figuratively. What place and what future will they find in today's globalised world? Migration and migratory labour, in other words displacement. By occupying the El Tanque Hacienda the small farmers of Casita demonstrated that they were not willing to accept this fate. Together we tried to establish a new home for them. If neo-liberal globalisation means displacement, any attempt to resist and create alternatives is then re-location. That's what El Tanque stands for.

For several years the project in El Tanque was financed by the Federal Ministry for Economic Co-operation and Development (BMZ). How can one put in words such complex, unforeseeable events in applications for State grants which call for some kind of guarantee of the project's success?

The magic word in the world of public grants is "goal-oriented project planning". The funding applications imply that it is possible to plan social actions in a linear manner. As they say, there's a reason for poverty – remove the cause and you remove the poverty. When I see the progress of the community development in El Tanque, I can not confirm this chain of cause and effect. The fact that the village still exists and that the agriculture and thus the livelihood of the inhabitants is expanding and would expand even more if the land were not in short supply because of the huge plantations – does not depend on one single measure. An integrated community development project like El Tanque has many components, from house construction to agriculture, from secondary and further education to psycho-social work. The decisive factor was the legal protection ensured by the granting of house and land titles – and the participation of those involved at the regular meetings at which all issues were, and are, discussed. We have been trying to build up the people's self-esteem, so they will both want to and be able to continue their project without us. There is no guarantee of success when you work with people, especially in such an economically fragile context. Thank God the BMZ knows that, too. The facts given in the application are not reality and amendments can be made. Nevertheless Medico bears the risk of failure, also financially. Wouldn't it therefore be better to invest in lower-risk projects which can also be beneficial?

If you want to have sustainable projects which show ways to escape from poverty, if you want to overcome poverty structures, you have to take this risk. If you only want to administrate distress, you can run low-risk projects. Medico however has always supported projects whose aim is to enable the people to achieve autonomy. This is how I see the project in El Tanque which now requires hardly any support at all, and also the two-year old project of integral community development in Palmerita which, however, still contains a great risk of failure. It's all about practical, not formal, democracy. Meetings take place every week where production plans and financial statements are presented so the people can have some say in their own future.

How does the project in La Palmerita differ from El Tanque?

In El Tanque the small farmers built a new village. In Palmerita there are migrant workers who have only known extreme poverty all their lives. So they either survive on less than one dollar a day or they have either no income at all. About one quarter of the Nicaraguans are classed as extremely poor. This "target group" is not part of the programmes combating poverty, as they are considered to be too difficult. Some are severely traumatised people who do not know who to make responsible for their plight or their systematic exclusion. They channel their impotence into aggressive behaviour towards others. They have a different survival culture from the small farmers. Flexibility and lack of bonding are the prerequisites to be able to survive their nomadic life style. Long-term planning for the future is not possible and is even counter-productive. Now these people in Palmerita want to become small farmers in order to escape the extreme poverty. They have to learn new survival techniques: long-term planning, settling in one place, bonding with the land and the community. You can not bring about such huge changes in culture with the classic project methods set up from outside. "Goal-oriented project planning" does not work here. It can only work when you talk with these people eye to eye accepting, not condemning, their old survival techniques. In this way we brought about the situation that today some of the residents in Palmerita are proud to be called small farmers. But the whole situation is still extremely fragile.

From supporting revolutionary processes to integral community development – what has that got to do with health support?

Actually, the people expect Medico to hand out pills. But what is health actually? I can give you a negative definition. The absence of sickness. I can however also formulate this positively. Health is wellbeing. Wellbeing is having food to eat, a roof over your head, being able to send your children to school and also democratic participation. In the 1980's we believed, and I think rightly so, that: Salud es revolucíon – Health is Revolution. Today I would say "salud es bienestar" – Health is Wellbeing. So one can draw a line from our beginnings in Río San Juan to the projects in El Tanque and La Palmerita.

The interview was conducted by Katja Maurer.