Program Overview
Discuss about the Primary Healthcare and its Practice in Developing Countries.
Project Piaxtla is located in the western parts of Mexico. It is a rural primary healthcare program that is majorly operated by its local villagers. It was named after the close by river known as Piaxtla. Piaxtla healthcare was established three decades ago with its primary being to serve the larger, sparsely and rugged populace of this part of the country in the state of Sinaloa. The program is located in Ajoya, which is the biggest village with a population of approximately 1000. Since the inception of the program it has been led by David Werner who has been acting as the advisor and facilitator of the healthcare service. Before the healthcare was established, people of Piaxtla were faced with a rage of challenges such as they were dominated by the “disease of poverty” in the health scene. As a result, one out of three kids could die before locking the age of five years. These children were faced with diseases such as diarrhoea as well as other infectious that were combined with chronic undernutrition (Donelson, and Esparza, 2016). On the other hand, seven out of ten women were at risk of suffering from anaemia and one out of the two women could die at or after child bearing.
Certainly, this adverse condition was as a result of majority of the population in the regions facing the problem of inequitable distribution of wealth, land, and power. Most of the individuals in the region came from poor families that possessed either little or no land at all. However, if they owned land it was of inferior quality. To the contrary, the few rich people were in possession of large tracks of fertile land, which was in the river valley. Therefore, they were in position to rear huge herds of cattle making them to very wealthy. Consequently, due to the wealth possessed by the rich in the region, it gave them power to control the Ajoya community council. Subsequently, these individuals constantly acted as stamping blocks to all the attempts by the poor farmers to organize as well as make demands for their constitutional land rights. Thus, they could even resort to violence at times when they felt that it was necessary so as to make sure that they were able to maintain their dominant positions. Therefore, David Werner, plays a significant part in ensuring that Piaxtla healthcare works to save people of western Mexico particularly from Piaxtla village do not suffer the challenge of death rate among children below five years as well as the loss of life of women due to anaemia.
The Challenges Facing Piaxtla
The participatory approaches used by Project Piaxtla fall under various plans such as curative care to social action, practices to defend the health as well as rights of the less fortunate in the society, and the working of women in unison to condemn the excessive drinking among men.
The improvement strategies for Project Piaxtla health have been grouped into three classes. The initial stage primarily focused on curative care, which was the core need for Ajoya community (Abel-Smith, 2016). Accordingly to make sure that the project becomes a success, the village healthcare supporters were trained through participation, making sure that participants become competent in the treatment of common injuries and diseases as well as learning-by-doing methods. Thus, as time went by the participants and the health team as well as the villagers who were being served got used to the diseases and injuries that kept occurring repeatedly. As a result, the second stage for the project’s health team slowly by slowly moved its concentration to preventive and enhancement of healthcare measures like water systems, latrines and immunizations. Therefore, in the course of this stage some of the illnesses started to become less common, which led to noticeable improvements in Ajoya village healthcare. Consequently, the number of death cases due to whooping cough and tetanus, declined. On the same note, the stage resulted in less cases of children being disabled by polio in addition to complications from measles drastically declined.
Nonetheless, at times when poor harvest were registered a majority of the kids and women were faced with high malnutrition and continued experiencing sickness. Similarly, during poor harvest years the under-five Mortality rate remained high, particularly among kids coming from the less fortunate families, which were underpaid, landless and underserved. Thus, the project Piaxtla healthcare program was forced to change its focus by forming an organized action to protect the fundamental needs and rights of all people regardless of their wealth. In this sense, the village health program progressed from curative care to preventive as well as enhancing measures to socio-political action (Kelly, 2013). The move in the healthcare program from the conventional measures to organized action was due to problem-solving approach, discovery-oriented, learner-centred to health education. The success of the healthcare initiative was realized through workshops, which were led by health supporters together with mothers, farmers and school kids who started with “situational analysis.” The primary intention of these workshops was to identify and discuss problems that are related to health in Ayoja community and the manner in which these problems are interconnected. Instead of looking at the child mortality rate as having one causative agent particularly diarrhoea, the health team was able to explore a chain of causes that were resulting in the high mortality rate.
Improvement Strategies
Therefore, the investigations helps to identify the health problems as caused by a range of factors such as physical, biological, economic, cultural as well as political. Additionally, these health problems were also as a result of germs, power, beliefs and customs, worms and money. During the early stages of the health program when the core focus of the program was curing and preventing, individuals mostly identified cultural, physical and biological factors as the leading causes of death among children.
A far as the health enhancers as well as the community in concerned, it looked deeper in the underlying causes of poor health with a more keenness. Therefore, the health team started by figuring out approaches using collective action in an effort to dismantle the connections between the chain of events leading to illnesses and death. In the process of identifying the causes of illnesses and death it was realized that there was need to correct the inequality that existed between the rich and poor and that there was need to rectify this problem (Kelly, 2013). The less fortunate were greatly taken advantage of by the rich, whereby they continuously mistreated and cheated on the poor. Therefore, to correct the inequality the Piaxtla health program came up with some practices as an attempt to pinpoint the challenges that were leading to issues that led to healthcare problems particularly among the poor. These activities included:
- Making a demand for the owner of the local bus route to reduce the fares to the legal rates;
- Initiating a farmworker-operated maize bank;
- Making arrangement that were spearheaded by women with the effort to stop the public bar with the intention to bring down the number of drunkenness and violence among men;
- Arranging for protests to manage the way the village water supply could get out of the hands of rich and introduction of public water supply system that was managed by the community (Kelly, 2013).
To begin with, the main challenge that Piaxtla health program decided to tackle is that of land-owners usurious system for loaning maize. By the beginning of the sowing period most of the poor families had always run short of food in their stores, thus they were being forced to borrow from their counterparts wealthy ones (Edington, 2017, p. 177). During the time of harvesting, the poor were therefore required to repay back three sacks for every sack that they had borrowed. Consequently, after making the repayment, a majority of these poor families were in possession of almost nothing. Making matters worse, if one was not in position to repay the debt, their creditors could seize their properties, thus pushing the poor families into absolute destitution. As a result, the majority of such families were forced to give up farming and move to urban regions in search for work.
Accordingly, to combat the exploitative loan system used by the rich, the Piaxtla health team supported the poor farmers by staring up a cooperative maize bank. Certainly, the maize bank charged a bit less interest as compared to the farmers, then the interest gained was used to enlarge the bank’s lending capability. Consequently, the community-regulated loan program at last spread to other villages, thus it was able to aid in enhancing the economic scale of the poorest families, which eventually played a significant role in improving health and nutrition (Donelson, and Esparza, 2016).
Empowering the Poor
Farmers came together as a team to counter the problem of poor farmers by enhancing their economic base. The main goal of this cooperation was to look for a lasting solution that was cheap to keep of the cattle of the rich people from destroying their crops. Initially the poor had to borrow from the rich cattle owners for the fencing tools and in return they were supposed to give grazing land to the rich. Nevertheless, after a long discussion and analysing the effects of this condition to the well-being of the, the Piaxtla health initiative in collaboration with the small members’ organization started to explore for the likely solutions. As a result, the health team makes arrangements for the poor people to come together and collectively fence their land as a team (Cueto, 2004, pp.1864-1866). The starting capital was got from a nongovernmental organization courtesy of the health program and after fencing their land the poor were in a position to charge the rich for grazing on their land. Thus it become possible for them to repay the loan in a period of two years. After the first loan was repaid the same money was given to a new group of farmers. Therefore by revolving the funds among the poor farmers the initiative helps the poor to become more self-reliant. Consequently, it aids to reduce the gap between the rich and the poor thus, the health of most of the children from the poor families begun to change because children were now able to get enough food to eat.
In addition, as a result of the organized actions, the poor in the region started to gain confidence as well as experience due to the strength of the cooperation. The ability of poor farmers working through cooperatives empowers them in various ways which in turn comes out as successful and it was within no time routine since all the poor farmers in the nearby villages had joined the informal but cohesive organizations (Cueto, 2004, p. 1871). Indeed, as the number of poor farmers kept rising the spirit of solidarity also kept growing, thus likewise to the health team, which leads to a bigger combat against the highly dangerous matters that was affecting them.
The women of Ajoya as well as the nearby villages started to discover and put their power into action and one way in which they exercised their power was to take a collective act to pinpoint the problem of excessive alcohol abuse among men. The problem of excessive abuse of alcohol had been a primary cause of domestic and interpersonal violence in the region. However, the people who suffer most as a result of the men’s alcohol abuse were kids and women. Certainly, other than the direct physical violence, the drinking conducts of men was directly interfering with the nutrition and health of children and women, the reason being that men could purchase alcohol at the expense of money meant to feed the family. Before the initiative to fight against them drunkenness of the men in Ajoya there were countless bars, nonetheless, they went into extinctions as a result of the violence that was linked to alcohol (Schweiger, 1997). The fight of men drunkenness was fully supported by Piaxtla health members by organizing women to spearhead the movement. The health program placed on public farmworkers’ theatres skits dramatizing the manner in which drinking habits of the men was affecting the children and women. Generally, all parts were being played by children and women, with women festooned in pants as well as moustaches to take the roles of men. The skit illustrated how, if women worked together, they could do something about the men’s problem. In response to the skit in addition to other awareness-raising practices, the village women of Ajoya takes a joint action to protest against the opening of the bar in the region. Consequently, a number of health workers who had taken part in making arrangements for the protest were jailed, but the women still kept on with their fight until all the health workers were released.
The Piaxtla health program was faced with a number of problems such as the unfair treatment of the poor by the rich as well as the jailing of its health workers who had spearheaded for women protest against the opening of bars in Ajoya village. Most of the rich people in the region were in possession of vast fertile valley lands while the poor were either in possession of small infertile pieces of land or had none at all. Therefore, there were always faced with a problem of food shortage since their farms could not produce enough food to last the whole season. As a result, during the season of planting, poor farmers could borrow from the rich and then at the harvest time it was a requirement by the rich that they returned with interest. Thus, poor farmers were forced to three bags for one that they had borrowed. Nevertheless, Piaxtla solves the problem of mistreatment of the poor by forming a maize bank that could lend poor farmers money at a less charge as compared to the rich exorbitant famers. On the other hand, the problem of jailing the health workers who initiated the protest against drunkenness’s among men was solved through women’s die heart spirit of not relenting to the oppressive authorities until all the health workers were set free.
Conclusion
In conclusion, the project Piaxtla was a significant milestone towards the growth and development of improved healthcare amongst the people of Ajoya and specifically children and women. Indeed, the non-relenting spirit of both the health workers together with the cooperation of women in the region plays a major part in saving the lives of most below the age of five as well as women who initially were losing life either at child birth or after. Accordingly, despite the fact Piaxtla health program target was to save the population of Ajoya from the different illness, it also saves the poor from being exploited by the rich and shedding them light regarding their constitutional rights.
Kelly, J.K., 2013. Village-Scale Practices and Water Sources in Indigenous Mexico after the Neoliberalizing of Social Property (Doctoral dissertation, University of Kansas).
Donelson, A.J. and Esparza, A.X., 2016. The Colonias Reader: Economy, Housing and Public Health in US-Mexico Border Colonias. University of Arizona Press.
Edington, J., 2017. Indigenous Knowledge and the Course of Development. In Indigenous Environmental Knowledge (pp. 171-201). Springer, Cham.
Abel-Smith, B., 2016. An introduction to health: policy, planning and financing. Routledge.
Schweiger, M., 1997. Questioning the solution: the politics of primary health care and child survival. BMJ, 315(7107), p.555.
Cueto, M., 2004. The origins of primary health care and selective primary health care. American journal of public health, 94(11), pp.1864-1874.
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