Health is a fundamental human right. Clinica Ana Manganaro (CAM) is a champion of this cause, working daily to provide holistic health care to its community and surrounding area. While the current climate of health policy in El Salvador is shifting for the better, Clinica Ana Manganaro has always functioned for the cause even in the midst of the violent twelve year civil war that gripped the country. Such strong resolve to provide health, even in the most difficult situations, is a mission that Clinica Ana Manganaro hopes to spread throughout the world. By implementing different health initiatives in the community of Guarjila, the clinic hopes to successfuly instill the same programs in surrounding communities, countries, and even the world.

Problema

Health is a fundamental human right. Clinica Ana Manganaro (CAM) is a champion of this cause, working daily to provide holistic health care to its community and surrounding area. While the current climate of health policy in El Salvador is shifting for the better, Clinica Ana Manganaro has always functioned for the cause even in the midst of the violent twelve year civil war that gripped the country. Such strong resolve to provide health, even in the most difficult situations, is a mission that Clinica Ana Manganaro hopes to spread throughout the world. By implementing different health initiatives in the community of Guarjila, the clinic hopes to successfuly instill the same programs in surrounding communities, countries, and even the world.

Solución

As an urbanizing economy has led to the influx of processed food and sedentary lifestyles, proper food and nutrition has become an increasing concern in El Salvador. While revolutionary health reforms have been set in place by the government providing free appointments and medication in its public clinics, there has been less of a priority on education for healthy lifestyles and preventative care. It is here that the staff at CAM is different, designing programs like group exercise classes, a rehabilitation center, and the mother-infant nutrition program. As innovative as the idea itself might be, it must be noted that even the best health improvement plans fail because of a lack of sustainability. The project that CAM employs, however, was built around this aspect. While the program gives free food to pregnant mothers, infants, and children with low BMIs, the comedor also sells healthy, low-cost meals to other visiting patients, as well as staff. As mentioned before, nearly all services provided by the clinic are free, and it accordingly relies heavily on funding by the government and partnerships around the world. Knowing this, it is surprising that none of the proceeds made from the dining hall revenues actually go to the clinic, but rather to a cooperative of women from the community of Guarjila who staff the kitchen and distribute the earnings among themselves monthly. Furthermore, all the food that they do prepare (with the exception of soy milk) is grown and produced in the community itself, which supports the primarily agricultural local economy of Guarjila.

Ejemplo

While the clinic currently employs itself in many diverse health initiatives, the specific project that is being highlighted on Changemakers involves its comedor (dining room), which engages in a novel program to provide for the unique needs of the clinic's patients. As expected, the comedor offers daily, low-cost breakfast and lunch for its staff and patients that travel from hours around to seek medical care at CAM. However, a unique mother-infant nutrition program has been established in Guarjila that offers meals and nutrition education free of charge to pregnant women, infants, and small children. All the food that is prepared is made from locally grown produce and livestock, with the exception of powdered soy milk, which must be imported and introduced into the diets of many of the infants and small children to bolster their health. In addition, pregnant women, small children, and their guardians receive consultation from an onsite nutritionist and gynecologist concerning proper nutrition during pregnancy and the formative years. In this way, the clinic prioritizes good health in its patients at an early age, instilling a lifelong commitment to achieving it. By first ensuring that it remains successful in its own community of Guarjila, the program is one that the clinic hopes to spread to neighboring clinics and communities.

Mercado

As mentioned before, the community of Guarjila is a close-knit group of people who have been forever tied together by a violent twelve-year civil war that gripped the country until 1992. The battle raged in both neighborhoods and cities, and whole households and family members were lost; the people lived through a nightmare, as boys were taken to be child soldiers on both sides of the conflict by the time they turned twelve. People sought shelter in Honduras, where conditions were just as horrific. One specific group of refugees, however, decided to return and build Guarjila from the ashes of a still torn El Salvador in 1987. Interestingly, the health program that the clinic currently relies on was started the same year the community was founded (the actual brick and mortar clinic was completed in 1991). In this way, Clinica Ana Manganaro’s presence in the community is central with values that are so aligned with the people. From these humble beginnings, Guarjila has since grown to almost 2,400, developing an economy that is highly dependent on agriculture, especially corn. From its founding during the war when no strong government was present, the clinic has maintained an authoritative, governing role, and most decisions and programs for the community are implemented by the nurses, doctors, and health promoters who staff CAM. This engagement has thus far been extremely successful, including elaborate census work, sanitation initiatives (trash disposal), and even infrastructure (construction of latrines). A lot of this is due to the fact that nearly all the nurses and health promoters are actually members of the community of Guarjila. The chief doctor and director of the clinic himself is a Guarjila local. Thus, the norms and values of the clinic are aligned with the community, which are rooted in a reliance on teamwork and compassion, adopted nonetheless by overcoming the hardships of war. Demographically, the community is still largely represented by the mixed Spanish and American Indian people, characteristic of northern El Salvador. It is also worth noting that the prevalence of households supported entirely by single mothers has increased greatly, primarily due to many male figures leaving to find more sustainable jobs elsewhere. It must also be highlighted that the community the clinic serves is not only limited to Guarjila but also expands to seven other municipalities in Northeastern El Salvador (who nonetheless face most of the same conditions as the residents of Guarjila).