Community and Sexual Health in the Chaco

Changemaker Catalyst Award recipient Laura Murphy traveled to Paraguay during the summer of 2018 to participate in an internship and professional development experience with the nonprofit, Fundación Paraguaya. During her two months abroad, she had the opportunity to work with a community health worker in the Toba Qom indigenous community, as well as make and present information on sexual health in the Benjamín Aceval region of the country. Laura is majoring in public health and international development and minoring in economics.

This summer I had the opportunity to intern with the Paraguayan-run non-profit, Fundación Paraguaya. I lived and worked in Cerrito, Paraguay, a small town that is approximately three hours by bus from the capital city. Besides a restaurant that serves some of the best empanadas in Paraguay, Cerrito is special because it is home to the Toba Qom indigenous group. The Toba Qom are an extreme minority in Paraguay, numbering at only around 3,000 in total. They have a vastly different culture and language than the other 97% of the Paraguayan population that identifies as mestizo (mixed indigenous and European ancestry). Their unique heritage, along with their continued marginalization by the Paraguayan government and mainstream society, has created many challenges for the Toba Qom. Fundación Paraguaya has partnered with the leaders of the Toba Qom to try and address the debilitating and widespread poverty present in the community through both economic and public health initiatives, which are formulated based on self-identified points of need by community members.

The road to the Toba Qom community in Cerrito on an ideal winter’s day in June.

I was able to work alongside the community health worker of Cerrito hired by Fundación Paraguaya, Ada Diaz. We worked on a variety of projects to address the lack of adequate health services available to the community. Together, Ada and I helped to initiate a variety of health related programming, including providing eye tests and eyeglasses to community members, organizing a free flu vaccine day, and visiting local clinics to create a definitive list of reproductive health services available locally. In order to organize and plan these various activities, every day included walking miles along red dirt roads to reach isolated pockets of community members we needed to speak with. Using my feet as my primary mode of transportation really allowed me to get to know Cerrito and its rhythms as a community. Eventually, getting to know the friendlier faces made my personal pet project of the summer much easier.

Performing the oil-based lubricant and latex condom demonstration for high school students at the Escuela Agricola San Francisco.

My personal project during my internship was to write a Spanish sexual health education manual, as well as to create tailored presentations to summarize the manual’s information for groups of local high school students and several groups of adult female Toba Qom community members. Each presentation brought unique challenges and experiences, as can be expected with sexual health education, but one experience in particular stands out. In my presentations with the high schoolers, I had a demonstration with a latex condom and oil-based lubricant to show how sexual activity using this combination of products would cause tears in condoms and therefore be ineffective at preventing pregnancy or STIs. As usual, during the presentation I inflated the condom and covered both it and my hand in oil-based lubricant. I then proceeded to demonstrate the folly of using these two products together by rubbing my hand vigorously over the latex membrane to cause a rupture. After about 30 seconds of deafening silence, the condom finally exploded, as expected. However, in this case, a large piece of the oil-covered condom landed directly onto the head of a student sitting in the front row. An audible gasp reverberated throughout the room, followed by the laughter of about 40 teenagers. Fortunately, the student quickly recovered, and graciously joked about her role of becoming an unintentional volunteer in my demonstration.

It was a humbling and amusing experience that reminded me of why I love sexual health education both abroad and back in New Orleans. The element of the unexpected is always present, and every moment has the potential to teach us something or spark new conversations. I am so grateful for the opportunity to have gotten to know the Toba Qom community in Cerrito with the help of the Taylor Center and several other campus partners. I know that this summer will be the first of many returns to the wonderful country of Paraguay, and has absolutely been a crucial part of my journey to becoming a sexual health educator and researcher.