New Intake Workshop 2011

Over 40 promoters arrived bright and early on day 1 of the training, several more than the
TFH volunteers had anticipated. This was both heartening and a tidbit overwhelming. After
some scrambling to find enough binders and materials, the group embarked on the 10 day
course, starting with introductions and ice-breaker activities. The group was a big mix of ages,
from adults with children, to the youngest members in their early teens. Later in the morning,
promoters received their copies of Donde No Hay Doctor, and worked in small groups with
facilitators to get familiar with using this fabulous resource. It was apparent that there was a
wide range of literacy levels, with some catching on quickly as to how to locate information,
others struggling. Facilitators emphasized that throughout the capacitación, or training,
participants with less experience using books and writing could pair up with someone with
more experience. With such a large group, it was essential to break into groups for activities in
order to encourage everyone to participate.

Each day of the NI workshop brought a new surprise to the TFH crew (not uncommon
here in Nicaragua, as the team learned). Challenges included: arriving in town to find the
planned workshop location unavailable; the whole town without power, making copies of
handouts not possible. But it was valuable lesson in rolling with the punches, improvising, and throwing in games to keep everyone laughing in the meantime. We managed to pack A LOT into the
curriculum, and the NI crew was pretty exhausted at the end of each day.

Over the two weeks of training, promoters covered health topics in a framework that
examined issues at individual, community, and system levels. For example, participants
brainstormed barriers to stopping disease transmission, from individual habits to lack to
infrastructure such as trash collection. As a group we discussed reasons why people don’t wash
their hands: no access to soap and water, no concept of the need to clean hands,
inconvenience. Spreading glitter among their hands to represent germs, and singing a song
about hand-washing, the group practiced effective hand hygiene, scrubbing down with buckets
of water and soap in the courtyard. For the topic of diarrhea and dehydration, facilitators acted
out a skit to show symptoms of dehydration in a baby. Promoters looked up the topic in their
books, and topped off the lesson by making their own bottle of suero, oral rehydration solution,
out of salt, sugar, and banana for potassium. Hands-on activities like this are always popular.
We had several guest presenters as well. Everyone loved the impassioned sociodrama
on community organizing, full of Nica slang and funny antics. In light of the strong tradition of
herbal medicine in Nicaragua and especially in the campo, a presenter led a session on
medicinal plants. Then, another one of our TFH volunteers gave a presentation on diabetes,
going over the basics of the condition, which was new information for the majority of the
group. Two days were dedicated to First Aid, taught by the San Ramon firefighters.

Participants also explored the role of the promotora, a community health worker who
evaluates the needs of their community, shares information, provides basic treatment, and
works with the community to make healthy changes. After reviewing the obligations and
expectations of the promoter and TFH, each participant signed a memorandum of agreement
acknowledging their scope of practice. Promoters also practiced adapting their style of
communication to fit different individuals in the community, using techniques of therapeutic
communication, e.g. using open-ended vs. closed questions, validating feelings, sharing
observations of the other person. Finally, we spent ample time refining presentation skills to
encourage promoters to become comfortable giving charlas to groups. After drills on speaking
in a loud voice, using helpful body language and position, and making illustrated health
messages, the week culminated with each community group presenting a charla in either a
sociodrama, song, game, or poster presentation. Some groups were very creative, especially
hilarious was the drama of an elderly couple on health of ancianos. The final day was full of
team-building games with the promoters from last year’s group and a certificate ceremony.
But the highlight may have been the piñata that sent the group into squeals of delight and a
frenzy of scrambling on the floor for candy—who knew that would be such a hit?