Education for Health: Chagas Disease in Sacaba, Cochabamba, Bolivia

Chagas Disease is one of the most forgotten diseases in the world. Annually, it affects between 16 and 18 million people and kills another 50,000. It is calculated that 80% of the infections are produced by the bite of the vinchuca, an insect that lives in the cracks of walls and/or straw roofs of adobe housing. This insect is mainly found in rural areas and in poor urban neighbourhoods in Latin America. Bolivia is the country with the highest number of people affected by Chagas: 13% of the deaths of people aged 15-75 years old in this country are due to Chagas Disease. Closely linked with poverty, Chagas Disease has sadly become known as the "Poor People's Disease".

Incidence and risk factors for Chagas Disease

To fight against Chagas Disease, Educación Sin Fronteras (Education Without Borders) and CETM (Centro de Estudio y Trabajo de la Mujer - Women's Study and Work Center) have developed and carried out activities since 2003 in Cochabamba, Bolivia. The program started with the goal of strengthening public and private mechanisms for the prevention, control, and protection against the disease. With this aim in mind, an epidemiological belt was designed to improve the health conditions of the most impoverished families in the 23 rural communities in Sacaba municipality, thus involving close to 2 million people.

One of the main initiatives of the program has been the creation of Vector Information Posts (PIV in Spanish) and the training of leaders to occupy these posts, both in the community sphere as well as the scholastic. These Information Posts allow the inhabitants of the communities and schools to benefit from having a reference point for everything related to the disease. The Information Posts, for example, by being linked with the primary healthcare system, publicize places where free diagnosis and treatment is performed for children under 15 years of age.

In only six years of working in the area, the following has been achieved by the Project:

• Organization of the 28 PIV (Vector Information Posts) created by Educación Sin Fronteras so that they are almost self-sustainable;
• Consolidation of various aspects of Education for Health regarding Chagas Disease;
• Following up on the renovation and sustainable maintenance conducted in many homes in the epidemiological belt;
• Strengthening of the coordination mechanisms between the Health and Education municipal authorities in order to support the operation of the Vector Information Posts (over 150);
• Systematization of the collective experience;
• Improvement of the negotiation capacities of the grassroots associations, mainly women's organizations.

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Many goals have been achieved but Chagas Disease still has not completely disappeared from the area. Unfortunately also, there remain organizations that have not completely taken on their responsibility for the sustainability of the Vector Information Posts: private institutions do not fully take charge of the tasks and public institutions do not grant the necessary instruments and resources to manage prevention and the strengthening of such activities. Although Education Without Borders' program against Chagas Disease has reached its institutional end, we think that we should continue to work with CETM to continue the fight against the disease.

What could we do?

• Strengthen the supervision of the community Vector Information Posts network so that it can consolidate itself as part of the community.
• Achieve that "teaching and learning" about Chagas Disease become standardized by the appropriate education authorities so that the choice of going into more detail on the subject is not left up to the teacher.
• Keep on working with women, the key agents of change as they are the ones primarily looking after children, managing household animals, and making the purchase decisions regarding home and hygiene products; issues of paramount importance with regard to Chagas Disease.
• Conduct a follow up of the housing renovations carried out in the 36 communities that participated in the project and evaluate the improvements achieved by the project.
• Increase the number of communities that participate, in which housing renovation and consciousness raising takes place.

Help us to keep working in those communities