The purpose of this project is to support and extend the work of VIIDAI in San Quintin, Baja California. VIIDAI is a unique international consortium of two medical schools and a school of public health in San Diego, California and Tijuana, Baja California, Mexico (see www.viidai.com). VIIDAI provides medical services and performs public health research in poor farm labour communities of San Quintin. Students and faculty from San Diego State University, the University of California San Diego School of Medicine and the Universidad Autónoma de Baja California, a Mexican State supported Medical School, participate biannually in 4-day weekend field trips to Colonia Lomas de San Ramon Otreque in San Quintin. The goal of VIIDAI is to promote health and to provide medical services to underserved populations. VIIDAI also attempts to increase cultural awareness and academic collaborations between the three participating institutions, their faculty and their students. On average, 125 students, 15 faculty, and a dozen San Diego based Rotarians participate in each trip.
This project contains three specific goals: (1) to provide medical supplies and equipment to VIIDAI for use in the biannual weekend clinics established in both the Spring and Fall each year in San Quintin, (2) to address some of the educational and public health issues in San Quintin identified by VIIDAI, Rotary, and the elders of Colonia Lomas de San Ramon Otreque, and (3) to engage several San Diego Rotary Clubs and the Ensenada Riviera Rotary of Ensenada, Baja California in supporting the VIIDAI project.
San Quintin is an agricultural area on a western facing coastal plain on the Pacific Ocean of Baja California four hours drive south of the International Border with the United States. Farming in San Quintin is based on well water and high technology farming techniques pioneered in Israel. The farming supplies vegetables to the USA. Farm labour is provided by emigrant native Oaxaca Indians from the mountains East of Acapulco. These emigrants do not speak English or Spanish, but rather a native Indian language. There are about 30 farm labour villages or colonias in San Quintin with over 50,000 people. The daily wage for farm labour is $10 US. Workers are collected from the colonias in the mornings six days a week and bussed to the fields. Colonia Lomas de San Ramon Otreque, just north of San Quintin, has 4000 inhabitants with one school. The school serves as the colonia community centre and the site of the VIIDAI clinics. VIIDAI research has shown that most colonia children complete no more than six years of school, that most girls are pregnant by 14 years of age and that adult teeth start to be lost by age 10 due to sweets. VIIDAI research has also shown that malnutrition and anaemia are major health problems in the colonia.
This project is to aid education by establishing a computer laboratory and to equip an existent kitchen that currently feeds only 50 of 350 children. Computers that are surplus in San Diego and are a disposal problem, are reused for the needs of these children. As we all know, computers open a new world to those who use them, and indeed internet access is a realistic goal for this school. The computer lab is an educational tool for not only the children, but also the parents and the teachers, and more broadly the entire colonia. The purpose of the kitchen equipment is to provide one good meal each day for each child. Malnutrition and anaemia have been identified as major health problems in the colonia (see below). Since the school doubles as the community centre, the expanded kitchen facilities will also serve the needs of the entire community.
The project at Colonia Lomas de San Ramon Otreque is an outgrowth of Rotary involvement with VIIDAI (see http://www.viidai.com) The Colonia benefits from a significant increase in access medical resources – in the form of medical expertise, health education and promotion, as well as much needed medical services. Because of high levels of interest, cooperation and participation, colonia leaders build capacity to continue the work of the universities beyond the VIIDAI trip.
The student participants of VIIDAI gain valuable insight into global health issues, while being rewarded with experiences that they will carry with them into their futures. Students benefit from a truly unique opportunity to apply skills learned in the classroom to a hands-on setting. They learn from professors and community leaders, as well as peers from collaborating institutions. The exchange is as much cultural as it is academic and VIIDAI has helped build the cultural sensitivity of the universities and the participants through working with indigenous communities. Students have the opportunity to creatively develop and implement international public health research projects – a multi-disciplinary challenge. Furthermore, the research accomplished during these VIIDAI projects contributes to the field of international public health.
Medical Clinics and Public Health
The Clinical Services of VIIDAI Include: Health pre-consultations with medical students; Health consultations with medical doctors; General Health Clinic; Dental Clinic; Eye Clinic; Female Health Clinic; and Pharmacy Services. In consultation with community leaders, needs assessment projects are conducted by VIIDAI every semester. The specific services and details of the projects vary by need each year, but generally include: Health Education Services; Health Survey Teams; Family Planning; Anthropometry; and Nutrition.
Major Impact Projects.
Each VIIDAI trip includes a focus on a major project that addresses a critical need of the community as identified by previous trips. These major projects include:
Family Planning Project
In the Fall of 2004 a needs assessment with community leaders of a colonia identified high parity and gaps in family planning as particularly challenging for families to cope with and a high priority issue for the community. Focus groups, in-depth interviews and a quantitative survey were conducted to gather base-line information on knowledge and practice of contraception, socioeconomic status indicators, and reproductive history of women in the community. A principal objective of this pilot study was to assess the feasibility of implementing acommunity based intervention in family planning. As a result of the pilot study, a full evaluation of unmet needs for reproductive health services in this community, as revealed in the preliminary findings, will be done and a proposal for implementing a plan to meet those unmet needs will be made. Also, a pilot educational intervention done with community health promoters and the general population will be refined and implemented.
Anemia Project
Anemia is a major public health problem in developing countries. Approximately 2 billion people worldwide suffer from anemia and the World Health Organization (WHO) estimates that 9 out of 10 of these are in developing countries. Anemia can be caused by blood loss, parasitic infections or nutritional deficiencies, and less commonly, genetic disorders. Anemia caused by nutritional deficiencies is most commonly the result of iron deficiency. As a result of anemia, persons may experience impaired cognitive performance and development, compromised immune status, decreased work capacity and, in women and children, increased maternal and infant mortality. Previous work in one of the communities we work with showed the anemia prevalence in the community to be higher than that of the national average in Mexico. The anemia project seeks to assess the prevalence of anemia and identify potential causes in indigenous communities in Mexico as a matter of public health importance. If anemia prevalence is severe and causes of anemia are determined, steps can be taken to target persons at risk for anemia at both the individual and community level through interventions developed to prevent and reduce frequency of anemia.
Water Project
The data from the water survey at VIIDAI-9 provided evidence that a point-of-use water intervention would be advantageous to this community, as it appeared that purchased drinking water became contaminated in the home due to either improper storage or poor handling practices. Subsequent follow-up visits at this colonia between May 2003 and February 2004 included safe water educational interventions focusing on storage and handling. |
