Looking Back on our First 20 Years

As Mano a Mano celebrates 20 years in operation in 2014, we will be looking back on our first 20 years, highlighting some of the stories, projects, pictures, and people that have been part of Mano a Mano. On social media, we will be using the hashtag #manoamano20years, and if you’d like to share your own pictures or stories we would love to highlight them! Just contact us.

Interviewing Beneficiaries of Mano a Mano Projects

In 2012 two Mano a Mano volunteers from Minnesota traveled to Bolivia for an interview project. Their primary goal was to interview beneficiaries of Mano a Mano projects, which included clinic staff, who were in Cochabamba for Continuing Health Education Workshops and agreed to talk about what it is like to work in a Mano a Mano clinic (watch a video interview with Mano a Mano clinic staff here).

The following is an interview with Jovita Orellana Harrara, the nurse working and living in the Mano a Mano clinic in Kayarani.

Jovita with her 6 month-old son.

Jovita with her 6-month-old son.

Talking with Jovita, Mano a Mano Nurse

A few things that stood out after talking with Jovita:

  • Three days each week Jovita leaves the clinic at 6 or 6:30 a.m. to visit a community according to a monthly schedule. The farthest community is not accessible by road. It is a 4-hour walk, carrying vaccines, medical supplies and her baby, wrapped close to her body in a colorful aguayo (shawl).
  • She vaccinates children, provides education in health, nutrition, the importance of boiling water for drinking, and family planning. Many families have 8 to 10 children; younger families are choosing to have fewer children.
  • She encourages families to eat the nutritious quinoa they raise; most prefer to sell the valuable cash crop.
  • Like other Mano a Mano clinic staff, she works hard and loves her work. She has 5 free days per month and cannot take them consecutively, except to attend the Mano a Mano continuing education courses in Cochabamba. It is a term of the contract between the community and Mano a Mano that the staff attend continuing education workshops (read more about our partnership model here).
  • Jovita’s 5-year-old nephew lives with her in the clinic. His parents, like many rural Bolivians, have gone to Argentina to find work.
  • Jovita is 23 years old. She speaks Quechua and Spanish.
  • Since 2009, she has worked at the Centro de Salud Kayarani, the 22nd Mano a Mano clinic built in 2002. Before the Kayarani clinic, Jovita worked in a hospital elsewhere in Bolivia.
Kayarani Clinic

Kayarani Clinic

Advantages to Working in a Mano a Mano Clinic

Jovita says there are many advantages to working at the Mano a Mano clinic compared to the hospital. The clinic receives much more support. It has better equipment. It has living quarters for the staff as well as an inpatient room for new mothers and their babies. It is much more comfortable and welcoming for patients. Perhaps most importantly for the people the clinic serves, Jovita sees patients in their homes; the hospital provides treatment only to those who can travel to the hospital.

7 Communities Served by the Clinic

The 7 communities served by the clinic are agricultural. They grow a variety of crops—greens (verdura), corn, and quinoa, but suffer from a lack of water. Many families are poor, with 8 to 10 children. The community farthest from the clinic does not have electricity. The typical house has a dirt floor, a roof of straw, and no bathroom. Most families have two one-room structures, one room for sleeping and cooking and a separate room for food.

Seeing Patients in their Homes

During her community visits, Jovita sees patients in their homes, vaccinates children, provides education in health and nutrition and family planning, and works with the community promotor de salud (health promoter) who is the “first responder” in case of emergencies. Diarrhea and resfrios (colds) are the most common problems. Sometimes there are problems with domestic violence when the men have been drinking chicha. Since the recent adoption of a law protecting the rights of women, the dirigente (local leader) of the community has the responsibility to deal with problems of domestic violence and she refers such cases to him.

The clinic closes at 8 or 9 at night, but the knocks on the door continue for emergencies. Because she does not have transportation she does not leave the clinic at night; patients must be brought to the clinic. She encourages the women to give birth in the clinic, not at home, and most do.

After 3 years, Jovita knows everyone in the communities and they know her. She has friends among the other young mothers. She visits them, and they visit her in the clinic. She likes her work and the people in the communities she serves.

Interview Details

  • Name: JOVITA ORELLANA HARRARA, interviewed while holding her 6 month old son, Jose Miguel
  • Location: Mano a Mano Bolivia office in Cochabamba, during a Curso para Enfermeros (Continuing Education Course for Nurses)
  • Relationship to Mano a Mano: Enfermera (licensed practical nurse) at Kayarani Clinic
  • Date Interviewed: Friday, April 20, 2012
  • Interviewers: Andrea Bond and Charles Skrief