From a report to Subud Enterprise Services International (SESI) by Illène Pevec, November 2018
Wawa Illari (‘Child Star’ in Quechua) is a multi-disciplinary health intervention project for children from birth to three years old in eleven very poor communities belonging to the Pachacamac health district in rural Peru south of Lima.
It involves three components:
community and home gardens, where Illène Pevec, PhD, director of A Child’s Garden of Peace, leads the teaching of gardening to grow vegetables and fruits organically at home;
- mindful nutrition, where Dr. Emilia Galarza Garzon of Ecuador, leader of Asociación Vivir, teaches the conscientious eating and healthy nutrition that provides the nutrients needed for appropriate child development; and
- the International Child Development Programme (ICDP) headed by Nicoletta Armstrong and taught in Peru by Ana Sofia Mazzini and Honorata Herrera. The ICDP methodology aims ‘to enable children to reach their full potential through relationships with their caregivers’.
Virginia Hamida Thomas, sociologist and executive director of SDIA, obtained the primary funding from Grand Challenges Canada via a program called Saving Brains. As part of the project, research carried out in partnership with the Peruvian Ministry of Health seeks to discover if this multi-faceted intervention improves the health of children. There are 115 children enrolled in the programme and 150 children in a control group who receive normal health care at the local public health clinic.
The project received ethics approval from the Peruvian National Child Health Institute and McGill University. The principal investigator is Doris (Magdalena) Gonzalez, MD. ICDP Peru, led by Ana Sofia Mazzini and Honorata Herrera, who besides teaching and implementing the ICDP component, administer and coordinate all Wawa Illari activities. Ana Sofia and Honorata work in logistics, provide support and follow-up to community health workers weekly in the garden and mindful-nutrition components, and support the three data-collection points (the public health clinics) for research. In addition they purchase and deliver all food and gardening supplies to the fourteen health promoters who do the distribution to each family and all medical supplies needed for the health evaluations to the three public health clinics involved.
Wawa Illari had an agreement with a university in Lima that its nursing students would receive all elements of our program for parents to raise their children in healthier environments and in turn the nursing students would teach the classes in the community. Our budget was based on this formal agreement with the university. However, the university pulled out of the project entirely.
Our need to teach all 115 families cooking, nutrition, gardening, hygiene and ICDP therefore led us to work with our own community educators. We began recruiting them October, 2017 when Magdalena and Illène were both in Peru to work with ICDP to initiate project implementation.
We pulled money from other parts of the project to pay the health promoters on a per-family visit basis. We began with basic organic gardening training in October and November. By June we had run out of money to pay what had become a terrific team of health promoters and are so very grateful for the SESI grant that allowed us and the health promoters to complete the community education in 2018.
The health promoters all live in the eleven communities we serve and some had babies or toddlers in the program. Some had only elementary education and only two had some technical education beyond high school. What we have seen over the last year is extraordinary personal development in the 14 women we hired. This fall we needed to have formal contracts and pay health insurance and liability insurance as there had been violence in one of the communities and we felt responsible for the safety of these women as they walked up and down the hillsides that make up this region. Seven women had to drop out when we started formal employment, because receiving their personal health insurance from us meant that they lost government benefits given to families in extreme poverty. Therefore, during the last three months, eight women visited all 115 families weekly.
The work: From September 2018 through November the health promoters taught eight weeks of the ICDP protocol, eight weeks of nutrition and cooking reinforcement and three more weeks of gardening-based lessons with Illène’s presence in October. We visited every family with every promoter over eight days and planted a fruit tree of the family’s choice at all participants’ homes. We also planted fruit trees at the public preschool, at the community garden we started and at the public health clinic where many families take their children for all the medical evaluations in this project.
Results: The day I she arrived in October, I witnessed one of the weekly health promoter meetings focused on teaching an ICDP protocol: following the initiative of a child with encouragement. One woman had two of her older children with her, sons 6 and 9. They were playing with some of the educational toys and modeling exactly the content of the lesson in the way the older brother supported his younger brother’s exploration with the new toy. Then Juan David, age 9 gave a lecture to all the women gathered on the importance of listening to one’s child and not interrupting, but allowing the child to express his experience or opinion. He was ready to teach ICDP himself at age 9! We all realized that the older children of these health promoters have benefited enormously from this program as they accompany their moms and learn with them.
Skills learned. The health promoters have learned to teach, increasing in skill each week as they carry new information they have just learned to their families home by home. The health promoters have implemented what they have learned first within their own families. They have gained confidence as they have learned the program content and how to share it with the families who are their responsibilities. They have successfully run the community garden and enriched their family’s diets with the produce from it as well as planting their own personal container gardens at home.
One health promoter has a severely disabled child who cannot leave her bed. This past year she joined a government program to help families with children with severe disabilities. In this support group she shared what she has learnt with Wawa Illari and the program director has asked her to do a full presentation on ICDP to a regional gathering of this program, which she will do in 2019.
Another health promoter attended a nursing assistance course and, once qualified, was offered a job at the local health clinic because the medical staff knew her – she had frequently accompanied the mothers in her group to their medical appointments with their babies.
A third health promoter was told at school that she was slow and has suffered from low self-esteem ever since. As a result of being a health promoter she discovered that not only could she learn, she could teach. She beams with happiness and self-confidence now. Two of the women were beat up by their husbands in September, had their husbands arrested and decided to leave them due to their newly-acquired self confidence and awareness of what constitutes good emotional health, learned in our program.
As I walked with these women to visit all the families to plant fruit trees I heard parent after parent say how grateful they were for their improved diets with the program and how happy they were learn to communicate more patiently and lovingly with their children. Most of our families live in extreme poverty in houses with less substance than a shed in North America. To see them become more self aware and better able to parent as a result of Wawa Illari has made us all very happy. The older children consider themselves ambassadors and followed us from house to house to help plant trees. The health promoters, Ana Sofia and Honorata had a wrap-up party on December 8, a feast made in a traditional outdoor oven. All the health promoters want to continue to work with us. We hope to find a way to do so.
The last of the three evaluations is now in place, and by the end of December we hope to have all information needed to process data and find out how the project has impacted children’s health.