Out in the Comunidad

While in Huaral, besides doing some of the MAIS forms I also spent a lot of my time going out into the community with the health center staff to participate in health education activities. The centro works with people on a family level by doing home visits and at a community level by organizing charlas in a community member’s home. They also have a escuela saludabe and a centro laboral saludable program.

Our outing into the community was with the midwives for a charla on family planning as well as free rapid HIV tests. Like most community work it takes a little convincing to get people to participate. The internas told me that they had canvassed the neighborhood the week before to let people know about the talk and when we arrived no one was there. So we went knocking on doors and ultimately I think it was the free rapid HIV tests that brought them to the talk, but at least they came. The health center has only two patients from their catchment area that have tested HIV positive, but there is a big push by the ministry of health to test as many women of fertile age as possible. Most women who are HIV positive in Peru contract HIV from their husbands/partners. If you test positive the ministry of health will pay for HIV treatment. There is currently a rapid HIV test campaign, but otherwise the test is fairly expensive.

The escuela saludables program is a partnership between the health center and two schools in the area to work on a few specific health topics. There are four health topics they want to cover during the year and they are currently focusing on nutrition. Huaral has a mix of children with chronic malnutrition and then others who are on the road to obesity. Like many places in Peru people eat an abundance of carbohydrates, but little proteins, fruits, and veggies. Unlike other places in Peru, b/c there is not as much poverty as in other areas some children do have a little money to spend at the school snack bar and tend to buy unhealthy snacks (potato chips, soda, etc).

There is a school health committee and they are in charge of choosing the areas they would like to focus on and work with the health center on how to address the issues. First, the health center staff meets with the teachers to get them to buy into the program b/c ultimately it gives the teachers more work to do. The health staff is supposed to mainly educate the teachers and the teachers are then supposed to work the topic into their education plans. The health committees decide how to best involve/work with parents. I was able to attend three nutrition-focused events. The first was a meeting with teachers to explain the escuela saludables program and then we had another session with teachers where we went over what a healthy diet consisted of and some sample meals. The teachers are a tough bunch and they had many critiques about the suggestions made, most of which were totally reasonable. Mostly they were concerned about the ability of parents to afford healthy foods. Our last nutrition talk was with a parents group at an elementary school and we adjusted the talk to come up with very concrete examples of affordable, but nutritious foods. The parents seemed to be open to the talk and asked lots of good questions. On our way out we were offered a snack of cow lung with potatoes. First time for me…probably good, but I had a hard time getting past the idea of lung.

The last talk we did was at a pig farm. This is a new area of work for the health center and they chose a farm whose owner is already very active in the community. We didn’t see much of the farm, but overall it looks like a pretty nice place. We met with all of the workers as well as the veterinarian, the head manager, and the owner. The session started off by naming employees to the health committee. Then everyone was asked to list problems they’d like to address and they were really some very basic hygiene, sanitation, and biohazard material disposal issues. My thoughts while listening were that this place would be shut down in a second if it were in the states. I think the important thing is that the owner is open to addressing these issues and the vet is very interested in making real improvements. We then proceeded with a very basic talk on hygiene that was very needed given some of the issues the farm is facing. When it was done we got served some very yummy pork sandwiches.

While in Huaral, we were fortunate enough to be housed by the nicest family on their farm. They were some welcoming and the food was amazing and I got to go on runs through some of the nicest scenery, including some of the biggest mangos I’ve seen in my life. It was just one of those unexpected bonuses you get when you’re doing this stuff.