The Remote Village Project
In 2005, the Medical Brigade implemented a capacity-building, sustainable, and reproducible model of primary and preventive healthcare interventions to supplement its annual, high-impact, humanitarian healthcare mission trips. The Remote Village Project is designed to posture the leaders of remote villages to provide public health education, basic primary healthcare, and complementary public-works development projects to their communities. The model has now been implemented in two villages - Valle Bonito and San Antonio de la Libertad.
Valle Bonito and San Antonio de la Libertad are small, poor, rural agricultural communities, both located approximately 2-3 hours away from Comayagua, by car, in the mountains that surround the city. The roads to the area can only be traversed with 4-wheel drive vehicles. During heavy rains they are not passable. The populations in the villages are estimated at 1,600 people, living in 205 houses and 1,200 people, living in 145 houses, respectively. The average household income is $1.50 - $2.00 USD / day, and is primarily obtained through coffee farming. Coffee is harvested in January and February, and therefore income varies widely throughout the year. There is presently no access to potable water in either community.
The Remote Village Project (RVP) was initiated as a project that would help communities in Honduras maintain a basic level of healthcare on their own. In establishing the RVP model, the vision was to facilitate a process of sustainable primary healthcare in rural communities in Honduras through the education, guidance and supervision of Community Health Workers (CHWs). With the full permission of the Honduran Ministry of Health, the RVP has trained community leaders in the two captioned villages to serve as CHWs. The CHWs have been trained by Medical Brigade physicians, using both classroom and clinical curriculum developed by the Medical Brigade, to provide year round counseling on community health improvements and preventive care, and to diagnose and treat a limited number of medical conditions common to central Honduras, including infant diarrhea, ear infections, bronchitis, simple skin disorders, and intestinal parasites. The curriculum and training programs were designed to complement the book: Where There is no Doctor, A Village Care Manual, by David Werner, which is widely used internationally and published in over 75 languages. Since their initial training in November, 2006, the CHWs have seen over 2,100 patients.
The Remote Village project also seeks to address the root cause of the majority of health conditions in the villages, in addition to the symptoms, by developing gravity-fed potable water and sanitation systems for the villages. In this regard, the Medical Brigade has joined forces with Engineers Without Borders (www.ewb-usa.org) and the Peace Corps (www.peacecorps.org), to partner with and to advocate for these two villages in these development efforts. These infrastructure projects will be introduced to the communities along with specifically tailored public health intervention plans - plans that will raise the awareness of the link between proper hygiene and disease prevention - plans designed to educate and encourage new healthy behaviors surrounding personal hygiene, food preparation, and water storage. Detailed patient records from the CHWs' first year of service to the communities will serve as benchmarks against which progress, in terms of future experience data (data developed after clean water and proper sanitation services are provided), can be measured.
Remote Village Project Update – Betsy Koop, November 12, 2007 - return to top
The RVP continues to grow and succeed with the intense work of the last week. We have two new health workers in training for the village of Valle Bonito and our three current health workers will add to their clinical education in the coming months. We hope to add at least one additional health worker for the village of San Antonio de la Libertad in the near future. Our team worked hard with the health workers throughout the week getting their knowledge and skills up to date. New treatment algorithms and teaching tools have been added to assist the health workers in their practice and in their roles as health educators. These remarkable volunteers continue to amaze as they expand their roles in service to their communities. Thank you to all of the adult and pediatric practitioners who acted as preceptors for the health workers seeing patients in the daily clinics, your contribution did not end when you got on the plane to Miami- the knowledge you imparted will continue to serve the people of Valle Bonito and San Antonio de la Libertad through the year.
A quarterly site visit was also conducted during the week with the assistance of Dr. Wolfgang Rennert and the Pediatric Resident Team from Georgetown University. Work on getting clean water, sanitation, and public health projects implemented in Valle Bonito and San Antonio de la Libertad is also progressing well under the direction of Dan Tiedge and the volunteers from Engineers Without Borders and the Peace Corps. They had numerous meetings with government officials and the Water Boards of each of the villages and took some rough on and off-road trips to make site visits to the community water source sites.
It is hard to believe that just two years ago discussions about the impact of the Brigade hatched some vague ideas about implementing a program of sustainable access to health care and improved community health. Now here we sit with a project that is succeeding in its mission to extend our vision and work throughout each year. It is amazing to see what has been accomplished that makes such a profound difference in the lives and well-being of others with the mixture of time, dedication and talent given freely. A sincere thank you is extended to each and every one who has helped to make this happen.
Community Health Workers
San Antonio de la Libertad - return to top
Daniel is a lifelong resident of San Antonio where much of his extended family still lives. He is a coffee farmer with a large independent farm. He lives in the village center with his wife and two children. Daniel's daughter suffers from a kidney ailment which has intensified his interest in providing health care and education in his community. Daniel served on the Village Health Committee, along with four other coffee farmers, which initiated this project for his village. Daniel takes an intense interest in his studies as a CHW and is often found reading his health text when the clinic is not busy. He is also very active in the local Catholic Church, and each week uses the opportunity of these large local gatherings to provide basic health education at the conclusion of services.
Cainan is a coffee farmer and lifelong resident of San Antonio where he lives with his wife and children. Cainan is the quiet presence of the San Antonio clinic where he spends many hours each week seeing patients from San Antonio and the surrounding villages. Cainan also served on the Village Health Committee which initiated this project. Both Daniel and Cainan are also involved in the water, sanitation, and public health project, which will bring sources of potable water to the village in the near future.
Valle Bonito - return to top
Irene is a Sister of San Geronimo, an Italian order whose mother house is located in El Salvador. Sister Irene runs the Santa Maria del Valle Orphanage, which houses approximately 20 children - infants through high-schoolers - along with several other Sisters of the same order. She holds a certificate for initial nursing training and she grew up in Valle Bonito. The orphanage has been a valued partner and supporter of the water, sanitation, and public health team, regularly affording lodging, meals, and construction material storage to the efforts.
Elisa is also Sister Irene's blood sister and a lifelong resident of Valle Bonito, where she currently lives with her family. Elisa served on the Village Health Committee which initiated this project. Elisa has long been active in community health issues, maintaining community immunization records, running a women's support group, and providing health education to the villagers.