Community Health Projects
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Santa Marta Rehabilitation Center - Operations, 2002 CoCoDA's cooperation: $2,000 (2nd Quarter 2002) This $2,000 cooperation made possible by a contribution from Patchwork Center in Evansville, Indiana supports the operations of the Santa Marta Rehabilitation Center and the CoCoSI sex education and AIDS prevention programs in northern Cabañas, El Salvador. The Santa Marta Rehabilitation Center attends to men, women and children in the rural communities of Cantón Santa Marta in northern Cabañas, El Salvador, including those dealing with war wounds, accident and work related injuries, congenital defects, respiratory problems and post traumatic stress related aches and pains. Some people have special orthopedic needs and in several cases the Rehab Center has helped patients find much needed surgery in other health facilities. The Center coordinates an outreach and education program called CoCoSI, educating for prevention against AIDS, and on topics relating to reproductive health and family planning. In 2001, the Rehab Center attended to 308 individuals (1,183 sessions). The CoCoSI group gave presentations and led workshops with 2,098 participants. Members of CoCoSI participated in 11 training workshops. Educational radio spots were broadcast from Radio Victoria. The personnel involved in ADES community health and the Rehab. Center also mobilized to assist in the 2001 earthquake relief efforts, taking health brigades with supplies and medicines to 450+ individuals in 42 communities of Cabañas. Brenda René Hubbard, a woman from the United States who has a home and has lived in Cantón Santa Marta for about 10 years, is coordinator of the Center, and René Beltrán, a resident of Santa Marta, is a physical therapist in the center. They are looking for funding to hire a woman to do physical therapy with women. In July, 2001, CoCoDA-River Road Unitarian Church (MD) granted $3,887 to the construction of a fence around the Santa Marta Clinic and Rehab Center, to help keep out animals, vandals and mischievous individuals. A CoCoDA-RRUC delegation assisted with that construction. In March, 2002, a delegation from the River Road Unitarian Church donated an exercise bicycle to the Rehab Center. Doctors for Global Health (DGH) have also made a contribution to help fund operations of the Center in 2002. Due to lack of funding, Brenda Hubbard does not receive a stipend for her work with community health, which is presently a limitation of the program, as well as the lack of having a woman to do massage with women patients.
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Santa Marta Physical Rehabilitation Center - Construction CoCoDA's cooperation: $4,075 (4th Quarter 2001 & 1st Quarter 2002) A January, 2002 Winter Team in Service (WITS) team from DePauw University in Greencastle, Indiana spent three weeks helping put a new roof on the Santa Marta Rehab Center, a new room and a pila (wash / water basin) in both the Rehab Center and the main Santa Marta clinic. |
Community
Health Programs in Northern Usulután CoCoDA's cooperation: (new 3-year goals being discussed) In 1999, CoCoDA - Patchwork Central (Evansville, Indiana) - Emmanuel Baptist Church entered into a three-year cooperation agreement to advance community health and community organizing in 6 rural communities of Northern Usulután, with a population of about 4,000 people. CoCoDA - Patchwork Central provided $9,000 in grants for IBE's health work from 1999 to 2001. IBE's work in community health, under the leadership of Dr. Rebecca
Kragh of Minnesota, had five areas of focus during this period: (the following report was prepared by Dr. Rebecca Kragh, IBE. Edited by CoCoDA staff) Assessing IBE's work with community health promoters and clinics In reviewing the health work over the past 6 years we have had many personal victories for the patients, the health promoters, and myself, and also there have been some frustrations. The first 3 years, the clinics we focused on self-sustainable general operations of the clinic and management of common illnesses. During the next 3 years, general operations continued but special products and resources became available due to the public emergencies related to Hurricane Mitch and the 2001 earthquakes. Each emergency resulted in large quantities of donated medications for the clinics from many nations. The process of learning about these new products was a challenge for some promoters, an obstacle for others. The Italian Cooperation, CRIC agreed to dedicate its emergency funds to the water filter and latrine project for La Barca and San Benito and the promoters took the responsibility for implementing these projects. CRIC also donated hygiene products and expensive medications that allowed us to offer free campaigns against gynecological and sexually transmitted diseases. In the years 2000 and 2001 the nature of the weekly clinics changed, the health promoters had greater ability to diagnose and treat diseases independantly, and therefore fewer common illness required clinic consultation. At the same time, the availability of free treatment for sexually transmitted diseases shifted the demand in the clinics to a majority of patients seeking consultation for obstetric/ gynecological and sexually transmitted disease problems. Donations of the nebulizers and glucometers after the earthquakes have again shifted the clinic population, as more people seek help in the clinic for problems of asthma, diabetes and hypertension control. As problems of gastrointestinal and parasitic illnesses will hopefully decrease in the communities due to the availability of potable water, other diseases are emerging. In the future, HIV and dengue hemorragic fever will demand greater efforts at prevention, and diabetes, hypertension and heart disease are increasing problems in the developing world. Earthquake Response The health work of Emmanuel Baptist Church in 2001 was shaped principally by the emergency needs and resources provided in response to the disastrous earthquakes that struck the region on January 13 and February 13, 2001. The main donors to the health area were as follows: The earthquakes and aftershocks caused extensive damage in Mercedes Umaña and Berlín with about 40% of the houses in the 2 municipalities irreparably damaged. The percentage of irreparably damaged houses was even greater in the communities where Emmanuel works: 95% in Horcones, 85% in La Barca, 90% in San Simón, 60% in San Benito, 80% in Talpetates. Two children died in Mercedes Umaña (Santa Anita) when an adobe wall and heavy roof beams fell on top of them, but generally there were few injuries caused by the earthquakes in Usulután. Many emergency programs sprang in action after the earthquakes; the staff of Emmanuel dedicated about 3 months working on community damage censuses and distributing donated materials in the communities ( food, clothing, blankets, plastic sheeting, steel roof sheeting, lumber). During the first 3 months after the earthquake there were free medical brigades almost weekly offered by the Ministry of Health, the military, church groups and social service agencies, which temporarily reduced the demand for everyday treatments from the clinics supported by Emmanuel. People never-the-less sought out Emmanuel for more specialized clinic care; providing treatment for sexually transmitted diseases, prenatal care and treatment for injuries from house demolition, clean-up and new construction. Donated medicines were received from churches and religious organizations in Canada, the USA and Europe which supplemented the needs of our clinics and provided surpluses that were shared with other private and public clinics and hospitals. Three donated nebulizers were received, one for each clinic, and the health promoters were trained to recognize signs of severe respiratory distress and how to apply nebulization therapy in a day-long workshop in April. These skills and the local access to the nebulization equipment were especially helpful in May and June when epidemics of severe respiratory infections struck with the coming of the rains. |
Potable Water Project The construction of the potable water project by the American Red Cross was about 40% completed when the earthquakes struck, but after the quakes work stopped for 4 months. The quakes caused multiple cracks in the buried tubing and some damage from landslides, but mostly diverted the attention of the American Red Cross who were committed to provide water and sanitation to the earthquake refuge encampments in San Salvador. The earthquakes also changed the requirements that the Red Cross placed on the communities. The majority of beneficiaries of the water project had extensive earthquake damage to their homes, and therefore the Red Cross felt they could not demand weeks of work without pay from people who suffered the loss of their homes. After the earthquake an engineering firm was contracted to complete the remaining 60% of the water project, with the possibility of temporary employment for the local people. At the same time the Red Cross engineers took over the responsibility to repair the damage to the 40% of the project that was previously built. During many months threats and criminal violence drained the energies of the water project. After numerous threats and assaults, the Red Cross paid 4 local men (sharpshooters from the war) as bodyguards to follow the engineers where they travelled. International policies of the Red Cross do not permit arms in their vehicles, so the bodyguards were restricted to another vehicle close-by. One day in July 2001 the engineers were making a short trip between La Barca and San Benito, and some of the bodyguards climbed on the Red Cross pick-up. The other bodyguards were aboard the other privately owned pick-up that travelled a block ahead. In the barren region near the cemetary of La Barca, some assaultants waited for the bodyguard pick-up to pass, and then stood in the road firing at the Red Cross pick-up. The bodyguards fired back from the Red Cross pick-up, with the result that one of the assailants was killed (a youth from Jícaro) and two or more of his accomplices escaped into the brush. The Red Cross pick-up was impounded by the police as evidence. From that time on, the Red Cross withdrew all their staff from the region, placing the contract engineers in charge of completing the project. The Red Cross heirarchy also reprimanded their staff for not obeying the Red Cross policy regarding arms in their vehicles. The Red Cross´abrupt termination of responsibilities meant that a number of prior commitments were abandoned, such as the funding for waste water drainage systems, latrines, and follow-up work with the water board to assure appropriate administration and maintenance of the system. The completion of construction and formal transfer of the water project from the Red Cross to the local water board occurred in December 2001, so the water board is now just starting to take over its administrative role. Most of the local violence appears to have been perpetrated by delinquent youth who robbed for personal gain, and who also performed targeted attacks apparently under contract of certain wealthy land owners who have a personal interest in blocking local projects. In 2001 there were 2 additional gunpoint assaults with violent threats against the Red Cross, one against the environmental NGO, SalvaNatura, and one against my IBE co-worker, Antonio. Twice, grenades were found planted in the work areas near the springs in Santa Anita. Threats were made against persons from Jicaro and Santa Anita who cooperated with the water and environmental agencies. An attempted murder in Horcones resulted in serious wounds to the victim and in the death of the attacker. A hold-up near Santa Anita resulted in the death of a worker from Jicaro who was returning home in his pick-up. A delinquent youth from Santa Anita was shot when he tried to rob vehicles on the highway. Little by little these bloody trails have brought to light some of the people responsible for these violent actions, though the police do not have sufficient legal evidence to arrest the perpetrators. The past 2 months have passed with greater police presence and without bloodshed in the Santa Anita/ Jicaro area, but the feeling of insecurity persists in this context of threats, vandalism and violence. In our daily work we recognize that we need to be careful, constantly looking and listening for potential problems and threats. In May 2001, we offered a workshop, in coordination with the Ministry of Health, for health and sanitation workers and for members of the water board to learn about the design of waste water systems and to visit homes with working waste water absorption pits, but the promised financing for the waste water systems disappeared in the next conflictive months. |
Community Health Services In the second half of 2001 the health work was supported by resources from the ecumenical emergency funds of the agency ACT, with the special focus of ministering to the emergency, emotional and mental health needs of the communities affected by the earthquake. The funding from ACT was highly restricted and limited to a 7 month period, so resources from COCODA and other sources covered expenses not provided by ACT. Two day mental health workshops were offered in San Benito, La Barca, San Simón and Rio Los Bueyes with the focus of helping people identify problems of depression, family violence, and addiction, and to know about local and national social service resources that respond to people in emotional crisis. Using brochures, videos, group discussions and small group exercises the adults and youth analyzed the emotional problems found in their community and proposed ways of supporting others in emotional turmoil. An intensive 3 day workshop was also provided for health promoters and community leaders that involved visits to 4 social service agencies that treat the mental health needs of abused, abandoned, addicted and delinquent populations. By visiting these agencies, the participants learned more about the therapy offered by each institution, and the mechanisms for referring persons in need. The workshop also included sessions focused on recognizing physical and psycological signs of domestic violence. Utilizing slides and videotapes, the participants learned about recognizing characteristic injuries produced by child abuse and about recognizing the multiple different ways that physical and psychological abuse is perpetrated against women. Four public health campaigns were offered, during the year: Four workshops specifically for health promoters were offered focusing
on emergency treatment of injuries and illnesses. The 3 clinics operated by IBE in Usulután had both improvements
and damage during this past year. Some of the emergency funds were used
to purchase storage and cleaning supplies that help protect the medicine
and equipment in the clinics. |
Financial Cooperation with IBE's health work in 2001 • CoCoDA – general operations and workshops January- May
2001 and special needs
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Last Revised on 15 May 2006