Moyobamba, Peru
Education is Clinic's Primary Tool
Psychologist Grissel Tandozo sits cross-legged on the floor in front of a mirror. She looks at six-year-old Nilton, who is sitting next to her. Both of them have grape jelly smeared on their upper lips as part of Nilton’s therapy after his cleft palate surgery. He watches her mouth in the mirror as her tongue slides across her lip, licking off the jelly. The jelly that is smeared across his upper lip seems just out of reach, especially in the corners. Although he doesn't get all the jelly, it is an improvement from the last session.
“Okay, now try this,” she says, making a fish face in the mirror. After giggling, Nilton tries to create the suction in his mouth needed to make the funny face. If he hadn't shown me where the hole used to be in his mouth, he would look like an average kid. But the birth defect has affected his ability to make certain vowel sounds, to breathe through his nose and to make the “rolled r” sound that is prevalent in the Spanish language.
The clinic, through the Solidarity Program, is helping up to 50 children a year who suffer from the genetic defects of cleft lip and palate. As with many other health problems, education to seek early intervention is a key factor in treating this problem. It is important for a child with cleft lip or cleft palate to have surgery within three months of birth. Most of the patients are coming to the clinic after they are a year old, with one man seeking help at age 40.
The Solidarity Program is one of many programs of the Luke Society of Moyobamba, locally known as Asociacion San Lucas. Three years ago, the clinic was directed by Almanzor Fernández. When he left the Luke Society to start another ministry within a local church, staff member Marlith Flores felt God calling her to the director position. With a strong understanding of the Luke Society vision, Marlith and the staff combine to make an valuable team. Every person has his/her place, and every program is running effectively. Vanessa Lovera, Olguith Masa Gaslac and Gremberg Lopez are the clinic’s community health workers, venturing out to the surrounding communities, training health monitors and implementing the Good Food and Improved Farm Programs.
Vanessa Lovera is responsible for the health promoters in the communities. “Health promoters have the materials to teach others and prevent disease, and they know how to recognize diseases,” says Vanessa. In the village, each promoter works with children age 5 and up. Every month, the promoter weighs the children and measures their height. These measurements are graphed on a chart which helps indicate if the child is malnourished or healthy. There are trained health promoters in three communities -- Las Palmeras, Nuevo Milargo and Guillermo.
Gremberg Lopez teaches the community farmers about techniques in raising quality crops. “Health is not only in the body, but also in the farm and wealth, having the money to buy the things you need,” says Gremberg, who heads up the Improved Farm program. The program is a four-step process -- from seeding, to planting, to growing, to selling at the market. “My goal is to grow the food with inexpensive technologies and get it to market at a good price,” he says. The traditional practices the farmers know need to be changed. Usually, a farmer will cut down the jungle trees and burn them to clear his land. Then he will use the ground until it is dead, not rotating the plants. “They want the most money as soon as possible, but they need to take care of the ground so that in the long run, they will get more out of it,” Gremberg says.
It is also traditional practice to grow only what you can sell, so the farmers aren’t using the ground to provide for themselves. “Both economy and ecology need to be considered,” Gremberg says. “Each family needs to know where to farm, the farming techniques, the nutrition -- for the ground and themselves -- all these factors are part of economy and ecology, which all affect the community.”
The government offers loans to farmers to help pay the cost of labor, which is about 50-60% of farm cost. But the loans seem to be more hindrance than help. The interest on the loans is 7-15%, but can go as high as 45% per month. “Out of 300 loans, only 50 pay them back in full, and only 20 pay on time with no debt,” says Gremberg.
Gremberg offers help -- not by way of loans --but with farming techniques. Asociacion San Lucas owns a private farm where Gremberg grows crops, fine-tuning the techniques the farmers need to know. He teaches the farmers that patience will help them in the long run. “Rather than wait and give the supplier good coffee and get their money in parts, they give bad quality coffee to get their money right away,” he says. Gremberg usually teaches farming lessons in group sessions, but occasionally will help a farmer individually. The private farm is producing fruits, milk, fish, honey and other produce that will be sold in the market. Profits are returned to the farm to improve the learning environment.
While Gremberg is working with the adult farmers, Olguith Masa Gaslac has targeted schoolchildren, ages 8 to 14, to raise crops. In 2000, Olguith started school gardens, and then began community gardens with 10-20 people working in each garden. When conflict arose about who was doing more work and should get more food, Olguith changed the program to start family gardens, which has proved to be more successful. While walking through the Nuevo Milargo community, one can see several fenced-off gardens belonging to families trying to improve their nutrition.
Olguith will usually stay in a community for three days, living with a family from the community. She says it helps her better understand the people’s needs, and she wants to make trusting relationships with the people. “It’s challenging to me because health includes more than nutrition, but also spiritual and family care,” she says. So sometimes Vanessa and Olguith’s jobs include family counseling. “The man is the leader, and he does what he wants,” Vanessa says. “It’s hard when you tell him he needs to change.” The change these women are looking for is respect, not only husband and wife, but also children and parents.
When the community women came into the schools to teach a nutrition lesson to the children, the children didn’t want to do the cooking. “They said that was the women’s job,” Olguith said. “They learned they have hands.” And in some cases, the men don’t agree with the women wanting to become health promoters. The men don’t want their wives doing anything other than traditional housework and taking care of the children. To relieve the tensions, Vanessa and Olguith are trying to educate both the men and the women.
Besides Gremberg, Vanessa and Olguith teaching in the surrounding communities about health, the clinic staff is also working to educate the people living in the town of Moyobamba. One of the main focuses of the education here is about AIDS and sexually transmitted diseases (STDs). Dr. Fernando Salazar, the clinic director, is teaching three groups of people -- monitors, teenagers and homosexuals.
The monitors are the people that are being taught in order that they may teach others. These monitors include local students, pastors, religious leaders and teachers. Every three weeks, Dr. Salazar rounds up the monitors for a three-hour session using speeches and workshops to teach them lessons on sex education and interpersonal techniques. “Our objective is to prepare the people to teach teenagers about sexual education,” he says.
The teenagers are the second group in the AIDS/STD program. The monitors are visiting three schools chosen for their high risks in drugs, pregnancy, alcohol abuse and STDs. Inside the classroom, the monitors give speeches on how to recognize the characteristics of STDs. STD tests are given before and after the speeches and those that test positive are invited to come to the clinic for free medical assistance. Dr. Fernando says the response from the students has been excellent.
The homosexual community is the third and newest target in the AIDS/STD program. A get-to-know-you meeting was held in November 2002, followed by a workshop in December. Right now, the goal is to gain the trust of the group and encourage them to seek medical help at the clinic. “Like Jesus, we are coming to help the sinners, not the righteous,” said Dr. Fernando. Nearly 70 people make up the homosexual population ranging from 17 to 55 years old. “We approach them not as different, but as equals. We show them the love of God and give them a way to change their lives,” said Dr. Fernando. “Our objective is for them to realize they are in the wrong way.”
The Luke Society is making headway with the homosexual community. There are six homosexuals coming to the clinic to receive free tests and treatment. And there is acknowledgment among the community that their lives are centered on evil. “They want to know God,” said Dr. Fernando, so he is planning on starting Bible studies with the group this year.
The Luke Society in Moyobamba is being successful in its holistic mission. They are helping children with cleft lip and palate, they are growing gardens in surrounding communities, they are educating people on nutrition, farming and sexually transmitted diseases and putting forth the radiating love of Christ.
Laura Eisenga