Roy Emblen recalls one of the more moving moments of his recent trip to Nicaragua, when he visited la Chureca, the infamous rubbish dump in the capital city Managua.
“For years there was a community living on the tip, surviving on whatever they could scavenge from the rubbish. But now the Sandinista government has built a recycling plant there. Many of these people have been given jobs in the plant. They have a community, housing, a school. It was quite inspiring, to meet people who have literally crawled out of the rubbish – and are still smiling. It drove me to tears.”
That visit wasn’t central to the purpose of the small delegation, of which Roy was a part. But it summed up his experience of a country that is emerging from years of turmoil with heads held high.
Although Nicaragua remains the second poorest country in the Western hemisphere, after Haiti, Nicaraguans enjoy free health care and have benefitted from advances made in health care and education since the return to power of the Sandinista government in 2007. Maternal mortality and malnutrition rates are said to have been reduced by up to 50%.
A unique partnership
The delegation represented a unique partnership between UNISON and the George Eliot NHS Trust in the West Midlands. Two of the delegates were from the union: Roy, who works in IT at the hospital and is UNISON’s deputy convenor there, and Mark Glover, international officer at the union’s Solihull branch; the third was Dr Sebastian Yuen, a consultant paediatrician at George Eliot.
Their aim was to lay the groundwork for a twinning agreement between George Eliot and the Nilda Patricia Hospital in Managua, which will lead to an exchange of advice and expertise benefiting health workers in both countries.
George Eliot branch secretary Dawn Downes said that the twinning idea was in part spurred by the desire to share the experience of the successful campaign to save the hospital from privatisation last year, in which UNISON collaborated with the wider community.
In turn, she added: “Like ours, Nicaragua’s health system is provided by the public sector and funded by general taxes. If the health system in such a poor country has improved, and has some sort of good practice, we ought to see if it’s something we can adopt and benefit from.”
The one-week visit, which Roy calls “full-on” and Mark “intense”, enabled the three men to carry out various missions.
Roy and Sebastian visited the hospital and other health centres, including pre-natal clinics serving communities outside the cities, in order to get an overview “of how their health system ticks”.
And he observes: “The health buildings are lacking in good maintenance, fixtures and fittings are dated and worn. That’s partly due to earthquakes, but also investment.
Unhindered by technology
“Another thing I picked up on was how limited their IT resources are. One hospital would have just four PCs. They’re still using typewriters, or handwritten reports. Technology is not a big thing there.
“At the same time, they don’t appear to be stressed,” he laughs. “They are not lumbered with the additional pressures that technology can bring.
“And there is a lot we can learn from them. Their motivation is high, public information is really impressive, there is a good volunteer system in the community, performing weight and height and other health checks for children.
“I saw efficiency and structure at every level. I think that’s because there is no separation between the union and the hospital organisation. Every member of staff is a union member. Everything is intertwined, with fewer workplace issues than we have here.
“It’s in such contrast to this country, where the staff are not looked after, with that leading to a lack of motivation.”
Mark was struck by the warmth and hospitality of everyone he met, with a personal highlight being when he was invited to address a workers’ assembly.
“Obviously, Nicaragua has had a troubled history. Its people have been through 40 years of turmoil, of dictatorship, revolution, the Contras, the neo-liberal regime.
“Yet they are proud of being trade unionists, of being Sandinistas, and of the links with UNISON through these difficult years. They’re aware that we have provided not only material support, enabling them to develop and grow as unions, but moral and political support. They were very effusive in their praise.”
The delegation was sponsored by UNISON’s International Development Fund and organised by the Nicaragua Solidarity Campaign Action Group. The fund is also supporting a return visit to the UK, in April.
This article first appeared in the Spring 2015 issue of U magazine