NEWS FROM THE MÉXICO PROJECTS
Roberto Fajardo’s Report on Piaxtla: Farmworkers Grow Dry-Season Crop
Roberto Fajardo has worked with the Piaxtla primary health care program for seventeen years, and has been one of its leaders for the past ten years. He first came to Piaxtla at the age of fourteen as a patient, carried on a stretcher from a neighboring village. In the course of his long recovery from a severe case of juvenile arthritis that had completely immobilized him, Roberto helped the health workers with various tasks and began to learn health care skills; when his treatment was over, he stayed on to work with the program.
During a visit to the Hesperian Foundation in July, Roberto discussed Piaxtla’s recent achievements, noting in particular the program’s growing emphasis on the underlying social and political causes of health problems. This focus has led the Piaxtla team to become involved in helping local villagers to organize in defense of their rights. The team has come to feel that campesinos will not improve their health significantly until they empower themselves, raise their standard of living, and put an end to the exploitation and repression they currently suffer. Here are some of the highlights of what Roberto reported.
For some time now, Piaxtla has been working with a farmworkers organization. Over the past several years, this group of poor farmers, insisting on its rights under the Mexican constitution’s agrarian reform provisions, has managed to reclaim a fertile land tract that was being illegally held by wealthy landowners. For the last three years, the farmers have been trying to install an irrigation system that would enable them to grow a second crop of corn and beans during the dry season. In the winter of 1987-88, the group bought an irrigation pump with a grant from the German organization Bread for the World. The campesinos worked enthusiastically to produce a crop during that dry-season, but the effort failed because they were not familiar with dry-season farming techniques.
The campesino organizers were determined to try again, however. They decided that they needed more pumping equipment, so Roberto and two farmers who had never been to México City before travelled to the capital and applied in person for a grant from the Dutch embassy. Before the next dry season (1988-89), the team learned that their request had been approved.
But the campesino organizers found that, even after hearing this good news, most of the farmers were too discouraged by the previous year’s failure to try again. Roberto ended up working with a very small group (about six farmers) to cultivate a little plot of land With the help of Pablo Chávez of the health team, who has experience growing dry-season vegetables, they managed to raise a magnificent crop of corn and beans.
Because of this successful experiment, many campesinos want to participate in the project this coming dry season. The farmworkers organization is eager to plant all the river bottom land that has been recovered from the big landowners. The lesson the group learned from this experience was that it should start small. By working out problems and achieving successes at a small-scale level, the group can show the campesinos that a project will work on a larger scale. An overly ambitious start, on the other hand, can result in a disappointing failure, jeopardizing the project’s survival.
The farmers' success in growing this second, dry season crop has meant better nutrition for the villagers and thus less illness and death in the community. It has inspired the campesino organization to continue its struggle to reclaim lands illegally held by large landholders. As a start, the group has brought in a government engineer to survey the size of these tracts.
Update on Other Piaxtla Programs
Piaxtla continues to move forward with several other innovative community programs. These include a corn bank, a chicken-raising enterprise, and a family vegetable garden project. The campesinos have plans to set up a common credit fund in the near future.
The Piaxtla health workers have also helped get a primary health care program under way in the nearby Huachimetas area, located in the state of Durango. Because of its isolation and inaccessibility, this vast region containing same 100 ranches and 8,000 inhabitants is completely without government medical services. ‘The Piaxtla team has trained two health promoters from Huachimetas, and Piaxtla staff regularly visit the new program to help upgrade the skills of the local workers.
Piaxtla continues to carry out exchanges with other community health Projects, both within México and abroad. An example of this is the recent visit to Alaska by Miguel Angel Alvarez, a long-time Piaxtla health worker. In June 1988, Miguel Angel led a workshop at the annual meeting of the National Council for International Health in Washington, D.C. A representative from a group of Alaskan health promoters who vas present was so favorably impressed with Miguel Angel’s presentation that he invited him to visit their program; which works with the indigenous peoples of that state. This past summer Miguel Angel was able to take a little time off from his work in Ajoya to visit the program and teach a mini-course on “Training Community Health Workers.”
The Piaxtla health workers have joined the PROJIMO team to start a program for elderly people in Ajoya and the surrounding region. So far the two teams have held several meetings with older members of the community, who have selected leaders from among themselves to coordinate the program’s initiatives. Meetings have been held to an elderly carpenter’s home, which the old people’s group has made wheelchair accessible. The community has also given the group an orchard to tends its harvest will provide them with badly needed income. The project is coordinating its efforts with other programs designed for the elderly. The Hesperian Foundation and the México projects hope that a new publication, a kind of Where There Is No Doctor geared specifically to the needs of the elderly, will eventually grow out of the experience gained from this project.
PROJIMO Report: Helping the Spinal-Cord Injured
Project PROJIMO, the rehabilitation center for disabled people founded in 1981 as an outgrowth of Piaxtla’s work, continues to grow in scope and reputation.
One of PROJIMO’s biggest challenges has been to meet the varied needs of spinal-cord inured children and young adults. In developing, countries, 90% of paraplegics and nearly all quadriplegics die within one or two ears after their initial injury. PROJIMO’s efforts are proving that rehabilitation of spinal-cord injured persons is possible at the village level, and at relatively low cost. To date, the project has served over 100 people with spinal cord injuries. Nearly all of these persons were completely dependent and had life-threatening pressure sores when they first came to PROJIMO. Most of them have made remarkable advances. Many feel so welcome and accepted in the PROJIMO community that they stay on to act as peer counselors to newcomers, to work in the wheelchair workshop, or to take on other jobs using skills learned at PROJIMO as part of their rehabilitation.
Since PROJIMO is still the only center in México that offers a full range of services to the disabled, people in need of care now come there from many different parts of the country. PROJIMO has helped disabled people from eleven of the country’s 32 states, and from urban as well as rural areas.
In recent years, PROJIMO has been supplying appliances to three rehabilitation projects in Sinaloa, two of them sponsored by the Mexican government. The PROJIMO team provides these groups with orthopedic aids that are not only less expensive than those made by professional technicians m the city but often better made, lighter, and more appropriate to local conditions. PROJIMO is able to sell such appliances at one-third what they cost in the cities and still make enough money to cover production costs and generate some income for the project. Due in part to the demand from these urban programs, production of artificial limbs, orthopedic appliances, and wheelchairs at PROJIMO has increased dramatically in the last two years.
PROJIMO’s work has been receiving increasing recognition from government rehabilitation programs in Sinaloa, the state in which Ajoya is located. After a recent visit to PROJIMO, the coordinator of the government rehabilitation programs in Sinaloa was so impressed that he is now planning to refer disabled people from throughout the state to the project for orthopedic appliances and other services.
The experience of visiting and working with PROJIMO led the director of the Center for Rehabilitation and Special Education (CREE), a federal government program based in Culiacán, to launch an outreach program consisting of 15 small community-based rehabilitation centers across the state. The director thought so highly of PROJIMO’s work that he asked the project to join this network, offering its workers three times their present salary if they agreed to become part of the government program. The team, however, has been reluctant to place itself under government control. As one of the team members explained to the government director:
We value our independence at PROJIMO. As disabled persons, since we have begun to work at PROJIMO we feel like we have escaped from a prison—a prison into which society put us, and perhaps partly into which we put ourselves. We delight m our new freedom and in running our own program. We know we make lots of mistakes, but at least they are our own mistakes, and together we look for our own solutions. We are happy to cooperate with the government program in any way we can, and appreciate your help, goodwill, and advice. But we want to be our own bosses, in charge of our own lives and our own work. Can you understand how important that is to us? We want to be free!
PROJIMO Entering into Exchanges with Rehabilitation Programs Around the World
Word of PROJIMO has spread far beyond Mexico’s borders. The project has been visited by rehabilitation workers from around the world, including Guatemala, Honduras, Nicaragua, Belize, Panama, Bolivia, Colombia, Brazil, India, Burma, Pakistan, Sri Lanka, the Philippines, South Africa, Zimbabwe, England, Sweden, Germany, Canada, and the U.S.
PROJIMO has entered into an ongoing exchange with NORM, a disabled persons’ project in the Bacolod region of the Philippines. This past spring, David Thomforde, an American physiotherapist who has worked extensively with PROJIMO, visited NORM for three months to share his experience and act as an informal consultant. This was followed by a three-month visit to PROJIMO by Lowell Raner, a disabled leader of NORFI. Lowell came to learn brace-making and other rehabilitation skills, while offering in return his own wealth of practical experience and creativity. He was particularly helpful m the PROJIMO toy shop, where he helped invent some imaginative new puzzle designs. Lowell also taught a course in the repair of electronic equipment to disabled people from neighboring communities.
PROJIMO’s Example Inspires New Programs Elsewhere in Mexico
PROJIMO’s example has provided ideas and inspiration that have been instrumental in the launching of a number of other community-based rehabilitation programs in various areas of Mexico. These include Project Más Válidos (“more valid,” as opposed to “invalid”) in the town of Culiacán. El Proyecto Pitillal in a barrio on the outskirts of Puerto Vallarta, and a project in Mazatlán. Another program is just starting up in a squatter settlement of México City. Disabled leaders from all these programs have received on-the-job training at PROJIMO. HW
PROJIMO Needs Your Help!
Perhaps the most remarkable feature of PROJIMO is that it accomplishes so much while operating on a shoestring: its entire annual budget amounts to what it costs to treat a SINGLE spinal cord injured patient for a year in the U.S. But as Mexico’s economic crisis has worsened and its cost of living has soared, the project’s expenses have inevitably risen. Many poor Mexicans can barely feed their families, let alone care for a disabled child. The PROJIMO workers frequently see cases where children paralyzed by polo who had begun to walk using braces have to go back to crawling; when they outgrow their braces, their parents simply cannot afford new ones.
Because of the growing economic crisis, more and more of the disabled people who come to PROJIMO lack the resources to pay even its low fees arid must be seen free of charge. PROJIMO needs your help if it is to continue its policy of serving all who come through its doors, regardless of their ability to pay. If you can, please help us.