October 29, 2004

Care Across Borders

By Joseph Peña

Barbara Baquero returned to a small migrant camp in San Quintin recently and met with one of the promotoras that she helped train in 2003. The man and his wife had been working in the community, promoting health education and building relationships with members of the small colonia.

“He was one of the only promotoras that we trained that had really become a leader in the community,” said Baquero, a student at the Graduate School of Public Health at San Diego State University. “He and his wife have been so committed to the program and that has helped my commtiment be even stronger.”

Baquero, along with more than 110 others, made the trip to San Quintin as a part of VIIDAI (Viaje Integracion Docente Aprendizaje Investigacion), a biannual clinic trip that provides primary care services and public health promotion in an extremely poor area of Baja California. Students, staff and faculty from SDSU’s Graduate School of Public Health, UCSD’s School of Medicine and the School of Medicine at the Universidad Autonoma de Baja California organize and participate in the program.


Chris Muhart gives household anemia interview

The trip was the program’s 12th. VIIDAI started in 1998 and the number of participants, about 30 or so people to start, has grown with time.

Baquero said the man she met with has become a true promotora, “helping for the sake of the community.”

The students and faculty working with the VIIDAI project have helped set up a water purification system for people in San Quintin, helped educate community health advisers, the promotoras, and most recently, tested community members for iron deficiency anemia.

Because migrant workers in San Quintin don’t have roots in the community, it is difficult for them to maintain good health, said Miguel Fraga, a faculty member at the UABC and co-director of the program.

“...They don’t take care of themselves to get a better level of life, because some of them live in SQ just for some months each year and [then] go to another area of Mexico or California,” said Fraga, via email. “The access to medical services is low and their hygiene and nutritional culture are extremely bad. The money that they earn is not enough to seek medical care and improve their way of life—they work in the field all day long for five dollars a day.”

Fraga said the purpose of the program is “health without borders.”

“Part of the purpose of being outside the classrooms and going into the communities of need is to better understand where the problems emerge and who the people in the community are,” said Stephanie Brodine, a professor of Public Health at SDSU and co-director of VIIDAI.

John Elder, a professor of Public Health at SDSU and one of VIIDAI’s founders, said he’s always found international health work an important are of study for students.

“You can’t work with public health in the United States and still not have much of a perspective of what’s going on with the larger issues,” said Elder.

Brodine said there are alumni in the program now working in San Quintin and the connections the organizers of the program have made are useful in expanding the project’s service components.

The Sunrise Rotary Club in La Mesa assisted VIIDAI with funds to help test the children in San Quintin for anemia. It also helped establish a connection between the VIIDAI organizers and a Rotary Club in San Quintin.

“The clubs have supported our efforts to allow us to more significant work and do more substantial projects in the colonia,” said Brodine.

Diego Castaneda, a 29-year-old graduate student in Public Health at SDSU, took the trip twice, once as a course requirement in April 2003.

Castaneda also volunteered for the four-day trip this past April.

“The multi-disciplinary part of public health comes to fruit [with VIIDAI],” said Castaneda, who is finishing his master’s degree in Public Health at SDSU. “I’ve been lucky to have this experience twice.”

Castaneda was struck by the living conditions in San Quintin when he took his first trip.

“I kept telling myself, this is why I’m working, this is why I’m helping, this is why I’m here, said Castaneda. “We go down for research purposes. Alternately, these are human beings that we’re working with and it’s hard to see the poverty. It’s tiring to work with people who are really sick and really poor. It takes a toll, an emotional toll on you.”

Castaneda said it was a unique opportunity to work outside of the classroom and alongside professionals and students in an international setting.

“The triumvirate of the School of Medicine at UABC and the School of Medicine at UCSD and the Graduate School of Public Health at SDSU is special,” said Castaneda. “There’s a unique aspect of binationality, working with Mexican students with the same goals and the same ideals as the American students.”

Part of the VIIDAI’s goal is to teach cultural sensitivity to the students working on the project.

“It’s getting away from the ivory tower syndrome, the ‘We know what’s best’ kind of attitude,” said Castaneda. “It’s about effectively creating positive choices for people and opporutnities for people in developing nations to be healthy.”

Joseph Peña is an intern with the UCSD San Diego EXPORT Center and is a recent graduate of the journalism program at Point Loma Nazarene University. The San Diego EXPORT Center is a partnership of organizations focusing on community minority health and health disparities research.

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