This past Tuesday and Wednesday, we participated in a health promoter training course entitled, "Medioambiente," or "Environment." We started with a review of the topic of last month's training, "Pregnancy and Prenatal Care"; these reviews are an important part of ensuring that health promoters in training continue to renew their knowledge base and recognize their strengths and weaknesses.
.
The first day of Medioambiente training consisted mainly of discussions led by Vicente and Dominga on water systems and sanitation in the rural communities around San Lucas, and resultant disease burden. In nearly all the communities we serve, there is an elected committee overseeing water and sanitation. Sometimes parish health promoters are on these committees, sometimes not. In either case, the objective of the first day of training was to provide them with an understanding on the basis of which they could play an advisory role for their community's water committee.
.
The second day, Kate and I talked about water-related infectious diseases seen in the communities, such as dengue (breakbone fever), malaria, onchocerciasis (river blindness), infectious diarrhea and intestinal parasites. The Centro de Salud (government health center) has vertical programs in vector-borne diseases, but their active case finding, prophylaxis, diagnosis and treatment are plagued by poor coverage, lack of resources (they don't do thick smears to diagnose malaria?!), and inflexible protocols that don't respond to individuals or communities. Similarly, the local government-funded NGO, APNACH, is responsible for management of diarrhea and intestinal parasites in the communities, but their health workers are only paid to work 3-4 hours a day, and their community formularies are stocked erratically (a community can go 4-6 weeks, or more, without oral rehydration solution or deworming medication). Teaching the parish health promoters to identify and begin first response to these problems, it is hoped that they will be able to fill in some of the gaps left by an ailing public health system.
.
Here are some photos that Elena took during the two-day training:
---
Kate, teaching the symptoms of Malaria: fever, chills, and headache, among other things.
---
Kate must have said something hysterically funny, because Vicente is cracking up in this picture!
---
Day One: The health promoters from each community were invited to bring water samples from their community water source(s) to test them for contamination. Here, Delma and Micaela measure out 20ml of water that they brought from their community, Totolya'.
---
Dominga rips open the packet of test powder, to pour into Domitila's water sample. Domitila's community, Xejuyu', does not have potable water running to each house. Instead, they have made an agreement with the finquero of Sto. Tomas to bring water from a spring on the finca's land.
---
Day Two: After 24 hours, Benita, from Totolya', was surprised to discover that her community's water results came out black = contaminated. Per Micaela, another promoter from Totolya', nobody in Totolya' or Porvenir, which share a water supply, is doing anything to purify their water. The health promoters from Totolya', after discussing this result with Vicente and Dominga, decided to get additional tests at different points in the community's water supply to determine the source of contamination. They intend to take these results to the community leadership so that plans can be made to clean up the water.
---
Ingrid, from Xejuyu', holding her result (yellow)--no coliforms!
---
Vicente (who lives in Quixayá), was so proud of his community's result!
Vicente (who lives in Quixayá), was so proud of his community's result!---
The results are in: 4 out of the 7 water sources tested were found to be contaminated with coliforms (that is, poop). For those promoters whose water is contaminated, they are charged with the task of presenting these results to their COCODE (community leadership council).
The results are in: 4 out of the 7 water sources tested were found to be contaminated with coliforms (that is, poop). For those promoters whose water is contaminated, they are charged with the task of presenting these results to their COCODE (community leadership council).--- 
Dominga, being silly... This past month leading up to the Medioambiente training, we have had several discussions about how to get the 2nd year health promoters more interested and about how to provide opportunities for non-threatening self-assessment. Dominga really shone, coming up with several excellent ideas to break up the monotony, promote interactive learning, and incorporate assessments into fun activities.
Dominga, being silly... This past month leading up to the Medioambiente training, we have had several discussions about how to get the 2nd year health promoters more interested and about how to provide opportunities for non-threatening self-assessment. Dominga really shone, coming up with several excellent ideas to break up the monotony, promote interactive learning, and incorporate assessments into fun activities.--- 
"Medioambiente" was the last training we will participate in, since we're leaving in less than three weeks. This is one final group photo of us and the 2nd-year students in the health promoter program. They thanked us for our support and presence in their work and capacity-building, and we thanked them for their acceptance of us and for the opportunity to help and learn from them. We said that we respected their committment to their communities, and we wished them the best in their continuing studies and engagement in the health of their people.
"Medioambiente" was the last training we will participate in, since we're leaving in less than three weeks. This is one final group photo of us and the 2nd-year students in the health promoter program. They thanked us for our support and presence in their work and capacity-building, and we thanked them for their acceptance of us and for the opportunity to help and learn from them. We said that we respected their committment to their communities, and we wished them the best in their continuing studies and engagement in the health of their people.
No comments:
Post a Comment