EAPSEC / Mexico

EAPSEC works with local people to manage chronic diseases such as epilepsy.

Health promoter in Chiapas
A health promoter in Chiapas.

The residents of the southern Mexican state of Chiapas, including millions of indigenous Maya, have long struggled with poverty, political violence and dismal health conditions. Chiapas is burdened with one of the highest rates of maternal and infant mortality in Mexico, as well as one of the highest rates of tuberculosis.

El Equipo de Apoyo en Salud y Educación Comunitaria (EAPSEC, The Team for the Support of Community Health and Education) was established in 1985 by a small group of Mexican health promoters. They initially worked with Guatemalan refugee communities in the Chiapas border region, later expanding their work to other marginalized people in Chiapas.  EAPSEC believes that for everyone "a life of dignity" is a human right.  This includes a strong public health system that responds to the most pressing health needs of the population, and individual access to high quality health care.

Since 1989, PIH has collaborated with EAPSEC to improve medical infrastructure in the region and to recruit and train hundreds of health workers, known as promotores.  As a "supported project" of PIH, EAPSEC shares many of the principles and practices of our model of community-based care. In particular, EAPSEC has focused on training and empowering promotores to educate their neighbors to attend to many of their basic primary healthcare needs, and to recognize when they require transfer to a more advanced clinical care. Over the past two decades the EAPSEC has partnered with dozens of indigenous and rural communities throughout Chiapas to develop local health capacity.  In addition, EAPSEC is dedicated to helping communities build self-sufficiency and counts many successful community health groups throughout Chiapas among its "alumni". 

PIH supports these efforts with modest but important contributions to EAPSEC's annual budget.  PIH also facilitates periods of service by Harvard Medical School students and resident physicians in the Global Health Equity Residency program at the Brigham and Women's Hospital's Division of Social Medicine and Health Inequalities. A Global Health Equity Residency graduate is now one of two pro bono staff members who together spend the majority of the year in Chiapas helping EAPSEC increase its impact.

Today EAPSEC is expanding a long-standing partnership with a network of Community Health Promoters living in over 20 isolated farming communities in the Sierra Madre Mountains of southern Chiapas. Faced with treacherous roads and an absolute lack of communications infrastructure, local families are frequently impoverished by the cost of the trek to government or private health care facilities, let alone the cost of the consults and medicine.  With physician support, Community Health Promoters provide unprecedented access to treatment as well as prevention information in their own communities at almost no cost.  They are also able to provide crucial follow-up for diseases such as diabetes, epilepsy and tuberculosis.  In 2009, the project will pilot PDA-based software that helps CHPs follow established criteria to make health care decisions. 

EAPSEC also brings health promoters from throughout Chiapas' diverse regions together to learn and share experiences.  In 2008, the team organized certificate courses in health promotion sponsored by Universidad Autonoma Metropolitana de Xochimilco that included dozens of participants. They also coordinate quarterly meetings and contribute to curricula for the Chiapas Network of Health Promoters.   

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