Submission: Dr. Julio José Flores
Thoughout the district of Cardenas, a health project is working with 652 participants under seven years of age, 65 pregnant women, and 121 nursing mothers.
The municipality of Cardenas is located south of the department of Rivas, approximately sixty kilometers from the city of Rivas. From Rivas, you must travel 43 kilometers on the Pan-American Highway and then another seventeen kilometers on a dirt road in poor condition. Cardenas has a population of 6,560.
The economic activity in the municipality of Cardenas includes small parcel agriculture providing mostly for family consumption, domestic fishing, and large cattle ranching.
Only sixteen communities within this area have public transportation, which is sporadic in service at best. Dirt roads are often interrupted by considerable river flow that impedes access and isolates residents during the winter, or rainy, season. Several communities in this region are accessible only by water, and these trips by boat are only made twice a week, depending on the climatic conditions.
Institutions that have offices in the municipality are the mayor, the Ministry of Health, the Departments of Education, Justice, and Police, telephone and water companies, and the national army. MINSA offers health care for children and pregnant women, service for patients with chronic illnesses, maintenance of the community health networks, and centers and health posts. The Department of Education provides pre-school education.
Potable water exists for only three percent of the urban population due to bad water quality. The community water supply is from hand-dug wells, rivers, or springs.
Organizational Protocol
To ensure that we meet the goals of the project, we must:
- secure the enrollment of technician meeting requirements;
- establish an office location and provide equipment within the municipality;
- determine available resources;
- identify the basic aspects of the study;
- confirm the need of the services;
- present the study to the current municipal officials and mayor's office;
- visit the leaders of the involved communities and appraise them of the pattern of activities in the municipality;
- confirm the committees in the beneficiary model communities;
- create support networks in the community;
- enable the community to select promotors;
- identify places where CICOs/Casas Bases will work.
Technician José Palma Escorcia is working in the Colon Viejo, Colon Nuevo, and Zapotillo communities; Alejandro Briceño Ruiz covers the Palos Verdes, Rio Mena, and El Truinfo areas; and Lesbia Vilchez Mejía is responsible for the communities of Cardenas, Sapoa, and Santa Rosa.
The technicians' responsibilities include:
- providing early childhood health care and pre-school training;
- training promoters and community members on topics of reproductive health, pregnancy prevention in adolescents, and breastfeeding;
- the detection and referral of those with high obstetric risks to qualified promoters and midwives in the communities supported by the municipal Ministry of Health;
- training on the development of square meter gardens;
- the involvement in practices and techniques of environmental and water sanitation;
- modifying the nutritional habits in communities prioritized within the municipality;
- monitoring the growth and development of children under the age of six.
The Cardenas Project Director is responsible for:
- coordinating support with local authorities of the municipality;
- coordinating support activities with MINSA, including the provision of printed materials and, in some cases, transportation within the municipality;
- providing school registration data by way of the Department of Education;
- training the pre-school promoters of the community;
- promoting assistance from the Women's House;
- renting space, audio/visual equipment, and furniture for training;
- promoting activities of the Catholic and Evangelic Churches;
- leading the community in support of the project directives of the participating community citizen groups;
- training the promoters about the PAININ programs and square meter gardening techniques;
- using seed donations for the square meter garden project;
- distributing bicycles to promoters;
- equipment and training site administration.
Limitations And/Or Difficulties Found
Obstacles have been encountered during the project. These limitations include:
- discrepancies between the actual data and statistical estimates for children under seven years of age;
- difficulties in reaching isolated communities due to poor road conditions, landslides, and high river episodes;
- the continuous interruption of basic services such as electricity, telephony, and transportation by either land or water;
- political division in the municipalities;
- budgetary limitations in a deprived area;
- problematic maintenance of vehicles.
Some of these issues may be solved through:
- a double transmission vehicle to handle the environmental characteristics of the land in the winter season;
- additional support and the development of other projects, primarily those concerning nutritional safety;
- creating an income source that will sustain the projects over time, i.e. a number of craft shops.
