The Power of the Health Promoter Program

By Linda Foxworthy

For the past twenty years, I have volunteered as a nurse practitioner with the San Lucas Mission. I am forthright about the fact that I do this for myself. Guatemala is a country of contrasts: mountainous beauty next to poverty; a warm and gentle people who have been victimized by  oppression and violence. It is also a several week winter relief from the line-up of coughs, colds, and body aches of my patients. I enjoy the time out of context, the home visits with chickens pecking at my feet, improvised remedies, and exam rooms with a single dangling bulb. As Father Greg used to say, we have so much more to receive than we have to give when we come to San Lucas.

Twenty years ago, to reach one of the villages called San Martin, the healthcare team had to hike up a mountainous unpaved road, past fields of dried corn stalks and beans terracing up to the clouds. We encountered wiry old men and small boys carrying firewood bundles twice their size, strapped to their foreheads. I thought of arguments with my boys about unloading the dishwasher. We arrived with a plastic tub of medicines and supplies. A long line of women wearing intricately woven traditional Mayan clothing, with children in tow, waited outside the dusty room that is the community center, church, and makeshift clinic.

These clinics, or consultas, are not typically life-saving events. People come with aches, coughs, and diarrhea to get free Tylenol, vitamins, and parasite medication that they cannot afford. Though we occasionally see very sick children, malnourished pregnant women, and ravaging skin infections, we mostly treat parasites that will return the next month. Even faced with such dire need, it’s not easy to figure out how truly to be of help.

One young woman, eyes fixed to the ground, complains of a headache she has had for two weeks since her baby was born. She is withdrawn, exhausted, and speaks limited Spanish—mostly Kakchiquel, the local Mayan language. Asking basic questions about her symptoms, I notice she does not have her baby with her. Village mothers always carry their infants wrapped on their backs until they can walk on their own. I sense this woman needs more than the usual medicine, and gently ask if something is wrong with her baby. Crying, she tells me her baby has a curse. I ask her to take me to the baby. With a translator, we walk to a one-room house of bound vertical branches with a corrugated tin roof.

Inside, an emaciated infant lies crying through a jagged, opened mouth split up to the side of his nose. I explain to the mother that she has done nothing wrong. Her son, Simcum, has a cleft palate, a common birth defect in Guatemala. An operation can repair it. She is hesitant, not convinced. I know that a local nutrition project has the soft nipples, bottles and formula available, which will keep the child alive for now.

The next day I return with a local health promoter and a mother with her two-year-old daughter, who recently had a cleft palate surgery. We reinforce the instructions on infant formula preparation, no small feat in a house with an open fire for cooking and no clean water supply. The mothers talk but the smile of the two year old tells more than I could ever say.

In the past 10 years my work has moved on to the training of local health promoters to care for ordinary problems in their communities—a far better plan for improving infant mortality than relying on a chance encounter with a health provider from the U.S. In fact, this situation would not happen now. The growing cadre of trained Health Promoters keep track of infants born in their communities. Seriously ill children are referred to the Mission Hospital. Infants at risk for malnutrition are monitored by the Health Promoters as part of a nutrition program which has changed the lives of many children and families in the communities around San Lucas Toliman.

The Health Promoter Program is now at the front lines of the growing Covid-19 threat. As you read this, Health Promoters are receiving special training, protective equipment, and medicine. They are beginning to use a mass-texting application to communicate quickly with each other to monitor the spread of the virus in their communities. They will also use this system to receive updated treatment protocols. And while, as of March 29th, Covid-19 has not arrived in San Lucas, they will be ready when it does.

Your support for the Health Promoter Program and the hospital is more important than ever. Many of the people the Mission serves have underlying conditions that put them at greater risk for severe reactions to the virus. Diabetes, respiratory disease and malnutrition all increase risk of severe illness in a healthcare system poorly equipped to deal with the challenge. Your gifts will equip health promoters with the tools they need to protect themselves and their communities from coronavirus.

Join the historic #SanLucasStrong campaign by making your gift to the Mission healthcare program today. Thank you for your life-changing generosity.