Healthy Perspectives

Health is an issue that merits much attention in Chaquijyá Central. Currently, the most pressing problems affecting the community include malnutrition, dental issues, respiratory diseases, and skin ailments. Although residents will travel to the nearest hospital (about 40 minutes away) when faced with a dire emergency, most community members rely on the services provided by a few local practitioners and organizations. Ixim Achi is the primary health organization in the community and receives funding from the Guatemalan national government. Working in numerous communities throughout the country, Ixim Achi sponsors health clinics in all four caserios in Chaquijyá and provides them with medicines, equipment, and oversight on monthly health workshops (“charlas”) provided for expectant mothers and women with recently born children. The clinic in the Chaquijyá Central is directed by Rosa Chumil, who also oversees nine volunteer health promoters, or “vigilantes,” who assist in the monthly charlas and monitor health issues and pregnancies in assigned sections of the community. Despite the presence of these individuals and organizations, existing programs in Chaquijyá Central only target children under 5 years of age, expectant mothers, and women over the age of 15, as many girls in Chaquijyá begin having children at this age. Children between the ages of 5 and 15, namely the children in primary and middle schools, do not receive adequate medical attention or health education.

Consequently, considering the number of preventable ailments affecting children in the community, my fellow PDs and I concluded that health education in the Primaria Central would be an ideal premier health program for MPI in Guatemala. Our initial idea was to collaborate with the nine local health vigilantes to lead monthly charlas in the school. Each month would target a different grade of students and focus on basic health topics, such as washing hands, sanitizing food, hygienic dental practices, and women’s health for girls in the older grades. Providing incentives for their efforts, we would work closely with the vigilantes to create lesson plans for the workshops, and then the women would lead the charlas themselves. Although we would devise ways to reinforce the lessons in our classes throughout the interim months, we would take a backseat during the actual workshops, so that the vigilantes might be able to lead the lessons themselves if we were forced to leave Chaquijyá suddenly (yay sustainability!).

Well, it was a great plan. We held the first day of the program this past Thursday and Friday, and the charlas themselves were very successful. Health promoters from Ixim Achi generously offered their time to help us conduct our initial two charlas with the first grade students, and the women lead workshops that not only were fun, but that also instilled in the students useful information about personal hygiene. By and large, we were so thrilled with the charlas and the students’ positive responses.

Unfortunately, the vigilantes did not share our same enthusiasm. My coworkers and I had asked the nine women to attend the charlas so that they might receive a clearer idea of our vision for the project, and they did react to the workshops as eagerly as we had hoped. Lacking a financial incentive, the vigilantes did not feel as though the program would be valuable use of their time.
Needless to say, my coworkers and I were disheartened. We had invested significant time and effort into devising the details of the project, and the most crucial component of the program, the vigilantes, were reluctant to participate. What were we going to? Considering that Chaquijyá has no other organized health promoters working solely in the community, should we scratch the program? We could lead the charlas ourselves, but then how could we make the program sustainable?

My coworkers and I ultimately decided to keep the program with a few alterations. For the time being, we will lead the charlas ourselves; however, we will continue searching actively for other individuals and organizations with whom we could partner. To make the program more immediately sustainable, we will pull from our connections and resources to create a health curriculum with various topics, activities, talking points, and other information that may be used by PDs or organizations in the future. Additionally, we have spoken with Ixim Achi concerning the possibility of training a community member to lead charlas, and so we will be searching within the community for someone who is interested and qualified.

Overall, despite the change of plans and initial disappointment, I believe that we have learned many valuable lessons from our experience with the charlas and the vigilantes. Primarily, the experience serves as a reminder to establish shared goals with our partners and partner organizations. If we are not on the same page with our desired partner organization, we cannot hope to accomplish any program. Effective and lasting change cannot occur if the community and we are not striving for the same objectives; development is a joint effort. Furthermore, we have once again realized the importance of flexibility and resourcefulness. In the sphere of international community development, events and programs sometimes (in fact more often than not) do not unfold as planned. In creating a health charla curriculum and working with Ixim Achi to train individuals, we have learned to make the best of what resources we have and allow for flexibility in our programs. There is no easy road to successful development, and we must remember to remain flexible and positive, while keeping realistic expectations.