The day marked my fourth month in Belize. My husband, Norm, and I had spent weeks and shed buckets of sweat turning a dirty, dilapidated corner of a building into a medical clinic for women. Since then, day after day, for long hours I attended to patients while geckos climbed the walls and termites built fresh trails on the ceiling over my exam table.
   
Though I was a nurse, my duties had expanded beyond providing basic health care. I also disposed of the occasional dead rat on the path to the clinic, swept mounds of dead bugs from the floor, and waged daily war against mosquitoes big enough to ride. Once I even armed myself with a machete and battled an opossum that wanted to make my clinic his home. But on the day that marked my fourth month in this tropical country, I was taking a much-needed break from work. For one day, at least, I would be Nancy- the- Photographer and not Nancy- the- Nurse.
         
I arranged to spend the day with a young woman named Terese. Terese had seemed both shy yet excited about the idea. We agreed on a price and arranged a date. But, that was two weeks ago and now, without a telephone, or any other way to confirm our plans, I wondered whether my visit would be welcomed.
             
As the truck lurched up to the small grass-thatched hut, I saw that my concerns were unwarranted. Terese and her entire family—mother, grandfather, two sisters, a pack of little boys, and two babies—were all waiting by the road with wide smiles.
       
I came to the village with an agenda: to play, not work. While nursing is my vocation, photography is one of my passions. I was eager to capture the distinctive beauty and culture of Belize and its native people on film. I planned to spend the entire day, from dawn to dusk, photographing Terese and her family as they went about life in the rainforest.
        
As they began their day, I observed the well-choreographed bustle of daily work. Most efforts involved food preparation for the mid-day meal, with all family members pitching in. I marveled at both the rustic simplicity of their life and at how creative they had been in adding modern “technology” to lighten their workload. For example, to grind corn for tortillas, Terese replaced the traditional flat rock and pestle with a hand-powered grinder much like the one my grandmother used to grind meat. She boasted that her new grinder made her work much easier and faster. It now took only two hours to prepare the cornmeal and make the tortillas for lunch.
        
Once the corn was ground, I helped Terese and her sister, Justina, gather the laundry and carry it down a dirt path to a small creek that ran behind their home. All eight little boys of the house, ranging in age from three to ten years old, accompanied us. On the way I tried to memorize their names and identify who were Terese’s sons and who were Justina’s. I learned that one of the children was actually Terese and Justina’s brother.
         
There were no technological advances for washing the clothes. Just as their ancestors have done for hundreds of years, the women simply laid each piece on a flat rock, rubbed it vigorously with homemade soap, rinsed it in the creek, and then wrung it out with their hands before placing it in a large handmade basket. Standing in thigh-deep water, Terese and Justina scrubbed each article of clothing carefully, taking great pride in how clean the clothes became.
     
Soon we headed back toward the house. There was more work to be done. The huge basket of clean laundry was carried back to the hut atop Terese’s head and then hung on the line to dry. Next, Terese weeded the garden using a pointed stick and machete. I helped her dig and pull weeds from around tomato plants, yams, and chilies.
        
“If we don’t do this every day, the forest will eat the garden,” she explained solemnly.
          
I was surprised to find no corn in her garden, but Terese said the men could bring corn home from the fields. While photographing the family going about their normal routines, I realized that everyone did their part with little or no discussion or instruction. They each seemed to know their respective role in the lively choreography of their daily life. Even the little boys returned after their morning swim to cut grass with sharp machetes. What had at first looked to me like the playful attacking of grass with their “weapons” soon turned to hard labor that caused tiny beads of perspiration to form on their little foreheads.
       
Later that afternoon, we sat crouched on low stools outside the thatched hut in the shade of the cashew tree, resting and chatting. Occasionally, the soft afternoon sounds of a birdcall or cricket were heard. The morning work was over. Children were bathed, laundry washed, garden weeded, yams dug, corn ground, tortillas cooked, the black hen killed, plucked, and boiled. We had filled our bellies with the simple food and now was the peaceful time of day, the siesta, when the children played quietly and the women sat undisturbed, enjoying a few moments of female companionship and tranquility.
        
“You are the nurse?” Terese asked hesitantly.
        
“Yes,” I answered, also hesitantly, reluctant to return to nurse mode just yet.
        
“For my sister—you have medicine to make no more babies?”
        
I smiled to myself. For my sister…how many times have I been approached since coming to Belize with that question prefaced by “for my friend, for my sister, for my cousin”? It was easier for most women to ask for someone else, more difficult to own their own questions. The question was, in fact, the real reason I had come to Belize. The primary purposes of the Women’s Clinic were to improve women’s health and offer modern methods of family spacing.
        
And so we talked. I learned that, at age twenty-four, Terese had four children and that her sister, Justina, twenty-six was the mother of five. They had many questions and misunderstandings, which soon poured out.
       
“If I drink the pill, I will catch the cancer,” Justina said.
         
“The injection—will it make me crazy with sex? Will I want many men?” Terese asked.
        
I had heard these same misunderstandings about contraception from other women who came to my clinic. The pill would cause cancer, injections increase the libido dramatically, and my personal favorite: “If a man jumps up (withdraws) then I won’t get pregnant.”
         
I talked with Terese and Justina and tried to dispel each of the myths. Then I explained not every method of contraception, but the choices available in Belize at the time—the Pill, injections, IUDs, and condoms. We talked. We laughed. We talked some more.
        
When Grandfather stepped outside the door to see why we were laughing, their talk quickly changed to the art of making jippa-jappa baskets.
        
“We gather the leaves from the forest,” Terese said, “and then we boil them for hours until only the spines are left. Then we hang them in the sun to dry.”
        
“They must hang for many days if it rains,” Justina added, picking up the conversation.

“Once they are dry, we begin to weave. Each basket takes many hours. A large basket maybe days,” said Terese.
         
I appreciated that Grandfather was not to know their secret. Only when he reentered the hut did our talk resume. Perhaps the idea of family spacing was too modern for grandfather to accept. His generation had babies whenever they came—usually about a year and a half apart thanks to breast-feeding’s temporary natural contraceptive effect. And contraception implies one has a sex life. I think granddaughters everywhere, married or not, hesitate to admit it to their grandfathers.
        
Terese and Justina are a new generation who will bridge the centuries between pounding clothes on a rock and using modern birth control.  I felt like Margaret Sangor floating diaphragms into the New York Harbor in whiskey barrels as I arranged for the women to walk ten kilometers to my clinic during their next moon time. They chose “the injection.” They smiled. They sighed. They seemed so grateful, it more than made up for all those wretched mosquitoes, rats, termites, and opossums.    
          
When I reflect back on that hot, dusty afternoon in a remote village in the middle of the rainforest, I am filled with gratitude. I remember the day when I sat under a cashew tree with two lovely young women and witnessed the power of simple conversation to change women’s lives. We talked. We listened. We laughed. We made a connection.

One Nurse at a Time is a nonprofit organization created by nurses and supported by nurses and nurse practitioners who are passionate about giving back to their local and global communities through volunteer and humanitarian medical pursuits. ONAAT is dedicated to helping other nurses and nurse practitioners enhance their profession as they look for opportunities to serve locally, nationally, and internationally. Together—one nurse at a time—we can change the world.

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