When we arrived in the community of Rumira Sondormayo, Community Coordinator and Registered Nurse Mary led me on a path up to the home of promotora (community health worker) Fanny. We found her weaving chin straps for monteras, traditional hats worn by women in the Ollantaytambo district out in her yard. After chatting about the artesanías, she and Mary reviewed the topics of the most recent training – the dangers of obesity and remedies for back aches. After the review, Fanny disappeared into her house and returned with her botiquín. The promotoras tote this bag of medical supplies around to the house visits they make in their communities.
We walked in through a wooden gate into a garden to visit Fanny’s first patient. The older woman was seated at her loom, just as Fanny had been. Her husband reclined in a nearby patch of shade and was cutting a sheet of sheepskin into a round, a component part of a craft drum he will sell to tourists at an upcoming fería. Fanny greeted the woman and asked in Quechua how she was feeling. I looked on as the patient gripped her lower abdominals and winced to highlight her discomfort. “It seems she has a urinary tract infection,” Fanny explained to Mary and me. Mary prompted her to ask the patient follow-up questions to determine the duration and severity of the infection. After about ten minutes of back-and-forth, we learned that the course of treatment prescribed to her weeks ago by the posta (government health clinic) had been inadequate, and the infection had worsened. Fanny encouraged her patient to return to the posta for a followup visit. She explained the importance of drinking lots of purified water to flush out bacteria and prevent future infections. Additionally, Fanny gave her patient a lower-back massage with a tincture made from local herbs to lessen her aches. The woman thanked us and Fanny confirmed that she would return to the posta the following week for followup.
The next people we visited were younger and appeared close to Fanny’s age. She saluted them informally, motioned to a cooing baby resting on a colorful manta, and began to inquire about their health. A young man explained that he had a fever and backaches. Fanny initiated a line of questioning to learn more about his condition and decided his symptoms were flu-like. She prescribed him water and adequate rest, and taught his wife how to perform massages with therapeutic balm to relieve his muscle aches. She passed her a container of balm to keep, and we were on our way.
Our final patient of the day lived just down the road: a very hospitable woman who had recently fallen off her roof while working on it. Although she reported that a clinic told her she had broken a rib, Fanny and Mary decided she didn’t present the associated symptoms. “Possibly just bruising,” said Mary, which Fanny translated into Quechua. Fanny administered some of her curative balm and referred her to a clinic that performs chiropractic services for a nominal fee, or free of charge if the patients claim undue economic burden. The patient seemed pleased with the advice, and offered us a large sack of potatoes and lettuce freshly picked from her garden. I reciprocated with the only food we had on us, a large bag of trail mix, and we embraced goodbye.
On the beautiful walk back to Fanny’s home, Mary asked her what she would present at the next General Assembly, an opportune setting for the promotoras to disseminate important health information to their communities. We said goodbye at her door and walked back to find Mary’s friends. Our pride in Fanny’s displays of leadership throughout the day helped carry our heavy feet back down the trail.
– Written by Courtney Weintraub