Day in the Life of an SVH Promotora

One of my favorite part of my job as a Community Coordinator is spending time with our promotoras (community health workers) in their communities. Community Coordinator Josselyn and I recently spent two nights in Soccma. Living with our promotoras even just for a night, playing with their kids, talking with their husbands, and helping them cook allows us to gain a deeper understanding of their challenges and joys.

We’d like to share a few of the moments from our stay with Ignacia in Marcuray and Luzmila in Pilcobamba so you too can get a look into the life of a promotora:

8:30 am. On Wednesday morning Josselyn and I left Ollantaytambo and took a 15 minute combi (shared public van) ride to Pachar. Then we rode the market truck 45 minutes up to Soccma. From there we hiked two hours to Marcuray where promotora Ignacia lives. This is the route that people living in this community take two days a week to buy groceries and sell goods at the market. They leave at 10 in the morning and get back after dark. If they need to go to town on a day when the market truck doesn’t run, they have to walk two to three hours down to Pachar to catch a combi to the market. This poses a problem for health care in these communities because if there is a medical emergency they have to take the same long journey into town. This is why the work of our promotoras is so vital to the health and livelihood of these communities – some of these long trips are no longer necessary.

Community Coordinator Josselyn pauses for a snack break on our hike up to Marcuray.
Community Coordinator Josselyn pauses for a snack break on our hike up to Marcuray.

5:00 pm. Ignacia came back from the market, and she made us potatoes with cheese for dinner to go along with the guacamole we had brought. We sat on little stools in her kitchen next to the wood cooking fire watching a music video on her TV and asking her kids how to say phrases in Quechua, the local language. After dinner as we drank tea made from manzanilla (chamomile) from her garden, three year old Celia slept on her father’s lap and the cuys (guinea pigs) cooed in the next room. That night we slept in the same room as her family, and they smiled at us from their beds as we settled into our sleeping bags on fluffy sheep skins.

6:30 am. Ignacia let us sleep late, and when we woke up the whole family was already awake – preparing breakfast, washing their faces, and combing their hair before going to school. When we walked into the kitchen, Ignacia was grinding habas (fava beans) that she had roasted that morning. She boiled them with sugar and cinnamon to make haba molida, a popular breakfast drink, which we ate with bread.

Promotora Ignacia’s daughter Saraida studying in the morning before school
Promotora Ignacia’s daughter Saraida studying in the morning before school

9:00 am. Ignacia’s 18-year-daughter teaches the pre-K class, so we all walked up together when it was time for school to start. Ignacia had organized a presentation on family planning to give to other parents. After dropping their kids off at school, the other mothers gathered around Ignacia to listen to her presentation. Promotora Valentina came down from nearby Rayan to support Ignacia and together they answered the women’s questions.

Promotoras Ignacia and Valentina present on family planning
Promotoras Ignacia and Valentina present on family planning

11:00 am. Next we reviewed a capacitación (training) with Valentina that she had missed. One of the challenges of working in rural communities is that the promotoras sometimes miss capacitaciones due to transportation issues or harvest schedules. We finished the training in time for lunch, but Valentina couldn’t stay because she had to go back up to Rayan to take care of her cows. Most of the women we work with consider themselves amas de la casa (housewives), which turns out to be one of the hardest jobs I have heard of. They are some of the strongest and busiest women I have met, taking care of their animals and kids, cooking, cleaning, weaving, and helping their husbands farm.

2:00 pm. For lunch we ate a delicious soup that Ignacia had made with organic cauliflower and habas from her garden and potatoes her husband had grown in their chakra (small farm) up on the mountainside. School was finished for the day and we ate with her kids and some neighbors that had come over.

Promotora Ignacia cuts potatoes for lunch.
Promotora Ignacia cuts potatoes for lunch.

3:30 pm. That afternoon we walked down the mountainside to Pilcobamba where promotora Luzmila lives. We helped her peel potatoes to add to a ground corn soup she was making for dinner. As we drank muña (Andean mint) tea after dinner, Luzmila’s son Adrial sat by the light of a lantern doing his homework. Just as we were going to bed at 8:00 pm, Luzmila’s husband got home from his construction job.

6:00 am. When we woke up, embarrassed that we had slept late again, Luzmila’s husband had already left. Luzmila told us that each day he leaves at 4am to walk two hours to Pachar to take a combi to his construction job in Ollantaytambo. Luzmila had already roasted habas to make haba molida for us and her kids. In these remote communities the day starts early and ends early with the sun.

Promotora Luzmila’s kids ready for school.
Promotora Luzmila’s kids ready for school.

7:00 am. We all brushed our teeth together and the kids started off on their hour-long walk to school. Ignacia started cooking the second meal of the day and told us she was worried the women wouldn’t come for the health presentation she had planned because of the corn harvest. They were already 30 minutes late. “What are we going to do?” she asked. I’ve learned that even when we plan carefully, there is always something that doesn’t go according to plan.

9:00 am. We rescheduled the presentation for another day and focused on finishing Luzmila’s map training. She told us she would do a few patient household visits later that day after she took her sheep to graze. We said goodbye and walked 30 minutes down to Soccma to catch the market truck. Josselyn and I climbed into the truck bed with the locals taking their beer crates, dried corn, and pigs down to sell at the market. A little tired and very well fed from our two days in the Soccma district, we headed back to Ollantaytambo with a renewed appreciation for the important work done by our promotoras.

Community Coordinator Lydia and Luzmila talking about SVH’s mapping program.
Promotora Luzmila and Community Coordinator Lydia talking about SVH’s mapping program.

 – Written by Lydia Jessup

 

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