2 Promoting Communit y Environmental Health
Health Promoters Stop Cholera
On the coast of Ecuador, for 6 months it is very dry and for 6 months it is
very wet. This makes it hard to grow food. There are few markets, and the
government does little to provide schools, health clinics, and other basic
services like clean water and sewers. When cholera struck the area in 1991,
most people were not prepared for it, and many became very sick.
Day after day, people brought family members to the local health center in
the town of Manglaralto. They were weak, trembling, feverish, and suffering
from terrible, watery diarrhea and dehydration (loss of too much water in the
body). The health promoters realized this was a cholera epidemic and many
people would die if they did not act quickly to stop it.
Because cholera contaminates drinking water and passes easily from one
person to the next, the health promoters knew that treating the sick people was
not enough. To prevent cholera from spreading, they would have to find a way
for everyone in Manglaralto and the nearby villages to have clean water and
safe toilets.
The health promoters began to organize the villagers who were still healthy,
and they asked local groups for help. They persuaded an organization that had
partners in other countries to give money to start an emergency program to
provide clean water and toilets.
Calling their project Salud para el Pueblo (“Health for the People” in
Spanish), the health promoters organized public health committees in every
village. Committee members selected “village health educators” who were
trained to teach people about water and sanitation (building and maintaining
toilets and washing hands to prevent the spread of germs). In this way, the
health promoters enabled the villagers themselves to take responsibility for
important parts of the fight against cholera and for environmental health in
their communities.
Having money to do
something was good, but it
was not enough. We needed
people to take action to do
the work it takes to prevent
cholera from spreading.
A Community Guide to Environmental Health 2012