Health Guardianas Program Update

In 2007, The Health Guardianas Program was founded with the help of Episcopal Diocese of Ohio and the Episcopal Deanery of Yuscaran, Honduras, where they train local Hondurans in first aid. These workers from rural villages around El Paraiso are called Guardianas de Salud or Health Guardians. The goals for them to provide simple first aid and simple chronic care.

To maintain a good, sustainable health care in these areas, the Guardianas de Salud need continuing health education. This is a mission of The Health Guardians Program, ensuring quality medical training to these workers for the benefit of their community. Honduras Good works has partnered with Dr. Francis Aleman, a Honduran physician, who has helped with Guardiana training in the past. 

Here is Dr. Aleman’s assessment after her first training class held this January 2025:

Training Class Blood Pressure Measurement

Of the 25 communities that we intend to serve, only 3 currently lack guardianas. In the previous workshop (July 2024), 10 out of the 25 communities were without guardianas.

Our Specific objectives:

1. Ensure that health guardianas understand what hypertension is, how to measure it, recognize when it is within normal parameters, hypertensive, and when it constitutes an urgent or emergency situation.

2. Instruct health guardianas in recording the data on the blood pressure card for proper patient follow-up.

3. Provide health guardianas with the necessary knowledge about diabetes, proper glucometry techniques, and the procedures to follow based on the results obtained.

4. Instruct health guardianas on the importance of recording glucose data in the corresponding card for proper patient follow-up.

Hypertension training:

 The hypertension training included a detailed explanation of what hypertension is, its causes, clinical signs, how to identify it, how it affects blood pressure, and how to properly record the data on the blood pressure registration card. Each participant was individually assessed with the assistance of a Nurse Amaya, a new guardiana.

Diabetes training:

 We followed the same approach for diabetes education. However, due to time constraints and limited supplies, individual assessments were conducted with 8 volunteers, all participants were shown how the assessments should be performed. 

Psychology presentation:

Psychology student Dorian Lagos delivered a presentation on self-esteem. Following this, three guardians who have been part of the program for eight years, and who are elderly, shared their experiences, followed by comments from the new guardianas.

Guardians Performance during the Workshop

The health guardianas demonstrated a high level of competence during the practical workshop I facilitated as a physician. They exhibited a thorough understanding of the key concepts, including the significance of monitoring, the proper techniques for measuring blood pressure and blood glucose, and the appropriate responses for each scenario. The majority were able to perform these tasks successfully on their first attempt, and all guardians were able to do so correctly upon being reassessed. All guardianas filled out the paperwork correctly and recorded the information on the record cards as instructed.

Non Medical Experience of the Workshop

In the workshop, I had the privilege of working with both experienced and new health guardianas from rural communities with limited education. Some of the senior guardianas, who have been in the program for 8 years, face challenges. They shared feelings of isolated without individual support to each guardiana in their community. Despite these difficulties, they were deeply encouraged to see new guardianas who would carry on the work. The presence of new faces, along with the support of a doctor now involved in their communities, gave them a renewed sense of hope and purpose. These communities, often neglected due to a lack of resources, felt a revitalized spirit, knowing they are no longer alone in the fight against hypertension and diabetes.

The senior guardians were eager to express their feelings and experiences in front of the new guardianas. They wanted to share the lessons they’ve learned over the years, their challenges, and their triumphs, as a way of inspiring the newcomers to continue the important work. They felt proud to be able to pass on their knowledge and ensure the program’s continuity, motivated by the fact that their efforts are making a real difference in the health of their communities.

Conclusions

● Ongoing Motivation of Guardianas:

The senior guardianas are motivated by the presence of new guardianas and the chance to share their experiences. This has helped them feel more positive about continuing their work. Their enthusiasm, along with the support from a doctor, will help keep them active and engaged in the program.

● More Time Is Needed to Interact with the Guardianas:

More time is needed to work closely with the guardianas and collect all the necessary information.

● Lack of Signal Makes Communication Difficult:

The lack of a reliable cellular signal in these rural areas makes it hard to communicate with the guardianas. This causes delays in gathering data and addressing any issues they may have. Finding better ways to stay connected will be important moving forward.

● Efforts to Contact Unreached Guardians:

There are still some guardianas I have not been able to contact or collect data from. It will be important to make more effort to reach these guardianas and gather their information, either through local community members or additional meetings.

● Updating the Guardianas directory  with Missing Information:

The directory needs to be updated with the missing information from the guardianas who have not provided their data yet. Keeping the directory up to date is important for making better decisions and improving the program.

Training Class January 2025