Editor’s note: Margarita Quintanilla is PATH’s country leader in Nicaragua. This is her story, as told to PATH writer Emeline Cokelet.

I have a simple wish for my three-year-old daughter: I want her to grow up in control of her life so that no one—no man, institution, or the state—can demand of her something she doesn’t really want or deserve.

In my home country of Nicaragua, cultural and gender expectations and daily realities like violence against women make it hard for girls and women to exert their own will. This is something I’ve been working to change for most of my career.

Mother knows best

It started with a seed planted by my own mother many years ago during my childhood in Managua. She raised four children while at the same time teaching gender courses at a local university and working hard to provide for us. She constantly encouraged my sisters and me to pursue education and academic achievement.

She gave us compelling words of advice: pursue what you want to do.

And so I did.

I moved to León, a city northwest of Managua, to study dentistry at the university there. After graduation, while working as a dentist in a public health center as part of my nationally mandated social service, I became intrigued by both the social intricacies of community health and the link between gender-based violence and health. Women are victims of violence throughout Nicaragua, at all levels of society. Health professionals were just beginning to see the relationship between this violence and women’s health, and it made me want to create more evidence of that link.

The connection between violence and health

I left dentistry behind and moved to Spain to study public health. The connection between health and violence was underrecognized there, too. In my master’s degree thesis, I analyzed the correlation between violence against women in Spain and the country’s health services—and showed that it wasn’t just a third-world issue.

When I returned to Nicaragua, I wanted to work directly with communities, with people at the grassroots levels, to understand their challenges. I started working as a community health coordinator, teaching preventive health such as washing hands to avoid disease transmission or getting regular pap screenings. I also considered how gender-based violence affected the health of the men, women, and adolescents I met, how it might contribute to the spread of disease or unwanted pregnancy, or keep someone from going to a health center for treatment.

In 2002, I joined PATH as the first staff member of the Nicaragua office. I worked on the Entre Amigas (“Between Girlfriends”) project, an initiative to provide preadolescent girls with life skills to understand gender-based violence, protect themselves from early pregnancy and disease, and help them improve their health. Later I helped establish InterCambios, an inter-American alliance that brings together people and organizations to respond to gender-based violence. As PATH’s office in Nicaragua has grown, my work has expanded to include both technical and social approaches to increase the country’s capacity to ensure better health.

A commitment to Nicaragua

I have always believed in my country and have worked hard to make it a better place. But in 2006, the government prohibited therapeutic abortion, including cases in which the mother’s life is in danger or following rape. This decision made me feel very depressed, not only because it disrespected the value of a woman’s life, but because of what it might mean for women in Nicaragua—perhaps even my own daughter—in the future. For the first time in my life the idea of leaving the country crossed my mind, but it didn’t last long.

All of this has only increased my determination to work to improve lives for women in Nicaragua—and to express my desire for change. It means questioning very deep cultural roots and speaking more clearly and directly than some Nicaraguans are used to. It’s not easy, because I have to be aware that I may not always be liked. But I’m heartened that PATH shares my beliefs and my values.

At PATH, we listen to communities, we understand that culturally accepted practices aren’t necessarily good ones, and we know we have to be wise and intelligent in our solutions. We have the responsibility of promoting change in the right way.

I hope my daughter can benefit from that change. I want a world in which she has the same access and the same opportunities as everyone else. It’s going to be her choice and no one else’s.

Photos (from top): Miguel Alvarez, PATH.