Friday began early, with SVH/Ayni Wasi staff members piling into two vans to pick up the Cycle 2 promotoras (our second cohort of community health workers) for a training session, or capacitación. These amazing women come from six different comunidades. Since narrow, rock-laden roads do not accommodate our vans, we picked up the promotoras at more accessible meeting points lower down on the roads. The van carrying my group rode an hour southeast of Ollantaytambo to Soccma to retrieve promotoras Ignacia, Valentina, and Berta, who met us in front of a cow stable. We greeted them with newly-learned Quechua pleasantries, and soon enough a promotora declared, “Haku!” Let’s go!
Back in the van, we made our way towards the government-run posta (health clinic)in Chillca, where we hold capacitaciones. Along the way, the van picked up schoolchildren heading to class and women en route to the market. A young girl seated beside me told me she’d like to be a nurse when she grows up.
Por fin at our destination, we reunited with the other van, which had picked up promotoras Fanny, Silvia, Griselda, and Luzmila. Together we ate a hearty breakfast of mulled beans and bread, and then our community coordinators, Mary and Josselyn, took the floor to review topics from the previous training session: obesity, prenatal nutrition, diabetes, and back pain. Using projector screens as teaching aids was really helpful, especially to display diagrams of the correct posture to assume when lifting heavy items. Promotora Silvia volunteered to demonstrate how not to lift a heavy box, which brought giggles from the others.
The women then divided into two groups to review the material in greater detail. The first group discussed prenatal nutrition with Community Coordinator Mary, who engaged them in true-or-false-type questioning. With the second group, our head nurse Leticia led a practice in muscle stretches and massage techniques. “Oh, I’m going to ask my husband to practice on me!” exclaimed one of the more gregarious promotoras.
Mary and Josselyn led the second half of the session, which highlighted the risks associated with obesity and the symptoms of diabetes.
“I’m overweight and I feel fine,” chortled Josselyn, strutting with hands pressed to her back to support the pillow “gut” she had stuffed under her t-shirt. “What’s the problem?”
Timidly at first, the promotoras began to call out possible answers: too much blood sugar, lethargy, high pressure, blood clots. The promotoras could stick a laminated illustration on the corresponding body part of a laminated “patient”. The illustration of high blood pressure was pasted on the patient’s chest, a frowning representation of a blood clot on its leg. We continued with a similar exercise for diabetes, an illness that often goes undiagnosed in the communities we serve.
To cap off the training, we played a game where the promotoras registered their agreement or disagreement with coordinators’ treatment plans with checks or X’s on whiteboards. Mary feigned, “I’m about to have a baby and I want it to be born healthy. Should I eat foods that contain folic acid?” Yes! they uniformly demonstrated with check marks.
Over a lunch of rice, cooked lentils, and gaucho salad, the coordinators rejoiced at how well the promotoras engaged with the slides. Displaying the information through a visual medium reinforced the group’s understanding of certain topics, like what a well-balanced meal should look like — colorful, just like the group of promotoras themselves.
– Written by Courtney Weintraub