Guest blog from William Ugarte, Medical Epidemiologist and Lecturer, Department of Women’s and Children’s Health at Uppsala University, Sweden

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Evidence is the foundation for effective policy engagement and advocacy, and the growing field of gender-based violence (GBV) prevention provides an ideal example of this. The fact that GBV is now recognized as a “global epidemic” is largely due to the remarkable contributions of researchers, particularly in developing countries.

In fact, my own field research and first-hand experiences in Nicaragua demonstrate how a local experience can both create change at the individual level and transform the world. Personally, our recent study, Candies + 20, linked my past and present in a unique way.

 During my medical training at the end of the 90s, I attended several meetings of a group called “Men against Violence,” organized by the Nicaraguan NGO “Puntos de Encuentro.” This group offered men a platform to discuss and create awareness about our roles in a post-war society. While in Nicaragua, I read the magazine “La Boletina”for the first time, which was chronicling and revealing for the first time women’s personal stories of violence, spurring massive social change. Inside the magazine, I read a phrase that transformed everything: “I do not want candies in hell.”

How and why I became involved in the study

In the ensuing years, I started working as a research assistant in the area of sexual and reproductive health at the Research Center for Demography and Health (CIDS) within the National Autonomous University of Nicaragua in León (UNAN-Leon). There I met the Executive Director of CIDS, Rodolfo Peña, who was also one of the co-authors of the original Candies in Hell study. He emphasized that “Candies” represented an outstanding opportunity for academia and society at large in Nicaragua to understand the sheer prevalence of intimate partner violence (IPV) throughout the country. Thereafter, several subsequent epidemiological studies were conducted, including studies on IPV towards pregnant women and its impact on child outcomes, the process for women who ended violent relationships, masculinity roles, and other forms of violence and controlling behaviors over women’s autonomy. We were all proud to be a part of helping reveal these untold stories and collecting the data needed to affect change. 

A moment to contribute – Preparing for Candies + 20

In 2016, three years after obtaining my Ph.D. in International Health at Uppsala University in Sweden, I was very fortunate to meet GWI Director Mary Ellsberg and Margarita Quintanilla from Intercambios and to become the Executive Director of CIDS. Like Rodolfo, Mary and Margarita were two of the original Candies in Hell authors, and they kindly invited me to take part in the follow-up research project entitled Candies + 20. We all shared a vision that this study would be even more comprehensive and impactful than the last one. Inspired by the WHO recommendations for ethical research on violence against women, we teamed up with female psychologists, epidemiologists, doctors, and others to safely carry out the new study. I remember visiting the primary health facilities and local NGOs to set out the referral strategy for women with IPV history. Interestingly, they told us unsolicited that women were not receiving adequate support from the legal system. This was an important concern that we tried to address during the study preparation, by making sure that participants would have access to referrals for psycho-social support.

Data collection – the human impact of researching GBV

The fieldwork was very demanding and intensive.  We worked at night and on weekends to reach potential participants and to give them the opportunity to share their stories. The dedication of our field workers was essential for achieving the study’s goals. Both the interviewers and the researchers felt that participating in this extraordinary project positively affected all our lives. Many gained increased professional confidence and experience from the study. As one of our interviewers recently told me: “Participating in the study represented both an exciting challenge and a great responsibility. It was very moving to hear about the cruel reality that many women face during their lives and the strategies they used to overcome these conditions.” However, the most important impact was mentioned during our project evaluation, when the  interviewers told us how they were transformed by the study and that it boosted their morale and desire to continue working for women’s rights.

The present crisis and the uncertain future

You’ll often hear  health experts say: “There is no mystery surrounding what is needed to tackle GBV and its consequences, many of which are preventable.” Unfortunately, due to the COVID-19 pandemic, women are not getting access to basic services in many countries. Even worse, the current political, financial, and social crisis in Nicaragua is undoing the remarkable progress on women’s rights and GBV prevention that were documented in our study. Both local and global organizations have recognized the seriousness this crisis in Nicaragua, which has forced more than 100,000 people, including me, to flee. Yes, I am now far away from home, due to the persistent violent context that affects everyone, but mostly girls and women of all ages. Nevertheless, there is hope for a better future. In the words of our Nicaraguan national anthem: “The blood of brothers no longer stains thy glorious blue and white banner.”

William J. Ugarte is a Medical Epidemiologist with a Ph.D. in International Health at Uppsala University, Sweden. His work identifies and elucidates the processes by which psycho-socio-cultural factors influence health outcomes and behaviours in relation to sexual and reproductive health in Low- and Middle-Income countries, including Nicaragua. He is a former researcher, academic, and Executive Director of a Research Center in UNAN León. Currently, he is a senior researcher and academic at the Master’s program in Global Health at International Maternal and Child Health (IMCH) in Uppsala University.