According to the Peace Corps (2012), "Nicaragua most likely derives its name from an Indian chief, Nicarao, who ruled part of the area at the time of the Spanish Conquest. It is believed that Christopher Columbus was the first European to touch Nicaraguan soil in 1492. Francisco Hernandez de Cordoba was next and founded the colonial cities of Granada and Leon in 1524. Nicaragua gained independence from Spanish rule in 1821. Nicaragua has a history of peace and war. More recently, in 1979 the Somoza regime was overthrown by a populist revolution, and was replaced by the Marxist Sandinista National liberation Front (FSLN), which ruled until 1990. Free elections occurred in 1990, placing Violeta Barrios de Chamorro in the role as President. Nicaragua has experienced relative peace since 1990, and the country has celebrated four successive free elections to date."
Presidential elections occur every 5 years. In 2013, president was Daniel Ortega, who was elected in 2006. Ortega was the leader of the leftist revolution that helped overthrow the Somoza regime in 1979 and was elected democratically to his current position (Peace Corps, 2012). It is common to see symbols of the country’s support of Ortega in the form of red and black painted rocks, building, fences, etc.
Nicaragua is the largest of the five Central American republics with a land area almost 50,000 square miles (slightly smaller than New York state) and is the least densely populated (Peace Corps, 2012).
Nicaragua is known as the land of lakes and volcanoes. "Lake Nicaragua is one of the largest freshwater lakes in the world and contains such aquatic oddities as freshwater sharks. The principal crops are corn, beans, sorghum, and rice. Cotton, coffee, sugar, bananas, and tobacco are the principal export crops" (Peace Corps, 2012), and are a cornerstone of its economy. Nicaragua is susceptible to natural disasters, including earthquakes, volcanic eruptions, floods, droughts, and hurricanes, which can disrupt agriculture and negatively affect the economy. The last earthquake was in 1972 and caused massive destruction in and around the capital city, Managua.
Population: The population of Nicaragua is 5,637,104 (Country Watch, 2013). "The majority of Nicaraguans can best be classified as mestizo, a mix in which neither the European nor the Indian cultures predominate" (Peace Corps, 2012).
Language: The official and predominant language in Nicaragua is Spanish (Peace Corps, 2012).
Religion: Nicaragua is composed of primarily Christian beliefs (more than 90%) while 8.5% declare no religious affiliation or claim to be atheists (Peace Corps, 2012).
Values/Beliefs: Common cultural threads are heavily based on la familia (family), respeto (respect), personalismo (personal relationships), and confianza (trust). Traditional "family" in Hispanic culture can include immediate family, extended family, close friends, and godparents (LMHSC, 2013). Interdependence is common in Hispanic families, therefore family will likely be present at medical visits and involved in treatment and decision making (LMHSC, 2013).
Respect is an important part of the Hispanic culture. Elders expect respect from youngsters, and respect is given to authority figures'; a high level of respect is given to health care providers (LMHSC, 2013).
Personal relationships are stressed within the Hispanic community. It is common practice to greet patients warmly, and to ask about family and to show an active interest in the patient's life (LMHSC, 2013).
Trust must be built through building personal relationships. Patients will tend to be more compliant with a provider that they trust. With an individual's experience through Global Partners, there may not be the possibility of repeat, frequent exposure, but it is important to spend time on the quality of the relationship and not rushing.
Social Etiquette: Most Nicaraguans are warm, generous, friendly, and are proud of their cultural heritage. Although many enjoy talking about politics, their jobs may depend on being loyal to a political party, so it is best to refrain from publicly talking about their political views.
"Hispanics show respect by avoiding direct eye contact with authority figures, however health care providers are expected to look directly at the patient, even if using an interpreter" (LMHSC, 2013). A provider can show respect to patients by greeting him or her in a formal manner, and continuing to address them as such unless requested an informal greeting. It is polite to address Hispanic adults as:
- Senor (Mr.), Don (Sir)
- Senora (Mrs.), Dona (Madam)
- Or Mr. and Mrs.
Even if you do not speak Spanish, you can show respect with greetings such as:
- Buenos dias (good morning)
- Buenas tardes (good afternoon)
The concept of personal space is much different among Hispanics when compared to Americans. Hispanics values closeness; lack of closeness may be offensive because it implies rejection or serious illness. In order to show you are interested, it is important to be aware of your body language. Sitting closer, leaning forward, or giving a comforting pat on the shoulder are all acceptable forms of engaging non-verbal behavior (La Crosse Medical Health Science Consortium, 2013).
Hispanics tend to live by elastic time; meaning that schedules and appointments do not carry the same value as Western society. They tend to be present oriented, and focus on relationships with others opposed to following a schedule. This may mean that the patient may be late to appointments or meetings, or expect your undivided attention during an encounter.
A typical Nicaraguan diet consists of gallo pinto, a mixture of red beans and rice fried in vegetable oil. This dish is usually consumed daily. Other common staples include beans, rice, eggs, dairy products, meats, and foods made with corn, as well as a wide variety of fruits and vegetables, including cabbage, carrots, avocado, pineapple, bananas, and papaya (Peace Corps, 2012).
"The U.S. Marines introduced baseball to Nicaragua in the early 1900s, and it is now the national sport. Other past times include soccer and volleyball" (Peace Corps, 2012).
Health Concerns/Challenges: "The most common health problems among volunteers and the Nicaraguan population in general are upper respiratory infections and diarrhea" (Peace Corps, 2012). Malaria and dengue fever, two diseases carried by mosquitos, are also major health concerns. It is important to protect yourself from mosquito bites by using mosquito repellant and/or wearing protective clothing. Clean water for drinking is a challenge and many illnesses can be attributed to unsanitary water sources throughout the country.
Feelings toward healthcare: Hispanics tend to have a broad definition of health, which can be best described as a continuum of body, mind and spirit. Religion also plays an important component to daily lives (La Crosse Medical Health Science Consortium, 2013). Herbal treatments are common and can be used alone or in conjunction with Western medicine practices (La Crosse Medical Health Science Consortium, 2013).
Take Home Message:
- Basic knowledge of a culture is helpful; however keep in mind that individuals may have different beliefs within that cultural group.
- Dress modestly and appropriately.
- Educate yourself on appropriate social etiquette in order to foster trusting relationships.