New Internationalist

The Story Of Chelo

Issue 127

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HEALTH [image, unknown] Politics and primary health care

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The story of Chelo
David Werner has spent the last 19 years helping organise Project Piaxtla - a health scheme run by campesinos in the rugged Sierra Madre mountains of Mexico. Author of the widely-used health manual ‘Where there is no doctor’, Werner has found his concern shifting from health care to social justice. Here he explains why.

LET ME TELL YOU about Chelo, whose family I have become close to over the years. Chelo has advanced tuberculosis. Before the villager-run health centre began in his village, he received no treatment. He knew he was sick. He wanted treatment. But he could not afford to buy the medicines.

For years he had worked for the richest landholder in the village, an unhappy and overweight man with heart trouble. Apart from his enormous landholdings he owns about four thousand head of cattle. When Chelo began to grow weak and unable to work as hard as before, the landholder fired him and gave him notice to move out of the house he had been permitted to use.

Chelo, his wife and his stepson (he has no children of his own) built a mud-brick hut and moved into it. By now Chelo was coughing blood.

At around this time the community-based health programme was beginning in area, but no local health worker had yet been trained in Chelo’s village. A visiting health worker taught Chelo’s 11 year-old stepson, Raul, to inject him with streptomycin and keep records to be sure he took his other medicines correctly. The boy did a good job and was soon injecting and checking up on several other people with tuberculosis. By age 13 - still attending school - the boy had become one of the central team of health workers in the area.

Meanwhile, Chelo’s family had cleared a small weed patch and garbage dump at the lower edge of the village. After much hard work they had constructed a simple irrigation system, using ditches and grooved logs. At last they had a successful vegetable plot which brought in a small income. Chelo’s health had improved but he would never be strong. Treatment had begun too late.

Economically, Chelo had one setback after another. Just when lie was beginning to get out of debt to the landholders, he fell ill with appendicitis. The surgery could not be handled by local health workers. So they carried him 17 miles on a stretcher to the road - and from there by truck to the city. The surgery (in spite of the fact that the surgeon lowered his fee) cost as much as an average farm worker cams in a year. The family was reduced to begging.

About the only valuable possession the family had was a donkey. When Chelo returned from hospital, his donkey had disappeared. Two months later a neighbour spotted it grazing on the land of one of the wealthier families. A new brand still fresh - had been put right on top of the old one.

Chelo went to the village authorities, who investigated. They decided in favour of the thief and fined Chelo. To me the most disturbing thing about this was that Chelo, when he told me about it, was (on the surface at least) not even angry. He ~ simply shrugged and laughed weakly, as if to say: That’s life: nothing can be done.

His stepson, Raul, however, took all these abuses very hard. He had been a very gentle and caring child - but stubborn, with an enormous need for love. As he got older he seemed to grow angrier.

An incident at school topped things off. Raul had worked very hard to complete secondary school in a neighbouring town. Shortly before he was to graduate, the headmaster told him, in front of the class, that he could not be given a certificate unless his parents got married (he was an illegitimate child). This happened at a time when the national government had decided to improve its statistics. Spearheaded by the president’s wife, it had decided to launch a campaign to have all unwed couples with children get married. The refusal to give leaving certificates to children of unwed parents was one of the pressures used. Chelo and his wife did get married - which cost more money - and Raul did get his certificate. But the damage to his pride will remain forever.

Raul began to drink. When he was sober he was usually self-controlled. However he had a hard time working with the team of health workers because he took even the most friendly criticism as a personal attack. When he was drunk, his anger often exploded. He managed to get hold of a high-powered pistol, which he would shoot into the air when he was drinking. One night he got so drunk he passed out on the street. Some of the young toughs in town, who had also been drinking, took his pistol and his pants, cut off his hair, and left him naked in the street. Chelo heard about it and carried Raul home.

After this, Raul hid in shame for two weeks. For a while he did not even visit his friends at the health post. He was afraid they would laugh. They did not. But Raul had sworn revenge - he was never quite sure against whom. A few months later, when drunk, he shot and killed a young man who had arrived that afternoon from another village. The two had never seen each other before.

This, to me, is a tragedy. Because Raul was fighting forces bigger than himself. As a boy of 12, he had taken on responsibilities of a man. He had shown care and concern for other people. He had always had a quick temper but he was a good person - and, I happen to know, he still is.

Who was to blame? Perhaps no-one. Perhaps all of us.

Raul fled. In the night, the State Police arrived looking for him. They burst into Chelo’s home and demanded to know where Raul was. Chelo said Raul had left. He didn’t know for where. The police dragged Chelo into a field outside town and beat him with their pistols and rifles. Later, his wife found him still lying on the ground, coughing blood and struggling to breathe.

It was more than a year before Chelo recovered enough to work in the garden. His tuberculosis had started up again after the beating. Raul had gone and could not help with the work. The family was so poor that, once again, they had to turn to begging. Often they went hungry.

After a few months, Chelo’s wife also developed signs of tuberculosis and started treatment at the village health post. The health workers charged her nothing. Nor did they charge Chelo, even though the health post was in economic difficulty itself. However, Chelo’s wife did what she could by helping to wash the health post linens at the river.

Chelo and his wife are now’ both somewhat healthier, but are still so poor that life is a struggle.

But recently a new problem arose. The landowner, for whom Chelo had worked until he became ill with TB, was determined to take away the small plot of land on which Chelo planted his vegetable garden. When it had been a useless weed patch and garbage dump, Chelo had been granted rights to it by the village authorities. Now that it had been developed into a small, fertile, irrigated vegetable plot, the landowner decided he wanted it. He applied to the village authorities, who wrote out a notice granting him rights. Of course, this was unlawful because the rights had already been given to Chelo.

Chelo would have lost his land, which was his lifeline to survival, if the village health team had not stepped in. They had struggled too many times - often at the cost of their own earnings - to keep Chelo alive. They knew what the loss of his land would mean to him.

At an all-village meeting, the village health workers explained to the people the threat to Chelo’s land and what losing it would mean to his health. They produced proof that the land rights had been given first to Chelo by the town authorities. They asked for justice. The village decided in Chelo’s favour.

The village authorities were furious - not to mention the landholder.

The health team had taken what could be called ‘political action’. But the health workers did not think of themselves as ‘political’. Nor did they think of themselves as capitalists or communists, or even socialists, for that matter. They simply thought of themselves as health workers - but in the largest sense. They saw’ the health, and indeed the life, of a helpless person threatened by those with power. And they had the courage to speak out, to take action in his defense.

Increasingly, the village health team has come to realize that the health and wellbeing of the poor often depends on the poor and oppressed recognizing their needs, analyzing their situation and finding the courage - and strategy or plan - to join together and work toward social change. They have seen enough of reality to know’ that social change will never really come from those at the top. It must come from those at the bottom: from themselves.


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