Happy Hearts in Manabi

A Story by a Peace Corps Volunteer

By Kristen Mallory - Peace Corps Volunteer: Ecuador (2007-2010)

When I first arrived in Manabí, Ecuador as a health volunteer, I was warmly welcomed by Senora Nelly, my host mother and extremely dedicated counterpart. Sra. Nelly and I wasted no time in conducting a community diagnostic. After getting approval from community leaders, we interviewed every family in eight communities. Although this process was lengthy, it was an excellent way to meet everyone and identify the communities' needs.

Our most notable finding was the unprecedented incidence of high blood pressure and diabetes. We also observed prevalent obesity, inactivity, and a lack of access to health information. While Sra. Nelly and I discussed what should be done to combat these health issues, Nelly casually asked me if I knew how to take blood pressure and mentioned that it would be great if the community members could learn to monitor their blood pressure. Her question triggered a vision which would later become Corazon Feliz (Happy Hearts).

We envisioned Corazon Feliz as a well-structured, sustainable project that provides rural Ecuadorian communities with the tools to improve their heart conditions. We presented a preliminary outline of the project to the local health center, which supported our idea and helped me write a proposal requesting materials from the local municipality. We asked for a blood pressure apparatus, measuring tape, and scales for each of my eight communities. After presenting our proposal, the governor and Plan International, my counterpart NGO, agreed to finance the supplies we requested.

Once we had the equipment, the projected unfolded rapidly. In order to ensure the sustainability of the project, we recruited 25 volunteers, or "health promoters," from the eight communities that we used in the preliminary diagnostic. A fellow Peace Corps Volunteer, Sarah Young, helped me author a manual that outlined program objectives and twelve workshops to be used to educate the health promoters. We launched Corazon Feliz in May 2008 with a three-day workshop. During that time, we distributed the manuals and taught the health promoters to take blood pressure (BP) and calculate body mass index (BMI). The three-day kick off also included an overview of nutrition and healthy lifestyles.

For the next six months, myself, Sarah, and a team of coordinators supervised the volunteers as they put our lessons into practice. We received support from a local blood lab that agreed to issue glucose and cholesterol tests for a reduced cost in the first community controls. In each of the eight participating communities, the promoters took bimonthly weight and BP measurements and gave lectures on techniques for a heart-healthy lifestyle. The promoters also executed monthly health fairs during which they measured weight and BP, calculated BMI, and gave recommendations. In each of the communities, an average of 50 people participated in the bimonthly programs, and we were proud to see over 100 people take advantage of each health fair.

After six months of supervision and training in how to lead the heart healthy workshops, I was proud to see that the promoters were no longer dependent on me and the other coordinators. I was just as pleased that we were able to get the communities to start thinking and acting in new, healthy ways. The communities weren't familiar with general nutrition and weight loss strategies, but they were eager to learn. We used games to teach the food pyramid, ran healthy cooking challenges, kept food journals, created walking groups, taught aerobics classes, practiced yoga, and learned stress relief techniques.

Although individual progress varied, there were some clear successes. Most individuals with high blood pressure were put on medication or were able to control their condition with lifestyle changes. Weight loss was slower, but participants learned how to lose weight, and we are still working on changing habits. The community promoters exhibited the most rewarding changes. Most promoters were young people and were empowered by this experience; they recognized the positive impact that they were making in their community and in the county as a whole. After six months, the promoters organized the first 5K race in the county, and 100 people from all ages participated. Given that running for pleasure and exercise is an unheard-of practice in this region, this participation was very noteworthy and hopeful.

Corazon Feliz has grown to be a movement in Manabí, impacting 350 members of eight communities, and is on course to work with 850 more people in 17 new communities.

The success of Corazon Feliz lies in the project's versatility – it can be adapted to fit any community, on any scale. At its basis is continuing education. In our case, a few Peace Corp Volunteers, with the help of a manual, trained a group of native volunteers who have passed their knowledge to their communities. As evidenced in Manabí, the project can start small and grow very large in a short period of time, especially if local governmental and health center support are involved.

Heart conditions due to poor nutrition and lifestyle habits are not unique to Manabí; these health concerns prove especially formidable for many developing countries. Taking blood pressure, teaching about healthy lifestyles, and encouraging activity can be done anywhere in the world. Fortunately,Corazon Feliz offers a manageable, sustainable way for Peace Corps Volunteers and others to tackle the issue. Little by little, hearts all around the world can be made healthier and happier.

Although I'm approaching the end of my Peace Corps tenure, I'm confident thatCorazon Feliz will not die with my departure. Over the past year, the project has not only thrived, but has nearly tripled in size. After completing the pilot group, the promoters wanted to continue the project. Also PCVs Sarah Young and Alea Richmond helped revise our original manual and are starting up the process in their communities. The 25 original community promoters were instrumental in the planning and administration of initial workshops for our 17 new communities. They were able to apply their knowledge and lead the next generation of Corazon Feliz. I know I can leave my beloved country with faith that soon, all of Manabí, and Ecuador, will have happier and healthier hearts.

Testimony from one of Kristen's Community Members (Translated in English below)

Como persona a mi me beneficio mucho. Primariamente arqueando conocimientos con que a veces una ni si quiere nos tomaba enante. Porque en realidad no había una persona indicada para ser le conocer los grandes beneficios. Mas que todo sentado en las realidades que tenemos como persona que una de los mejores proyectos porque arquemos experiencias como prevenir diferentes enfermedades sin estar atrás de un medico, cirguerno, o experto. Por que con estas capacitaciones de la persona indicada como es Kristen Mallory aprendimos muchísimas cosas. Muy particularmente en mi familia, mi hogar. En mi familia tome mucho en práctica para realimente hacer los alimentos primero que nada consumir y cocinar con menos sal y grasa. También a comer más frutas y verduras, donde muchas veces teníamos en grandes cantidades pero no sabíamos como consumirlas ni la forma divariarla.

En la gran vida diaria que tenemos nuestro proyecto como es Corazón Feliz se ha fortalecido mucho mas a un porque he asumido un reto como siendo la presidenta de nuestro comité de voluntarios en el canton. Yo personalmente me siento mucho mas capaz para ser voluntaria de salud y presidenta con los conocimietnos que he logrado del proyecto corazón feliz especialmente la abilidad a tomar la presión que no sabía antes del proyecto. El proyecto Corazon Feliz se ha unido mucha mas comunidades al nuestro comite porque lo vieron como un valor. Absoluto dentro de nuestras comunidades por las diversas actividades y éxitos el proyecto ha sido tan cojido en nuestras diferentes comunidades. Incluso atraves del proyecto y ferrias de salud que hemos hecho parte de corazón feliz, se hizo nuestra comité y voluntaros mas conocidos y respetados en el canton.

Ahora no tenemos el tiempo suffieciente para dedicarse a todas las comunidades que desean el proyecto. Estamos dedicando el proyecto a las comunidades mas vulerables, y de allí comenzaremos poco a poco por todas.

Como parte de ser voluntaria y una de las fundadoras del proyecto corazón feliz, yo personalmente me siento capaz y orgullosa de seguir adelante con este proyecto. Esto me deja una gran reseña historia en mi vida. El projecto que elaboramos con Kristen fue algo muy especial y exitoso para todos los que participaron y contiunan a participar.

Personally, I benefited a lot from this project, primarily acquiring knowledge that many times we don't even think about because in reality there has not been an indicated person to let us know these great benefits. More than anything, we have felt the reality that we have, as people, one of the best projects because we have acquired so much experience. We have experienced, for example, how to prevent many different diseases without having to be with a doctor, surgeon, or expert. From these workshops, given by the indicated person, Kristen Mallory, we have learned so many things.

Particularly in my family, my home, I have been able to use the information. In my family I practiced how to prepare healthier foods. Most importantly, I now consume and prepare foods with less salt and fat. Also we eat more fruits and vegetables. Many times we have these foods in grand quantities, but we don't know how to eat them and how to vary them. I have been trying to teach my family by example in our meals every day.

In the grand daily life, our project has become fortified much more. For example, since the start of the project Corazon Feliz, I have assumed the role of president in our county's volunteer committee. (This committee has almost 15 years of service). I personally feel more capable to be a health volunteer and president of the committee with the knowledge I have gained from participating in the project Corazon Feliz, especially to be able to take blood pressure, which I didn't know how to do before the project. The project has brought many new communities to join our volunteer committee because they have valued the project, and it was an incentive to unite with all of us. Because of the novel activities and successes in the communities it has attracted a lot of interest. Also, through the health fairs that we administered every month as part of project Corazon Feliz, our volunteer committee is much better known and respected by the county.

Now we hardly have sufficient time to dedicate to all the communities that wish to participate in the project. For that reason we are dedicating the project to the communities that are most vulnerable, and from there we will continue little by little to include all the communities in the county.

As a health promoter and one of the founders of project Corazon Feliz, I personally feel very capable and proud to continue on. This has been a grand history in my life. This project that we elaborated on with Kristen is something very special and successful for all those who participated and continue to participate.

About the Author

Kristen Mallory

Serving as a Peace Corps Volunteer in Ecuador, Kristen Mallory worked primarily on health and nutrition projects.

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