When Miguel Cayo first visited the Bolivian Chaco, a desert region in the southern part of Bolivia, he was an evangelist looking for a place to minister. As a new Christian, he had just finished seminary and was anxious to share his new-found faith with whoever would listen. And because he grew up in poverty, he wanted to reach out to those in need.
As he began working in this desperate area, he knew this was where God wanted him to be. "They all had immense needs and were totally unaware of their potential," said Miguel. While visiting with the minority groups of this region, he saw a child die of diarrhea. "His parents and the other community dwellers did nothing, and simply looked on," he said. "It was then that I received the Lord's call to give myself to these poor people to help meet their needs and train them." From this experience, he knew that God was not finished training him for ministry.
Miguel had been working with a Swedish missionary couple in the Chaco region. They noticed that Miguel was always reading theological books in their home library. The missionary woman wrote to her church youth group back in Sweden, and they sent a check to cover three more years of theological studies for Miguel. "But I could not erase the picture of that dying child," he said. "That was when I decided to study medicine." He told the missionary couple he would not cash the check because it was designated for seminary training. But after hearing his plans to attend medical school to help the people of the Chaco region, they encouraged him to cash the check, which paid for all of his medical studies.
Before Miguel left for medical school, the Swedish missionary told him, "I knew one of my children would continue the work I have started here." So Miguel promised the man that he would return to the Chaco region.
In 2004, Dr. Miguel returned to the Chaco region, settled his family in Yacuiba and started his work as director of the Asociacion San Lucas of Bolivia. Two days a week, Dr. Cayo sees patients at the clinic. The other three days are spent visiting rural villages to teach community health and improve the quality of life.
It is an advantage that Dr. Miguel is a Quechua Indian. As a native, Dr. Miguel is more readily accepted into the rural Quechua villages around Yacuiba. "When I first came, the people simply observed my teaching on community health and did not get involved," he says. "They assumed that I was politicking and making empty promises."
Miguel soon discovered that they made these assumptions from their previous experiences. When Dr. Miguel first came to the one of the Quechua villages, the government had just set up a hog farm project there. A government technician came to the village, set up the hog farms, and taught the people how to care for animals. The community was surprised when the sale of the hogs raised $3,000. However, the technician took $2,000, leaving the community dejected and cynical. Dr. Miguel encouraged the men to continue with the farms, but to find their own technicians to educate them. Now the community pays a one-week fee to the technician rather than a three-month salary.
However, hog farm management was not the most urgent problem facing the Quechua Indians. More pressing issues are that of education, clean water sources and sanitation. Education for children is only available for three years, and after those three years, the children usually drop out of school because they then have to travel at least an hour by foot to a secondary school. From August to November, the seasons change and the river dries up, so clean water is difficult to find. The communities dig holes in the riverbed to get water, but it is contaminated. Therefore, sanitation is inadequate, hygiene is minimal, and no latrines are used in any of the communities.
The three staff members of Asociacion San Lucas are committed to developing solutions for each of these problems which are detrimental to the lives of the Quechua Indians. Each week, the staff visits a rural community, and every 30 days, they hold a Community Retreat. Genoveva, Dr. Miguel's wife, teaches the women about sexual health, about child rearing and about basic health care. Jose Quiroz, the nurse at the clinic, teaches the children about basic health care, such as washing hands. Dr. Miguel teaches the men about their rights as Bolivian citizens and basic community health. The Quechua village of Pananty seems willing enough to learn from Dr. Miguel and his staff.
On November 9, 2001, the village of Pananty was attacked by landowners and police who thought the people should not live on that particular land. The landowners and police came at the village with guns, and the people of Pananty fought back with sticks. Six people were killed in the tragedy, and many more have scars and bullets remaining in their bodies. The Quechua took the issue to court and officially won the rights to the land.
The nearest health center to Pananty is five miles away, and the only form of transportation is bicycles. "But because they are Quechua, they are treated as second-class citizens," Dr. Miguel says. "No matter how early they get to the clinic, they are repeatedly postponed, even until the clinic closes and they have to come back the next day." Dr. Miguel hopes to build a consultation room in the village and is currently training two members of the community in acute health care.
Being formally trained in nursing, Dr. Miguel's wife, Genoveva, is an integral part of the ministry. But because Genoveva is from the Aimara tribe, it was difficult for her to gain acceptance in the Quechua village of Pananty. Even though she was associated positively with her husband, the people kept Genoveva at a distance. It seemed she could do nothing to bridge the gap between them.
Finally she had an idea. The next time she visited Pananty with Dr. Miguel, she brought ingredients with her. She asked to use one of the mud ovens, and the village leader allowed her to use his. Within an hour, she had baked a cake, and she presented it to the village. Since that visit, she has no problems with acceptance. But even after finally being accepted, Genoveva was frustrated with the Quechua's lack of trust in public health care. In spite of her constant encouragement and urging to get pregnant women to the hospital to deliver their babies, the women refused to go.
While Dr. Miguel was at the Luke Society International Conference in 2005, Genoveva visited the village, concerned about a woman who was ready to deliver. She found the woman and her new baby. Both were suffering from severe infection, yet the woman still refused to seek treatment. Genoveva finally convinced the mother to take the baby to the hospital.
"When we arrived at the hospital, they were rough with the baby, and I overheard them mocking the mother," said Genoveva. "They were saying that the mother was dirty, that she was making their bed dirty. All because she was Quechua." It was then that Genoveva understood the Quechua women's hesitance about coming to the hospital. Genoveva asked the hospital nurses to leave them alone, and Genoveva tended the mother's and baby's needs.
Because of the success in Pananty, Dr. Miguel is hoping to spend much of his efforts there to make it a model village. "They trust us so much that for every opportunity, they open up and allow us to teach them," he said.
Dr. Miguel has many plans for the village. "We need to plant fruit trees to provide better nutrition for the children," he says. "We need to teach provision of water and latrines. We need to continue in the selection and training of community health promoters. But above all, we need to focus our entire ministry on taking advantage of the opportunities to share the Word."
The spiritual development of the community is already taking shape. "Every Sunday, the village has a time of worship, and slowly people are coming to the Lord," Dr. Miguel says. And when the Luke Society staff comes to teach community health once a month, those attending ask to begin and end the sessions with prayer. "There has even been talk of people donating land to build a church," he says with obvious excitement.
As the Luke Society Bolivia begins its second full year of ministry, Dr. Miguel is excited to see what will happen now that the groundwork is laid. They have established good relationships with the Quechua people, they have built up good clientele with the clinic in Quininde, and most of all, they have been reassured of God's calling to the Bolivian Chaco.