Los Julcaneros

I had my first work meeting yesterday. It was with the jefe of the Red Julcan...so that's the chief of the Julcan health network, Dr. Henry Guanillo Che and also the president of the Comite Local de Administracion de Salud (CLAS), Sr. Julio Ramirez Mendez. The CLAS is a community run organization that makes administrative decisions about health services in Julcan. They are part of an effort by the Peruvian government to decentralize the administration of health services. The CLAS is in charge of making decisions about health at the primary care level - which are their health posts and health centers. It removes some of the bureaucracy from the health care system, b/c if the CLAS wants to hire a new doctor or start a new program they can. The CLAS does not have that same control over hospitals, which seems to be something Julcan is struggling with b/c their health center may soon b/c a level 1 one hospital.

Julcan is a district that has about 30,000 people. The Red de Julcan currently is made up of one health center and 16 health posts. They refer more complicated cases to Otuzco which is about an hour away. Their current health care concerns are:
1. dealing with the lack of access to clean water - most people do not have potable water.
2. child malnutrition
3. preventing maternal morbidity and mortality

Dr.Henry said there focus is on prevention of illness. They are very interested in trying to figure out the reasons that people don't access health care - they tend to have difficulty getting women to prenatal care, routine child exams/immunizations, and they want to find interventions that work and are sustainable. They are happy to have students come and work with them...they have lots of health care surveys/data they'd like to collect. I'm planning to go to Julcan in February for about 6 weeks, so I'll see what it's really like.