Our Community Health Program offers volunteers an opportunity to see the context from which our patients come and to better understand the barriers to care. We work to provide health promotion and disease prevention to the community in two ways: through the Promotora Program, and Community Health Outreach.
Clinica Esperanza is adjacent to a “colonia” of 3,800 inhabitants who are literally squatters on once vacant land. A large percentage of these people are recent immigrants from the mainland of Honduras. Most come for work in the construction and tourism industry. Few have any education beyond the sixth grade. Many have left their extended family to seek jobs that pay $300 a month.
Half of the population of the colonia is under age 25. The fertility rate is high, family planning and adolescent health education is an urgent need. Many young mothers fail to get appropriate pre-natal care. Childhood malnutrition rates in this area is consistent with the WHO’s profile of malnutrition in Honduras. Formula is very expensive and we find infants being fed with powdered milk often mixed with water of questionable quality and sometimes with Sprite or Coca-Cola.
The Promotora Program
Promotora (which literally means “promoter”) is a community member who volunteers to serve as a liaison between their community and heath care institutions. A Promotora serves as a health educator, patient advocate, mentor, outreach worker, role model and health status monitor.
We currently have ten communities or neighborhoods that we are working with. In each of these communities, we are training selected community leaders as Promotoras. They will act as liasons between their community and Clinica Esperanza. Their population of focus is children under 5. They will visit the homes of 20 children under the age of five who live in their target area. Dehydration and diarrhea are the leading causes of death in children under 5 years old in developing countries.
At each home visit they will weigh the child and plot them on them on a growth chart to assess for malnutrition. They may see children with diarrhea, cough, fever, and provide management in accordance with a simple evidence-based checklist on interventions and/or referrals. Additionally, they may discuss the role of diet in growth and development. They will identify and problem solve regarding barriers to appropriate clinic visits and act as advocates for their clients.
The training and oversight of the Promotora Program fall largely under the direction of the Program Director Dr. Stacy Zuniga. Clinic Volunteers are encouraged to get involved with the Promotora Program by developing training materials for Promotoras or observing them on home visits.
Community Health Outreach
In addition to the Promotora Program, Clinica Esperanza offers community health outreach initiatives. These initiatives include an outreach clinic, vision screenings, health education in schools, hosting a health fairs, putting on a public education sessions, diabetic classes for English and Spanish speakers, among others. Promotoras promote the initiative ahead of time and encourage community members to attend. The Promotora attends and acts as a liaison with the community they live in.
This program was designed to provide for the needs of the community we serve and to offer volunteers the opportunity to understand the context from which their patients come from. Having this opportunity enriches the volunteer experience and offers learning beyond the scope of an outpatient clinic.