One of the most remote communities we serve, Yanamayo is hidden in a high mountain valley, a two-hour drive from our headquarters in Ollantaytambo. Though the roads to Yanamayo were impassable for months during the rainy season, they are finally open and dry. This past weekend, Community Coordinators Catherine Hansen, Escolastica Castillo Obando and Mary Underwood R.N. went up there to spend the night with promotora (community health worker) Matilde, not only to get some work done, but also to spend quality time with an incredible woman in her community.
The road to Yanamayo twists up the mountain, hugging steep cliffs and traversing waterfalls alongside herds of grazing alpaca. During the rainy season, this road—the only entry to Yanamayo— turns into a dangerous mudslide, often preventing SVH/Ayni Wasi coordinators from making it up to the community. The impassable road also prevents the residents of Yanamayo from reaching the government health clinic.
This is why we train promotoras. Although the most isolated communities we serve, like Yanamayo, Kelkancca and T’astayoc, present the greatest challenges with respect to transport and communication, they are also the communities with the greatest need of our services. If trying to get to Yanamayo to visit Matilde is frustrating, then trying to get out of Yanamayo when you are sick or in labor must be terrifying and even life-threatening. Matilde has been a community health worker in Yanamayo for almost two years now and is about to graduate from our core promotora training program this fall. She, along with her peers, will then partake in ongoing education sessions on a bimonthly basis to continue to maintain their status as promotoras and continue to build their knowledge.
Upon their arrival in Yanamayo, a mountain community shrouded in mist, Catherine, Escolastica and Mary met Matilde as she returned from another mountain where she had been pasturing her sheep. After a hearty lunch of boiled potatoes and tea, the women set off to visit houses in the area to see if anyone needed medical advice. With Matilde in the lead, they trekked up steep slopes from house to house.
At each home they encountered a similar scene: a low stone cottage where with children played in the yard and where dogs, chickens, guinea pigs and alpaca roamed freely. Matilde introduced herself with warmth to the women she encountered outside weaving. Matilde explained that as a promotora, she is a trained health representative for the community. In response, they told Matilde of chronically aching backs, bladder infections, headaches, and foot ulcers. She listened intently and gave advice to each woman in turn. Meanwhile, Escolastica translated Matilde’s rapid-fire Quechua into Spanish for Catherine and Mary. They visited women in five different homes and discovered that many were interested in natural medicine, such as local plant remedies. Women in Yanamayo are often unable to attend the community’s General Assembly, during which Matilde gives brief presentations on public health issues, because they are expected to cook and clean at home instead. Excited to learn more, many women asked Matilde to give a presentation just to them; she happily began planning one for next month.
After a day of home visits, the SVH/Ayni Wasi staff retired to Matilde’s home where they ate another helping of potatoes for dinner and talked about the day. A spectacular array of stars shone through the window of the darkened kitchen; because electric light is still unavailable in Yanamayo, starlight is unobstructed. They drifted off to sleep on thick piles of smoky sheepskins.
– Written by Mary Underwood R.N.