The Dartmouth Center for Health Care Delivery Science

Visionarios Perú

Working on the ground with Dartmouth and other international partners, a community-based NGO starts to change the world by asking a fundamental question:
“What do you need?”

Lorena Mestanza and Eda Palacios are warriors in the war on poverty. Fighting to eliminate sickness and need in the hillside slums of Lima, Peru, the two nurses target basic and compounding societal ills: lack of potable water; unsanitary bathing and sewer conditions; improper garbage disposal; the absence of basic health services and health professionals. Working with Visionarios Perú, a Peru-based NGO, the nurses’ first line of attack is deceptively disarming. “What do you need?” they ask.

In Villa Maria del Triunfo, a desperately poor Lima district whose name translates roughly to “House of Mary the Triumphant,” the concerted outreach has had its first triumph in the form of systematically identifying the needs of the people living in three neighborhoods: Jesús de Nazareth, San Isidro Labrador, and Santa Rosa — a massive undertaking. In February, Visionarios Perú released Diagnóstico Situacional, a report detailing the information gathered there by Mestanza, Palacios, and others working the front lines. The report’s findings will direct the group’s efforts in the coming years.

More than 50% of the above-seventeen population does not have anything beyond primary education;

60% of citizens lack health insurance, even though the state-offered health insurance (known as SIS) could cover them;

18% of families use ill-defined or haphazard outdoor “latrines”;

in more than 60% of families, the head of household has undependable work.

Among the report’s more sobering numbers: more than 50 percent of the above-seventeen population does not have anything beyond primary education; 60 percent of citizens lack health insurance, even though the state-offered health insurance (known as SIS) could cover them; 18 percent of families use ill-defined or haphazard outdoor “latrines”; in more than 60 percent of families, the head of household has undependable work.

That major task completed, the real work for Visionarios and its partners is now underway. Joining the fight on a number of fronts is Dartmouth College, with the efforts of The Dartmouth Center for Health Care Delivery Science (TDC), the Geisel School of Medicine at Dartmouth, and the Dartmouth-Hitchcock Medical Center. In the coming months and years, Dartmouth’s teams plan to develop and strengthen a system of primary care centers in the district. A focus on preventative medicine as well as first-line care will lead to a healthy and vibrant community.

Dartmouth students helped Mestanza and Palacios develop and conduct their health surveys. In the near future, interns from the Geisel School of Medicine will research barriers to SIS and possible solutions for expanding its coverage, and set up a program to develop community leaders who understand the tight nexus of health, economics, education, and development. Dartmouth will also help in improving latrines and sanitation.

While leadership teams from Dartmouth continue to explore possible new ways to partner with the Peruvian government and academic and health institutions, the students on the front lines will be immersed in the local communities, learning and implementing what works. Ultimately, the visionary partnership will be mutually beneficial. Dartmouth’s students will put their global understanding and experiences into practice for local solutions. And they’ll take the high-impact, local solutions that work in Villa Maria del Triunfo back with them into the world.