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Promotora Program in Dallas Morning News

Location:
Thursday, September 9th, 2010

Details:

In brutal Juárez, woman faces fears to save lives
12:00 AM CDT on Monday, September 6, 2010

By LAUREN VILLAGRAN / Special Contributor to The Dallas Morning News
Lauren Villagran is a freelance journalist based in Mexico City.

CIUDAD JUÁREZ, Mexico – Social worker Graciela de León spends her days crisscrossing this death-marred city alone, bringing health services to women in poor neighborhoods notorious for drug and gang violence.

Graciela de León, undeterred by drug and gang violence, is determined to provide health services to poor neighborhoods.

Not even the carnage that has gripped this city on the border with El Paso has deterred de León from her mission of combating another killer: cervical cancer, the No. 1 killer of Mexican women in their reproductive years and the cause of about 4,000 deaths each year – 12 women daily, according to Mexico's Health Ministry.

"We spend all day in the street, and we go around afraid," de León said as she drove alongside the railroad tracks that famously divide the city's prosperous and poor areas. "But we don't stop doing our job – of course we don't." De León is one of the 1 million or so Juárez residents who haven't fled to Texas or elsewhere to escape the violence. Since January 2008, drug-related violence has killed more than 6,000 people in Juárez, including dozens of innocent people unconnected to the warring criminal organizations in the city. De León continues to live her life much as she always has, albeit with more trepidation.

Each week, she and a handful of volunteer doctors and a network of 300 dedicated women continue to save lives by bringing health services to Juárez women who lack access to clinics, information or resources. Cervical cancer is slow-growing and treatable in the early stages, which can last years. It's most often caused by certain strains of the sexually transmitted human papillomavirus, which affects about half a million Mexican women annually.

"With the information that exists today, no woman should die of cervical or breast cancer," said de León, whose program is funded by El Paso's FEMAP Foundation. The Texas nonprofit foundation raises funds for the Mexican Federation of Private Associations, also known as FEMAP.

"But if women are worried about feeding their children, their priority will be their children and unfortunately not their health. So when we can offer this attention for free, we save a lot of lives."

For residents, de León's dedication sparks a ray of hope. In a tiny house pieced together with recovered materials, Rufina Montelongo Mijares is making soup. Her neighborhood is in Puerto Anapra, just south of the Texas border, where the cobbled-together houses still don't have sewers or drainage after 30 years. It's the city's western frontier.

Montelongo says that last year, de León showed up in her neighborhood just in time, "because, you know, sometimes you've just got barely enough" money, and she knew she needed surgery. With five children, Montelongo was so financially strapped that she had to scrape togetherthe seven-peso bus fare to get to the FEMAP hospital, where she received an operation free of charge. De León jokes with her, saying that now she should volunteer with FEMAP as a promotora, or community health promoter. Montelongo smiles at the thought.

It is a summer afternoon, and de León is making her daily rounds of the city's needy neighborhoods. She turns into Mexico 68, a community of small concrete-block houses behind a cluster of maquiladoras, or assembly plants – some shuttered since the economic downturn – and an open-air brick factory that until recently burned tires to heat its ovens. Here, women often run informal shops out of their homes, selling clothes, food, toiletries or other products to make ends meet. But even these small enterprises have been hit by the extortion and assaults, the kind that have led the city's wealthier residents to seek refuge north of the border.

De León knocks on the iron gate of Reyna Palacios, a 42-year-old mother of three who for 11 years has volunteered as a promotora, one of the 300 de León manages who help educate women in poor communities about the importance of women's health care, family planning and disease prevention.

"I know it's for my own good," said Palacios of the checkups she shunned when she was younger. "I have to do it. But I was one of those who 20 years ago was too embarrassed to go."
In addition to the educational talks, the program provided 116 free Pap smears through de León's mobile "clinic" last year – services delivered on a cot unfolded in the living rooms, classrooms or social halls of neighborhoods with little or no access to care. Through the FEMAP-sponsored Family Hospital in Juárez, the program also provided nearly 300 gynecological exams; 150 colposcopies, a procedure to remove cancerous lesions; 80 mammograms; and other women's health services.

The federal government is counting on locally run social programs like de León's to make its Plan Juárez – a $268 million investment program designed to rescue the long-neglected city – a success. "There is no way more powerful than empowering society to take this responsibility," said Arturo Cervantes Trejo, who heads the Plan Juárez health strategy. "It will be a success, because it will be run by the locals.

They are the players in their own success stories." De León's program operates on about $70,000 annually; hers and other FEMAP programs are together receiving $51,000 through Plan Juárez. "The work they do is so valuable," said Dr. Gustavo Martínez Mendizabal, director of FEMAP's Family Hospital in Juárez. "Any day, even if there was peace, it wouldn't be easy. The violence and the poverty – they don't forget it or ignore it. They face it and overcome it."

Lauren Villagran is a freelance journalist based in Mexico City. CHRIST CHAVEZ/Special Contributor