Daniel and Diane have submitted their complete health report. They have done an incredible amount of work for the village, for which we are deeply grateful.
La Libertad: The Report of Daniel and Diane
We have provided a report of our months stay volunteering in La Libertad; it has been separated into sections:
After living with the residents of La Libertad for one month and after visiting and treating approximately 80 people, I can say that the situation in terms of health care is very serious. I will explain why I have come to this conclusion:
La Libertad does not have access to clean water. The residents keep rainwater in large containers which is suitable but only within the first instance, it falls. Over time the water is infected by insects and different animals e.g. leaving eggs and feces which are harmful. In the dry season, we found out that many of the residents resort to drinking the river water which is contaminated for different reasons.
There is a small waterfall located within the jungle with pure water however many do not have the option to access it due to the distance and challenge of getting it.
It’s obvious that the lack of clean water causes illness (diarrhea), parasites, and some skin disorders. The only family we know who use chlorine to treat the water is Gustavo and his family.
2. Visits and Treatments
Visits and checks were given to 80 residents of La Libertad. Many received consecutive care and treatments due to the gravity of the situation. Approximately 50 children and 20 adults were treated (the list is available on request). The common denominators were:
· Stomach infections
· Skin infections
Many children needed consecutive treatment due to the lack of knowledge of how to reduce sickness from the parents. An example of this was that some exposed sick babies and children to hours of sunlight and heat when they had had a severe temperature or were not hydrating them frequently. This advice was given but on numerous occasions was not followed through. We made sure that the advice was understood by asking the parents what advice we had given in order to make sure it was not a question of miscommunication.
Vicente XXXXXXXX, 4 months old:
He had a fever (42 degrees at highest), severe diarrhea, and respiratory problems. He was severely ill for four days due to the causes mentioned above and hygiene etc.
On the fifth day of illness, this coincided with a social worker visiting the children in lessons on nutrition, Coincidently this was the day Vicente was seriously ill, I advised the social worker to visit Vicente and it was decided to transfer him to San Rafael hospital in Leticia. Vicente recovered in the hospital for seven days before returning.
Bebeto XXXXXX, 12 years old
Bebeto had wounds and abscesses. One abscess, in particular, was swollen (on his leg) and it was very infected, this needed repeated draining. This was a severely painful process and it needed several days of treatment. This was not the first treatment that had occurred for Bebeto (had it completed in the past in the hospital). Also, Bebeto lived with his elderly grandparents and his younger brother (orphans). Grandfather had been recently diagnosed with tuberculosis and they were living and sleeping within in the same room- Tuberculosis is incredibly infectious through air particles.
Grandmother had a broken shoulder bone from 3 weeks prior and this was not treated. She had a large inflammation on her bone and was in pain. Bebeto and grandmother were both treated and cared for. Bebeto’s infection was successfully reduced from the draining and disinfected, he was given painkillers and antibiotic cream. Grandmother was also given painkillers. Grandfather did have treatment from the hospital (antibiotics) and we strongly advised them not to share space and cover his mouth when possible, a severe case.
Olga XXXXX, 65 yrs old
Olga was suspected of having Alzheimer’s. She had an accident and fell and split her lip as well breaking some teeth. The family requested that I provide stitches to the wound instantly. I refused due to the lack of anesthetic as the process would have been incredibly painful and because of the fragility of the woman. I advised her husband and daughters to take her to the hospital-this was possible as the Curaca was already traveling to Leticia that evening. However, this didn’t occur. I gave painkillers and antibiotics to her.
Haco XXXX, 3 yrs old
One day before we left La Libertad we saw Haco, he had several infected wounds as well as a severe level of filthiness (we have photos showing his wounds). We cleaned and disinfected the wounds and treated them with antibiotic creams. Due to the timing, we are unaware if the treatment was effective and it’s apparent this needs continuous care. The Curaca was informed about Haco.
There is an extreme lack of medicines and treatments. The families I visited didn’t have sufficient means of treating basic conditions with treatments such as painkillers, antibiotics, inhalers, etc. Besides this, the lack of knowledge of how to use such medicines was scarce when having to deal with an illness.
During the first week, we detected that the culture and knowledge about natural medicines were extremely poor (we assumed that there would be more use of these). Just in rare exception did we find some people initially treating illnesses with natural medicines but then were not continued? We could say the majority of the families have lost their culture of medicinal treatments with the time. Only the families of the Shamans (and even those on not on many occasions) used some small measures of natural medicines.
We believe and respect the usage of these natural medicines based on trees, plants, and vines and the effectiveness of these in a lot of cases. At first, we tried to encourage classes from the Shamans to share their knowledge of these plants with the rest of the community. This way to reinforce and share this knowledge, but because of the lack of interest and initiative from both parts (lack of time for us to focus on this), it was not possible to continue with this objective. We think that focusing on natural medicines as basic treatments of symptoms such as fever, diarrhea, skin conditions, and different conditions. This is based on the evidence of learning about existing remedies during our stay.
e.g. Mucura and Lancatilla: good treatment to reduce fever
Murure: to heal wounds
Renacho: Pain reliever
There is a large natural Pharmacy available from the surrounding of this area, in our opinion they are not being taken advantage of.
On the other hand, we knew some families who travel to Zaragoza where a woman healer/Shaman lives and they receive treatment for some conditions, the result of this and is a contradiction there are already existing shamans and medicines within La Libertad.
The lack of hygiene, it was one of the main causes of the majority of conditions I witnessed particularly in the illnesses of the children. Small children including babies were incredibly filthy (body and clothes), the awareness of hygiene and the repercussions of the lack of it was practically zero within the majority of families treated. When we advised that this habit needed to be changed and a need to clean their children better, we found the families rejected this notion or in some cases, their reaction was indifference to the matter. The only moment when the children wear clean clothes is within the school because this is obligatory. This however was not enough as the children spent the majority of the time out of school. The fact of the dirtiness within cases is not banal…. it’s important to understand that this community eats with their hands from a very early age. It’s necessary to within the dirtiness resides bacteria and microbes and parasites, all extremely harmful for their health.
Practically none of the families clean their hands before and after eating, only some families were witnessed doing this.
Practically all of the children, many adolescents, and some of the adults had parasites. These are due to the contaminated water supply and lack of hygiene.
The community is aware of the existence of parasites; in a lot of cases, it was more than evident within the swollen stomachs. At the same time, this issue was not confronted by the residents and many showed indifference to the problem.
Secondary effects of parasites:
We understand that this treatment can sometimes be too expensive for a lot of families (there are however some natural medicines to treat this). In the second week of our stay, the community received a donation of remedies for this from a tourist cruise liner.
After receiving this donation, we believed it would not be enough to treat the entire community. But there is nothing farther from the truth. The community was informed about the purgatives by me and through the curaca (the curaca requested that I give the dosages, due to needing to understand the correct measures of the medicine, etc). During the first days of giving the purgatives, practically none of the families came to the scheduled place and time to receive them. Throughout these first few days to initiate the treatment we repeated to the families that we had the purgatives (completely free) however the interest was scarce (a minority showed interest). These families brought their children to the required three-day treatment. The rest however required strong encouragement.
We tried to change the way of administration due to the lack of takers in a way that was easier and collective. This is personally due to the effort of chasing and giving the treatments. Conceding with the school semester and a general teacher-parent meeting we spoke with the teachers in order to organize the administration of the purgatives during three days of school (it was essential that those taking the purgatives was taken 3 days consecutively). The advantage of having support from the school routine was perfect in order to administer correctly and concisely. The meeting also gave us the opportunity to explain to the families as well as gain the consent of the families for their children. During the meeting the families showed more interest, however unfortunately on the last week of our stay the school closed (teachers meeting held in Leticia at last minute) and the plan was unable to go ahead. Instead, we advised all families that we would hold the administration at the specific time near the school. This, however, was unsuccessful many didn't attend that said they would, and for some that did they did not attend for the three days consecutively which they were aware of the need to do. It was necessary to complete house visits at this point.
Finally, at the end of our stay, we gave the donation box of medicines to the health volunteer with explanations and written explanations on how to administer, personally, however, we do not have a great deal of confidence that the treatments will be successful or be taken correctly e.g., consecutively.
5) Health Representative and health care Resources
La Libertad has two health care promoters /Volunteers. In our point of view, these volunteers are inoperative, they are Wagner and Emma. In theory, they should take care of the people/within their capability.
The problem is their capacity is influenced by two basic factors:
1) The lack of time to do this effectively due to their own obligations such as fishing, agriculture, and childcare.
2) Their lack of knowledge on health care, eg diagnosis and treatment of illnesses.
They are volunteers and haven’t received enough training /education to have this responsibility. Wagner is the only one who has received some minimal training; however, from my point of view, this is insufficient. Wagner has a first aid kit which contains:
a) A stethoscope – he didn’t know how to use
b) A neck brace-didn’t know how or when to use it correctly
c) A thermometer- he didn’t understand what was normal or high temperature and was unsure how to use it.
d) The kit also contained things such as an IV Drip-this is impossible to teach and in most cases should only be used in the hospital.
On numerous occasions, I offered Wagner the opportunity to learn how to use the equipment and usually had the same response ‘Yes’ but then excuses were made e.g. not having the time and or not showing particular interest when I visited him. His lack of initiative and interest continued throughout the month until the first aid class.
Emma is the second health care promoter of La Libertad. It’s important to say she demonstrated more interest and motivation. She is the promoter who showed motivation and I focused on teaching her e.g. Purgatives and their uses and how to use a thermometer. Without being Critical to her knowledge of health was also quite minimal. It’s evident however that her motivation was clear e.g. taking care of her child throughout studying the basics I was teaching. It would be effective if the healthcare promoters collaborated on their knowledge in the future.
Our visit in Leticia. In our stay in Leticia during the 2nd week, we visited the healthcare organization in charge of the Indigenes villages of the Amazons. The health minister informed us that ten days prior to our stay the Village had been visited by a healthcare team. She was astounded about our finding s and suggested the team had not been aware of or reported issues to her. This was surprising due to the number of sick children. In my personal opinion, her attitude was defensive; we witnessed some visits during our stay and know that they were brief and not extensive to La Libertad which may suggest they did not find the extremes that we had.
In a conversation with a visiting social worker we were informed that the residents of La Libertad receive healthcare assistance in two ways, some receive from a private company called Capricorn and some from the public health care system. Speaking to the residents it’s unclear to what extent they are covered as they are unsure about this and it differed from family to family. Due to this confusion, many of the residents reject the option of traveling to Leticia when sick, it’s also due to the cost of travel to Leticia (it’s been suggested however they are given money for travel expenses in emergencies and severe cases should have access use the community boat).
Water and Hygiene:
2 classes for adults and 4 classes to children of different ages were given. Firstly, a class was given about the importance of water and methods to purify it. The information was obtained from a Spanish Organization that provided a system to an Indigenous village in La Libertad “Proyecto Araucaria/Agencia Española de cooperación Internacional para el desarrollo –(internet information given to Ben). This information has also been left along with the English class info in the volunteer bag.
The class was given to 15 adults; the lesson was publicized daily with some interest particularly in the assemblies. Times and location were informed by myself and the Curaca. On the day of the initial class, only two residents attended (Gustavo and Rosalba). It was necessary to re-inform by walking from door to door and state the class was about to start.
Prior to the initial class, I provided similar but lower-level information classes to children (focused on aspects of hygiene they can incorporate in their daily routine). The teachers were supportive in enabling me the time to provide these classes during school. It’s evident that the children were more receptive than the adults. A positive step as they are the next generation of La Libertad.
Finally, I gave first aid classes: CPR techniques for adults and children, mouth to mouth resuscitation as well how to deal with bleeding wounds, etc. I assisted around an average of twenty people including the health care promoters which were incredibly positive. I insisted that Wagner attended and learn the basics and he showed interest within the class. The interest in the class was limited by the villagers and their participation too. 20 people from 150 adults are limited and unfortunately due to checking and treating many patients I did not have the opportunity to give more classes and highlight the importance of them.
The Curaca did advise the members of the village to attend these classes however he himself never attended and as the representative of the village, he did not set an example.
8. Incident with Social Worker (Familiars En Accion)
The second week whilst Diane was recovering from illness I went to get information about the resources available to the community of La Libertad e.g. Social benefits.
Apparently, each family had a subsidy which was available if the families accomplish several requisites e.g. be conscious and provide nutritional meals to their children. In my visit to the main social worker of the Amazon villages we spoke about some of the issues within La Libertad and the lack of attendance in wanting support and education in health matters. The social workers gave me the power (a piece of paper stating my role) to obligate the members of La Libertad to attend the classes. We were given a list of names that were known by ´Familiars en Accion` and they needed to attend these classes. At the first moment I thought this was a good idea however before returning to La Libertad I realized that this was not the correct way to manage the situation in my voluntary role and so I did not use the paper to obligate any attendance this would have been detrimental and I did not want to affect the benefits they receive from the association. It would be more effective to have voluntary attendance and meet much more effective education.
On return to La Libertad, I went on my daily health check visits and was surprised by the lack of requirements of help, everyone suggested they were healthy. Three days prior to this the situation had been very different. We found out the Social worker had called the Curaca to request his support but had obviously scared him. He wrongly informed the residents of La Libertad that someone (me) had suggested there were problems of malnutrition of children- This was not true, as malnutrition was never an issue. The situation changed when I was able to explain my intentions (making sure they had to support) to the residents and state they had been wrongly informed by the Curaca.
Two days prior to me leaving La Libertad, the social worker contacted the Curaca in order to find out about the report; this once again changed the situation. I had a meeting with the Curaca for one hour explaining how on my return to Leticia I would inform the social worker I had not obligated families to attend classes etc. The Curaca was unfortunately not open to hearing me and was constantly worried about losing benefit money. I gave my opinion on the situation of the village in terms of health highlighting such gravities as the cases mentioned above. He was not interested in this.
The morning of our departure he held an assembly to inform the residents about this issue ignoring the conversation we had had the previous day. This obviously caused the residents some worries as he continued to suggest I would inform the social worker of specific families and issues. I defended my position once again but faced hostility from some of the mothers, I continued to repeat that I was only in a helping role. This issue was caused by the attitude of the Curaca and it’s evident that he preferred to lay blame on me when it’s him who was failing in his role to help the village.
Once in Leticia, we spoke to the Social worker who was alarmed that Curaca had blown the situation out of proportion and stated she had never mentioned malnutrition as a factor in the chat. She stated that La Libertad was one of the most challenging villages; she added that neighboring villages prospered far better due to the leadership and care of its Curaca.
We want to explain this issue in order to support future volunteers in management with the Curaca.
In health care, the recommendation we are giving is our long terms goals. In our opinion, La Libertad has lost its direction and is trapped between some of the old traditions and the western traditions. The long-term goals could be achieved by prolonged support e.g., long-term volunteers. The situation in La Libertad is the same that is faced by many impoverished communities throughout the world. These include poor physical and mental health conditions and issues such as alcoholism.
These recommendations of priority are from highest to lowest:
a) Drinkable water: clean water is essential for the health of the residents to avoid some of the basic conditions/illness, they had.
This could be faced by supplying water via the waterfall e.g. by tube and suction system.
Another option is the construction of a large tanker (Zaragoza a neighboring village has this) through gravity means it would supply clean water. This water could be controlled through the maintenance of the residents.
This issue needs to be addressed by professionals and experts on this matter.
In our time in Leticia we addressed the water company which stated LA Libertad would be provided with a clean water system within the next year however we are unsure and unconfident on when this will actually occur.
We suggest that the next volunteers who are focusing on the water solutions contact the local water company based in Leticia.
We advised that the residents boiled their water to reduce contamination however this only a short-term step.
b) Healthcare: A small healthcare clinic or space should be provided within the community. To be able to check and treat patients within a clean and hygienic environment. This should contain basic healthcare equipment and supplies such as bandages etc. At this moment a healthcare area does not exist. During my checks, it was necessary to check the patients in very unclean conditions such as home and on floors, etc.
c) More healthcare volunteers need to be recruited; this is essential in order to continue the teaching of the healthcare promoters Wagner and Emma and overall continue to create a new understanding of health care. It’s about helping them to help themselves.
d) Encourage Emma and Wagner within their roles; we think it would be suitable for them to have some incentive for this which would need to be managed by the Curaca or health care team in Leticia e.g. a small amount of money or useful resources provided by the community for their work.
e) Work in cohesion with the local government and the Curaca in order to gain more support and resources for the residents.
f) One of the most ideal recommendations are for there to be more emphasis and use of the natural pharmacy they have close by, this alongside the help of the Shamans. However we understand that this may be the most challenging.
g) The community boat should be established as accessible for emergency trips because this was not the case during our stay. In this process, the Curaca and the residents should always be involved.
h) Hygiene should be continuously promoted by volunteers and in order to raise the consciousness of its importance by the residents.
· Children and Teenagers attended daily English Classes between 2pm and 4pm.
· Attendance ranged from 20-40 in the initial weeks and about 15-30 in the last weeks
· Attendance was higher on school days
· The classes were held in a school classroom completely available when teachers were present in the village and when not the caretaker had access to the keys
· Lessons were split into two levels depending on age, 4-10 yrs from 2-3 pm and 11 yrs onwards from 3-4 pm.
· Topics introduced by previous volunteers were continued with including numbers, colors, greeting, food vocabulary, animals and for the older class an introduction to basic verbs.
· The lessons consisted of a mix of activities including pronunciation and grammar games, writing activities as well as art and craft activities.
· Balloons and sweets were used as incentives.
It’s important to understand that the children and teenagers are very shy and reserved and so it’s essential to use lots of icebreaker activities and positive encouragement to build confidence. It took time for many to speak a word in English.
Although attendance was good (particularly in the first two and half weeks), Interest in the classes did reduce and I believe this is due to a number of factors including:
A) The children only had 8 days of school whilst we stayed in the village; this was due to a variety of reason including weather issues and teachers attending meetings however it was apparent that Children in neighboring villages had far more school days than their La Libertad counterparts.
Breaking from this routine meant that some had other responsibilities such as working in the field, going to Leticia, or taking care of the home.
B) Some children lost the initial interest particularly when incentives were not used as it was impossible to provide daily sweets.
There are several issues in terms of the education of the residents of La Libertad. As mentioned the children regularly miss school and so are lacking the fundamental educational attributes such as reading and writing. I witnessed many children aged 9yrs plus who were unable to recognize a word in Spanish, 12-15 children aged between 6-10 yrs were unable to spell basic words and had difficulty handwriting. This obviously hinders the learning process of English due to them having difficulties and needing support with their first language.
Adult lessons were offered to the community on numerous occasions, some showed interest and it was arranged to hold these classes in the morning. When this was not suitable evenings and weekends were offered, however, the interest was not followed through and adults did not attend. I believe that this is due to their lack of confidence, particularly with their own reading and writing skills.
During our stay, it was evident that neighboring villages wanted to increase their tourism and requested that many adults were interested in the classes.
· Although English Classes would be beneficial to the residents of La Libertad, I am of the opinion that there needs to be a more holistic approach to the education of the residents. Recruiting primary and secondary teachers or teachers in training with a good level of Spanish would be extremely beneficial in all areas of education e.g. Spanish, Math, and Sciences. English in my opinion is a long-term goal.
· Recruiting art workers and playworkers as volunteers would be beneficial to the children of La Libertad. Many of the preschoolers relished the opportunity to create and learn. This would enable them to have a head start prior to attending school.
· Support not to use their traditional languages. Many of the older adults speak within their own language such as Yagua however many are not continuing with this process. It would be useful to link with other local villages that encourage the active learning of the traditional languages. This is just as important to their culture as learning a new language.
· Long-term or consecutive teacher support. If future volunteers wish to support English teaching it would be ideal to have long-term stays in order to impact the language development. This would limit the breaks in children learning a topic and then forgetting it due to a break in learning. Long-term volunteers would also have the opportunity to develop relationships with adults and encourage learning.
During our stay, it was evident that the responsibility of childcare varied from family to family. Some take their children to the field and fish with them. A large majority of babies and toddlers however are left in the care of their siblings, many as young as 6yrs old.
In some extreme situations, we witnessed children as young as two being left unattended and unsupervised. In one incident one child of two years old suffered burns to his leg whilst being left unattended whilst his parents bathed in the river.
Numerous children had minor accidents whilst being left unattended which Dani treated; fortunately, major accidents did not occur that we were aware of.
It is necessary to understand that some families do not feel they have a choice about childcare when they have a responsibility to work in the fields and fish however there are accidents waiting to happen.
La Libertad does not work as a community to address this issue.
· We were informed that neighboring villages have systems to address this issue. In Zaragoza and Macedonia, the Curaca´s organize childcare duties between families in order to share the responsibility. This would be suitable for La Libertad but in our personal opinion, further community cohesion needs to be addressed.
· Childcare education/classes would also be beneficial to the residents particularly as some mothers are very young and would benefit from the support.
· Many families live within extreme poverty within La Libertad and rely heavily on childcare benefits and charitable donations. During our stay, the community received a charitable donation of medical supplies from a tourist cruise liner. These donations from the same company occur annually. The donation is based on the request from the previous year.
· The medical donation included 5 boxes of x 100 painkillers, 3 boxes x of antibiotics. 12 antibacterial, anti-inflammatory creams and 14 boxes of purgatives medicines 8these were administered by Dani before being giving to Emma (health volunteer)
· The village receives 5,000,000 COPS annually from the local government. This year this money was spent on construction and supplies.
· The village also has a contract to produce plantain and other such products in exchange for benefits from the local government.
· A minority of residents have profession such as in tourism (Gustavo) and running small shops (Curaca)
· Many of the families make artisan crafts to sell to visiting tourists.
· The majority of families survive by farming and fishing.
· Many families have motorized boats and the cost of these, as well as petrol, is expensive.
Many of the villagers complain about the lack of money they received in benefits and many suggest it is not the correct amount; The Curaca has not addressed this issue with the local government. Some families may be entitled to some more money. We were told by some villagers that under other Curacas, the families had access to further resources and benefits but they have diminished in the past years.
The families with outside work such as in tourism prosper far better than those without.
A great deal of money is spent by families on traveling with their motorized boats. The cost of this takes money away from other necessary things.
The artisan makers make very little money from selling their crafts as they do not have numerous tourists on which to rely on.
It would be useful for future project workers to understand what entitlements the villagers are missing and address this with Curaca and local government.
It would be good to address alternative transport systems for the residents of La Libertad and to encourage sharing transport with other families in order to reduce the cost. This was addressed during our stay but needs further focus.
Life, Culture and Community of La Libertad.
The residents of La Libertad originate from the Amazons of Brazil, Colombia and Peru.
Many of the families are large and extensive some families have 8 or more children. In addition, there are very young mothers residing in La Libertad some as young as 15 years old.
Unfortunately, due to the illness and death of their families, there are numerous orphans within the village who live with either elderly grandparents or older siblings.
During our stay we became aware through talking with villagers that there are issues of community cohesion, some of the minority families such as those from Brazil tend to be poorer and less integrated. There are also issues in terms of which members of the group can run for Curaca: those originally from Colombia have been the only leaders of La Libertad in recent times.
It’s important to understand that those who have big families are a sign of health and fortune within the community, however many are unable to cope with the growing number of children. Many of the residents are under the age of 18 and numerous mothers are very young. This has had an impact on the above issues such as child care education.
One major concern is specific to some of the orphan children with elderly grandparents, is there a system in place for children without care?
It’s incredibly difficult to be recommending many aspects in relation to the culture of La Libertad. We are not in a position to change these long-term issues. They need long-term relationships to tackle some issues such as racism, discrimination, and the issue of the high birth rate. These are issues seen within numerous societies. However, it is essential for the project to be aware of how they affect relationships within the community. Linking with community workers would benefit the village.
It would be positive for some focus to be on the development of the childcare systems related to those children with elderly grandparents and this may be developed by future volunteers in connection with the Curaca and local childcare teams.
Information for Volunteers
We are adding some information that was created by previous volunteers in order to help future volunteers.
· Living conditions are adequate for Volunteers and the family of Gustavo and Rosalba make you feel very welcome.
· Bring dry and canned food. Fruit and vegetables are not suitable and do not last very long.
· Bring a plastic container for the food. We had some issues with nightly visits from rats attracted by the food.
· Security is not a problem. We never had any issues with belongings being taken. The children love to look through your possessions but are very respectful. There is now a lock on the volunteer hut for your peace of mind, however.
· We suggest that volunteers have a good level of Spanish in order to communicate effectively with the residents or have a full-time translator. On occasions, it can be difficult for a native speaker to understand some of the local colloquiums and this needs time to understand. Speaking the same language does build confidence with the residents and enables relationships to be built.
We do not wish to hinder volunteers from going who do not have a good level of Spanish but would just like to highlight it would be very difficult without it. An example of this is that we found some discrepancies and faults within the last report due to language issues.
These are only our recommendations and ideas due to our experiences in La Libertad and in our professional fields as a nurse and youth and community worker /English teacher. We feel that it is necessary to highlight that health care is not a moderate issue as previously reported. It is a high priority. We feel that teaching English or focusing on ecotourism is of a low priority at this stage and should be addressed once other aspects are focused on.
In our opinion, if the project really wants to help the community it has to listen to the requests of the people and spend time living with them. It would be an injustice for people such as Bebeto, Haco, Olga, and Vicente to ignore the real issues such as Water and Health.
New volunteers should have the opportunity to influence and evaluate the needs of the project due to it being in its early stages. Through collaboration, this will be more effective.
We recommend this experience to anyone really willing to help. It’s an experience of a lifetime.
Diane and Daniel