As Rose mentioned in an earlier blog post, one of our new volunteers, Gil Bell, is going to be moving around between the communities we serve and living in some for weeks at a time. I, Stewart Decker, also a new volunteer, and several others plan to spend a few days at a time with Gil in the communities. This is part of our effort to get to know the people in our communities better, and to increase our understanding of the health challenges they face.
I recently returned from Patacancha, where Gil and I spent several days working alongside the nurses at the local posta. A posta is a rural outpost clinic where Peruvian nurses work in 10 day shifts, and are available to community members 24 hours a day during that time. The posta nurses are important partners for SVH as they have so much firsthand knowledge of local health issues. Gil and I helped the posta nurses with their daily tasks, from seeing patients to providing health education. We, the nurses, and the Patacancha community health workers (promotoras) discussed the structure and goals of our promotora training and health education programs. We asked them to share their views on our current approach, and to identify practices will maximize the programs’ impact.
A little background may be appropriate here. For the past couple of years, the Peruvian government has been in the process of decentralizing healthcare authority from the national to the regional level. The Cusco region has been divided into four public health networks. Each is meant to have a director of strategy to whom each posta answers. However, the true administrative power these days lies with the directors of the individual postas. They create their own programs and run them with money and supplies from the Ministry of Health. In our area, the Ollantaytambo District, the Ministry started a community health worker program about eight years ago, only to have it fall apart within five years due to lack of funding and supervision. The community considers this a major loss, and the nurses in Patacancha are excited about renewing promotora training in partnership with SVH. We asked the posta nurses about the skills that they want the promotoras to develop, what additions they would like to make to the SVH curriculum, and how involved they would like to be in SVH trainings. They shared their insights into what worked and didn’t work in the previous community health worker training effort, and how we can make the SVH’s program sustainable and successful.
We had valuable conversations and left with many suggestions and a sense of mutual excitement and support. We also came away with a strong sense of friendship from spending time with the nurses on a daily basis. I went running with them each morning, we cooked and ate together (I taught them how to make lentil soup, ratatouille, Spanish tortilla, caramel popcorn, and toasted chocolate oats), and we watched emotionally charged Spanish films which of course left us crying. We taught hand washing and tooth brushing at the local high school, and the kids offered to be an official hand washing and tooth brushing delegation, sharing what they had learned with their families and neighbors. All in all, we had a highly successful trip. Gil will stay at the posta for the rest of the week, and we are excited to hear the further insights that she will gain there. In coming weeks, we will post reports from our extended visits to the other communities that SVH serves!