Food for a New Generation

Food for a New Generation

El Salvador
Organization type: 
nonprofit/ngo/citizen sector
Budget: 
$10,000 - $50,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

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.

About Project

Solution: What is the proposed solution? Please be specific!

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.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

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.
About You
Organization:
Clinica Ana Manganaro
About You
First Name

Ryan

Last Name

Thomas

Facebook Profile
About Your Organization
Organization Name

Clinica Ana Manganaro

Organization Phone

(503)2352-2303

Organization Address

Unidad Comunitaria de Salud Familiar "Ana Manganaro," Calle Principal Sur, Cantón Guarjila, Ciudad de Chalatenango, El Salvador

Organization Country
Country where this project is creating social impact
How long has your organization been operating?

More than 5 years

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Innovation
What stage is your project in?

Operating for 1‐5 years

Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.

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).

Share the story of the founder and what inspired the founder to start this project

If the history of Guarjila has shown anything, it is the resilience of the human condition. Surviving one of the most violent, longstanding wars in history, the people returned, reunited with what family that could, and showed that even in the most terrible conditions, people have the ability to act to make a change. For the people of Guarjila, this change came through the work of physician Sister Ana Manganaro and Father Jon Cortina, two individuals who took it upon themselves to build a clinic, empower a workforce, and serve a crippled nation.

Currently, the clinic is under the direction of Dr. Dagoberto Menjivar, who continues the work started by Sister Ana and Padre Jon. He follows their same mission, focusing on empowering the community through the clinics extensive and continuosly expanding programs. This specific mother-infant nutrition project, Dr. Dagoberto explains, was inspired by the enormous priority the clinic has given to pregnant and nursing mothers since its founding. Boasting a near 0 infant mortality rate, this project hopes to extend the clinic's expertise in this area, while also teaching a new generation the importance of a healthy diet and proper nutrition. The allure of free food is a global phenomenon that doesn't escape Guarjila, but Dr. Dagoberto hopes to capitalize on this draw by prioritizing healthy eating habits and nutrition for a growing generation. Along the way of course, he still manages to bolster the local agricultural economy and provide a source of income for many single mothers who staff the clinic.

Social Impact
Please describe how your project has been successful and how that success is measured

Clinica Ana Manganaro was built in the village of Guarjila and the subcommunity of Guancora, combining to a total of almost 2,400 individuals. Regionally, however, the clinic serves as a referral center for 7 municipalities in Northeastern El Salvador, adding almost 17,500 individuals to this mix. A surprisingly vast majority of the actual patients who frequent the clinic and its comedor (dining hall) are individuals who travel for hours from these neighboring municipalities to seek the quality care and amenities offered by CAM. This being established the number of mothers, pregnant, nursing, and with small children, account for almost 20 percent of the clinic's daily traffic. The project, which is still fairly new, has proven greatly successful thus far. This is measured by an extensive archive of patient files and histories, with specific graphs pertaining to children graphing their weight, height, and subsequent BMIs. Infants and children with low BMIs are placed in the soy program and closely monitored. Results are promising as almost 25% of the children with low BMIs have already recovered from its installment in the community, a number that continues to grow. Most notable is the infant mortality rate and rate at which children are born underweight. Both are at 0%, numbers greatly attributed to the mother-infant nutrition program when you compare it to data before its implementation.

How many people have been impacted by your project?

More than 10,000

How many people could be impacted by your project in the next three years?

More than 10,000

Winning entries present a strong plan for how they will achieve growth. Identify your six-month milestone for growing your impact

Clinica Ana Manganaro is revolutionary for its health initiatives, and it hopes to have its mother-infant nutrition program mimicked in neighboring communities and clinics.

Task 1

Compile the stastistics for surrounding community clinics regarding infant mortality, infants born with low birth weight, and the numbers of malnourished children (irregular BMIs).

Task 2

Design a formal proposal of the current mother-infant nutrition program used at CAM and dispatch community health promoters to the areas of most need.

Task 3

Closely monitor and gauge the data in these communities, relying on the health promoters to empower other clinic staff to take up the cause after identifying the impact of such a program.

Identify your 12-month impact milestone

As the existing comedor serves a combined population of almost 20,000 individuals, it is necessary for the actual dining hall to expand with the core clinic that is almost doubling in size.

Task 1

Identify partnerships throughout the world that will assist in raising the required capital. Many do exist and one in particular has already pledged $6,000 for the cause.

Task 2

Expand on the actual cooperative of women, primarily single mothers, who staff the comedor to meet the increased demands of a larger dining hall by empowering women in the community.

Task 3

Better understand the structure and workings of the current comedor in order to maintain strengths and correct inadequacies through the expansion.

How will your project evolve over the next three years?

Over the next three years, this current project will evolve to not only focus on pregnant, nursing, and mothers of small children, but also on the food and nutrition of the community at large. Building on the infants that initially receive care in the current program, the aspect of healthy eating education must remain prevalent as the children grow. Furthermore, the economy of the region is quickly urbanizing, leading to a more sedentary lifestyle and an influx of processed foods. Such a social pressure means maintaining a healthy diet as adults in the community is more important than ever. Finally, with a substantially increasing life expectancy in the region, the clinic must be able to provide for the nutrition education of older patrons, a segment that must rely on a proper diet.

Sustainability
What barriers might hinder the success of your project and how do you plan to overcome them?

The most obvious pitfall of providing free food for pregnant and nursing mothers, as well as infants and malnourished children is actually funding the costs of the food that is given away at no charge.

This particular segment, however, combines to a total of 20% of the traffic the clinic sees. The other 80 percent of patients are responsible for paying for their meals. Since the educational aspect of the comedor is not only limited to the mothers and their children, this further draws in traffic, as patients are less likely to opt for easy to find, processed alternatives and opt for organic, homemade meals.

Furthermore, the actual costs of the food is undercut by the fact that mostly all of the ingredients are provided by a more than gracious local community who welcome the business and do not charge higher margins that can arise from shipping and handling.

In addition, what expenses exist are taken by the comedor staff, who also enjoy 100 percent of the profits. Many of these workers are single mothers who work passionately alongside the clinic staff in their mission, as in many cases the station provides the only source of revenue for their households.

Tell us about your partnerships

As mentioned earlier, the actual clinic is not run for profit. In fact, it doesn't charge for patient appointments or medications. The salaries of its employees are paid in a large part by the government's ministry of health and to a smaller part by international partnerships.

The actual infrastructure and programs the clinic is home to is predominately funded by its extensive international partnerships. The biggest provider is CAFOD, the Catholic Overseas Development Agency (UK). Other significant funders include GlobeMed at the University of Texas at Austin (USA), the Bielefeld Germany Group, the Saint Louis, Missouri Group, and the Tamarindo Foundation (USA). The work they do for the clinic is due to the fact that the clinic works hard to maintain the relationships and the belief that these institutions have in its mission.

Explain your selections

The mother-infant nutrition project itself runs at a cost of almost $4,000 a year. The salary of the individuals who engage in preventative education and related health administration is around $20,000.

Foundations and NGOs account for almost 60% in aid for the actual preventative education salaries. The rest of this amount is made up for by local revenues and government aid, specifically its Ministerio de Salud.

As you can see, the clinic relies heavily on its partnerships and the funding it receives to continue to implement its innovative programs and make a tangible difference in the country of El Salvador and beyond.

How do you plan to strengthen your project in the next three years?

As mentioned previously, Clinica Ana Manganaro continues to search for partnerships around the world who believe in its mission for global health equity.

With each additional partner and each additional dollar of funding the clinic receives, it is one step closer to its goal of providing a continuously improving standard of healthcare to the people of El Salvador.

Challenges
Which barriers to health and well-being does your innovation address?
Please select up to three in order of relevancy to your project.

PRIMARY

Limited access to preventative tools or resources

SECONDARY

Lack of access to targeted health information and education

TERTIARY

Restrictive cultural norms

Please describe how your innovation specifically tackles the barriers listed above.

CAM is perfectly poised to make a difference in its community by employing healthcare on a personal level to the community that it is a part of. The staff is able to identify needs in the health of the population it serves and work intimately with the people to discover solutions to overcome these hurdles. In regards to food and nutrition in the community, they saw that there was limited access to preventative tools and resources, as well as a lack of access to targeted health information and education, and they worked to create a sustainable project to tear these barriers down. Through the program, they included a cooperative system to empower single mothers to be independent and self-sustaining to break restrictive cultural norms facing the community today.

How are you growing the impact of your organization or initiative?
Please select up to three potential pathways in order of relevancy to you.

PRIMARY

Enhanced existing impact through addition of complementary services

SECONDARY

Influenced other organizations and institutions through the spread of best practices

TERTIARY

Grown geographic reach: Multi-country

Please describe which of your growth activities are current or planned for the immediate future.

Clinica Ana Manganaro is seen as a beacon in the country for its innovative programs and services. Before it could make such a tangible difference elsewhere, it first had to succeed in its primary activities- offering healthcare to the community of Guarjila and the seven other municipalities it serves as a referral center for. With the addition of many complementary services from sexual education to exercise and rehabilitation to food and nutrition, CAM plays an active role in the lifestyles of the communities. This personal relationship has been adapted by other organizations around CAM who capitalized on the best practices of the clinic. As Central America as a whole has similar functions and demographics, CAM's projects are continuously adopted beyond the borders of El Salvador.

Do you collaborate with any of the following: (Check all that apply)

NGOs/Nonprofits.

If yes, how have these collaborations helped your innovation to succeed?

The governments work in the area of healthcare has increased greatly with the recent campaign of President Mauricio Funes. The clinic, however, has always had a longstanding commitment to this cause. The government recognizes this and often uses the clinic and its programs as an example for the country. Directly, the government has helped the innovation succeed by staffing and paying salaries for many specialists to supplement the expanding services the clinic, including a Pediatrician, Dentist, Internal Medicine, and Gynecology.

CAM also heavily relies on NGOs and nonprofits around the world to provide the funds necessary to carry out its vision. These partnerships have only been possible due to the fact that the ideal of health equity is a concern ingrained in the human race.

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