Mexico is the fifth-largest country in the Americas with a population of almost 127 million people, where almost half of the country’s citizens lives on less than $2 per day. Seeking a better life for their families, many migrate to Mexico’s urban areas, especially in the border states, only to end up living in makeshift communities that lack basic services like water and sanitation, and with no access to nutritious food. Families living in these conditions suffer from poor health, obesity and diabetes, diseases such as tuberculosis and HIV/AIDS, and susceptibility to violence.
In 1961, a young doctor from San Diego, California, traveled to Tijuana to volunteer his medical services and saved the lives of two small children that were gravely ill from pneumonia. Since that time, PCI has remained committed to improving the health and well-being of populations on both sides of the U.S./Mexico border. For five decades PCI has facilitated health and development programs throughout Mexico in areas spanning maternal and child health, infectious diseases (HIV/AIDS and tuberculosis), community and public health, violence prevention, and gender and masculinity, among others. Furthermore, PCI has extensive experience building and mobilizing local capacity to identify and respond to the challenges faced by communities, civil society and governments.
PROMOTING HEALTHY CHILDREN & FAMILIES IN TIJUANA’S MOST VULNERABLE COMMUNITIES
True to its roots, for over 25 years PCI/Mexico’s Well Baby Clinics have promoted the healthy development of families and children living in Tijuana’s most vulnerable and difficult to access communities. Well Baby Clinics provide essential health services, including life-saving immunizations and growth monitoring for children; health education, including nutrition counseling and information on chronic diseases such as diabetes; and referrals to primary and specialty health care professionals. Critical to the success of the program is a local network of volunteer community outreach workers who are trained by PCI staff in health and nutrition promotion and disease prevention. In 2008, PCI joined forces with Sempra Energy to launch a mobile health clinic to extend the clinics’ reach to additional families in need. Today, the mobile clinic travels to ten different neighborhoods each week and provides quality outreach, health education, and preventive medical services through house visits and community fairs.
A PERSON-CENTERED APPROACH TO DISEASE PREVENTION
Globally, one third of the world’s population is infected with the bacterium that causes tuberculosis (TB). Even though the disease is curable and its spread is preventable, approximately two million people die from TB worldwide annually. In Mexico, TB is a significant public health concern, particularly in the country’s urban areas. In response, PCI has been collaborating with USAID and the Mexican Ministry of Health to improve TB prevention, early detection and management of TB nation-wide by building the capacity of health systems and staff at national, state and jurisdictional levels to take a coordinated, person-centered approach to TB screening and treatment which improves quality of care and mitigates stigma and discrimination. Furthermore, through the promotion of proven strategies such as “Voices and Images” for TB, health providers are taking a more holistic, human rights-based approach to TB prevention and management, thereby contributing to the greater participation of people affected (GIPA). Individuals affected by the disease have become important regional and national advocates working together with the Ministry of Health to mitigate stigma and discrimination.
The program evolved to address TB-HIV and TB-Diabetes co-morbidities in five high-need states in Mexico. Diabetes is a national emergency in Mexico and TB-Diabetes comorbidity is a major public health threat. Mexico is now a leader in the management of TB-Diabetes, due in large part to PCI’s efforts to improve coordination between the Mexican Ministry of Health’s National TB and Diabetes Programs to improve screening, diagnosis and early detection of the disease. Through the development of a strong information system, the Ministry of Health has improved its decision-making ability to improve the frequency and quality of co-morbidity care.
MOBILIZING COMMUNITIES TO PROMOTE GENDER EQUITY & PREVENT VIOLENCE
Gender equity is both a programmatic and organization-wide commitment for PCI, and it has been a cornerstone of PCI’s work in Mexico. One of PCI’s most influential projects effectively engaged four different audiences: physicians working in the public health system, community members from Tijuana’s most vulnerable communities, police officers, and prison inmates. The project reached over 300 men and led to the publication of the manual “Como Hacer un Hombre” or “How to Make a Man,” which was shared with hundreds of organizations working in the field. Building on this experience established relationships, and PCI’s capacity to facilitate community-driven assessment and planning efforts. In 2012, PCI collaborated with TetraTech ARD and USAID to lead a community mapping initiative in Tijuana’s and Monterrey’s most violence-prone neighborhoods. This effort is part of a larger community mobilization effort that aims to reduce violence in Mexico’s most vulnerable cities.
BI-NATIONAL CAPACITY BUILDING
Capacity building is defined as a continuous participatory process of organizational self-discovery and improvement, and it forms the foundation of PCI’s work in Mexico and worldwide. In Tijuana, PCI’s local programs are managed by PCI’s local affiliate Medicina Social Comunitaria (MSC), an independently-registered NGO established by PCI 20 years ago. Over the last decade, PCI and MSC have focused on building the capacity of a number of organizations along the California / Baja California border. Currently, with funding from The California Wellness Foundation, PCI is applying its model of integrated assessment, planning and capacity strengthening to organizations and networks working in priority areas of HIV/AIDS, TB, reproductive health and substance abuse, identifying key needs and opportunities where collaboration can leverage resources.
RECENT PROGRAM HIGHLIGHTS
In the wake of Mexico’s devastating floods in Tabasco and Chiapas in 2007, PCI didn’t simply provide temporary relief, but engaged local communities in livelihood recovery that resulted in sustainable incomes at levels higher than prior to the floods. For every dollar of investment, $4-12 dollars in earnings from improved agriculture, fisheries and livestock were produced.
PCI’s nation-wide tuberculosis control program reached over 8.2 million individuals with prevention messages and resulted in an average cure rate of 90% in participating states, compared to a national rate of 84%.