Promotor Class

A Promotor is a lay health care worker who is either elected by the community or who has shown interest in healthcare and is accepted by the community as the promotor.  At some point most promotores have gone to the local clinics for some brief education with the doctors, usually a week.  Some return for more education, but many go back to their villages and assume the role of caretaker of the village's healthcare needs.  They are taught in Western ways, but also use natural herbs and plants as they know them. 

The local shamans assume the role of caring for the village in traditional ways, using potions and balms made of plants, barks and herbs growing nearby.  Many in our area of the jungle use the hallucinogenic plant, ayahuasca.  They take the drug themselves, then examine the patient and are "shown" through their experience how to cure them.  They are sometimes called curanderos, and use a more mystical approach, based in rituals and traditions.

Our work is with the promotor.  We feel that the better educated the promotor is, the better the health of the community.  Once a year, we organize 2-day classes for the promotores at the local clinics.  The classes are taught by the doctors, nurse midwives, nurses and dentists at the clinic, using material from the Minister of Health.  At the end of the class, we provide certificates of attendance and parting gifts of first aids supplies and items that they have learned to do in class.

The focus of the classes is:

First aid - theory and practice (dressings, splints)

Common medicines, their uses and side effects

Differential diagnosis, ie starting with a symptom(s), considering the most common causes and then how to treat   

Dental health

Practice labs, such as making slides with a blood smear for malaria testing

 

In the villages, the promotores keep logs of the patients they see and treat, and we, along with doctors, examine these records for appropriateness.  This gives us an opportunity for teaching if needed, and suggestions for learning needs for future classes.

Promotor Julio from San Juan de Floresta with his certificate presented by Renzo

Nurse Ruth teaching the class at the clinic in Mazán

Nurse midwife (obstetriz) Jessica teaching her portion

Local shaman Guillermo sharing his knowledge of local plants and herbs. 

We give each promotor a resource book called Donde no hay Doctor

(Where there is no doctor) by the Hesperian Foundation. 

If you would like to donate a book, they are $20 each

New program added

Our promotor class taught in July 2010 was held in the village of Mangua.  Todd Carlson and Annie Slaughter, 4th year medical students from the University of Colorado, obtained permission to teach the class from the Minister of Health and Dr. Davila in Lima, who was one of the authors of the program specifically targeted to lay health workers in the communities.  First-year medical students, Brandon Konkel, Richard Actis  and Adam Plate assisted in the classes, as well as Shelby Kemper, pharmacy student.  These classes were conducted for the promotores from the Indiana district as well. 

There were 20 promotores in attendence, along with 7 midwives.  The importance of making home visits by the promotor to families in their village was stressed for the purpose of teaching and modeling healthy lifestyles.  A  booklet was given to each promotor, along with the questionaire to be used in home visit documentation.  The focus for community teaching was safe handling of food and disposal of garbage, clean water, waste sanitation methods, ventilation of smoke from wood-burning cooking fires, and using animal pens to keep livestock away from home-area, etc.

The students then made daily village visits to work one-on-one with the promotores to help reinforce teaching and model family visits.

Brandon, Todd and Annie  conducting the class

Shelby, Brandon and Annie (with pillow tucked in blouse to appear pregnant) model the family visit

Todd taught the class and led most of the discussion in Spanish

Each promotor received a certificate of attendance by the group - Brandon, Rick, Annie, Shelby, Todd, and Renzo.  Promotor Gumercindo from Llacapa receiving his certificate.