Proyecto Promotores de Salud San Quintin Mexico Marianne

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Proyecto Promotores de Salud San Quintin, Mexico Marianne Mckennett, MD Mary Richards, MD Téah

Proyecto Promotores de Salud San Quintin, Mexico Marianne Mckennett, MD Mary Richards, MD Téah Caine, MD Scripps Chula Vista Family Medicine Residency August 2017

Acknowledgements Dr. Marianne Mc. Kennett Dr. Claire Ojima Dr. John Prucha Dr. Betania Nogueira

Acknowledgements Dr. Marianne Mc. Kennett Dr. Claire Ojima Dr. John Prucha Dr. Betania Nogueira Meaghan Roach Dr. Noe Crespo Bonifacio Mendoza Karen Wind Keila Arteaga Daniel Navarro Community of Poblado Chula Vista & San Quintin

What we will talk about Project Goals, Mission and Approach Target Community: San Quintin

What we will talk about Project Goals, Mission and Approach Target Community: San Quintin History and demographics El Centro Familiar Los Promotores and Projects Future Plans Your input

Proyecto Promotores de San Quintin Mission: Sustainably improve the health and well being of

Proyecto Promotores de San Quintin Mission: Sustainably improve the health and well being of severely impoverished border communities through collaboration and education. Means: Provide reproducible, culturally competent health education and resources needed, as identified by the target community, to key community members who will then take the material to educate their communities. Approach: Listen, seek understanding, work together. Empower promotores to learn and engage.

San Quintin, MEX 5 hour drive from San Diego 75, 000 day laborers Indigenous

San Quintin, MEX 5 hour drive from San Diego 75, 000 day laborers Indigenous workers: Oaxaca, Guerrero, Chiapas Migrant workers, semi-permanent, permanent communities.

San Quintin “Jornaleros: esclavitud sin cadenas” Freseros: 100 -180 pesos/12 hours 44% of households

San Quintin “Jornaleros: esclavitud sin cadenas” Freseros: 100 -180 pesos/12 hours 44% of households with working children Pesticide exposure Sexual exploitation

San Quintin Day laborer living conditions: ▪ Poorly constructed huts ▪ Overcrowded ▪ Poor

San Quintin Day laborer living conditions: ▪ Poorly constructed huts ▪ Overcrowded ▪ Poor access to clean water ▪ Poor access to latrines ▪ Poor access to electricity DOHO Magazine-Griselda San Martin

San Quintin Education: Many cannot afford it Shoes, uniforms cost money School supplies cost

San Quintin Education: Many cannot afford it Shoes, uniforms cost money School supplies cost money ----------------Parents work Children stay home DOHO Magazine-Griselda San Martin

San Quintin Strikes and Marches 2015

San Quintin Strikes and Marches 2015

San Quintin Strike Results? Very Little La Cronica de Chihuahua

San Quintin Strike Results? Very Little La Cronica de Chihuahua

El Centro Familiar Original building: ▪ Built by Niles Sharif and his non-profit Frances

El Centro Familiar Original building: ▪ Built by Niles Sharif and his non-profit Frances Kitchen with Rotary support ▪ Intended as a women’s shelter for victims of domestic violence Currently: Centro Familiar ▪ Founded January 7 th, 2014

El Centro Familiar Mission Statement: “La misión del Centro de la Comunidad es alentar

El Centro Familiar Mission Statement: “La misión del Centro de la Comunidad es alentar un sentido de comunidad al formar alianzas con instituciones locales de salud, servicios y educativas y con los ciudadanos locales que tienen algo que quieren ofrecer a su comunidad. ” The mission is to encourage a sense of community by forming alliances between various institutions of health and education, and local community members that have something to offer the community.

History of Binational Community Collaboration • • • 1997 -2017 UABC Tijuana Escuela de

History of Binational Community Collaboration • • • 1997 -2017 UABC Tijuana Escuela de Medicina UCSD School of Medicine SDSU School of Public Health Rotary Club San Diego Scripps FMRP (2010)

Scripps FMR & El Centro Familiar helped identify key community members to become promotores

Scripps FMR & El Centro Familiar helped identify key community members to become promotores Other collaborating organizations in San Quintin were invited to send key individuals to become promotores The missions united… …and the rest is history.

Scripps FMR & El Centro Familiar July 2014 with a 5 -2 -1 -0

Scripps FMR & El Centro Familiar July 2014 with a 5 -2 -1 -0 fair October 2015 - Women’s health and cancer screening ¡Todos Los Dias!

Scripps FMR & El Centro Familiar April 2016 Nutrition in Diabetes

Scripps FMR & El Centro Familiar April 2016 Nutrition in Diabetes

Scripps FMR & El Centro Familiar April 2016 - Focus group: “What it means

Scripps FMR & El Centro Familiar April 2016 - Focus group: “What it means to be a promotora” ▪ There is no history of health promotoras in this community in the past. ▪ Overall a lack of communication about general/health education. ▪ Geography: Most women live within walking distance of the community center. In a normal day they stay in a 15 minute walking radius. ▪ Qualities of a promotora: Desire to be a promotora. Trained people. ▪ Obstacles to being a promotora: People not being interested in learning health topics.

Scripps FMR & El Centro Familiar April 2016 - Focus group Plan as promotoras:

Scripps FMR & El Centro Familiar April 2016 - Focus group Plan as promotoras: Go places where people tend to gather (schools, el centro comunitario) and ask if they are interested in “charlas”; presentations on health topics. ▪ Timing: this could most likely occur on weekends. ▪ Goals of different women included: ▪ Apply information learned to own life ▪ Next time bring a new person to our health fair/workshop ▪ Discuss new information with neighbors :

Scripps FMR & Centro July 2016 - First Aid Fair ▪ Build your own

Scripps FMR & Centro July 2016 - First Aid Fair ▪ Build your own handwashing station ▪ How to prevent and treat burns ▪ How to treat fever ▪ Wound care ▪ Dehydration and making your own suero ▪ What to do if someone is choking

Scripps FMR & Centro November 2016 Reproductive Health Fair ▪ STI’s ▪ Contraception ▪

Scripps FMR & Centro November 2016 Reproductive Health Fair ▪ STI’s ▪ Contraception ▪ Menopause

El Centro Familiar Collaboration 2017 : Collaborating for more enhanced education, community building, and

El Centro Familiar Collaboration 2017 : Collaborating for more enhanced education, community building, and data collection. ▪ Focus group -identify and focus our mission ▪ SDSU Masters in Public health Students developed culturally appropriate tool for measuring pre/post workshop knowledge ▪ SCVFM Residents developed cirriculum based on focus group outcomes ▪ SCVFM Residents & UCSD/UABC Medical Students taught the promotoras Outcome: Successful workshop designed to help parents talk to adolescents about substance abuse

El Centro Familiar Collaboration April 2017 Workshop on drugs, their effects, and how to

El Centro Familiar Collaboration April 2017 Workshop on drugs, their effects, and how to talk to your kids Inhalants, Crystal Meth, Marijuana most common Interactive workshop: myth debunking, substance and effect matching, and role-playing approach to drug-use conversation Pre-Post Survey: ▪ Significant increased confidence in knowledge about drugs ▪ Significant increased confidence in having conversations about drugs

Scripps FMR & Centro July 2017 Healthy Relationship & Domestic Violence Workshop SCVFMR +

Scripps FMR & Centro July 2017 Healthy Relationship & Domestic Violence Workshop SCVFMR + Centro Familiar + Oasis + Women’s Shelter Discussed boundary setting Media influence on behavior Stay-Talk-GO Zumba Class Role Play

Future Plans Future Workshops: Menopause, malnutrition in kids, diabetes, autism, reproductive health, pregnancy prevention,

Future Plans Future Workshops: Menopause, malnutrition in kids, diabetes, autism, reproductive health, pregnancy prevention, bullying, domestic violence Continue to foster relationships with current collaborating organizations Establish new connections Expand educational impact to include similar communities nearby Re-evaluate educational, resource and health care disparities Establish concrete, reproducible curriculum and resources to be provided by SCVFM Residents

Your input?

Your input?