The Current Reality of Honduras

Editor’s note: The following comes from a mid-term evaluation of our Infant-Maternal Health Project in Honduras. I was struck by the chapter that contextualized the situation in Honduras presently and thought it worthwhile to share with our members. This has been Google translated from Spanish so please keep that in mind.

The work of Vecinos Honduras (VH) is in rural zones of Honduras, in poor populations, marginal and excluded, who have to settle in remote hill areas, because they do not have another option to keep their families; who had to build with tenacity and sacrifice a social coexisting system with many limitations: they do not have public services, lack worthy income; high deterioration of the natural resources, low production and productivity; suffer contamination due to agro-chemicals and garbage; bad infrastructure.  The majority of the families do not have potable water; more or less half of them lack electricity, and in the majority of the cases the houses need to be improved.

Household plumbing.

This scenario of shortages contributes to the precarious life conditions of the population.  They basically depend of subsistence agriculture, mainly for consumption. The only factors that contribute to local economy and alleviate a little the crisis of family subsistence, are the remittances in the south and coffee in the eastern part of the country.

Vecino Honduras teaches families how to diversify their crops to not only grow coffee but also more food for their family.

There is a very deficient education service: pre-school and elementary school with many limitations, and a poor public health service oriented to curing illnesses.

In research made by the World Health Organization to measure the performance, quality and coverage of the health services, Honduras occupies the 131 place of 191 countries.

The greatest potential for development in Honduras is agriculture.  However, investing in this sector implicates a very high risk with respect to the return of capital.  It is for this reason that neither the private companies, nor the financial system or the government support this sector, which could easily generate one million jobs at the national level (study from ANAFAE).

A well ordered farm.

Support is oriented towards large enterprises and crops for exporting such as: Coffee, Bananas, Cantaloupe, Seafood and Tilapia, among others.  The families, who live on the hills in a subsistence limbo, in which institutions with a sustainable development approach, such as Vecinos Honduras, play a very important role in their lives are in many ways lucky because, these type of development institutions are few, and those who would assume challenges in this context, are even less.

According to estimates from the government, for each ten Hondurans seven are poor, and of these seven almost five live in extreme poverty.  This has been this way for at least 100 years; which puts in evidence the erratic public policies applied, which base their dysfunctional neoliberal approaches that had and still have the economy of some developed countries in crisis; the last ones Spain, Greece and currently Argentina.

Neoliberalism does not even work for great powers who have been their promoters; and now USA embraces protectionism, that has generated a commercial war between the USA and the rest of the world, mainly with China and Russia.  Moreover, Honduras continues betting on the recipes of the IMF, when it has been proven that these only seek the mobility of resources to the great powers.

Honduras is known in the world as the country of extreme: the most violent, the most corrupt, the poorest, the most inequitable and more recently, the one with more massive immigrations to the USA.  Complete unemployment and sub-employment has a direct relation with poverty, is because the people do not have access to economic income and are poor.  The development plans of the public sector are subject to national and foreign investment, which never arrives.  The problem is that the families have to eat today, they cannot continue waiting until investment arrives, and in the meantime, how do they feed their families?

Based on skills learned at a Vecinos Honduras workshop she started her own business selling plantain chips and can now feed her family and afford to send her children to school.

Because of the political instability characterized by disrespect to the judicial framework, disrespect of popular will, election frauds, corruption and impunity, as well as fiscal insecurity as the rules change as it is appropriate to the politician in turn, investors don’t know what to expect and prefer to invest their capitals in other countries.

The debt of Honduras is 12 billion Canadian dollars (SEFIM). The Gross Domestic Product (PIB), is approximately 22 billion dollars.  The general budget of the republic is 11 billion dollars for the year 2018 (less than the debt), of this budget, and each year 2 billion dollars are used to pay the debt (capital plus interests).  In the last 6 years, 9 billion dollars has been paid; and the worst part is that Hondurans do not know why we have this debt; how it is used; and if there is evidence of it reaching the country.

“The Honduran health system is deficient in: Doctors, nurses, equipment, supplies, medicines, health centers, beds and budget.  It also suffers from corruption and lack of social sensibility from the staff; therefore, it is considered to be in crisis.  All of the above is summarized in that the State provides the Hondurans a health service which is of a very bad quality.  The greater impact is suffered by the poor, and among these, we find the families who live on hills of the rural areas. “

Vecinos Honduras trains local Health Monitors to do regular health check-ups on the community’s children under the age of 5.

However, what we do see is that because of its payment, investment is reduced in social aspects such as: health, education, housing, community rural infrastructure, etc.  Instead of increasing the health and education budgets, increases go to the police and the army for weapons, equipment and war practices, in a country in which one third of the population is considered homeless. If this spending negatively impacts the living conditions of the urban populations, where there is more employment and more is invested in infrastructure; it affects the rural populations where there is no employment and investment is minimum even more. It is in this context, and with these families, that Vecinos Honduras works.

Cristina Margarita Alvarez’s success story

Cristina Alvarez

When Cristina Margarita Alvarez was a child she wanted to become a teacher. Unfortunately, because of a lack financial resources, she only attended primary school before leaving her community of La Batea, Honduras. She found work as domestic worker in the city of Danli in order to support her first daughter Berenice. She was sixteen at the time.

She lived in Danli for four years when she met Félix Donaldo Martínez.  They got married and decided to settle in the community of Flores #2 where Felix would grow coffee for 22 years.

They had three children; Darwin Donaldo, Josué Fernando and Josías Enoc. The first two have moved out and created their own homes and Josias studies at the Luis Landa Basic Education Center in the community of La Libertad.

Once settled in Las Flores # 2, she began to attend the Catholic Church, which motivated her to teach catechism to girls and children between 7 to 12 years of age. In a way, her dream of being a teacher of primary education was fulfilled with this task.

Christina teaching

When Vecinos Honduras began to support her community, she became interested in participating, especially in activities related to community health, drawing attention to the topic of food preparation based on local products. When the health monitors in her community were selected, she voluntarily offered to work with the children in Comprehensive Childhood Care in the Community and Early Stimulation. She mentioned that at the beginning of the AIN-C program she had not participated because her one-year-old granddaughter Tifany Mikeyla Salinas Martínez was in her care, which prevented her from attending the trainings. However, in the next phase of training for health monitors she managed to train and currently serves 15 girls and boys from the Las Uvas neighborhood.

“My wish is for children to be smarter so I treat them with all my love and affection. Now that I teach what I learned with mothers I feel good because I do not keep the knowledge, but I share it, taking into account that everyday I learn more.”

It is important to mention Cristina Margarita has the support of her husband and children, since they all share domestic chores, have common dreams and make efforts to improve their life situation. An evidence of the family effort is that based on their collective work they have managed to acquire other lands where they currently cultivate 15 blocks of coffee, a space in which the whole family works collectively.

Cristina Margarita is a worthy example of struggle, perseverance and dedication to her family; her volunteer work and her desire to serve others is a permanent source of inspiration.

Prepared by: Michael Newman program facilitator team

Date: August 25, 2018

Photography: Manuel Castellanos

 

Reflecting on progress in Maternal-Child Health

The Board of Directors of World Neighbours Canada met recently in West Kelowna for their Annual General Meeting. Board members responsible for communication with each of our partner NGOs – in Honduras, Burkina Faso and Nepal – provided an update on what has been achieved during the past twelve months. Highlighted here is only ONE of the achievements of the past year for each country. During the coming weeks, we will publish more in-depth articles about the activities that have taken place in each country.

Our matching grant from Global Affairs Canada is allowing us to provide much more monetary support to these grassroots organizations. Without our donors, it would not be possible for World Neighbours Canada to apply for such grants. The directors of WNC and our partner NGOs – Vecinos Honduras, TSS (Nepal) and APDC (Burkina Faso) extend a heartfelt thank you for the on-going support. Please remember our projects and our relationships are long-term and support locally appropriate initiatives. It is truly a model of participatory development.

Burkina Faso – During the past year, close to 5000 villagers have attended sensitization and/or information sessions on family planning, malnutrition, the importance of vaccinations, nutrition (how to prepare healthier, more balanced meals with local produce ) and gender equality.

Nepal – Over the past two years, TSS has supported villagers with the installation of 4012 toilets in homes in villages in Ramechhap District. This has been linked to a nation-wide campaign to encourage everyone to use proper toilets.

Honduras – The health initiative of monitoring young children for growth by measuring body weight has continued and expanded over the past year and positive results are being observed. Mothers are given advice and support in raising healthy, well-nourished children.

 

Kamloops West Rotary Club raises $1000 for World Neighbours with “Fox Hunt”

World Neighbours directors Bruce Petch, Judy Gray and Libby Denbigh, along with family and friends taking part in the Fox Hunt. This photo was titled “Top of the World” and needed to be “A creative photo of the team taken from a rooftop parking lot.”

Raising money for international projects can be fun, and nobody demonstrates that better than the Kamloops West Rotary Club! They raised $1000 for World Neighbours projects in Nepal with their fundraising “Fox Hunt” this past weekend.

The fundraising activity was a Fox Hunt – a 90 minute adventure game that combined a scavenger hunt with “amazing race” style challenges. Teams of 4 to 8 people raced to complete as many of the 74 challenges as possible within a 90 minute time period by capturing photo & video evidence.

Big Bad Biker – the team posing beside a Harley Davidson motorcycle … luckily one was found in Riverside Park.

World Neighbours Canada directors Bruce Petch, Judy Gray and Libby Denbigh, along with family and friends entered a team in this unique activity, spending a laughter filled time completing crazy tasks around the Riverside Park area of Kamloops. Though the WNC team did not garner a medal, we all enjoyed ourselves and have included a few pictures of the team “in action”.

The money will go towards rural water systems built by villagers with support from Tamakoshi Sewa Samiti, the Nepali partner organization of World Neighbours Canada.

Many thanks are extended to Kamloops West Rotary for the support, and to Global Affairs Canada for providing matching funding for all the work we do in Nepal.

Community Medicine Kit

Typical Community Medicine Kit

By Gabriel Newman

This a photograph of a typical community medicine kit. There are now twenty-six communities that Vecinos Honduras works with that have these kits. Community Monitors (Volunteers) received training in how to administer medication as local health units are short on medication and only are open Tuesday-Friday.

The kits are well equipped; they contain medicines to treat anemia, diarrhea, dehydration, conjunctivitis, fever, fungus, parasites, stomatitis, and scabies, among others. They also aim to prevent severe episodes of pediatric bronchitis or pneumonia.

According to what the volunteers report, 165 women and 54 men, 148 girls and 156 boys have been treated in the last six months, the most prevalent diseases in the communities are fever, headache, respiratory infections, diarrhea, parasites, pediculosis, and stomatitis in few cases.

A Reason to Celebrate!

Mr. Govinda from TSS accepts the plaque thanking them for their contribution.

We are celebrating at World Neighbours because our partner organization, TSS (Tamakoshi Sewa Samiti) in Nepal, was recently honoured for their work to help make the Ramechhap District declared an Open Defecation Free (ODF) Zone.

This was a multiyear process which involved the commitment of the community as a whole, individuals, TSS, and the local government. The progress was interrupted by politics and earthquakes but the end result spells a healthier future for the community.

Our TSS contact Suresh Shrestha reported:

“TSS was especially recognized & appreciated for the initiative and incredible contribution in toilet program. On behalf of TSS, Mr. Govinda received the appreciation frame. The appreciation frame was handed over by the Chief Guest, the Member of Parliament of Province No. 3, who was elected from Ramechhap.”

We too applaud and thank TSS for their hard work in helping the community of Ramechhap improve their own situation.

TSS  is one of the oldest and most respected non-government organizations in Nepal. It works in Ramechhap District (in the eastern part of the country) to alleviate poverty and help rural communities become more self-reliant. TSS helps village groups to organize themselves, manage finances, hold effective meetings, and undertake improvement projects. Their initial strategy is to establish and mobilize villagers to plan, organize, build and maintain water systems. When the water systems are installed, villagers often then choose to install sealed, sanitary toilet systems, which TSS and WNC also help them with. The combination of easily accessible potable water and greatly improved sanitation systems has greatly reduced the incidence of gastrointestinal disease in Ramechhap.

World Neighbours Canada, since 1989, has had the privilege of providing and facilitating financial support for the village water systems and the sealed, hygienic toilets that are all installed and maintained by local people. TSS provides only technical guidance and training, and the people themselves provide all local materials and all of the labour needed. Non local materials such as pipe, valves, cement, toilet pans and re bar, are purchased by TSS as needed, and are carried by men, women and children, from the end of the road to their remote villages.

Because the villagers take ownership of the projects from the earliest stages of planning and design, and because they are in charge of long term maintenance and repair, the projects have proven to be very successful.

The Strength of World Neighbours Canada – Enduring Partnerships and Mutual Respect

Mother and her children at health education session. Honduras

By Bruce Petch

At World Neighbours Canada we are sometimes asked what makes us unique. There are many charities that support people in developing countries; what does World Neighbours Canada do differently?

The answer is multi-faceted. There are many aspects of our organization that inspire loyalty among our donors – we are run by volunteers, have very low overhead, and use modest fundraising approaches. The attribute of World Neighbours Canada that we hold closest to our hearts is enduring partnerships. These partnerships occur at multiple levels – between the local organizations we support and the rural people they serve; between us and the local organizations; and between World Neighbours Canada donors and its board and volunteers.

The emphasis on partnerships is rooted deep. When World Neighbors was founded in the U.S. in the 1950s, it was ahead of its time in recognizing that poor people in developing countries deserved respect. World Neighbors founders embraced the United Nations statement acknowledging the “inherent dignity” of all people.

Community Meeting – Nepal

World Neighbors evolved into an unusual organization, focusing on long-term partnerships and outcomes when many organizations worked with only a one- or two-year project term in mind. Their minimal expatriate staff – called Area Representatives – often held their positions for more than ten years, sometimes more than twenty, which was remarkable in a field where terms of more than two years were uncommon. The essence of their work was building long-term partnerships with local organizations and communities, growing leadership capacity and fostering knowledge-based development.

Local NGO APDC leading workshop in Burkina Faso

The founders of World Neighbours Canada were inspired by the commitment and effectiveness of the World Neighbors family of organizations, and created a Canadian group to support the international network. Since its inception, World Neighbours Canada has worked to establish enduring partnerships with local organizations. We have supported Tamakoshi Sewa Samiti in Nepal and Vecinos Honduras (and its predecessors) since 1989, and APDC in Burkina Faso since 2006.

Finished Tap No. 6. – Nepal

Each of these organizations takes a different approach in working with local communities. Tamakoshi Sewa Samiti is committed to improving the lives of people in the district of Ramechhap. They support the building of water systems and latrines in different villages each year, and provide technical back-up for as long as is needed (nearly all of the water systems installed with TSS support continue to operate; in one or two locations, the water source has become intermittent). Vecinos Honduras takes a holistic approach to community development, gradually building local capacity for continuous improvement in agriculture and health. Typically, after 5-6 years they phase out intensive support, and instead provide advice to local committees or cooperatives. APDC similarly engages in a wide range of activities with villages, and shifts emphasis as local leadership takes on more responsibility.

Community members are taught how to test and treat for malnutrition.

Coupled with the theme of enduring partnerships is mutual respect. We respect the abilities and insights of our local partner organizations. They are led by some of the brightest and most committed people in their respective countries. Furthermore, we recognize that people who are materially poor are not bereft of ideas and ingenuity. We have the greatest respect for their ability to survive under extraordinarily difficult conditions, and to improve the lives of their families when given the opportunity and the knowledge to harness clean water, grow more crops, and raise healthier children.

This plantain harvest will help feed the family.

How are Gender and Environment Connected? Look to Grassroots work in Burkina Faso

Written by Diane Connors, BC Council for Global Cooperation

Interview with Charles Tankoano, Association d’Appui à la Promotion du Développement durable des Communautés and Judy Gray, World Neighbours Canada Director

Charles Tankoano had come a long way when he walked out of the chill Vancouver air and into the BCCIC office. “He hasn’t taken off his jacket since his arrival,” Judy Gray chuckled as the small group settled into their chairs. Charles had arrived from Burkina Faso, a small country in West Africa, earlier in the week. His visit to British Columbia was a whirlwind of presentations with schools, community groups, and donors of World Neighbours Canada, which, thanks to funding from Global Affairs Canada, is the partner organization that brought him over and supports his work in Burkina Faso.

Charles spoke only French, requiring Judy to translate for those who did not know the language. The group, consisting of Charles and 3 members of World Neighbours Canada, had come to BCCIC to use the teleconference system to hold a call with their project manager from Global Affairs Canada and a GAC International Development officer who will be travelling to Burkina Faso in the near future. As the call started up and the inevitable technical issues were mitigated, a photo slideshow appeared on the screen while Charles explained the work being done in 18 rural villages. The images showed children receiving medical care, people eating together, and people working with the flat, dry land in the Fada region of the eastern part of the country. This call was a valuable connection – giving voice to Charles to share the challenges and successes of community development, and strengthening the relationship between Global Affairs and a small Canadian development organization that receives project funding.

After the conference, we sat and talked a while about the organization Charles leads, called Association d’Appui à la Promotion du Développement durable des Communautés, or APDC for short. Charles explained that the organization began in 2002, with the vision of promoting sustainable and equitable development in poor and marginalized communities in Eastern Burkina Faso through capacity building of individuals and villages. The areas of focus for the projects include: food security, community health, female leadership and gender issues, environmental protection, drinking water supply, and adult literacy. Drinking water and adult literacy are addressed by APDC despite not having funding for these projects, as they realize that these two areas are critical to long term improvements.

As Charles spoke it was clear that the areas of focus were all linked – working in one area will often strengthen another. APDC’s gender work is particularly compelling, and some of the earliest initiatives addressed the connection between women and the land. At the village level, APDC promoted the idea that women have the right to work a parcel of land, and have access to that plot year after year, so that she might improve the soil and benefit from the productivity. This was done in line with the national government making policy changes and providing women access to land. APDC also reinforced the notion that when men and women work together, their lives and their children’s lives are better. This is mostly achieved through information sessions with men, giving examples and working through questions that reveal truths and inequalities. Through this work the men gradually come to new understandings such as the fact that women should not be doing hard labour when they are in late stages of pregnancy, and that household work should be shared between a husband and wife. Cultural changes like these are APDC’s goal, but there is still much work to be done in this area for these ideas to be accepted by the majority of villagers.

“I managed to get this great picture,” Judy said as she turned her laptop, showing a photo of a man and woman, side by side with the woman’s arm around her husband’s side. “Charles explained that 10 years ago, public demonstration of any kind of affection would not be visible or accepted. It’s a sign of progress.” Part of this progress has been enabled directly through Global Affairs Canada funding, as a Gender Consultant (local Burkinese professional) has been hired to evaluate APDC’s current gender initiatives and provide suggestions for enhancing this work. The resulting recommendations have been incorporated into project programming where possible. The improvement in gender equality often filters into benefits in other areas: improved supports for pregnant women, improved nutrition for children and pregnant women, improved environmental practices and improvements in health care. It also helps to develop a sense of community, which is an underlying foundational goal of APDC projects.

Charles explained that he gained experience in development work through a few different paths. He started out studying agriculture and agronomy in the nearby countries of Ivory Coast and Niger, and he began working with the Burkina Faso government, teaching farmers how to improve soil conservation. Over time he began to find the bureaucracy of the government frustrating, and wanted more freedom to work directly on strengthening community capacity. He worked for several NGOs; in particular an NGO in Senegal, where he solidified his understanding of a participatory philosophy in development. Then, he formed his own organization to address the needs of people in his home country of Burkina Faso. When asked why he pursued such challenging work he simply explained that he had a desire to work with people who are marginalized, taking into account their own culture and respecting their values.

When looking at the communities in the context of the future, the topic of climate change came up. One of the reasons for the impoverishment of the region is that the land is difficult to make productive due to less and less rain falling every year. Charles explained that though the people are mostly illiterate and uneducated, they don’t need to be told what climate change is. Living near the desert, it is already obvious that climate change has arrived: now there is only 3 months of rain per year on average, versus the 6 months of rain that could be expected in the past. The progression of climate change requires more tools for communities in these hard hit areas to be able to mitigate the effects of a warmer world – Charles explained that “the people of Eastern Burkina Faso are forgotten by the government and are being left further and further behind. More resources will be needed to mitigate the effects of climate change.” APDC is doing its best to address these challenges with simple but effective techniques, such as getting the right seeds to withstand dry conditions, creating and using compost, keeping trees to prevent erosion, and building “stone ribbons” along the fields to allow the water to soak into the soil more. These measures have already helped people to increase yields by as much as 50%.

Though the challenges are still great, and change is slow, Charles has seen significant improvements for people in the region over the years. With the help of APDC, people have learned to vary production with diverse activities and better techniques, which has improved nutrition, community resilience, and environmental stewardship. More children are getting vaccinated, and women’s health is improving, especially as attitudes toward family planning shift. The improved relationship between men and women has resulted in building up the confidence of women, which is visible when women speak at meetings and there is an expectation that they will be listened to. These things together create a more hopeful picture for Burkina Faso, though it is one of the lowest listed countries on the UN Human Development Index. Charles explains that he is always in a state of self reflection, asking whether he is doing the right things, and providing the right support. He says the next project is to look at new strategies and solutions for Burkina Faso in a changing world, to push further and go the next step.

 

World Neighbours Canada is a member of the BC Council for Global Cooperation, which is a network of global development organizations based in British Columbia, working toward sustainable development both at home and around the world.

Introducing Ides Onelba Bonilla – Honduras

The following is part of our series featuring the community participants in the various programs we support. It is through their hard, voluntary, work that leads to sustainable change in their community.

The following was written by Vecinos Honduras and translated by Mary Doyle.

Ides Onelba Bonilla

Onelba is a 34 year old woman who lives in the community of Casas Nuevas where she is dedicated to household activities.

Since 2010 she has worked in community development initiating participation with World Vision in another community. In 2015 she moved to Casas Nuevas where she learned about the work of Vecinos Honduras. She began to participate in community meetings involved with training in basic sanitation issues, child growth and development, food preparation and improved stoves. In 2016 she became involved in child welfare as a volunteer health monitor and has been helping children in the community ever since.

Onelba studied at school until grade nine and she enjoys participating in community meetings and training sessions to learn and experience new topics of interest.

 

Healthy Homes in Honduras

Editor’s note: A condition of our grant from Global Affairs Canada (GAC) is that an in-depth report must be delivered semi-annually. It is a Herculean task to compile all the data from these diverse projects. However, for those of us not tasked with this duty, the reports give us great insight into how complicated, varied and impressive these projects are. The following is from a recent report encompassing July 1, 2017 to December 2017, and comes in under the title “Healthy home environments and improvement” as it pertains to the Honduras projects. It is one page within sixty but gives a sense of how much is being accomplished, but also some of the challenges along the way.

Coordination was made with the Ministry of Health of the municipality of Danlí (with the coordinator of the Environmental Unit) and a study was carried out to determine the technical feasibility and environmental impact of the construction of sealed hygienic toilets in the communities of Boneton and Buena Esperanza. With this coordination, a technical report was produced, which describes that the realization of the toilet project is considered technically and environmentally feasible since it will not contaminate aquifers, and it will help to ensure the reduction of diseases such as hepatitis, diarrhea and others (see details in the Construction Annex of the annual report for 2016-17).

The toilet construction was approved by GAC. During the reporting period, using project funds and the contribution of families themselves, 31 household latrines were built: 9 in Boneton and 22 in Buena Esperanza. Before building the latrines, beneficiaries received training on their use and management.

Five training events were conducted to raise awareness on the benefits of using improved stoves. This technology reduces indoor smoke pollution from burning of wood fuel, firewood consumption, and consequently respiratory problems. In each training event an improved stove was built. The events were developed in the communities of El Picacho, Los Encuentros, San Jose, Casas Nuevas, and Llanitos Verdes; and 58 people participated (45 women and 13 men). In addition to the 5 stoves that were made in the trainings, 20 more stoves were built. The families built the 20 stoves with an approach called mano vuelta, which consists of all the participants collaborating in the construction of 20 stoves until they finish with the last one (“I help you help me”).

Three training sessions on leishmaniasis and leptospirosis prevention were conducted; 21 women, members of health committees, attended the sessions. The women implemented the preventive practices at their homes and each shared the practices with four families of their communities. As a result, four (4) families installed nylon (plastic) on their roofs; two (2) families build a fence around the house to keep animals outside the house; and two (2) families build enclosures for domestic animals.

The Secretary of Health through the HU carried out diagnostic tests to detect Leishmania parasites in the community of Llanitos Verdes; 15 people tested positive and received treatment. The occurrence of the disease was the reason for developing the training. Participants said they didn’t have any knowledge about the disease; nevertheless a group commented they still didn’t believe it exists, incongruously these group had infected patients at home.

Health committees conducted nine cleaning campaigns in nine communities: Matasano, Guanacastillo, Jocotal, Brasilar, Quebrachal, Lajas Blancas, El Rincon, Mal Paso and Torrecillas. The cleaning campaigns pick up trash and litter and remove standing water that could provide mosquito breeding habitat.

In Las Guarumas Program, a six-month training course on participatory diagnosis and project design, management, implementation, and evaluation was conducted. Six (6) health committees of the communities of Las Labranzas, Guanacastillo, Lajas Blancas, El Jocotal, Quebrachal, and El Rincon participated in the course; six men and 28 women. As training output, participants prepared project profiles for a community latrinization project because only 46% of 300 families have latrines in good condition. This training strengthened the institutional capacities of the health committees, providing them the tools to conduct a health needs assessment.