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Community Based Health and Rehabilitation Programs in Rural Mexico:

An Historical Overview of Piaxtla and Projimo

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The rural area of Sinaloa, Mexico, north of the the city of Mazatlan has been the location of community-based health and rehabilitation initiatives that have broken new ground in the fields of grassroots health and empowerment. Two programs that have had their training and coordination centers in area—through their innovative methods—have contributed to the evolution of Primary Health Care and Community Based Rehabilitation worldwide

Both Project Piaxtla and PROJIMO began in a remote village called Ajoya, in the Sierra Madre mountains (see map).  Both  were created with the advocacy of David Werner in the 70's and early 80's respectively.   PROJIMO (Program of Rehabilitation Organized by Disabled Youth of Western Mexico) has inspired the books Disabled Village Children (1987), and Nothing About Us Without Us (1998).

In the 1990s, however, Ajoya began to pass through increasingly difficult times. The economic crisis in Mexico—and the widening gap between rich and poor that resulted from the North American Free Trade Agreement (NAFTA) and the “global casino” of speculative investing—has led to a tidal wave of joblessness, falling wages, crime and violence throughout the country. As we have described in Newsletter #29, the village of Ajoya, a strategically-located exchange point for illegal drugs grown in the mountains, has suffered more than its share of robberies, assaults, and kidnappings. As a response to so much crime and violence, many families have fled the village. In the last two decades the population has dropped from 1000 to just a few families and elderly folks. As the result of the violence in Ajoya, in 1999 PROJIMO spit into two sub-programs.

The PROJIMO Rehabilitation Program left Ajoya and moved to the safer, more accessible town of Coyotitan on the main west-coast highway (67 km. north of Mazatlan, see map).  PROJIMO (Coyotitan) is a community based rehabilitation and education project run by and for disabled people. Its main objective is work with disabled persons and their families to increase their abilities and opportunities as well as help raise the consciousness of non-disabled persons and school children to include disabled person in the life of the community, and to "look at their strengths, not their weaknesses." The disabled rehab workers provide physical and occupational therapy, counsel families about how to assist (but not overprotect) their disabled child, teach self help skills, and make a wide variety of adaptive equipment.

For two more years the PROJIMO Skills Training and Work Program (wheelchair workshop) kept its base in the troubled village of Ajoya. Its goal was to provide socially constructive alternatives to both disabled persons and to village youth who, for lack of job opportunities or hopes of a viable future, were too often lured into drugs, crime and violence. For a time things seemed to be improving, but in the Spring of 2002, this program also moved to a safer location.  The PROJIMO Work (wheelchair workshop) Program is now located in the small village of Duranguito, about 20 km. east of Coyotitan, near the coastal town of Dimas (see map).