1. Maldonado, Monica

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THIS is a contribution from Monica Maldonado, health promoter in the Alto Hospicio shantytown outside of Iquique, northern Chile. Monica was trained by Fundacion EPES (Educacion Popular en Salud/Popular Education for Health). Now approaching its 30th anniversary, EPES has grown from a small emergency-response team to a leader of community mobilization for health services, awareness and empowerment in Chile. At the core of EPES, strategy has been a program to train and accompany community health teams in poor neighborhoods. Groups of 10 to 15 women receive technical and practical knowledge in health promotion from a holistic perspective that examines how underlying social, economic and environmental factors influence individual and community well-being. The teams work with neighborhood associations, schools, clinics, city government and coalitions around projects that mobilize local resources to achieve change.


Monica Maldonado: I am one of many poor women who, in the early 1980s and under the dictatorship, dared to believe that it was possible to change the lives we were leading and get rid of Pinochet.


Unschooled and largely misinformed about the meaning of physical and mental health, I joined the EPES "family." From the start, we were full of enthusiasm and commitment, knowing we were being watched by the CNI intelligence service, the Carabineros police and the military. They threatened us, saying it was subversive and dangerous to invite people to learn to distribute health materials and promote disease prevention and tell people that "health is a right, not a privilege." For them, this was politics, something that "subversives" did, especially when we organized demonstrations in the streets to draw attention to critical health issues in the community.


We trained with EPES to provide factual, precise information in our own words, organizing training in first aid, preventing diseases like meningitis and cholera, promoting PAP exams and self-care, plus workshops on leadership and self-esteem.



We also organized ourselves. For example, in 2000, several community health groups in southern Santiago began working together to raise awareness of the high number of deaths in their district from breast cancer. The campaign began by distributing information in the markets and painting murals. Eventually we decided to investigate, and we discovered that women attending the local hospital had to wait up to 10 months to see a specialist. And then, they were not being asked to get mammograms because these had to be contracted to private hospitals. We collected thousands of signatures and met twice with the Minister of Health, until, in 2004, when the hospital finally obtained one.



In 2003, EPES invited me to work with them to train a team of health promoters in the Juan Bautista Alberdi district of Resistencia, in the Argentine Chaco. Using popular education methods and "Where There Is No Doctor" as a guide, some 36 local women trained over several months. First, they diagnosed the district as suffering from lack of hygiene and excess of garbage, lice and skin diseases, teenage pregnancy, domestic violence/abuse, neoprene/alcohol use and crime. As health promoters, they also learned to deal with health emergencies as well as any health professional, but with more respect and empathy. We trained 40 local teens to work among their peers in issues of HIV/STDs/gender violence/unwanted pregnancy prevention, sexuality, and self-esteem.



Thus, day-by-day, we learned how to realize our dreams and our talents and move forward. We learned that many people have lost faith in making changes in their own lives. But once they see themselves reflected in others and recognize common problems, they become avid for information and training. This is a potent force: women and men committed to improving their own lives and the lives of other poor people; people who believe that empowerment by knowledge makes them freer, more aware and happier to be in this world.