As Community Health Workers, Women Find a Path to Empowerment

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More than 90% of community health workers in Peru are women. Delia Lunasco is among them.

Posted on Aug 4, 2023

In Peru, women make up more than 90% of community health workers with Socios En Salud, as Partners In Health is known locally. (Photo by Diego Diaz / Partners In Health)

In March, a woman was killed every three days in Peru. Since January, the country has seen at least 51 cases of femicide.

Gender-based violence is just one of the daily realities that women and girls face in Peru. They must also make their way, personally and professionally, in a society that is still sexist and patriarchal in many respects. More than 50% of Peruvians believe that women should put their role as mothers and wives first, ahead of their own dreams, according to Peru’s National Institute of Statistics and Informatics.

And then, for women who live in impoverished areas, there are challenges such as a lack of clean drinking water, a lack of sewage services, and overcrowding. In Lima alone, according to the National Superintendence of Sanitation Services, more than 635,000 people do not have access to clean drinking water, which can cause health issues such as parasitosis and chronic diarrhea.

Delia Lunasco has seen these problems first-hand.

In her role as a community health worker with Socios En Salud, as Partners In Health is known in Peru, she is not only dedicated to promoting health care and accompanying patients in their recovery—she has also become an advocate for women’s empowerment in her community.

A commitment to community

Socios En Salud has worked in Peru for more than 25 years, providing medical care and social support to thousands of patients in Lima and beyond. To provide this care, Socios En Salud enlists the help of 90 community health workers—local residents trained to provide basic health services in their communities, such as delivering medications and checking on patients at home.

Over 90% of these community health workers are women.

Lunasco, 54, has been a community health worker with Socios En Salud for more than a decade. But her commitment to the health of her community, El Progreso of Carabayllo district, began more than 20 years ago.

In Lima, the vast majority of settlements are on the slopes of hills on the outskirts of the city, where more than half of residents do not have title deeds or access to basic utilities, such as electricity, drinking water, or sewage, according to the NGO Techo Peru. Thousands of people live in the settlements, many of them migrants and refugees, and make a living by working informal jobs such as street vending.

It was in El Progreso that Lunasco became a leader of the neighbourhood committee, and her passion for community health was born.

“In the hills, there is always filth and diseases that especially affect the children,” she says.

Lunasco would have liked to become a nurse. But as a mother of six children, with limited financial resources, she was forced to set that dream aside.

It’s a reality all too common for women in El Progreso.

A survey by the Institute of Peruvian Studies estimates that, in 82% of Peruvian households, women do most of the housework, spending twice as many hours per week as men on tasks such as cooking, washing, or cleaning. The burden of unpaid domestic labour often means that women have less time and energy for education, work, or other pursuits.

Still, Lunasco was determined to find a way to strengthen her community and address the health issues she saw day-to-day.

In 2013, she learned about a new opportunity: community health worker with Socios En Salud. Not having higher education was not an obstacle—all residents were welcome to apply. Through a one-week orientation and recurring training, she could learn how to provide basic health care and prevention and eventually be dispatched to homes and clinics to care for patients.

Lunasco was thrilled at the news. Her husband was not.

After joining Socios En Salud, she started leaving her home in the mornings and afternoons to attend trainings and visit patients. One day, her husband, a bus driver, suggested that she should work for him instead as an assistant.

To this day, Lunasco remembers her answer vividly: “And me, what am I going to do sitting around? I’m not going to produce anything. Instead, by leaving [home] I’m helping [other people], because there are patients who can’t get up and we have to go find them.”

It took time, but her husband eventually began to support her. In a few weeks, her training was complete, marking the start of a decade-long career.

Facing challenges

Over the years, Lunasco has cared for dozens of patients, helping them access testing, treatment, and care for tuberculosis and other health conditions. She has accompanied them to appointments, visited them at home, and helped them navigate the local health system. She has also delivered a crucial message to the women in her community.

“I tell all of them that we are unique, that they should go forward and not be stuck at home,” she says. “We are women leaders—empowered.”

In June, Lunasco was recognized by Socios En Salud during its annual Community Health Worker Day, for her tireless work in the tuberculosis program and her years of service to the community.

For her, this recognition is a reflection of her commitment to the health of the most vulnerable people, as well as the value of community health workers—a role that is often overlooked, misunderstood, or unknown to people, even within health care.

Throughout her career, Lunasco has witnessed how some health centers downplay the importance of community health workers, even though they often have the strongest bonds and most frequent contact with patients. She also believes that machismo is still a problem in the health sector, making women’s empowerment and education ever more crucial.

Along the way, Lunasco has helped dozens of young women find work in health care, from becoming health promoters at the health center in El Progreso to community health workers with Socios En Salud.

“We want to rise and move forward,” she says.

Originally published on pih.org

Community health workers are the eyes, ears, and capable hands of Partners In Health everywhere we go. Their workaday heroics are what join the great promises of networked global health to the great power of individual compassion—in practice and in philosophy alike—one patient at a time.

Every person, no matter who they are or where they’re from, deserves the best health care we know how to offer.

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