by David Werner

Dear Friends of Project Piaxtla,

The substance of this Newsletter has been prepared by Victor Miller, a 28 year old Californian who, as a volunteer for Project Piaxtla, spent the last two years in the back country of the Sierra Madre helping villagers set up their own “clinics” or health outposts, and in training the village workers to take them over. Over the past year in the Pueblo Viejo area, he has done a superlative job in helping the villagers to pull together in the construction of their own health facilities. Teresa, who has trained as a promotora de salud or village health promoter, is an exceptionally gifted and sensitive young woman who is becoming increasingly competent in the provision of primary health care. When Victor leaves for the USA in June, he will not be abandoning those he has worked with, but rather leaving them with a modest but ongoing health care program run by the villagers themselves and linked to the Ajoya Referral Center for supplies, supervision and follow-up training.

Far better than to have health care delivered by outsiders, is to have it come from the community itself.

Last summer Victor was joined by Paula Haller, 23, who worked with him in helping train some of the villagers. Paula focused primarily on family planning and in organizing classes for mothers for child care. Victor and Paula have done an outstanding job in helping the people of the Pueblo Viejo area learn to cope more effectively with their own health needs.

The Evolving Role of Young American Volunteers

Before passing this Newsletter over to Victor, I would like to add a few words about the role of American volunteers in Project Piaxtla. Project Piaxtla went through a period in its evolution where young Americans played an important role as “backwoods medics.” These young Americans saved many lives, earned the love and esteem of the villagers and “had one Hell of a an adventure” while they were at it. But the days for the young American to “play doctor” are we hope, over. Far better than to have health care “delivered” by outsiders, is to have it come from the community itself. The role of the young American volunteer today, therefore, is not to deliver health care but to help foster it. This is a far more difficult, frustrating and challenging role. To handle it well, fluency in Spanish is essential, as is the capacity to work and relate to people. Some previous background in health care is, likewise, important. In the future, we will be asking young Americans who consider volunteering to commit themselves for a two year period, with the understanding that the last three months may be devoted to helping train the next generation of volunteers. The number of American volunteers that we can effectively use is smaller than it has been in the past, now that we have a growing number of competent village workers. Persons who have special skills which they can help teach—doctors, dentists, veterinarians, laboratory technicians, agricultural experts, continue to be welcome even for shorter visits. We do, however, encourage a working knowledge of Spanish as well as a willingness to focus on teaching rather than practicing of respective skills.

Those interested in volunteering with our project should contact Allison Orozco, 419 Webster Street, Palo Alto, CA 94301. Final approval will depend on the village staff in Ajoya.

Thanks for Financial Help, and a Further Request

I would like to thank all of you who responded to my request for financial help in the “Note From the Sierra Madre” which we put out last month. Thanks to the assistance of our own personal friends and the supporters of Project Piaxtla, our study team, which consists of Martín Reyes, Lynne Coen, George Kent and me, will embark on our “Project to Facilitate Rural Health Care in Latin America” as scheduled this April. (In fact, we will already be on our way by the time you get this Newsletter.) However, we are still sorely in need of additional funding for the development of the guide books, work manuals for village health workers and rural health planners which we hope will be the outcome of this project. If you would like to know, more about this “Project to Facilitate Rural Health Care,” please contact Trude Bock, PO Box 1692, Palo Alto, CA 94302.Your assistance either to this project, or to our ongoing work in the Sierra Madre in Sinaloa will be greatly appreciated. Thank you.

David Werner

And now from Victor . . . .