Expanding my Town's Health Center

The following is the grant proposal that I'm turning in to the Peace Corps on behalf of my town. We are going to be doing a PC Partnership grant of $40,000. You can donate to our project very soon:
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Executive Summary

San Luis Planes on a cloudy day.

The more than 4,000 villagers of San Luis Planes and neighboring towns have identified the expansion of their health center as the area’s top priority.

Health-related problems abound and, because of the highly limited physical space in the current health center, they simply are not adequately being attended to in San Luis Planes. The nearest hospital is an expensive emergency trip away (the equivalent of five-ten days’ wages for a local laborer), preventing many impoverished families from visiting a doctor.

The goal of this project is to more than triple the size of the current health center’s physical space. By doing so, the center will add ten new rooms, including an area dedicated to vaccinations, a maternity ward, an overnight room  and a doctor’s office, thus providing crucial new health services. Ultimately, with an improved building, the town will be able to receive the placement of a full-time doctor from the Ministry of Health and will thus begin work on preventative health and education, the truly sustainable solutions to the area’s health problems.
Community leaders representing the town’s various key organizations have come together to form a committee to oversee this project. They understand the importance of improving their community’s health and are dedicated to fighting for it. Additionally, the mayor of the city of Santa Barbara, the municipality of which San Luis Planes forms part, has promised to support to the project. The two parties together will contribute a total of nearly 65% of the entire cost.

Health is a fundamental public good and a person can’t hope to live a productive life without it, just as a town can’t hope to develop without prioritizing the health of its citizens. Thus we hope that this project will directly contribute to the area’s economic advancement and well-being.

Background Information

A local girl helps her mother on the coffee farm.

San Luis Planes is a village located within the municipal limits of Santa Barbara, the capital city of the department with the same name. The town rests on a plateau at around 1300 meters above sea level, within the buffer zone of the Santa Barbara National Park. There are approximately 1325 habitants and 290 households, putting the average number of people per house at around 4.6. What’s more, the nearly 4000 people of the seven surrounding villages also use the health center. People make a living primarily harvesting coffee and other agricultural endeavors. The average household annual income is approximately 25,000 lempiras (around $1315). San Luis Planes contains a K-9 school with twelve teachers, a coffee cooperative, three churches, a community center, a police sub-station, a soccer field, and said small health center. The town was connected to the national electric grid in 2008.

The town's soccer team and my left index finger.

The greater area has felt the need for this project for years, but hasn’t been able to obtain financial support until now. With that goal in mind, 25 community leaders from various key organizations in San Luis Planes (churches, the town council, the school, the coffee cooperative etc) came together to form a committee to work on this project.  They also have the support of the town councils of the surrounding villages as well as the mayor’s office of Santa Barbara.

Community Need

The Catholic Church during mass.

In San Luis Planes, like in many places in rural Honduras, the population’s overall health is sorely lacking. Some of the most frequent sicknesses include respiratory problems; skin diseases; diarrhea, amoebas, intestinal parasites and other stomach problems caused by contaminated water and food; high blood pressure, high cholesterol and general heart problems; diabetes; and injuries/emergencies related to non-mechanized manual labor. What’s more is that maternal care and sexual education is a growing necessity, considering the high birth and teen-pregnancy rate in the area and the effect they have on family economics.

This second-hand American school bus represents the primary
mode of transportation for most people in my town.

The nearest hospital is 36 kilometers away and an emergency trip there can cost between 500-1000 lempiras, the equivalent of five to ten day’s wages. Because of this steep cost, many poor families simply do not have the resources to visit a doctor when they get sick, much less for frequent checkups. To put it basically, the limited space and resources of the health center are simply not meeting the needs of San Luis Planes and even less so for the greater area. These problems will only become greater with time because of the rapidly expanding population.

The members of the health center committee believe that these problems can begin to be resolved by obtaining a doctor. And in order for the Ministry of Health to send a doctor to San Luis Planes, the health center must be expanded according to a list of specific requirements, more than tripling the square footage of the building. The idea is that along with being able to render more services, the health center’s doctor and new space/equipment will be able to focus more on preventative health and education. More physical space also means a bigger medical storage room and thus the ability to provide more medicine to the patients who need it.

This woman, posing with three great grandchildren, represents the
elderly population of San Luis Planes.

 Community Initiative and Direction

The committee that was formed elected its officers in its first meeting.  An in-depth community analysis followed, using survey results, input from representatives from various community-wide organizations and members’ own experiences and opinions. After the health center came out as the top priority, the committee wrote a work plan and the project proposal. The committee meets minimally once a week for two to three hours in the afternoon, but the officers often work much longer during the week and donate time and transportation without a second thought. Only after all this work was finished did committee members approach the Peace Corps volunteer to ask about ways to go about raising the funds required.

The Health Center's nurse likes to give shots.

Several members of the committee have worked with Peace Corps volunteers in the past on other large projects including eco-stoves, latrines and a new school. Additionally, almost every previous project that brought the current community buildings to San Luis Planes was implemented by at least one person on this committee.

The committee keeps the minutes during meetings, records agreements that are reached, stays in contact with the mayor and other town councils, and works closely with the Peace Corps volunteer who is helping them. When it comes time to buy materials and begin construction, the committee will take charge of managing the inventory, overseeing the foreman’s work, keeping accurate and transparent records of finances, and communicating progress to the rest of the community and to the other donors.

Community Contribution

Tripling the size of this health center will be relatively expensive at more than $40,000. However, between the people of San Luis Planes and their elected officials in Santa Barbara, the community will be contributing nearly 65% of total costs, approximately $26,000.

This is the crowded waiting room.

The people of San Luis Planes will donate the equivalent of nearly 900 work days in difficult manual labor supporting the foreman in the construction of the building. This includes not only helping to move and prepare materials, but also digging a large hole for a septic tank, leveling out the terrain for the new building and helping to install the plumbing, roofing and electricity. When put into dollar form, these 900 work days total out to nearly $7,000, which, for a town whose habitants’ average annual income is only $1,315, is substantial.

The municipality has promised to provide a few of the basic materials needed for construction, like rebar and steel roofing beams, a value of approximately $10,500. They will also pay the foreman and engineer in charge of the building’s architectural designs and construction, totaling more than $8,500.

The remaining 35%, $15,000, will come from this Peace Corps Partnership Program, paying for the rest of the construction materials and the value of the contract to install the building’s ceiling.

Project Implementation

The project’s first phase, which is the phase that corresponds to this Peace Corps Partnership profile, will take seven months. After writing the profile comes fundraising. The community will be in charge of promoting the project locally and organizing the work that people will contribute. The Peace Corps volunteer will be in charge of promoting the project abroad. The committee plans to spend four months on this fundamental step.

The Health Center from the outside.

While fundraising, the committee will also hold a community-wide meeting, passing on the details of their planning to the general public. They will also choose a foreman and write up a contract. Once the funds are raised the committee will purchase the materials and begin construction in February. The construction is planned to last four months until May, when the finished building will be inaugurated.

During the construction, committee members will take turns managing the inventory and will continue meeting once a week to give progress reports. Once the construction is finished, the committee will evaluate the project as a whole, and then enter into a second phase. The second phase will take the committee into November 2012 in which time they will work on obtaining the appropriate equipment and furniture and the placement of a full-time doctor. After the year is up, the committee will switch members. The goal, however, is to maintain the committee indefinitely, giving support to the employees of the health center.

Project Sustainability

Although a better building doesn’t automatically mean development, this project has everything it needs to be sustainable.

The committee, holding up the blueprints of the
Health Center's expansion.

In the first place, this committee is made up of people who have lived here their entire lives, whose families have lived here for generations, and who are dedicated to seeing their town develop. Their dedication to seeing this project through now and into the future is unquestionable because they have a real interest in seeing their area’s general health improve. Another reason they will be the first to defend the well-being of their health center because of the 900 work days they are going to put into its renovation.

The members of this committee are also learning valuable skills when it comes to project design and management and community analysis. The knowledge of how to organize a project this big will be useful years into the future as they start to tackle other issues confronting their community. This, in reality, is at the heart of sustainable development.

Finally, once the health center meets the Ministry of Health’s requirements, San Luis Planes will receive a doctor who will be able to better attend the health needs of people here. But also the doctor will handle education and work on preventing health problems. Education is the key.

Any contribution to a town's health and education is a contribution to its economic development.