Week 2On Monday morning Juan, María and I had meeting at the Guanajuato state health department (GSH), at their headquarters in the city of Guanajuato. At the meeting were Dr. Cabrera (Director of Public Health), Dr. Meza (HIV coordinator), and member of the Investigation and Training branch. The first topic of the meeting was the Bi-national Health Week conference, which is put on by Health Initiative of the Americas. It is a gathering of several American countries (Peru, Mexico, Canada, USA, Guatemala, Colombia, Panama, and a few other) to health issues that occur and can are affected across these countries. The GSH is interested in the hosting the conference in 2010, and María and Juan bring valuable connections and experience. If the Bi-national works out, it will be real feather in the cap of the GSH, however, to make this happen will require a lot of planning and expertise.
The second topic of the meeting was the primary reason why we had come, the HIV/AIDS stigma and discrimination workshop. We needed letters approving the project from the GSH to give to the collaborators in the project. The project was planned to occur in Celaya, a moderately sized city in Guanajuato. We needed the letters for the General Hospital of Celaya (who would have personnel trained), the local health jurisdiction (also would have personnel trained), and la Universidad Latina de México (whose students would administer the evaluations). As we were in position of value to the GSH, they provided everything that we had asked for. Our next meeting was to occur on Wednesday in the HIV clinic (CAPASITS) at the General Hospital in Celaya where the workshops were to take place.
Tuesday, I met up with Lourdes the coordinator of the nutrition program at CASA and we went over her evaluation again. I had given her a couple of pages of recommendations so that she could implement an improved version on the next day. A lot of the recommendation that I had was geared at creating questions that children would be able to understand. She incorporated a lot of my suggestions, but there were some issues that she had more insight into. Afterword, I met with the development director, Cynthia, and I from what I have gathered, I believe that I am now enlisted into the fundraising campaign. Aside from the evaluation stuff, she wants me to write an article for the local paper. I don’t have a topic yet, but I believe that it should have something to do with the nutrition program they are trying to raise money for.
Wednesday, we went to meet the powers that be in the CAPASITS of Celaya. CAPASITS is a comprehensive HIV clinic that provides treatment and services to people who cannot pay for the care themselves. As, universal access to treatment is supposedly available throughout Mexico; CAPASITS clinics are how they manage that task. While waiting for about a hour waiting for everybody to get there, I was able to get a quick tour of the facility. It’s a small clinic with a central waiting room surrounded by offices of different specialties that a person with HIV might be in need of. A model of comprehensive care where patients can get their needs met in one stop. The different services offered here included: primary care, dentistry, therapy, social work, nutrition, and a pharmacy. The facility was very new, so everything looked very clean, something I have not been used to poking around HIV services in the Tenderloin.
At the meeting, while discussing the logistics of the workshop I quickly realized that the hospital folks weren’t as excited about the project as we were. In the room was Dr. Meza the HIV coordinator of the GSH, and when someone from the state health dept. says jump, you say “how high?” During this meeting, there was concern as to what type of project this was, an investigation, a pilot workshop, or simple workshop. With the former two types of workshops, they hospital folk wanted the official sanction of an ”investigation committee,” basically an internal IRB. From that, we clarified that we were conducting a workshop for GSH, where we would monitor any possibly effects that are the result of the intervention. We made a plan to return the following day to return to share the details of the workshop to see if the Hospital people had comments. There were a couple of people from the health jurisdiction, but they mostly kept quiet.
Afterward, we went to the Universidad Latina de México to talk with the Dr. Lemas, the director of learning at the University. He was very helpful, and said that he would help out anyway he could. One problem that arose was that the students were in the middle of final exams, and soon they would be off for the summer breaks. So, it would be important to get the students soon.
Thursday, we went back to CAPASITS in Celaya to work on the details of the workshop and figure out logistics. With the state representative absent (Dr. Meza), the health jurisdiction and the hospital people had different attitudes. I hadn’t understood it in the last meeting, but we were supposed to train 250 people in the span of a week. The workshop would take 25 people from the hospital and 25 from the health jurisdiction each day. Understandably, both were concerned about how this would affect their respective programs day-to-day responsibilities. The local health jurisdiction was especially concerned because they had just finish canvassing the entire city of Celaya with information about the flu. In addition, they had a long-awaited National Health Week, which would start the following week. The hospital administrators had similar concerns of taking so many people out of their jobs for a week. It was agreed that it would work better if the workshops were done once a week. The administrators also had some comments about the PowerPoint of the workshop, the felt that it was long, and could be more interactive.
From the meeting it became clear that the health jurisdiction welcomes the opportunity of the workshop, where as the hospital has the attitude that it would be too cumbersome to implement. It would appear as if it is easier to keep the status quo, of having a bio-medical approach to health where all the hospital has to do is provide medicine and services and ya! From our perspective, the hospital was not interested in the workshop and perhaps they felt the possible benefits that it could bring aren’t worth the effort.
With these new developments, it’s back to the drawing board in terms of planning the workshops... Perhaps it will be best to focus on the local health department who seem to be interested in the workshop that we are offering. More next week...
On Friday, I went back to CASA, the non-profit in SMA to join them in a taste-test activity of new line of healthy products. From the outset, it appeared to me that it was just new packaging for the same products that were being offered in stores of the area. I was mistaken; the tortillas were fortified with soy. Also, the food products were for the most part healthy, such items as milk, tortillas, and cake. There were some products that I was confused to see, American cheese (with trans fat and everything), hot dogs, and sausage. The brand is called Nutrición y Vida!, I am beginning to suspect that it may just be a ploy to sell regular food under the guise of “healthy.” Fortunately, the Nutrición y Vida salesmen was there to assure me that was not the case, it was actually a program to subsidize healthy food for low-income families. I may need to do further detective work to get to the bottom of the case.
Next week, the plan is to make moves on the HIV-stigma project, as the workshop plan is proceeding as we thought that it would, it’s time to re-adjust. CASA work will continue, and I will try not to think about the American cheese.
Taste testing
Healthy Hot Dogs
Fortified with soy
