miércoles, 30 de noviembre de 2016

Let’s talk about HIV/AIDS

Pagina nueva 1

By Marco Paulini



In this space we look for talking about an issue what, despite overflooded information, it is evident that campaigns to use condoms are not getting the the wished asset, what it is not achieving to create consciousness for self-protection to prevent HIV/AIDS and the other sexually transmitted infections.

Thus, it is necessary a self-reflection on unprotected sexual practices between heterosexual, homosexual and bisexual persons. This clarification is made because it makes no sense to follow accusing the gay public of HIV/AIDS infection, stigmatizing them about a dirty behavior -- it is observed an awful reality on infection does not discriminate among sexual orientation or gender (male or female), and that is gaining space because of risky sexual practices as having sex without a condom, early beginning of sexual relations not using a condom, practices which nowadays are not because a lack of information but lack of conciousness attributed due to they are practices adopted by many young and not so-young, who simply do not pay attention on the risk of acquiring HIV.

It is also observed to all this that there are still rejecting persons to HIV free testing alleging they are not men sleeping with men or women who only sleep with their husbands, when the reality has taught us if there are groups presenting more risk before infection, we all could be victims of it.

It is important to highlight that scientific researchs prove the HIV infection is detected between 16 to 24 years old. It is very known from the moment of infection until first syntomatology appearing can last from five to ten years, if we consider that the person does not test for HIV while syntomatology is not present . Then, when that person is diagnosed, we realize the cruel fact that person was infected between 13 to 15 years old, in teenage, we mean, when the majority just does not realize to be the infection-target .


Diana’s Tale

I met Carlos when I was 14. then, he was 16. we were classmates at high-school.

Two years later, I got pregnant. Carlos left the school,  and I went to live with him as it uses to be. Everyday , he showed me that if we were very young, he loved me and was concerned I were well. We did not have much but with few, we were going up.

Time passed and I realized Carlos started to get sick. Once more, it was too continuing that ill. Then, he was 20 years old and I was three months of my second child’s pregnancy . everybody said me I might not be worried because that would affect my baby.

Someone advised me that I should get Carlos to the health post, that there was a little free test to be applied to persons with syntoms Carlos had, and I checked in my pregnancy by the way.

My father-in-law said me it was not necessary because the test was for men who slept with prostitutes or other men. As I was not neither both, I had to be calm.

Despite, Carlos got many pills as well as available herbs but even he did not recover.

One day, Carlos could not wake up. I encouraged, went to health post . there I was diagnosed with HIV and they told me it was necessary Carlos got tested too.

A day before dying, Carlos requested me for forgiving him among tears, he said never betrayed me and I was his life love, but when he was on vacation the year before we met, he went to Aunt Aydee’s in Chiclayo, because he used to do this that year’s season.

Aunt Haydee’s sons Paco and Juan used to visit Rosa, a powerpuff girl, he had to meet for becoming a man.

Crying, he said me that if he could get the time back, he never had condemn me to his unmadurity punishment. I also answered him in tears that we both were victims and there are not anything to forgive.

Today I am taking retrovirals and waiting for the birrth. I praise God that my baby does not born infected because my first son was not lucky.


What is HIV/AIDS?

The HIV (Human Inmunodeficiency Virus) is a virus what attacks cellsin charge of body’s defense called CD4 co-operative lynphocites. As infection advances and CD4 lynphocites account decreases leaving the body with less defense capability, HIV-infected persons begin to get very bad infections those normally are not infected, becoming inmunodefficient.

This advanced process with other oportunist diseases already presence is called AIDS (acquired Inmuno Defficiency syndrome).

Many times, the person is diagnosed with HIV even if there are not syntoms.

When the person is infected, the virus progresses arise, and the person is unsyntomed, who does not present symtons to suspect on infection, in other words. This process can last until ten years or more, time when the person can transmit the virus to other people.

If the person is not diagnosed and receives treatment, can develop AIDS.

Persons who develop AIDS have their inmunological system so damaged that they can easily get other oportunist diseases causing them death.


How is it transmited?

HIV can be found in body liquids or secretions as blod, semen, pre-cum liquid, vaginal secretion and mother’s milk. All practice implying contact of these body liquids and secretions with mucus and blood flow of another person can cause infection by HIV. Pregnant women also can transmit it their child during pregnancy, at birth moment or during milk feeding.


Who has more risk to get HIV?

  • All person sharing Needles to inject, babies from HIV-infected mothers who did not receive treatment against the virus during pregnancy.
  • Persons having unprotected sexual relations (not using a condom), and even more if if they have HIV-positive or AIDS-developed couples with high risk behavior (promiscuos).
  • Persons who received blood or hemo-derivates transfusions without hard standards to detect the virus.


Which are the syntoms?

When infection is acute, they are very often similar to flu plus  diarrhea, headaches, fever, muscular sore, diverse skin eruptions, mouth wounds, cold sweatting, throatsore, inflammed lynphatic gangles.


Have in mind…

Today, the science advances and we fortunately have retrovirals those help for infection not to advance, and so having a good life to enjoy. However, we do not forget even when infection is treatable and can be dealed as a cronic disease, there is not a cure yet and we do not have to keep unguarded.

Also, we have to be conscious once treatment has begun, this shall continue. If not, patient only wil expose to create resistance to drugs, and while more resistance, less effectivity. That means less life possibility.


Marco Paulini is a Sullana, Peru-based obsthetrician. Send him your questions to his Twitter account: @MarcoPaulini

© 2014, 2016 Asociación Civil Factor Tierra (@factortierra). All Rights Reserved.



lunes, 31 de octubre de 2016

Salvamos una mujer, salvamos una comunidad (III)

Previniendo embarazo adolescente en entornos mayormente rurales

El embarazo en adolescentes es un problema de salud pública importante, y su prevalencia se debe a las condiciones socioculturales, las mismas que han determinado su considerable aumento, aconteciendo con mayor frecuencia en sectores socioeconómicos más disminuidos, aunque se presenta en todos los estratos de la sociedad.

Muchas veces la violencia basada en género (VBG) está inmersa en la vida cotidiana de la mujer, surtiendo efecto de victimización sistemática en el género femenino. Esto se evidencia al analizar el alto índice de embarazos en adolescentes, ocasionando que la violencia pase desapercibida, dando origen a un tipo de “violencia fantasma”, sumando a la no identificación de la misma.

Por eso, esta intervención se propone prevenir el embarazo en adolescentes en una jurisdicción territorial específica.
Particularmente, la intervención quiere concentrarse en:
1- Sensibilizar a la población adolescente de la jurisdicción para prevenir el embarazo adolescente en un entorno de equidad de género.
2- Promocionar el desarrollo humano a través de proyectos de vida en adolescentes.
3- Estimular la réplica de los contenidos aprendidos por los y las participantes del taller educativo de “Prevención del embarazo adolescente” dentro de su comunidad educativa.
4- Desarrollar entornos saludables para el adolescente a través de la educación sobre sexualidad del adolescente a padres y madres de familia.

En esta intervención participan quien coordina la estrategia de salud sexual y reproductiva (SSR)en la oficina que administra la jurisdicción y los jefes de cada establecimiento de salud que estén dentro de ella; pero, el espacio de intervención serían las instituciones educativas a las que asistan los adolescentes (nivel secundario).
Y la razón lógica es que nuestro público objetivo son Adolescentes varones y mujeres que estén cursando la educación secundaria en instituciones educativas  de la jurisdicción.

Lo que tenemos que hacer es un (1) taller educativo conformado por cinco (5) sesiones educativas (una al mes por cada institución educativa) más una (1) sesión de réplica (expoferia) por cada institución educativa.
Se seleccionará una (1) institución educativa por cada Establecimiento de Salud.
Cada sesión tendrá dos horas pedagógicas, y los temas a abordar son:
  • Sesión 1: Equidad de género. 
  • Sesión 2: VBG y su prevención.
  • Sesión 3: Embarazo adolescente.
  • Sesión 4: Promoción de desarrollo humano y proyectos de vida en adolescentes.
  • Sesión 5: Intervención a padres y madres de familia: sexualidad del adolescente.
Al final se desarrollará una expo feria: Los adolescentes harán réplica de los conocimientos adquiridos a sus pares.
El monitoreo de la intervención es continuo y finaliza con la elaboración de un informe que tiene que ser publicado para verificar el cumplimiento de indicadores y tener una referencia que se conecte a futuras intervenciones.

Post-producido por Sheyla Benavente.

We save one woman, we save one community (III)

Preventing teenage pregnancy in mostly rural spaces

Teenage pregnancy is a public health important issue and its prevalence is due to social-cultural conditions, whichave determined its considerable increasing, happening mostly often in poorest social-economic sectors, although it is present in all society levels.

Many times, gender-based violence (GBV) is inside the daily life of the woman, provocating a systematic victimization effect in female gender. This is evidenced when analyzing the teenage pregnancy high rates, making the violence to go unseen, becoming a ‘ghost violence’ type, adding to its non-identification.

That’s why this intervention is committed to prevent pregnancy in teenagers inside a specific territory.
Particularly, the intervention wants to focus on:
1) Making the teenage population of the territory to be sensitive to prevent teenage pregnancy into a gender equity environment.
2) Promoting human development by life projects for teenagers.
3) Estimulating the repetition of learned contents by the teenage pregnancy prevention educative workshop’s attendants inside their educative community.

4) Developing healthy environments for teenagers by the education on teenage sexuality for parents.
In this intervention, the participants are who coordinates sexual and reproductive health (SRH) strategy at the territory under intervention’s managing office, and chiefs of every health stand inside the territory under intervention, but the space to do it would be the high-schools where the teenagers attend to.

And the logical reason is that our target are male and female teenagers who study at high-schools in the territory.
What we have to do is one educative workshopformed by five educative sessions (one monthly per every high-school) plus one repetition session (expo-fest) per every high-school.
One high-school per every health stand wil be chosen.
Every session will last two pedagogic hours and the topics are:
  • Sesion 1: Gender equity.
  • Session 2: GBV Prevention.
  • Session 3: Teenage Pregnancy.
  • Session 4: Human Development Promotion and Life Projects for Teenagers.
  • Session 5 – Intervention for Parents: Teenager’s Sexuality.
As a finale, a expo-fest to be made. Teenagers will repeat the acquired knowledge to their mates.
The monitoring of the intervention is continous and ends making a report that has to be released for verifying the indicators accomplishment and having a basis linking to future interventions.

Post-produced by Sheyla Benavente.

lunes, 24 de octubre de 2016

Salvamos una mujer, salvamos una comunidad (II)

Prevención de la muerte materna desde un enfoque integrativo

En el campo de la salud pública, el agente comunitario de salud ha contribuido a la disminución de muertes maternas e infantiles debido a la influencia que tiene sobre la  población para cambiar actitudes y  conductas, forman brigadas  sanitarias, contribuyen a la captación, identificación y  seguimiento de los grupos de riesgo, las gestantes se  encuentran mejor informadas  sobre los beneficios de un embarazo bien controlado,  también realizan transferencia de gestantes y población en riesgo al aumento de  coberturas de vacunación  en zonas rurales y urbano marginales, etc.

Por eso, este proyecto, que dura tres meses, toma ventaja de agentes comunitarios en la jurisdicción donde estamos interviniendo; es decir de las personas dentro de una localidad con capacidad de liderazgo.
Este agente se integra a un equipo compuesto por:
  • Quien coordina la estrategia de Salud Sexual y Reproductiva en la jurisdicción más grande en términos de poder de decisión
  • Representante de la municipalidad de la jurisdicción donde intervenimos
  • delegado de una organización social de base representativa en la jurisdicción donde estamos interviniendo
  • Quienes dirigen los establecimientos de salud dentro de nuestra jurisdicción
  • Responsables de la estrategia SSR en los establecimientos de salud dentro de la jurisdicción
Esta intervención busca mejorar la atención mediante actividades de promoción de la salud a través de la participación multisectorial y el compromiso de la sociedad civil.
Específicamente se concentra en:
1.         Lograr el reclutamiento de agentes comunitarios (AC), asegurando por lo menos uno en cada localidad de la jurisdicción donde estamos interviniendo.
2.         Garantizar la capacitación permanente e integral de los AC.
3.         Promover el rol activo y coordinado de los AC, para la promoción de los servicios de salud sexual y reproductiva, identificación de signos de alarma y referencia comunitaria de usuarias.
4.         Otorgar incentivos no monetarios a los AC afianzando su participación en el trabajo comunitario.
5.         Otorgar la certificación correspondiente a la labor del AC.

Esta propuesta se enmarca en la acción participativa multisectorial; en ese sentido el logro del objetivo será consecuencia de las sinergias logradas entre los diferentes sectores.

Cabe indicar que el Ministerio de Salud ha venido desarrollando experiencias exitosas de promoción de la salud a través de participación comunitaria., Una de esas experiencias ha sido el trabajo con los Agentes Comunitarios de Salud, que ha mostrado gran eficacia para enfrentar los problemas del sector.
Estos agentes han puesto de manifiesto su compromiso, realizando acciones de prevención y promoción de la salud en su comunidad. En ésta tarea han tenido singular importancia los establecimientos de salud y las organizaciones no gubernamentales, las que han contribuido a mejorar las capacidades del Agente Comunitario en Salud para enfrentar las emergencias y los problemas de salud comunales.

Post-producido por Sheyla Benavente.

We save one woman, we save one community (II)

Prevention of maternal death from an integrative perspective.

InPublic Health field,  health communitarian agent has ccontributed to decreasing maternal and child deaths because of the influence over people to change attitude and behavior, form sanitary brigades, contribute to recruiting, identification, and following of risk groups, pregnants are better informed about benefits of a well-controlled pregnancy, also transfer of pregnant and risk population to increasing of vaccination coverage in rural and urban/marginal zones, etc.

That’s why this 3-month project takes advantage of communitarian agents in the territory we are intervening on - the people inside a community with leadership skills, I mean.
This agent joins a team formed by:
  • Who coordinates sexual and reproductive (SRH) strategy in the larger territory in terms of decision power.
  • Representative of the territory’s municipality where we are intervening on.
  • Delegate of a repressentative grassroot organization in the territory we are intervening on.
  • Who lead the health stands inside our territory.
  • SRH responsibles in health stands inside the territory .
This intervention looks for improving the attention by activities of health promotion through multi-sector participation and civile society commitment.
Specifically, it is focused on
1) Getting to recruit communitarian agents (CA) assuring one-per-town in the territory we are intervening at least.
2) Guaranteeing the permanent and integral training of CA.
3) Promoting the active and coordinated role of CA for the promotion of sexual and reproductive health services, identiffication of alarm signs, and users’ communitarian referral.
4) Granting non-bill bonuses for CA, enhancing their participation in the communitarian work.
5) Granting the right certification to the CA’s job.

This proposal is outlined by the multi-sector participative action. In that sense,  the reaching of the goal will be consequence of gotten sinergies among the different sectors.
It is necessary to say that Peru’s Ministry of Health has been developing successful experiences of health promotion by communitarian participation. One of those experiences has been the work with health communitarian agents, what has shown great efectiveness to face the sector’s problems.

Those agents demonstrated his commitment making actions of health prevention and promotion in their community. On this work, health stands and non-profit organizations had a singular importance, which  have contributed to improve the health communitarian agent’s skills for facing emergencies and communitarian health issues.

Post-produced by Sheyla Benavente.

martes, 18 de octubre de 2016

Salvamos una mujer, salvamos una comunidad (I)

Interviniendo para reducir muertes maternas

Por: Marco Paulini Espinoza

La salud es un derecho humano fundamental que debe promoverse desde una perspectiva preventiva; además, la mortalidad materna constituye el indicador sanitario que con total fidelidad evidencia el grado de organización y accesibilidad de los servicios de salud.

Uno de los objetivos del sistema de salud es la mejora de sus servicios, logrando el mejor nivel de calidad (el sistema debe ser bueno), así como deben disminuir las diferencias entre las personas y los grupos (el sistema debe ser equitativo); entonces, hablamos de calidad de atención si el sistema responde de acuerdo a lo que las personas esperan de él, y es equitativo siempre que el sistema responda sin discriminación entre las personas.
Con base en la iniciativa tomada por la Dirección Subrregional de Salud Luciano Castillo Colonna en 2015 (primera medición del Plan de Mejoras del Desempeño), que demostró un nivel de calidad intermedio en los procesos de atención de salud, mediante la implementación de esta iniciativa se busca garantizar el derecho a la salud en términos de calidad.

La intervención dura tres meses y se concentra en los procesos de atención en Salud Sexual y Reproductiva (SSR) que se brindan en los establecimientos de salud.
En el aspecto global, la intervención se enfoca en mejorar la atención en salud mediante actividades dirigidas al fortalecimiento continuo de los procesos a través de la aplicación de técnicas y herramientas para la gestión de la calidad; con la participación multisectorial y el compromiso de la sociedad civil.

Puntualmente pretende garantizar la capacidad de respuesta del sector salud para la reducción de la mortalidad materna y perinatal, y asegurar la participación de la familia y la comunidad y otros actores de la sociedad civil en el sistema de salud para la reducción de la mortalidad materna y perinatal.

El enfoque metodológico que se da en esta propuesta está enmarcado en la investigación (medición) y acción participativa; en ese sentido el logro del objetivo será consecuencia del análisis de los resultados obtenidos.
El equipo que manejará la intervención (equipo de mejora) está compuesto por:
  • La persona que coordina la estrategia de SSR en la jurisdicción con mayor poder de decisión,
  • Las personas encargadas de cada establecimiento de salud dentro de la jurisdicción a intervenir,
  • Los responsables de la estrategia de SSR en cada establecimiento de salud dentro de la jurisdicción a intervenir, y
  • un responsable de intervención (que la monitorea a todo nivel).
LA idea está basada en experiencias exitosas llevadas a cabo durante los últimos 20 años en San Martín, Ucayali, Ayacucho, Madre de Dios, Loreto, Cusco,  Lima y Apurímac.

Post-producido por Sheyla Benavente.

We save one woman, we save one community (I)

Intervening to reduce maternal deaths

Health is a fundamental human right what must be promoted from a preventive perspective. Also,http://www.who.int/mediacentre/factsheets/fs348/en/ maternal death composes the sanitary index that with total fidelity evidences the grade of health services organization and accesibility.

One of the health system objectives is improving its services, reaching the best quality level (the system must be good) as well as must decrease the differences within persons and groups (the system must be equitative). Then, we talk about attention quality if the system responses for what persons hope on it, and is equitative whenever the system responses without discrimination among people.

Based on the initiative taken by Luciano Castillo Health Board, in Sullana, Peru, during  2015 (First Measuring of Performance Improving Plan), what showed an intermediate quality level itself in health  attention processes, by implementating this project, it is looking to guarantee the right to Health in terms of quality.
The intervention lasts three months and focuses on sexual and reproductive health (SRH) attention processes provided by health stands.

Globally, the intervention focuses on improving health attention by activities addressed to continous empowerment of processes through application of techniques and tools for quality management with the multi-sector participation  and the commitment of civile society.

Puntually, it pretends to guarantee the capability of Health sector response for reducing maternal and perinatal mortality, and assuring the participation of the family & community and other actors from civile society into the health system for reducing maternal and perinatal mortality.

The methodologic foccus given on this proposal is portrayed by research (measuring) and participative action. In that sense, reaching the goal will be consequence of gotten results analysis.
The tteam that is going to manage the intervention (improving team) is formed by:
  • The person who coordinates SRH strategy in the territory with major decision power.
  • The persons in charge of each health stand in the territory to intervene.
  • An intervention responsible (who monitors it in every level).
The idea is based on successful experiences held during the last 20 years in san Martín, Ucayali, Ayacucho, Madre de Dios, Loreto, Cusco, Lima and Apurímac States, in Peru.

Post-produced by Sheyla Benavente.