In 1992, the Santa Elena coastal region of Ecuador was the site of a widespread cholera epidemic affecting a population of 50,000 people. In addition, typhoid, dengue, and malaria were major public health problems. Sporadic medical intervention failed to bring control. Rotary International, responding to pleas from local clubs, issued a call for assistance. An Oregon-based NGO, Public Health International, (PHI), answered. PHI worked with individual volunteers and 65 elected vollage committees to form local public health systems in which villagers controlled their own public health conditions. "Salud Para el Pueblo", as the health systems have come to be known, has become a successful model of grass-root public health intervention. "Salud" has achieved near universal point-of-use water disinfecting, a 95% level of latrine construction (from an initial 10%), development of basic water systems in half the region's communities, implementation of a garbage collection and management system, and a full-scale vector and rabies control program. Cholera has been eliminated and there has been a sharp decline in other diarrheal diseases, even during the El Nino crisis. "Salud" has been invited to work with villages in Peru and Nicaragua and to expand in Ecuador. It is proposed for extension to population centers in the Galapagos Islands. Although currently dependent on external funding, "Salud" will generate sustaining funding as manager of a first-of-its-kind water district in Ecuador.
Learning Objectives: An instructional model demonstrating effective community organization and sustained motivation to provide effective preventive public health service
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
The 128th Annual Meeting of APHA