Common to every rural village in Bolivia is free-roaming dogs. They account for 99% of cases of rabies transmission world-wide (WHO, 2004). Last month the Ministry of Health launched a Canine Vaccination Campaign and turned to the Community Health Promoters (trained by Etta Projects’ Health Program) to lead the movement. For two full days, the Community Health Promoters made house visits to educate their neighbors about the social and health problems associated with free-roaming dogs, including fecal contamination, bitten children, spread of rubbish and diseases such as rabies. In addition, the promoters took to the streets and vaccinated every dog in all 15 participating villages! Check out the photo of Health Promoter, Enna Cardosa from El Fortin, making house visits and vaccinating dogs while toting around her small child. Like so many other community health promoters, nothing will stop these courageous, dedicated women to improve the health conditions in their villages.
In addition to the Canine Vaccination Campaign, the Community Health Promoters also led the Las Americas Campaign. In partnership with the Ministry of Health and Etta Projects, the Health Promoters organized and administered free vaccinations to all children under the age of five.
Etta Projects has continued to provide training to the 45 health promoters. Most recently they have learned about reproductive health, teen pregnancies and domestic violence. The program has continued to gain momentum and we are set to launch another health promoters program in the Municipality of Warnes, adding 16 new health promoters to the program! Villages in District 8 of Warnes will soon have trained local women responding to the health needs in their villages. The women leaders will learn about first aid, women’s health, children’s health, hygiene & sanitation promotion, and public health care policies. The villages will also receive distribution of fully-stocked first aid kits and participate in a series of community health activities.
We thank you for your generous contribution to this program. On behalf of the women leaders, the community families, and all of the street dogs, thank you for your support!
During the rainy season, roads that run through rural Bolivia become virtually impassable. After a heavy rain it is nearly impossible to travel down the dirt road, for example, that connects the eight villages in what is commonly referred to as La Banda of the Municipality of Minero. It usually takes days of sunshine before the road can be used again. In rural areas like La Banda, the rain affects much more than a day of outdoor activity and play. The weather impacts access to schools, health centers and services as well as economic livelihood.
For the past three years, Etta Projects has been training community-elected local women to serve as community health promoters. They have received training in first aid, nutrition, women and children’s health, and hygiene & sanitation promotion. The health promoters play an important role in responding to the health needs of their community year-round, but perhaps their job becomes most important during the rainy season.
At 11 a.m. on January 6th, Yovana began showing signs and symptoms of labor- severe back pain, cramping and diarrhea. She immediately turned to her community health promoters, Marta and Calendaria. By noon, the health promoters called the ambulance and the women waited and prayed that despite the heavy rain and impassable roads the ambulance would be able to arrive to the village to bring Yovana to the hospital.
While they waited for the ambulance, Marta and Calendaria put the lessons learned from the women’s health unit into practice. They held Yovana’s hand, kept her calm and led her through breathing exercises. It was not until almost 12 hours later that the ambulance finally arrived to the village. By this time, Marta and Calendaria were not about to leave Yovana’s side so all three women boarded the ambulance and started the commute to the hospital. About half way there, Yovana was ready to deliver. With no other options, Marta and Calendaria were forced to deliver the baby in the ambulance. When they arrived to the hospital the doctor said the promoters did a “flawless” job. Today both mama and baby - Luis Fernando Duran, 4,400 kg.- are doing well!
The support that Marta and Calendaria gave to Yovana and Luis Fernanado is just one out of countless moments that proves both the need for and the effectiveness of Etta Projects’ health promoter program. These women health leaders understand the health needs in their community, and they also understand the gap between their village and the available health services. They are uniquely positioned to effectively respond to community health needs. These women are known as community health promoters, but we like to refer to them as community heroes!
When Etta Projects began training local women from rural Bolivian villages to serve as community health promoters our goal was to bring skills and health supplies directly to isolated areas that would allow them to effectively respond to local health needs. Over the past three years, these newly-trained women leaders have risen to the challenge! Today they tend to the sick and injured, maintain community health kits, coordinate with local health centers, and host health fairs and events. Some of the health promoters have even returned to school to become nurses and others have earned leadership positions on municipal health councils. Each and every one of the health promoters have become protagonists of change in improving community health.
The health promoters have brought light to many issues faced by women in their communities- one of the biggest being domestic violence. Natasha Loayza of ONU Mujeres in Bolivia states, “Bolivia ranks 1st of the 13 Latin American countries in incidences of physical abuse of women and second in sexual abuse, after Haiti.” She adds that domestic violence is most prevalent in rural communities. Etta Projects conducted its own study with the 45 health promoters and found that 77.78% (35 of the 45 women) have been or are victims of some type of domestic violence. A woman from the village of Rio Viejo shared, “My husband is very jealous. He makes me stay at home and care for him and the children. One time, he abused me so badly I lost my unborn baby.”
Etta Projects has recently responded to this pressing issue by offering workshops to health promoters (and at times their spouses too) to promote gender equality, eliminate domestic violence and emphasize strong, positive values in relationships. We aim to include both men and women in the process of advocating for women’s rights and against domestic violence. Participants reflect on the importance of respecting the rights of women- not just for women, but for the entire community.
On November 25th hundreds of men, women and children as well as municipal representatives and local doctors came together from 15 villages to celebrate International Day for the Elimination of Violence against Women. The event, which was led by the 45 community health promoters, included presentations and songs from health promoters and male leaders, traditional dances by women and children and a large march where all the attendees chanted the rights of women. Our goal is to not only strengthen justices circles among women in the community, but to also include male partners, adolescents, local leaders, reproductive health providers and local social welfare agencies in a collaborative process of change.
Etta Projects began its Health Promoter Project three years ago. The journey of one young girl, Evelyn Orellay, echoes the impact this project has had on the lives of the participants, their families and the community at large.
Evelyn is a community health promoter in the rural village of Rio Viejo. Of the 50 women who currently participate in Etta Projects’ community health program, at 16 years old Evelyn is the youngest.
Evelyn is a single mother. She had her son, Jose, when she was 12 years old. Evelyn was rejected by both the baby’s father and her own family when Jose was born. She was forced to quit school to take care of her son. Evelyn says she joined Etta Projects’ health program looking for companionship and support. What she never expected was the impact it would have on her life.
Shortly after joining the program, Evelyn realized that she excelled in the training and had a unique passion to help others. She aspired to become a nurse or a doctor. Her parents recognized Evelyn’s new ambitions and agreed to allow her to return to school and help her to raise Jose.
Evelyn takes her position as a Community Health Promoter very seriously. She spends her weekends making house calls to check up on the sick, injured and malnourished. She is now the first person who community members turn to when they need medical support. In fact, on two occasions, she helped local women give birth when the ambulance was not able to arrive on time.
Evelyn’s recognition as a health leader in her community earned her the position of Local Health Authority, a role almost never held by a woman and never as young as Evelyn. Her ability to shine as the Local Health Authority led to election as President of the District Health Committee. Most recently, she was nominated to serve on the directory committee of the Municipal Health Committee. This is a group of six leading health authorities that represent the health needs of the entire municipality and hold voting power on how local government health resources are utilized. In addition to her new positions in the healthcare system, Evelyn also manages to maintain the rank of Valedictorian of her high school.
Evelyn says it is Etta Projects that provided her with this opportunity to change her life. “I think back to what my life was like before the program, and I never would have imagined I’d be where I am today. Now I believe that anything is possible. I know I will keep achieving new goals and now I am certain that I have a good future ahead of me.”
Etta Projects’ health promoter program continues to be a catalyst for change in the lives of the participants like Evelyn as well as the community at large. Over the month of September, in Evelyn’s district the trainings focused on the commonly taboo topic of reproductive health. Participants learned about adolescent pregnancies, contraceptives and family planning. Etta Projects' goal is to teach promoters to help community members recognize their right to be informed of and to have access to safe and affordable methods of fertility regulation, and the right of access to appropriate health care services for pregnant women.
In addition to trainings on reproductive health, over the past month the Municipal Health Committee where Evelyn holds a seat has been preparing its first official Health Development Plan. This is the groundbreaking plan developed by the Municipal Health Committee to be presented to the Municipality of Minero in the upcoming week. For Etta Projects' health program, the plan represents a new space for the voice of women in health planning and ensures equitable representation of community health needs.
We thank you for your commitment to Etta Projects' health program and for your support to Evelyn and the other participants. Evelyn's story is inspiring. Please share this story with your girlfriends because we all need to celebrate when one of us defys the odds!!!
Nine months ago Nely Ramos Malaga went into premature labor with Baby Nilda. Afraid and alone in the isolated rural village of Chuchial, Nely turned to the only health support her village can rely on regularly: the Community Health Promoter, Marleni Rodas. Armed with three years of health training from Etta Projects, Marleni quickly called the ambulance and while they waited over four-hours for its arrival, Marleni single-handily delivered Baby Nilda. Later after a doctor examined Nely and Baby Nilda he shared, “Given the weak and fatigue state of Nilda, it is doubtful that either the mother or the baby would have survived without the health promoter.”
Etta Projects has trained and empowered over 50 women health promoters from 15 rural villages to effectively respond to health needs in their communities. These courageous women leaders promote and advocate for improved hygiene and sanitation, family planning and nutrition. Today, with your generous support, medical supplies and services are available in isolated villages as health promoters administer first aid kits, facilitate health promotion activities, volunteer at local health centers, and care for the sick, injured and pregnant.
This year Etta Projects celebrates 10 years of impact in rural Bolivia. We have supported more approximately 61,850 people throughout the Department of Santa Cruz, Bolivia to implement sustainable water, sanitation and health projects. Thank you!!!!
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