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Diamonds in the Rough

School of Nursing program trains neighborhood residents to spark change

February 2003

by Natalie Gutierrez

The manís body was found lying in a cul-de-sac, the victim of an apparent drug deal gone bad. Thirty-two-year-old Natalia Huizar watched the chilling story unfold on the evening news. The attack had occurred in the Indian Creek subdivision not far from where she lives with her husband and three children. It was one of a rash of violent incidents plaguing her neighborhood.

Huizar lives in the Miller's Pond community, a rough neighborhood located on the far southwest side of San Antonio, just off Old Pearsall Road. The area consists of trailer parks, pockets of subdivisions and a small central business section, all separated by large areas of undeveloped land. Lackland Air Force Base and Kelly USA create a barrier that geographically isolates the community from the rest of the city.

Not only is violence a problem, the largely Hispanic populated area has some of the highest rates of poverty, teenage pregnancy, high school dropouts, babies born at abnormally low birth weights and infant deaths.

Diana San Miguel, project coordinator for the Promotoras on Old Pearsall Road Program, uses the tailgate of her pick-up truck to display health care pamphlets and educational brochures in the parking lot of the Culebra Super Meat Market on Old Pearsall Road. The promotoras travel to different locations in their neighborhood bringing much-needed resources
to the residents.

  Diana San Miguel
Diana San Miguel
"Weíre doing something about it," said Huizar, with a spark of determination in her voice. "I know we can make a difference with the Health Science Centerís help." Huizar is one of nearly 30 spirited neighborhood women, ranging in age from 25 to 70, who are health "promotoras," meaning promoters, in English. Theyíre part of the School of Nursingís new "Promotoras on Old Pearsall Road Program" in the Center for Community-Based Health Promotion in Women and Children. The program is the only one of its kind in San Antonio.

The Texas Department of Health recently awarded the project's director, Patricia Kelly, Ph.D., MPH, RN, FNP, assistant professor of family nursing care, a two-year, $150,000 Public Innovation Grant to train the women.

"We provide them with a meeting place in their neighborhood and literature on various health topics including infant growth and nutrition, immunization, breast cancer detection, diabetes prevention, adolescent sexuality, violence prevention and prenatal care," Dr. Kelly said. The women participate in comprehensive training sessions twice a week for a month where they learn how to present health information to public audiences. They also attend various health-, safety- and education-related workshops and seminars provided by outside agencies.

"This project fits perfectly with the mission of our new center," Dr. Kelly said. "We seek to empower people to work together toward healthy lives by overcoming challenges that result from poverty, lack of education and minimal community resources."

The promotoras set up tables outside their neighborhood Wal-Mart, laundromat, meat market or church and hand out health information pamphlets to passers-by. They even take turns holding health-related presentations at one anotherís homes, either in their living rooms or in their driveways. Their neighbors are invited and welcome.

"Sometimes you get people who just arenít interested in what you have to say," said 38-year-old Dora Ramos. "But when you see youíve actually taught someone something they didnít know before, that makes all the difference."

Huizar believes she and her fellow promotoras are positively impacting their community.

"The residents see that the promotoras care about them and their families," Huizar said. "Most of them appreciate the information we provide. We bring much-needed resources into a community that has so little. Many of our neighbors have to travel very far to see a doctor. And because many of them are from Mexico, there is a language barrier. They are intimidated and donít know what questions to ask. Sometimes they just decide not to go. We help prepare them for those visits and encourage them to see their doctors on a regular basis."

In addition to the informational presentations provided by the promotoras, faculty members from the School of Nursing and the Department of Family and Community Medicine provide a clinic in the Millerís Pond Community Center where residents receive free blood sugar and cholesterol screenings, blood pressure check-ups, physicals, immunizations, prescriptions and referrals.

"Itís all about bringing health resources into communities that need them the most," said Diana San Miguel, the projectís coordinator. "The promotoras are great women. They are real gems with amazing strength and can-do spirits."

"It might seem like a rough place to live," said Huizar, standing in the parking lot of a grocery store on a chilly morning with pamphlets in hand. "Most of the people here really care but just donít know how to make a difference. With continued education and support from the Health Science Center, I know we can transform our community into a safer, healthier place to live."

At five months pregnant, 30-year-old Carmen Rodriguez stands next to Huizar, vigorously rubbing her hands together to keep them warm. "Things are improving," she says emphatically. "In the future, our children wonít see so many negative things about this community in the news. Theyíll see the positive."

And in the quiet morning amid the dull pavement, the promotoras shine. Their voices call out in harmony to a family headed toward the store entrance. "Excuse me. Can we have a moment of your time? Weíre the promotoras Ö"


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