A Family Health Program for Galapagos
Development, as generally understood, is a risky endeavor in sensitive areas such as Galapagos. It may break the ecological equilibrium and its consequences will produce, instead of wellbeing, catastrophic results for man and nature.
Any development program must take into consideration two conditions: attention of health of the people and protection of the environment, two conditions that are intimately related.
Several health programs have been designed in Ecuador during different governments. All of them have been well conceived, with advice from the World Health Organization (WHO) and the Pan-American Health Organization (PAHO). All programs emphasize the prevention of disease, promotion of health and special care of children and mothers. It would be false to affirm that all these plans have failed. Significant progress has occurred in the health situation of the Country, as our health indicators testify. Nevertheless, the situation leaves much to be desired and we are far behind in the world and even in Latin America.
The situation is worse in the countryside and in distant areas, especially among the native population. Rural doctors have to serve one year after graduation of medical school working in the countryside. They are in charge of carrying out the health plan in a health sub center, usually very poorly equipped; they are in charge of a population between 5,000 to 10,000 and even more, population dispersed in a wide geographical area. This situation makes it impossible to perform a systematical medical care and the young doctor ends up in the health sub center taking care of the patient's demands. Only occasionally, they have the opportunity to organize programs in promotion of health or prevention of disease and the lack of resources orient the practice to merely symptomatic treatment.
This is the reason why health plans so well designed, do not have the expected results. They carefully explain what to do, but not how to do it. They do not specify strategies nor provide the means to carry out different sub programs.
The new Constitution, approved in 2008, points out that the health system in Ecuador is family and community oriented and the government has shown a political decision to implement it, assigning an important budget for health attention and organizing the basic health teams (Equipos Básicos de Salud: EBAS). Unfortunately, the insufficient number of these teams, the lack of adequate training and the exaggerated centralized management of the program has not produced, the expected results: the government informs about the great increase in the number of consultations and curative attentions but does not report, so far, any improvement in health indicators.
REDMANGROVE, according to the constitutional mandate and recognizing the authority of the Ministry of Health, wants to contribute to the healthcare of Galapagos with a Family Health Program that will start in the Island of Isabella, with the families of its employees. We believe that health is a responsibility of all citizens and we hope that our contribution will produce beneficial results.
INTEGRAL FAMILY HEALTH
The best results in healthcare in the world have been achieved through Family Health programs: a medical team is in charge of a defined group of families in a specific geographical area.
We will start obtaining and recording information about the health and other related data from individuals and their families. Then the population will be classified according to age in different groups and each one of them will have a specific health program to be carried out, such as immunization, control of growth and development, sexual and reproductive health, attention to the elderly, etc. All groups will receive medical care for their health problems.
The program will also have the goal to protect health of the visitors of the Islands.
We will start with one medical doctor and a local medical assistant who will be adequately trained. Local auxiliary personnel have proven to be an excellent link to the community. We will also have voluntary doctors and medical students
.REDMANGROVE will provide food and lodging for them and also the necessary medicines and medical supplies.
We call this program INTEGRAL FAMILY HEALTH: to recognize the relationship that health has with all aspects of human development. We understand Human Development as the liberation of human potential that leads to the improvement of the quality of life. This improvement is achieved, answering the basic human needs, that we believe are: food and nutrition, education, health, housing and clothing, communication, work and production and recreation.
All programs in human development should always stress the preservation of the environment, be organized with community participation and respect liberty of the beneficiaries.
The following picture shows our concept of Human Development and its relationship to Health:
SUMMARY PROGRAM DESCRIPTION
The health program has the ten following subprograms:
1 - Information: It is necessary to gather all the existing information, even though we have found it leaves much to be desired. Then, the medical team visits the homes to meet the families, verify the information and fill out the family record, which contains health and socio-economical data.
With all this information, a baseline is elaborated and will be used to make our health decisions. Also, it will be a reference to monitor and evaluate the results of our intervention.
This information will be updated every year.
2 - Immunization: all children are immunized according to the norms of the Ministry of health and using vaccines provided by this Ministry.
Pregnant women are also immunized.
3 - Growth and Development - Nutrition: Children under five years old are examined regularly, weight and height are recorded, and any detected malnutrition is treated. Nutritional supplements are administered to malnourished children and a program of mother education, regarding home production of food, food preparation and correct feeding is started., the later program, is much more effective and sustainable than the simple administration of nutritional supplements.
4 - Integrated management of prevalent childhood illnesses: This strategy, designed by the World Health Organization, treats the most common diseases in children, such as acute respiratory infections, acute diarrhea, intestinal parasites, malnutrition and any other common disease, in a particular community.
5 - School Children Health: School children are examined periodically to detect and treat any pathological condition, mainly nutritional problems, vision and hearing defects, intestinal parasites and dermatological conditions.
6 - Reproductive Health: This sub-program includes:
Sexual and reproductive education.
Prenatal and postnatal care.
Prevention and treatment of sexual transmitted diseases.
Early detection of breast, uterus and prostate cancer.
Gender related problems.
7 - Youth programs: sports and recreation, prevention of drugs, alcohol and smoking addiction.
8 - Attention of the elderly and handicapped: in coordination with community organizations.
9 - Traditional Medicine: Information about ancestral knowledge will be gathered to be tested as an alternative to academic medicine. A garden with medicinal plants will be cultivated.
10 - Attention of general pathology: Daily consultation and treatment of diseases will be organized. This program will have as headquarter, a ship that will be equipped as a small hospital with the four basic services: Surgery, Obstetrics and Gynecology, Pediatrics and Internal Medicine.
Besides the protection of the local population, the program will also have the goal to protect health of the visitors of the Islands. The health teams will be prepared to take care of pre-existing conditions, such as hypertension, diabetes, cardiovascular and respiratory diseases, as well as problems that may develop during their stay in Galapagos: bites and stings, problems produced by the environment (sun and wind), and gastrointestinal diseases (See a separate description about the Ocean Hospital Program)
In addition, temporary programs about different specialties, such as, oral health, mental health, surgical, obstetrical, pediatric and clinical subspecialties, will be organized.
It is important to emphasize that all programs have a very important educational component for everyone and with a special interest for women.
A detailed operative program will be written after visiting the Islands.
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