Help Rebuild Chicuma's Rural Health Clinic

This blog outlines fundraising efforts to help the rural community of Chicuma, in the Department of Chalatenango, El Salvador, realize their dream of a community health clinic.

Fundraising efforts are being spearheaded by Dr. Timothy Bood, an emergency room physician in Halifax, Nova Scotia, Canada, and Jay Hartling, a Canadian cooperant in El Salvador.  

Any and all donations or support are welcome and can be made directly through Dr. Timothy Bood:  tbood@eastlink.ca; or by mailing a cheque to CCHC, 40 Freer Lane, Lower Sackville, Nova Scotia, B4C 0A2

CASA DE SALUD UPDATE (APRIL 2013)

Dr. Timothy Bood of Halifax, Nova Scotia visited El Salvador from March 3-12, 2013 as part of the efforts to renovate the community’s Casa de Salud (Health House).  Tim spent 3 days in Chicuma during the week, where he delivered a donation of basic medicines and vitamins for all ages, as well as some useful books on basic healthcare in rural locations where there is no doctor present.  Dr. Deisy Lopez, Nueva Concepción municipal councillor Daniel Pacheco and Vice-presidential Social Action Commission member Jorge Luis Diaz, accompanied Tim and Jay Hartling to Chicuma where they were received enthusiastically by community members.

Tim gave two first aid and basic emergency medicine workshops – one in the Casa Comunal, and one at the elementary school, where students, teachers and parents were able to attend together.  The latter had 70 participants!  Tim was also asked to make a couple of housecalls. 

On the way to Chicuma, Tim and Jay stopped by the hardware store in Nueva Concepción to place the order for materials for the clinic - everything from bags of cement, to corrugated metal to nails and screws (Mayor Manuel Portillo’s office helped us get the best prices).  These were delivered to Chicuma in mid-March, and the work is expected to be complete in mid-April.  Jay will attend the inauguration and intends to have a dedication plaque made honouring the Nova Scotian donors.  Once the work is complete, we will assess if any additional work needs to be done - for example, they are hoping to plant a medicinal plant garden out back of the clinic!

After his stay in Chicuma, Tim participated in a Medical Action Day organized by the Office of the Vice President in Las Granadillas, Chalatenango, where he was part of a team of medical volunteers (doctors, nurses, physiotherapists, dentists, psychologists) that regularly provide free medical attention and medicines to remote communities.  Tim had participated in a Medical Action Day in 2011 near Panchimalco.  He also gave a presentation on the latest emergency medicine techniques to a group of Cuban-trained doctors that work with the Vice President’s office.  All in all – it was a productive and busy trip!

Click here for pictures:

https://picasaweb.google.com/jay.hartling/VisitToChicuma2013?authkey=Gv1sRgCLGVwpi3u-at5QE

FUNDRAISING UPDATE (2012):

The September 13 "Tapas and Sangria" and Silent Auction to benefit Chicuma's rural health clinic was a roaring success.  More than 60 people attended the intimate event in Dartmouth, and we were able to raise $3,000.00 thanks to the generosity of those present, plus some other donors that were not able to attend, but still wanted to participate in some way.  Dr. Timothy Bood and Jay Hartling gave brief presentations with a slide show to acquaint everyone present with the area and the project.  Those that attended enjoyed a selection of tapas, sangria and great conversation, while participating in a very competitive auction for some great gifts!  

Thanks again to everyone who participated, and special thanks to our generous hosts Patricia Gonzalez and Justin Huston!!  Special thanks also go to Dana, Teri, Bryan and Peter for a much-appreciated helping hand!  

Here is a link to a message from Dr. Deisy Lopez, the physician in charge of the Vice Presidential Commission for Social Action in El Salvador:
http://www.youtube.com/watch?v=dTF8pPtkbCE

Donations can still be made to the address above.


FUNDRAISER AND SILENT AUCTION IN DARTMOUTH, NOVA SCOTIA FOR CHICUMA RURAL HEALTH CLINIC

“10 TAPAS AND SANGRIA” - $25 PER PERSON

THURSDAY, SEPTEMBER 13, 6-9 PM (SILENT AUCTION FROM 7-8)

49 HAWTHORNE ST, DARTMOUTH

TICKETS MUST BE RESERVED IN ADVANCE. 

PLEASE CONTACT jay.hartling@gmail.com TO RESERVE A SPOT – TICKETS PAYABLE AT THE DOOR.

Background on Chicuma

Chicuma is located in Canton El Gavilan, Municipality of Nueva Concepcion, in the northern Department of Chalatenango, El Salvador.  The Lempa River, the country’s principal source of fresh water, runs alongside the community.  The closest town is Nueva Concepcion – approximately 20 kilometres away by rough country road that is often washed out in winter.  Chicuma is a “re-populated” community, re-founded in 1992, after years of social struggle, with the signing of the Chapultepec Peace Accords.  Families in Chicuma were driven from their land by attacks and constant bombings by the military during the civil war in the 1980’s. One of the agreements reached in the Peace Accords was that land would be put aside for families in combat zones as a settlement opportunity (one of the primary drivers of the civil war was the long history of inequitable land distribution for peasant farmers in the country).  Not only did the original families that survived the war return to Chicuma to rebuild their lives; they were also given access to low-cost loans to purchase land.  Despite this initial support, there has been little-to-no follow up in the subsequent twenty years following the Peace Accords by prior governments.

 

Most community members dedicate themselves to subsistence agriculture.  There are 203 families that live in Chicuma, and the surrounding communities of El Salitre and Hacienda Vieja. 

Healthcare in El Salvador

El Salvador’s healthcare system is a dual system: 1) private, for-profit practice and hospitals that have state-of-the-art technology, no wait times, and easy access to medicines.  Only the wealthy can afford this system (less than 20% of the population); and, 2) the public system – characterized by highly-centralized, ageing, poorly-run facilities, overworked medical staff, and death-inducing wait times.  This is the system that attends to the majority of the population.

 

After its election in 2009, the FMLN government, the first non-military or right wing government in El Salvador’s history, started a series of healthcare reforms to bring medical care closer to communities who need it most.  However, implementation is slow due to the lack of resources and a prior history of low government investment in social prorams.  The first reform was to increase healthcare spending from $299 million to its current level of $600 million.  The Ministry also hired 2,500 new healthcare professionals.  Next, the new government eliminated the not-so-voluntary “voluntary” payment made by patients to access healthcare at public hospitals.  The Ministry of Health then began a series of reforms to focus on primary healthcare, particularly in rural areas where 40% of the population lives.  The flagship of the new integrated health system are the ECCOS (Community-based Family Health Teams), which aim to bring healthcare to communities, rather than require that they seek it out elsewhere.  Teams consist of a doctor, nurse, nursing assistant, health promoter and utility person.  The team serves approximately 200 families, and there are currently 450 ECCOS, serving 1,600,000 in 535 communities.  The teams concentrate on clinic visits in the morning, and house visits by foot or on motorbike in the afternoons.  The program has now run out of money to expand.  To date, there is no ECCO anywhere near Chicuma.

Earlier this year, the legislature finally passed a bill to regulate the cost of medicine.  Salvadoreans currently pay some of the highest costs in the world for prescription medicines – in a country where nearly half of the population lives below the poverty line.  For many years, reform of the system was blocked vehemently by pharmaceutical companies and their political patrons – the ARENA party.

The Vice Presidential Commission for Social Action, which operates with no funds and 100% volunteers, holds Medical Days in several, high risk communities – on average, about two times per year.  A team of up to 22 medical professionals (general medicine, cardiologist, gynecologist, psychologist, dentist, internalist, etc) volunteer in a community, such as Chicuma, for the day and see as many patients as possible – sometimes up to 400 consultations.  The patients are tended in school classrooms.  If needed, patients get a prescription which they can fill, for free, at the makeshift pharmacy. The Commission also works with the community to establish a local health committee to assist with education and minor incidents when no doctor is present.  While laudable, these are stop-gap measures that demonstrate a huge vacuum in the healthcare system, particularly in poor, rural areas. 

Canada-Chicuma Clinic Project

Photographs of Community and Clinic: https://picasaweb.google.com/jay.hartling/ChicumaRuralHealthClinic?authkey=Gv1sRgCM-zjqezuZWAjgE

Since 2009, the Office of the Vice President of El Salvador has accompanied Chicuma, a long-neglected community, in its community organization efforts to improve living conditions, quality of life and employment opportunities for some of the most vulnerable people in the country.  Operating without a budget, the VP’s Social Action Commission has managed to work with other government ministries, international cooperation, NGOs and the community to help build some basic services in healthcare, education and agricultural production.

 

Inhabitants of Chicuma must travel 20 kilometres to the closest public clinic, and at least 40 kilometres to the town of Chalatenango to the closest hospital.  In order to help bridge that gap, the VP’s office pays for the services of a community health practitioner – a Salvadorean doctor trained at the Latin American School of Medicine in Cuba -- to spend two weeks in the community each month making house calls and individual consultations.  The doctor sleeps in the community, but has no centre to attend to the needs of patients, and when the doctor is unable to come to the community, they are without access to immediate medical attention.

That’s where the Chicuma Clinic Project comes in.  This is an idea driven by the community, led by community organizers.  The building that the community wants to use as the clinic can be seen in the pictures (see link above).  The building has some historical significance – it is the only original structure left standing after the bombings of the civil war.  The structure itself is sound, constructed of stone and wood, and consists of two rooms.  It has an existing cement floor.

 

The Project aims to raise funds to work in three phases:
* amounts in brackets in bold are updated actual costs

1.      Install a new roof, proper doors and windows, paint and landscape (all labour provided by the community).  Cost = $2,000.00 ($3,000.00)

2.      Provide basic medical equipment and furniture (new or used).  Cost = $1,500.00 (approx - pending)

3.      Provide community workshops to the Health Committee to manage the clinic and deal with minor health issues (spearheaded by Dr. Bood and Dr. Deysi Rodriguez as volunteers).  Cost = $1,500.00 ($0 - donated along with starter basic medicine kit)