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Community-based rehabilitation in coastal Oaxaca, Mexico: Projecto Piña Palmera

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Community-based rehabilitation in coastal Oaxaca, Mexico: Projecto Piña Palmera

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COMMUNITY-BASED REHABILITATION IN COASTAL OAXACA, MEXICO:
PROJECTO PINA PALMERA
By
David Kendall Grant
A Dissertation Presented to the
FACULTY OF THE SCHOOL OF EDUCATION
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
Doctor of Philosophy
December 1999
© David Kendall Grant
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Abstract
COMMUNITY-BASED REHABILITATION IN
COASTAL OAXACA, MEXICO: PROJECTO
PINA PALMERA
By David Kendall Grant, M.S.Ed.
Chairperson of the Supervisory Committee:
Professor Dr. Nelly Stromquist
Department of Education Policy and Administration
This is a case study of the Pina Palmera community based rehabilitation project in
southern Mexico. The project site and the villages that it serves are located on the Pacific coast
of the State of Oaxaca. Examined is how a non-governmental project delivers education and
services to the disabled and disadvantaged indigenous and mixed race peoples of the area.
The history of Pina Palmera is related from its beginnings as an informal effort to help
disabled and poor people on the part of a few expatriates living in the community of Zipolite
thirty years ago to its current status as a registered not-for-profit volunteer based development
organization. The views of participants, including patients, workers and volunteers are
described.
This study was conducted from June 1997 through January 1998. It is located in the
village of Zipolite on the southern coast of Oaxaca, Mexico. Interviews were conducted in
Spanish and English with 45 of the 60 participants who live and/or work on the site. They
included foreign volunteers, administrative staff, promoters, service recipients, children, adults,
and family members. Transcripts of interview were sent back to the subjects so that they could
make corrections, additions, and amplifications. In addition, Internet resources, published on-
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line and printed newsletters, e-mails, publicity materials, annual budgets, yearly reports,
videotapes and testimonies were used. Through the Internet and e-mail, the researcher had
been able to obtain current information about Pina through the summer of 1999. The
researcher also kept a daily journal of observations.
It was discovered that those whom it serves in a bottom up manner, not always from
the outside and by foreign experts, could successfully run a community-based program o f
education and health. Patients had been trained to work as health promoters. The self-image of
those afflicted with disabilities was transformed from fatalism to confidence. In the aftermath
of a major hurricane, the lesson learned and status gained by the programs made Pina Palmera
a relief center for the entire community.
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Table of Contents
Abstract ..................................................................................................................ii
Glossary ...............................................................................................................viii
Chapter I ................................................................................................................ 10
1.1. Introduction....................................................................................................... 10
1.2. The Study...........................................................................................................11
1.3. Significance of the Study.................................................................................12
1.4. Research Questions and Issues........................................................................14
Chapter II ................................................................................................................ 16
2. Review of Literature:........................................................................................16
2.1. Community-Based Rehabilitation.. ................................................................ 16
2.2. Effectiveness of Programs............................................................................... 27
2.3. Obstacles to the Effectiveness of Programs................................................... 30
2.4. Integrating the Disabled...................................................................................31
2.5. Child-to-Child Trust..........................................................................................35
2.6. How Children are Served in Mexico.............................................................. 40
2.6.1. Formal Programs..............................................................................................40
2.6.2. Nonformal Programs........................................................................................ 42
2.7. Indigenous World View and Social Structure................................................. 52
Chapter III ................................................................................................................61
3.1. Research Design and Methodology................................................................61
3.2. Limitations and Delimitations.........................................................................69
3.3. Biases ............................................................................................................... 70
Chapter IV ................................................................................................................ 72
4. Findings.............................................................................................................72
4.1. Introduction....................................................................................................... 72
4.2. Getting there from here....................................................................................73
4.3. The Project........................................................................................................ 80
4.4. Who Is Served by Pina..................................................................................... 88
4.5. Objectives......................................................................................................... 95
4.5.1 Objectives as Portrayed by the Administration..............................................95
4.5.2. Objectives as viewed by Patients and Workers............................................105
4.6. The Juntas........................................................................................................108
4.6.1. Positive Reactions to the Juntas.....................................................................I l l
4.6.2. Negative Reactions to the Juntas.................................................................. 120
4.7. Alternative power structure........................................................................... 127
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4.8. Recruitment......................................................................................................129
4.6.1. Rectruitment of Patients and Workers........................................................... 129
4.8.2. Recruitment of Volunteers............................................................................. 140
4.9. Adminstrative Structure..................................................................................146
4.9.1 Paid Employees...............................................................................................148
4.9.2. Volunteers........................................................................................................ 150
4.10. Financial Support.............................................................................................155
4.11. Educational Knowledge..................................................................................161
4.12. Physical recovery.............................................................................................171
4.14. Emotional Growth.......................................................................................... 175
4.15. Perceptions of Participants regarding Pina Palmera.....................................177
4.15.1. Mexicans.......................................................................................................... 178
4.15.2. Foreign and Mexican Volunteers................................................................... 181
4.16. Outcomes/Benefits...........................................................................................183
4.16.1. Growth and benefits to participants and the community.............................. 183
4.16.2. Physical Change...............................................................................................202
4.16.3. What Volunteers learn.....................................................................................207
4.17. Community Reactions.....................................................................................208
4.17.1. Positive Community Reactions...................................................................... 208
4.17.2. Negative Community Reactions....................................................................211
4.18. Perspectives OfParticipants Towards each other........................................217
4.18.1. How Foreigners are Viewed...........................................................................217
4.18.2. How Indigenous and Mexicans Are Viewed................................................220
4.20. Community Based Rehabilitation..................................................................223
4.20.1. Successes of CBR........................................................................................... 224
4.20.2. Criticisms of CBR........................................................................... 231
4.21. Conclusion.......................................................................................................247
4.21.1 Financial Support.............................................................................................247
4.21.2. Education Knowledge.....................................................................................252
4.21.3. Physical Recovery and Emotional Growth........................................... 252
4.22. Context of the findings....................................................................................259
4.23. Validity Issues................................................................................................. 267
4.24. Implications for Future Work........................................................................ 269
4.25. Recommendations for Future Research.........................................................270
Chapter V ............................................................................................................. 273
5.1 Review of the results.......................................................................................273
Index 289
Appendix ..............................................................................................................293
Maps 293
Mexico ..............................................................................................................293
Zipolite ..............................................................................................................294
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Map o f Pina Palmera................................................................................................... 295
Research Time Line............................................................................................ 296
Languages o f Intercommunication in Mexico...........................................................297
Pina Palmera Participant Listing................................................................................ 298
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Acknowledgments
Bismillah. I want to thank Dr. Nelly Stromquist, my advisor for her tireless efforts in
critique, editing and coaching, throughout the entire process from conception, fieldwork and
the final product.
Thanks to my parents, my wife Sharon, and Auden for encouragement and support.
Thanks to Anna Johansson de Cano and family, Jim Claus and Family, The People of Pina
Palmera. General Motors for building the Nova that got me there and back despite its full
immersion by Hurricane Paulina. My transcribers; Maquela Brizuela, Susan Welch, Beth Ann
Stair, Oralia Salazar. Also the Schoenhals Family, Food for the Hungry International, Summer
Institute of Linguistics, who helped me with materials, contacts and support during the
preparation of the manuscript
Thanks to my professors at the Rossier School of Education who gave great assistance
not only during the research process but also throughout my time at school. The members of
my Defense Committee: Dr. Nelly Stromquist, (Chair) Dr William Rideout, Dr.Alexander
Moore. Additional thanks to Dr. David Eskey, Dr. William Lee, Dr. William Maxwell, Dr. Judy
Grayson, Dr. Ed Williams, and the staff, Cassandra, Mary, Yvonne and anyone I may have
forgotten
Thanks to the Los Angeles County Office of Education and the students, teachers and
families at the special education program at the Lincoln School in San Gabriel, California.
Thanks to Ruth and Juana Malatesta for introducing me to alternative ways of health and
consciousness so long ago. Thanks to the United States Peace Corps and the Peace Corps
Fellowship Program that allowed me to take the experience back home.
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Glossary
Aire or Aigre: The traditional explanation for illnesses and the condition of the
world. The air itself is alive with spirits and their intentions and relations to people.
Ajoya: A mountain village in the northern Mexican State of Sinaloa and home of the
Projimo Project.
Ayurveda: Indian medical tradition dating from 3,000 BCE. It teaches that health is
related to maintaining ones balance in the cosmos. Somewhat analogous to aire but
more neutral. Meditation, proper use of herbs, diet and activity can bring balance.
Cargos: Roles or obligations to society assigned to men by the Mayordomias.
Chatino: A major indigenous community in the area near Pina Palmera
Child-T o-Child: A teaching concept that entails having children teach other
children, the underlying belief is anchored in the efficacy of peer tutoring.
Cocina: Kitchen.
Comedor: The eating area at Pina Palmera.
Community Based Rehabilitation: Education, health, and rehabilitation services
that are designed, accountable to and administered within a local community. CBR in
English and RBC in Spanish.
Curanderas: Traditional indiginous healers.
Junta: a meeting for airing opinions, making administrative decisions, and gathering
and sharing of information. Each of the programs at Pina is administered by its own
junta and the project has a general junta or mass meeting every Tuesday morning.
Ladino: White Mexicans
Llaga: ulcer or open sore.
Mayordomias: The traditional administrative structure to allocate roles and social
obligations among members of a traditional Mexican indigenous village.
Mazunte: A village three kilometers north of Zipolite
Mestizo: Mexican of mixed race heritage.
Oaxaca: A State in Southern Mexico that stretches from the Gulf of Mexico to the
Pacific coast. Oaxaca is also the name of the capital city of the state.
Orthopedagogy: Adapted teaching techniques designed around the learning abilities
of the student. Primarily aimed at the disabled and displaced student.
Palapa: A thatched covered open walled building
Pochutla: A town of approximately 20,000 on the main highway from Oaxaca to the
coast
Proyecto Projimo: The CBR project in Ajoya, Sinaloa, influenced by David Werner
and the inspiration for several books in the development area.
Puerto Angel: Town two kilometers south of Zipolite. The end of the road from
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Oaxaca to the ocean.
Salvavidas: Lifeguards; Salvavida Jr. is the name of the program to train young
people in ocean rescue techniques.
Susto: A sudden fright that may cause the loss of the soul or other illness (Kearney)
The West: In reference to the countries of Europe
Zapotec: The most populous indigenous community of the area around Pina
Palmera and in State of Oaxaca.
Zipolite: A village on the coast of Oaxaca.
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Chapter I
1.1. Introduction
Ten percent of the world’s school age children live with severe disabilities.
O f these, approximately 95 percent suffer multiple handicaps that include a combination of
sensory, mobility, and seizure disorders (UNICEF, UNESCO (1995)). These problems
often keep them confined to their homes and unable to attend school or participate in
society. They are not seen and therefore not counted. There are an additional ten percent of
school age children who have significant learning and behavioral problems that make it
difficult for them to be taught by conventional teaching methods in traditional classrooms
(Hesperian Foundation, 1990). Therefore, one fifth of all children require adapted teaching
techniques and environments that most countries are not able or willing to provide
(Hegarty, 1990).
The priorities of developing countries emphasize professional and
technological training at the university level. International development agencies target
primary education and literacy. The special needs of disabled and at-risk children are at the
bottom of that list of priorities (Werner, 1993). The literature review examines three aspects
of the Orthopedagogy issue and its effectiveness in Mexico, and the implications for other
developing countries. First, this review will look at the concept of community-based
projects. Secondly, we will examine the effectiveness of programs.
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Third, we will examine different ways of promoting positive interaction and
acceptance of disabled students by other children. Finally, the review will survey how
disabled children currently receive education and services both in the formal and nonformal
settings in Mexico. The dissertation research will investigate how a nonformal education
system within a community-based rehabilitation project meets the needs of communities
that are not addressed by formal governmental education in Oaxaca, Mexico.
1.2. The Study
This study examines the Pina Palmera Community Based Rehabilitation Program in
the village of Zipolite, Oaxaca, Mexico. It examines the effect it had on the lives of the
indigenous and Mexican people who have received care, training, and employment at this
project. What began nearly 30 years ago as the work of an itinerant healer wandering the
beaches of the then undeveloped coast of Oaxaca has grown into a multi-faceted program.
It has served hundreds of people both in Zipolite and in the Indian villages in the coastal
mountains hours away. From its earliest goal of bringing healing to poor people who could
not afford to access mainstream medicine, the program has expanded to include vocational
projects in carpentry, gardening, and physical and occupational therapy.
A qualitative approach was used to study this program. Data were gathered through
interviews with participants, from stories written in newsletters, journal entries, drawing,
photographs, financial reports and other artifacts that showed its growth and change over
time. This material demonstrates the changes in the lives of the participants. It also shows
what they felt about those changes. It describes how they viewed the changes in
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themselves and in others. The way each person evaluated the program depended largely on
his or her personal values shaped by their individual backgrounds and life experiences. Most
attention will be given to those who received care through Pina Palmera. However, because
CBR programs are so dependent on outside volunteers and agencies for their operations,
the viewpoints of these participants have also been included in this study.
1.3. Significance of the Study
The study of a community-based development program that concentrates on the
needs of the disabled in developing countries is important because there is little research
today available to development policy makers. In poor countries there is a higher
percentage of the general population suffering from disabilities and being at-risk. The need
for economically sound independent alternatives to government education, heath and
service programs are of great interest today. Many countries struggle with enforcing policies
of guaranteeing education for all children regardless of circumstance or physical ability.
Because disabled children make up such a large percentage of these student populations and
because American-style special education is so expensive, alternative methods must be
explored.
A nonformal program such as Pina Palmera provides an example of how a
community can endeavor to implement its own solutions. The hope is to succeed with
minimal assistance from the national government through the efforts of its own citizens
and through the assistance of volunteer agencies. This approach can serve as a viable model
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for other developing countries that are seeking a community-based solution to help solve
similar education challenges.
There are well-funded cross-cultural sensitivity programs in North American
schools designed to teach children to learn to work together and to accept each other’s
differences. There is still a need to include the disabled child in this multi-cultural approach
to include the disabled child. Many programs in the West are run on an ad hoc basis,
created by and promoted by individuals, such as parents, teachers, and politicians often
without looking at existing programs elsewhere for ideas that work. As a result there is little
uniformity in programming and techniques from state to state, city to city.
The creation and operation of a decentralized community-based program that
provides education and health services for children is an important social contribution and
service. Where people are the main resource and capital, and equipment, and formal
training are limited, successful programs should be studied to see what aspects could
potentially be adapted for use in similar programs around the world. Since the fieldwork
was completed, there have been hurricanes, civil wars, and ethnic cleansing worldwide that
have caused millions to become displaced from their homes. Perhaps the experiences
gained in community-based rehabilitation can be applied to the circumstances in Honduras,
Goma, Freetown, Kosovo, Turkey, East Timor and the next new name to learn.
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1.4. Research Questions and Issues
The study looks at how the lives of people who received care at Pina Palmera and
the way others were affected by their participation. Care recipients, promoters,
administrators, and foreign volunteers and workers were interviewed. They were asked
similar series of questions with variations on follow-up questions depending on their area of
participation.
Questions that guided the beginning of the research process include the following;
• Why did people enter the Pina Palmera program?
• How has the program changed over the years?
• What resources, examples of other successful CBR programs and models to
learn from did they have access to? What is the influence of outside agencies, and
individuals from foreign countries? What are the influence of local people and their beliefs,
culture and practices?
• How does the participation of members of the community shape the project
and its directions? How are they involved? How has their participation changed their
behavior? Has participation changed their expectations?
• What is the process for recognizing and addressing the needs of the
community?
• How do tire participants rate the effectiveness of Pina Palmera and its programs
and services?
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• How does the program integrate, challenge or otherwise consider the traditional
worldview of the indigenous participants?
These questions are answered through interviews, journals (daily records of
observations and impressions), and by access to documents, newsletters, budget, annual
reports, publicity materials, and other documentary sources. The researcher participated as a
volunteer in special education, lifeguard training, computer work, and communications.
This provided an opportunity to view die project from several different areas during the
eight months of fieldwork. Information about more recent developments at Pina was
obtained through correspondence with the participants at the project since the completion
of the fieldwork in 1998.
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Chapter II
2. Review of Literature:
2.1. C o m m u n i t y -B a s e d R e h a b i l i t a t i o n
Community-based rehabilitation follows the concept o f community-based projects
as run in various countries for many different purposes. According to O ’ Toole (1991),
CBR is designed to provide disabled individuals in a community with health, social, and
educational services that are operated in the home and at the family level, not through
institutions. This is particularly important in isolated rural areas. It is important to recruit
volunteers from among those who live in the community and train them in the skills of
health screening, therapy, and related sendees.
In the early 1970s, Helen Keller International first introduced the concept of CBR
to work with blind individuals in their home communities in India. This saved money; it
was no longer necessary for personnel to travel to the rural areas to work with the blind.
The idea of using local people to replicate services previously provided by highly trained
and costly professionals has been promoted ever since. This has occurred in the United
States and m other parts of the world (Zambone 1996).
The essential components of CBR programs include the following;
Services delivered in response to locally defined needs,
demystification of education and rehabilitation, responsibility
returned to tire family and community7 , acceptance of the concept
of simplified intervention, a structure built on existing resources,
local management through a community structure, partnership
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with family and community members, community involvement
and home involvement, incorporation into existing
infrastructures, integration of didactic and practical training, use
of functional and individualized curricula, establishment of links
to institutional-based services at the regional level for referral,
consultation, and training (Zambone 1996).
The similarities between CBR and the literacy brigades of Cuba and Nicaragua, and
the Head Start and Peace Corps programs of the United States can be seen on the
implementation level. What makes CBR different is that the promoters, instead of being
young college trained people from urban centers, are recruited from within the community
itself. The hope is that when the local population has a stake in these services and is
responsible for its success, it will make a greater effort to make the program succeed.
The problem with big name programs is that many operate without the direct
participation and ownership by the local population. Outsiders identify the goals, methods,
and implementation. An additional problem is that of continuity. Peace Corps volunteers,
development brigade workers, and others are only in the project for a short-term period,
perhaps two years at the most. There is no time to develop the relationships required to
build successful projects.
Some programs have from die start made efforts to solve this problem and to
secure participation from the targeted population from the start. The Bangladesh Rural
Advancement Committee (BRAC) begun by F.H. Abed in 1972 was an effort to utilize the
theories of Paulo Freire in creating a home grown NGO that would bring those they
wanted to serve into the program at the crucial aspects of needs assessment and
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implementation. In the more than 25 years of its existence it has institutionalized this
philosophy by the following principles:
• No matter how illiterate or poor a person is, he or she, if given
the opportunity, can rise to the occasion and deal with
problems.
• A development organization should never become a patron.
• Conscientization is necessary to empowerment; self-reliance is
essential.
• Participation and people-centeredness are essential.
• Sustainability is essential
• There is no one “fix-all” approach.
• Going to scale is essential.
• A market perspective and entrepreneurial spirit are useful.
• The importance of women in development is primary.
This summary of BRAC is from the book by Catherine H. Lovell, “Breaking the
Cycle of Poverty: The BRAC Strategy”, 1992.
The changes in local culture that community development brings, particularly in
expanding the role of women and changing the expectations of the poor do not come
without cost. In Bangladesh, in the aftermath of the election of 1991, NGOs were targeted
by reactionary politics. BRAC schools were destroyed, Muslim conservatives declared
“fatwas”, religiously sanctioned attacks against women who stepped outside of the
traditional roles and engaged in social development and activism. Demands were made that
foreign NGOs limit their activities. There was great resentment against NGO employees
because of the perceived class differences - their use of “Pagers,” (four-wheel drives) and
laptop computers. It was a case of “haves vs. the have-nots”. (Holloway, “Supporting
Citizens Initiatives, Bangladesh’s NGOs and Society, 1998)
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For projects to become sustainable in the country and not to simply be propped up
by foreign donations and personnel, there are number of factors to consider: The times,
politics and imbedded traditional culture all have to be considered when contemplating the
implementation of a program. In the countries where development projects have occurred
there has been a continual need to win over those in power who may feel threatened by the
change, even if it is presented as a potentially beneficial change. The US certainly
experienced this during the early 1960s when the Northern volunteers came to the South to
register voters, and some were killed, and most were resented for their desire to bring
change. According to Wunsch and Olowu in “The Failure of the Centralized African State”
(1990), several points must be pursued to achieve the goals of sustainability. These include:
(1.) decentralization of real responsibility and authority to
choose and provide social sendees and development projects to
local governments;
(2.) substantial shrinkage of the role of the central state in
the economy;
(3.) opening government to greater public participation.
However, not necessarily emulating the competitive and
adversarial political parties of the West;
(4.) legalizing and protecting extra-state voluntary groups
organized for social, communal, community, occupational,
professional, religious, labor, etc., purposes and encouraging their
activity in social economic and political affairs; and
(5.) restricting the role and power of public office holders
to those tasks necessary to manage the state, rather than allowing
them the ability to redefine the rules of the state to facilitate their
interests.
There are published manuals that describe the long-running CBR programs for
organizations that are interested in operating similar programs. David Baine (Guide to the
Development and Evaluation of Community Based Instruction, 1991), has written a guide
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to CBR that provides a basic checklist of talking points and directives for a program. It
covers the teaching environment, administrative issues, and problems of transportation. It
covers individual education plans that are standard items for the US schools of
orthopedagogy and it also covers basic psychological issues involved in education.
Brian O ’ Toole who works in Guyana has published materials on CBR in journals
and through UNESCO, (1988) A Community Based Rehabilitation Programme for Pre-
School Disabled Children in Guyana; (1990) Step by Step: A Community Based
Rehabilitation Project, UNICEF; (1991) A Guide to Community Based Rehabilitation
Services, Guides for Special Education No. 8 UNESCO; and with Roy McConkey (1995),
Development of Training Materials for Community Based Rehabilitation Workers in
Guyana., International Journal of Disability. Development and Education), these materials
were those that were used in Pma. Pina Palmera regularly received the newsletter from the
Guyana project, though there was initial skepticism about how well it would work in
Oaxaca. The project in Guyana has published articles, newsletters and a handbook on CBR
that is distributed by the World Health Organization. Interesting issues are raised such the
stress experienced by promoters of fostering realistic and limited expectations for therapy
and rehabilitation. One problem that faces parents of disabled children everywhere when
first entering a program is unreachable hopes of cures. When results are not timely or
visible to them, they may drop out of participation.
In India, an experimental study by P. Hanumantha Rao and associates (1993)
Community Based Rehabilitation Services for People with Disabilities: An Experimental
Study. International Journal of Rehabilitation Research was conducted to identify
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resources among the population for operating the CBR screening process. They wanted to
see if CBR promoters could be used in identifying potential care recipients and to see if the
local resources could be trained to manage long-term social services for die disabled in rural
areas.
The process of identifying participants sounds straightforward enough, going door
to door to conduct a survey to search for the disabled. This could only be conducted in
places where such confrontations are acceptable. The volunteer promoters were given a
two-day course in screening for disabilities, both physical and mental. After they had
conducted their sweep of the area, a population of 4,000 individuals, a group of
professionals repeated the survey over the same area to check the results of the volunteers.
They found that there was a 37% error rate. The volunteers had identified 40 people as
disabled but had falsely identified 15 cases as disabled and missed another five. This error
rate could be due to a number of factors. It suggests that volunteers could be used
conducting similar surveys.
The importance of participation by program beneficiaries is demonstrated in
“Institutional Incentives and Sustainable Development: Infrastructure Policies in
Perspective” by Ostrom, Schroeder and Wynne (1993). In the Philippines for the Bicol
River Program from 1973 through 1982 USAID had spent $30.4 million. And the
Philippine Government had spent over $75 million in an effort to improve the rural
infrastructure. These efforts included improvements in roads, irrigation and water systems.
They had a centrally located staff of over four hundred whose responsibilities revolved
around creating plans and studies for the region. They were expected to travel out into the
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basin and check on the irrigation systems. They apparently did not confer with the farmers
for whom the system was introduced.
The Bicol River Basin Development Program in the Philippines suffered from a
major weakness. It failed to include the farmers for whom this 75 million-dollar program
was designed. After the engineers from the city and USAID left the completed project,
maintenance problems inhibited the project from having any consistent benefit to the
farmers. The National Irrigation Agency (NIA) recognized that after an independent
evaluation that farmers were not participating in the planning, maintenance and decision
making processes, they hired community organizers to facilitate the participation of
farmers. They expected the engineers and government officials to arrive, evaluate, and take
care of repairs. It was not until the appointment of community organizers from among the
farmers did participation and interest in the project increase. However, this gain was
reversed when the central government in budget cuts discontinued the participation of
these community organizers. Other programs of the NIA were successful precisely because
in experiments with smaller budgets, they included farmers from the outset. One of these
was the Buhi-Lala Project as included in the book by Ostrom, the Bicol River Basin
Development was supposed to “establish as set of institutional innovations calling for
decentralized decision making, local people’s participation, and a multisectoral and
integrated area approach.” Without ensuring the participation at the local level, these types
of programs could not succeed
Critical to community-based development is the participation of those who are
stakeholders. Without the direct input of those who will receive benefits, the program will
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fail. They must be an integral part of the needs assessment, the implementation and
evaluation stages. Experts from the outside must act as advisors and resources only, careful
not to disempower those they are intending to assist. This philosophy is a main part of the
Projimo concept.
Project Projimo has as its central focus the separation of experts from the outside
and those who provide services at the local level. Professionals such as doctors and
therapists are not allowed to see a patient one on one but must instead consult with local
para-medical people from the community. Experts disempower the local caregivers and
decision-makers, just as the central government can do to the local officials.
BRAG limits its trainings to fifteen days. Afterwards there are follow-up visits to
help new teachers. A simplified curriculum covers topics. This allows the teachers to
continue with the obligations of their daily life without the sacrifice and time-commitment
that many college programs require.
Carol Davis is director of missions projects of the Church on Brady in East Los
Angeles, a multilingual, multiethnic small community church. She believes that the key to
successful, sustainable, and replicable projects is to provide training that people can
immediately implement by themselves and provide to others. The trainers stay only “a week
ahead” of the trainees. She says it is very important to let local teachers and development
animateurs feel that they can do the work themselves and that outsiders do not have skills
and experiences they themselves can’t achieve. (Interview with researcher, March 1997)
Such a rapid deployment of promoters may not work in the medical field.
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Rehabilitation therapy has a high academic component. Students must have an
understanding of anatomy, medical knowledge and training in proper technique. It is a
challenge to design a learning strategy. It is important not to overwhelm the promoter
trainees with more than they can absorb at one time. Because there is a high rate of illiteracy
among those who would like to become promoters and the families would be caring for a
disabled person, books and documents from developed countries are not considered
appropriate. The material must be taught in a way that will result in the highest rate of
retention and usability.
One problem with the concept of having promoters enter the field rapidly is that
they may be over-representing themselves as paraprofessionals when they may not have the
concepts and techniques fully mastered. Physical therapy and medical screening is
complicated and requires a complete understanding of a wide range of complex material.
This was a problem observed during the fieldwork. For example, the range-of-motion
exercises administered by promoters required regular observations and correction by
qualified therapists, because of poor practices. The promoters might have forgotten proper
techniques or developed poor habits over time without regular monitoring and supervision.
Sustainable rehabilitation until the last decade has meant either a continual infusion
of cash from the North or the creation of self-perpetuating programs that can generate
adequate revenues in order to survive. The other important aspect of administration is that
foreigners generally ran them. This can create resentment and can inhibit the ability of a
project to become indigenously run.
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Rehabilitation programs were begun in many countries during the last century by
mission organizations from England and the United States. The issue of funding then, as
now, made it important for these projects to be as self-sustaining as possible. Therefore,
certain projects and certain population were targeted. Most programs today, as then, were
aimed at the blind and deaf. These students could be trained to make salable crafts.
Although they represent a minority of the disabled population (approximately six percent),
they encompass the majority of long running and highly funded successful rehabilitation
projects (UNESCO Report on Special Education 1988). There is a lack of uniformity of
program types in most countries. O f all the countries examined in the UNESCO report
(Ross 1988), only Zambia has a balance of facilities and programs meeting the needs of
students in a number of disability categories, with the exception of a lack o f facilities for the
emotionally disturbed.
Some examples of odd distribution of programs include Uganda where there are
hospital schools, special day schools, and boarding schools - all for the emotionally
disturbed but no programs at all for any other disabilities. Ethiopia has extensive programs
for the blind and boarding schools for the deaf, but nothing for any other handicaps. The
other countries in the Ross/ UNESCO survey all show a focus on the blind and deaf over
other needy children. Foreign establishment of schools could explain this specialization.
Only Ghana and the Congo (until the fighting of 1998-1999) have a greater than
95% control of programs by the government. Whereas the Congo does have an even
distribution of schools aimed at the entire spectrum of special needs students, these are all
incorporated into health related institutes, not education. Ghana is one of the few
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countries that support mainstreaming for the blind and deaf. There are no special day
schools or integration for the physically handicapped or mentally and learning impaired.
Another implication of this is that sustainable replication of programs is difficult to
initiate by outside agencies without a long-term personal commitment. An organization
such as USAID cannot start a project in one place and then in another and call it
replication. Only the local people can birth a project and they must do it themselves using
their own initiative. There should be a distinction between simply repeating the elements of
a successful project and the birthing process of something new. This is important because
the birthing process requires an intimate connection between the mother and daughter
projects. This is an important distinction to make, and one that Projimo and its daughter
projects in Mexico and Middle America demonstrate successfully. People who received
training and experience in the original project created the new projects. The local people
know these people and recognize them as one of their own. On the other hand, foreign
development personnel will always be looked on as outsiders and their goals and techniques
as suspect. The key to sustainability and replication has to be the involvement of the local
community.
However, as shown by BRAG, Projimo, USAID sponsored projects, and most
community-based programs, the support roles of agencies and individuals outside the
immediate community have provided the necessary spark to ignite the projects. The
“experts” often provide the training and guidance through the stages towards sustainability.
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Few projects do not require some financial support by international agencies. This issue has
not been resolved in development.
The indication of successful promotion is not just the sustainability of the program
started by these agencies, but the birthing of new projects by the primary project. The Pina
Palmera project is an example of a project that was both nursed and supported financially
by outside agencies and volunteers, and inspired and trained by those who experienced the
Projimo Project.
2.2. E f f e c t i v e n e s s o f P r o g r a m s
On a small scale, these nonformal programs have been very effective. Programs
such as Projimo have been able to provide a wide range of sendees and training to parents
and children. However, the disabled population is so large that these programs cannot hope
to reach all the potential beneficiaries.
Another way of measuring the effectiveness of these programs is by their
sustainability and ability to propagate. Projimo started in the mid-sixties in a single village.
Its concepts and educational material have been adopted and distributed throughout the
world by major organizations such as Peace Corps and UNICEF. As pointed out in the
previous section, from one village the techniques and trainings developed by Projimo have
spread to six other Mexicans regions and Nicaragua, and the concept itself to UNICEF.
From an initial technique of training children to work with disabled children as a
single feature of an overall approach, it has blossomed into an independent,
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comprehensive curriculum with over 500 programs operating around the world (Child-to-
Child Trust, 1993). The Child-to-Child trust offers free copies of materials to any project
searching for new ideas. It could be said that these nonformal programs have been very
successful because they have exhibited the above attributes. Second, they are successful
because they are based on the belief that each program must freely adapt all material and
techniques. What does not work or is inappropriate to the local context is disregarded.
Mexico mandates that students with disabilities receive education (UNESCO 1995).
However, outside the capital and other major cities, insufficient service, and poor
infrastructure and training make it difficult for children to benefit. This scenario is repeated
in many other countries. Legislation without the ability to enforce it is no law at all. What
makes Mexico unique and particularly worth studying is its greater acceptance of its
disabled children.
Since a significant portion of the general population and culture of Mexico is
transnational, moving between political boundaries, discoveries about successful programs
in Mexico may have implications for the U.S., particularly in the Southwest, and Latin
America. The cultures have enough in common to assume that what has been working in
Mexico has a much better chance of working in Latin America or Los Angeles than a
program designed in Europe or the urban eastern U.S. that is imposed on Latin America.
Mexican families do not share the same perception of disabled children as displayed
in Africa or Asia. There is not the same sense of blame towards the parents for the state of
the child as in other cultures. Families, for the most part, rally around the mother rather
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than ostracize her. Studies by Barnartt and Kabzems (1992) and Obiakor (1985), illustrate
the contrast between Africa and Latin America. In these two separate studies, teachers said
they thought handicapped students should be included in class, but not theirs. The
resistance to their inclusion mainly revolved around fears of spreading diseases, disruption
in the classroom and the fear and distrust of handicaps from a cultural standpoint. In both
Zimbabwe and Nigeria, the teachers believed that the causes of handicaps were among the
following:
Nigeria: A curse from God, family sins, offenses against gods, witches or wizards,
adultery, misfortune, ancestors, misdeed of previous life, a warning from God, an evil spirit,
the killing certain forbidden animals (Obiakor 1985)
Zimbabwe: In addition to the above, cultural biases include: “N ot opening the ears” -
meaning that the mothers refraining from having sex within the first two weeks of birth leads
to the deafness of her child; the mother is guilty7 of some wrongdoing; the transference of
disability to a person or their children can occur if one laughs at a person who is disabled.
(Barnartt and Kabzems 1992)
Semi-autonomous, privately run programs by and for the disabled have been in
Mexico for over two decades whereas they have been little noted elsewhere. These
nonformal programs have replicated themselves in other areas of Mexico and Middle and
South America. A third world country leading the way in an area o f special concern for
education is unique and worthy of study.
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2.3. O b s t a c l e s t o t h e E f f e c t i v e n e s s o f P r o g r a m s
The problems confronting the community-based rehabilitation programs are two
fold. First is the increased workload on the primary caregiver of the family as a whole, often
the mother or the grandmother. Second, when there is no pay or additional help to
compensate for the time spent away from their main obligation, asking families to engage in
the work of CBR, even when their own family members are the care recipients is to put and
additional burden on them they can not easily bear. There is the assumption in the
developing world that the extended families are solid and can be depended upon for the
success of these programs.
Due to several reasons - economic, political, and environmental - families have been
broken up and these ties often do not exist. In Hong Kong, the supposed strong and intact
Asian family households shrunk from 16 in 1986 to an estimated three in 1999. The
informal netw'ork of caregivers in neighborhoods to check in and look after the elderly was
1.6 in 1991 (Kwok, 1995). With the increase of migrations to the city, the trend can be
expected to continue. There is fragmentation of the family in the rural areas as well as
disconnected individuals in urban areas. The cohesive units and approaches to problem
solving that were a feature of the tribal and clan structure cannot be relied on today.
The alternative to increasing the workload of a family member is paying a salary to
someone living in a community. The problem here is that development agencies no longer
want to pay salaries. Those who receive training as volunteers move on to the city where
they can command higher wages. There is little incentive to turn down opportunities and
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to do the extra work required to make a successful CBR project work. This is further
explored in the field research on Pina Palmera.
2.4. I n t e g r a t i n g t h e D i s a b l e d
“Using peers in the education of students with severe handicaps” is not a formal
study, but a series of suggested methods to increase positive interaction between regular
and disabled students. The six methods are “special friends,” peer partners, peer modeling,
social bids, peer reinforcement, and peer tutoring (Stainback and Stainback, 1982).
Special Friends: Emphasizes developing relationship through leisure time
activities. Students are paired up using similar criteria that researchers have found for age
group friendships among mainstream children. Depending on age, for example, they would
be paired by gender in interest activities.
Peer Partners: Trains children to help the disabled in the cafeteria, on the
playground, and in the non-academic social setting.
Peer modeling: Encourages the children to demonstrate methods of behavior and
response in the classroom, such as raising hands, putting coats on hooks, etc. Many disabled
children lack imitative skills, and this method is not appropriate unless they can acquire or
develop dais skill.
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Social bids: Mainstream children initiate play, conversation and activity with the
disabled. Other studies showed that as a result there is an increase in the initiation of
activity by the disabled child towards other children as a result (Young and Kerr, 1979).
Peer reinforcement: The praise of fellow classmates often means much more than
that of teachers and strangers. This applies to everyone. For behaviorally disabled children,
this can be particularly effective.
Peer Tutoring: Older children are used to tutor a younger handicapped child rather
than peer age students. There is a danger of condescension, domination and over-care by
same-age tutors.
Lynn Fox’s study, “Peer Acceptance of Learning Disabled Children in the Regular
Classroom” (1989), used dyads, grouping learning disabled students and regular education
students. In this study, students were placed in four groups: a mutual interest discovery
group, an academic task group, a Hawthorne Effect control group, and a regular control
group (no interaction).
There was an increase in positive ratings among the students in the experimental
groups. In addition, there was a greater level of acceptance among girls than among boys.
(The groups were sex paired.) The girls showed a much higher level of acceptance in the
mutual interest group than in the academic group.
A significant result of this study also showed that without the experimental
intervention, regular students never took the initiative to inquiring about the interests of the
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disabled student. Among those in the first group, the interaction resulted in continued
interaction over time. The other groups did not show an increase. In short, “friendships”
need to be promoted and established before academic and other social interaction and
acceptance could occur.
A research project was created in Zambia to see if the Stainback ideas were viable.
The results showed that when given training, regular education students do increase their
acceptance o f disabled children. The Zambia experimental program (Ronning and
Nabmoka 1993), structured the interaction of regular school students with the disabled. Its
goal was to test the viability of part the Stainback and Stainback program. The objective was
to lower the cultural walls and to ameliorate the misunderstanding o f those in the able
world with those in the disabled.
The Special Friends experiment in Zambia consisted of having a group of regular
students play with a group of disabled children in a playground over a period of weeks.
Feedback sessions and certain baseline establishing activities were included. First, the
students were only instructed to engage the handicapped children in play for a couple of
weeks. The second baseline added the feature of pre-training in play skills and leadership.
Again, the children were allowed to play freely.
In the feedback sessions, following the second phase, students were asked how they
would feel not to be included in play, to put themselves in the shoes of the special student.
For the third baseline period two children were assigned to each disabled child and either
could initiate play.
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At the end of this experiment, both regular and special students dramatically
increased their interaction and acceptance of each other. Second, the ratings of each group
by the other increased greatly as well. This experiment shows that the hope for integration
grows from the bottom up, at the student level. It may be said it is easier to change the
attitudes of students than it is to change those of teachers and other adults.
One of the problems of gaining a greater acceptance of disabled children in schools
is that most programs are aimed at adults and teachers, not at children. Most credential
programs in the U.S. contain a brief module that consists of transferring information to
new teachers about the conditions and teaching methodologies for special students.
However, most of these programs concentrate on the issue of higher functioning students
with learning disabilities, at risk students, and pertinent educational codes, laws, and their
implications, such as PL 94-142. (This is the American law that mandates education for all)
Actual content and preparation for working with the severely disabled, which constitutes
the bulk of programming and teaching opportunities, are cunously absent. Perhaps this is
because additional endorsements are required to teach in these programs and these
endorsements require additional classes, which are not offered at many universities.
Because of the scarcity of programs that train teachers in the techniques of
orthopedagogy, current efforts to train regular education teachers are through inservices.
(Together Schools - Training Regular and Special Educators to Share Responsibility for
Teaching All Students (1991). This study by Carrol Bailey, jr., Robert Gable and Jo M.
Hendrickson, brought together special educators, elementary teachers, and administrators
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to prepare the way for inclusion of disabled students into the regular school program.
This inservice consisted of a Friday evening and Saturday sessions. The sessions
consisted of role-playing and practice and information distribution and analysis. A control
group of randomly selected teachers and administrators participated in another inservice.
The results of the study showed a significant increase of trained regular education teachers’
ability to work collaboratively with special education teachers.
In many countries the same situation continues. Teachers receive inservice trainings,
if available, but most have to make it up as they go and learn what works through trial and
error. The following sections address attempts by various organizations to provide materials
and training to help those in the developing world wrestle with these issues.
2.5. CHILD-TO-CHILD TRUST
The Child-to-Child Trust addresses the challenges of Stainback and Stainback. The
various projects around the world seem to attempt to implement their suggestions. The
Child-to-Child was created in 1978 in anticipation of the International Year of the Child. It
is an information and resource center administered by the Institute of Child Health and
Education at the University of London. (Child-to-Child Trust, 1993)
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It has three main tenets:
• Empowering individuals and communities to share responsibilities for the
improvement of their own health.
• Faith in the power of children to spread health messages and health practices.
• Joint actions between schools and communities and health care workers.
The approach follows the schematic below:
One child spreads knowledge to/with Younger children
and or teaches skills Same-age children
Group of Children demonstrates by example family/families
works together with community
The approach of the Child-to-Child concept is one that acknowledges the
responsibilities that tine children in the developing world have and that for comprehensive
change and progress to be made it must start with children. Following these principles
Child-to-Child programs evolved with different goals, methods, and results.
• To assist programs in participating countries, the Trusts’ activities fall into three
categories: Materials production - design and distribution, while encouraging local
adapting of the material created by other programs.
• Implementation - assist in planning and monitoring activities in action.
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• Information dissemination and research - acting as a resource for those using the
approach around the world.
The Trust itself is not a funding mechanism but simply a resource, an encyclopedia
that collects information from projects around the world and then offers it for
redistribution to others engaged in these activities. Because it is not an NGO the programs
described in its catalogue are truly homegrown and operated from the bottom up. Outside
financial assistance is a part of all these projects but for the most part, they are created by
and through the people themselves who identify their own needs.
For the disabled poor it is a great resource of information on how to identify and
meet their own needs. Any of the projects that have implemented the methods would
provide rich research opportunities. There is a French program at the Institut Sante et
Developpement at the University of Paris that works with Francophone countries. It also
acts as a clearing-house for information. The United States Government has a catalogue of
informational books and pamphlets available as well.
It is interesting how experience drove theory, and theory and philosophy in turn
created programs that added to and further informed and developed theory. Child-to-Child
was woven from the Projimo experience. The techniques described in the following
paragraphs come from the books, "Disabled Village Children", and "Helping Health
Workers Learn". These were created by the team at Projimo in the early seventies and
adopted by UNICEF and later compiled and distributed by the Child-to-Child Trust.
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Several training processes prepare children to understand what it is like to be a child
with disabilities. The following are some of those processes:
Children who have poor memory: Ask the children to do
many things, one after another. Say the list of things in one sentence
very quickly. Do not wait for the children to do each thing before
you say the next.”
If the children cannot remember all the tasks, repeat the list
louder, but just as fast.”
Now do it differently. Say each task slowly and wait until
they do one thing before you go on the next.”
Children who have difficulty understanding: ‘Engleflip’:
This is a nonsense word, but let us pretend it means, “Stand up.”
1. Ask one child in the group to “Engleflip.” 2. Say it louder.
Get angry. 3. Ask several other children. 4. Now help the children
understand what you mean by showing them, assisting them or
gently explaining. After the activity, discuss. How did you feel when
you could not understand the teacher? Was it right for the teacher to
get angry? Did it help? Did the teacher finally do it better? In what
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ways? In what way was your difficulty with “engleflip” similar to that
of a child who has trouble understanding instructions?”
Popular Theater: Community, popular or street theater is a
way to bring the consciousness raising process to the community at
large, as well as transmitting techniques for intervention and health
care and sanitation. “The Measles Monster;” a skit from Nicaragua,
is presented by health animateurs and local children. A person
dressed up as the monster goes into the audience looking for an
“unvaccinated” child. This child wears a mask that is painted white
with a happy face. The monster catches up and surrounds the child
with its arms. When the child is released, the mask worn has
changed to a sad face covered with spots. The announcer asks why
the monster attacked the kid. The audience shouts back, “Because
there was no vaccination!” At the end of the skit, all the vaccinated
children from the audience are invited to join in to jump on the
measles monster and to beat it up. The announcer then informs the
audience when, where and how they can be vaccinated. These
examples are all from the book “Disabled Village Children by the
Projimo Project (Werner 1987).
The Child-to-Child Trust compiles many examples of these lessons and makes them
available around the world. Both it and Projimo stress the importance of making any of
these activities relevant to the local community7 . Equally important, if not more so, is the
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participation of the local children, teachers and animateurs in creating their own activities
that address their real life conditions.
The techniques of the Child-to-Child have much in common with the Stainback
and Stainback proposal. The people of Projimo have not had access to this material. Peer
tutoring does not have as much relevance to the situation of the rural poor disabled child.
The nonformal educational setting of special friends, peer partners, peer modeling, social
bids and peer reinforcement can all be seen to work in the Child-to-Child concept. The
primary thrust of Child-to-Child is to create greater acceptance of the disabled among the
mainstream population rather than simply teaching the disabled child. If this first goal can
be achieved, the second has a greater chance of success.
2.6. H O W CHILDREN ARE SERVED IN MEXICO
2.6.1. Formal Programs
In Mexico City, public and school buses are not wheel chair equipped. The numbers
of disabled students are served by separate and integrated school facilities are 21,000 or 1%.
This means that ninety percent of eligible students do not receive services. (UNESCO,
1995)
Training consists of inservice instruction in regular schools. There are college
programs for special education degrees. For the medically involved child there is a wide
range of traditional and experimental medical services. Parents are required to provide their
own transportation and the difficulty for poor parents to bring their children to service sites
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on a regular basis makes accessing these services difficult. Several therapy programs run by
the government are on a time frame so that, if the child fails to make measurable progress,
they are removed from the service rolls. There are 43 private schools for the disabled that
are certified by the ministry of education. Only 5% of educational budgeting goes to special
needs education. (UNESCO, 1995)
While traveling through Mexico, the researcher looked for and observed the
presence and participation of the disabled in everyday life, a sharp contrast to the U.S.
Individuals with Down syndrome worked in food sendees. Disabled women directed
health projects, (such as at the Projimo Project discussed in the next section). Retarded and
physically impaired were actively employed in agriculture.
The mentally delayed are given free rein throughout small towns and villages within
the ejidos (collective farms). Their boisterousness and affection are appreciated, and their
movement within the community and their relationships are not as sharply circumscribed as
in U.S. society. Some Mexican immigrant students have difficulty adjusting to the
restrictions imposed on their freedoms, by the dominant culture in the North.
While it lacks the financial resources of the U.S., Mexico benefits from the support of
extended families and community relationships in which the culture has inherent expectations
of cooperation and assistance for the support of disabled children. Mothers are not expected
to do it all alone.
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2.6.2. Nonformal Programs
2.6.2.1. Proyecto Projimo, Ajoya, Sinaloa
In Mexico, innovative programs have arisen. This may be due to economic
restraints that lead people to wish to try a variety of experimental approaches to problem
solving. Because of the tribal structure and its traditions of consensus building in decision
making, projects built around cooperatives with a more socialist approach are better
received than in the North and in Europe. This section will look at a selection of project
operating in the Mexican states of Sinaloa and Oaxaca.
Cooperatives run by the parents of disabled children and disabled adults have been
inaugurated throughout the country. Most have been created within the last decade. Their
influence, experience, and systems have spread throughout the developing world
(N ewsletterjxom the Sierra Madre, May 1995 Health Wrights). During the late 1960’s there
began a cooperative run by the disabled. They created two influential nonformal
educational programs: The Projimo (“Programa de Rehabilitacion Organizado por Jovenes
Incapacitados de Mexico, Occidental” or in English, “program for the rehabilitation of
disabled young people of Western Mexico”), an educational empowerment program for the
disabled, and the Piaxtla Project, a health program. (Hesperian, 1990) They are located in
Ajoya, Sinaloa; a mountain village of primitive resources located miles from the main paved
roads and cut off annually by rain.
Currently, there are seven major training and sendee facilities initiated by the
alumnae of Projimo in Mexico. These have assisted in the creation of programs in
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Nicaragua, Russia, South Africa, and other countries experiencing transitions. (Ajoya Field
Work, 1995)
Among the goals of Projimo are the following:
1. To set up an experimental rural rehabilitation center,
organized and run primarily by disabled young persons, that
provides simple orthopedic and rehabilitation services for physically
disabled children.
2. To form a team of “community rehabilitation workers”
who take pride in serving the people, to the best of their ability', for
modest wages.
3. To involve people from the local villages in a support
system to foster greater integration and appreciation for the
disabled.
5. To produce clear, well-illustrated teaching materials so
those community' rehabilitation workers, village health workers and
family members can be easily trained and continue to learn about
basic rehabilitation.
6. To help disabled participants to become self reliant
through production of low cost orthopedic appliances.
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7. To conduct public educational activities, to promote the
prevention of disability and the full acceptance of handicapped
persons as equals and as persons who often have special abilities
(Hesperian, 1990).
David Werner, a disabled teacher from San Francisco, helped to create Projimo. He
toured Sinaloa in the early sixties to find a good location for cross-cultural visits by his
students. In Ajoya, he met disabled individuals like himself who were working and living
together. Through the years, Werner has written several self-help books in the area of
medicine and education that have been adopted by such worldwide agencies as the Peace
Corps for use as training textbooks. The first versions of the Child-to-Child concept before
its adoption by UNICEF and the creation of the Child-to-Child Trust were expounded in
the project’s book, “Helping Health Workers Learn” (Hesperian 1984).
2.6.2.2. Nino-a-Nino, Oaxaca, Oaxaca
This project serves the needs of people who live in the midst of political and social
change that started with the extreme economic hardships brought on by NAFTA
(HealthWrights, 1995). A new revolutionary group has also begun its struggle against the
national government in the State of Oaxaca.
The Nino-a-Nino Health Program was created by parents of the disabled who could
not obtain services or class entrance for their children in Oaxaca. After heavy' lobbying with
the government and with assistance from the “Neighbors Abroad program” (Palo Alto,
California) and the Rotary Club of Oaxaca, they gamed use of classrooms, first after
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regular school hours and on Saturdays. Eventually, they incorporated and adapted the
Child-to-Child curriculum of Projimo to their needs and brought m peer age children to
work with disabled kids as tutors, role models and friends (Child-to-Child Trust 1993).
UNICEF research has found that in the developing world 90% of infant childcare is
provided by children from ages seven to nine (UNICEF 1990). Therefore, for successful
health intervention and education to be effective, children, rather than adults, need to be
targeted for nonformal health and education programs. The major goal of Child-to-Child
programs throughout tire world is to accomplish this task.
The program in Oaxaca has evolved from simply meeting the needs of disabled
children, to creating a cadre of young health animateurs who can decrease child mortality
and promote health where it is most crucial. Some of the children have grown up to be
health care professionals and teachers working with the disabled.
Oaxaca serves as a headquarters for the project. Children and guides are trained and
dispatched to remote villages where they work with disabled students and community
members. There are volunteers from Maryknoll missionaries who serve as guides and
trainers.
2.6.23. Pina Palmera, Zipolite, Oaxaca
Pina Palmera is the name of a project on the coast of Oaxaca. It is about eight
hours by car from the City of Oaxaca. The following section describes the goals, activities,
and accomplishments of the project. According to the director of the program, they use the
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Child-to-Child concept in working within its community-based rehabilitation programs. It
has established projects in mountain villages in the area. (http//palmera. webway.se) The
information from this section is taken from the website and from interviews done in the
field, which corrected, updated and expanded the information found on the website.
Pina Palmera, Centro de Atencion In fan til A.C., is a non-governmental organization
that works with disabled and non-disabled children and their families in the southern
coastal area of tire State of Oaxaca, Mexico. The center is located near Pochutla, in the
beach village of Zipolite. The only other facilities are very distant and the center responds
to the unattended needs of disabled and other children from local communities in this rural
area.
Oaxaca is one of the poorest states in Mexico. In the Pochutla area, over 60% of
the population earns less than 2.50 USD per day; 75% earns less than five USD per day.
The center has grown from its beginnings - from two adults and five disabled children to a
community of seven family households in residence and thirty children living on the
campus of Pina Palmera. According to the interviews of participants and members of the
community, Pina actually started closer to thirty years ago when the original founder began
informally working with the disabled in the area.
Many co-workers from the neighboring community come to the center to eat,
socialize and work. These workers include both disabled and non-disabled. There are also
about fifteen international volunteers. (This number varies with the seasons.) Children
without disabilities live at the center or accompany their mothers who live there.
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‘Disabled,’ according to Pina Palmera means, first, physical and mental disabilities,
including anyone who has trouble moving, learning, speaking, hearing or seeing, as well as
people with epilepsy, psychiatric disorders or chronic infections that require regular care.
Second, the definition of disability extends to the problems related to living in
poverty. It also encompasses other disabilities. The centre additionally works with children
suffering from “social” disabilities, i.e., the lack of normal stimulation that children need for
normal development due, for example, to malnutrition, parental alcoholism, and domestic
violence.
Over these ten years, Pina Palmera claims to have helped nearly 500 children and
their families improve their lives. With the summer camp, the Curso de Verano. this
number could be increased over 100 additional people during the month of August. The
center is not an orphanage, although it has sometimes felt obligated in the past to take in
abandoned children. Disability very often arouses fear and rejection. This is overcome by
demonstrating that, with some training, equipment and support, that the children, young
people, and adults can be better integrated into their families and communities.
The center provides three meals a day, basic and specialized medical care, health
education, and physical, and occupational therapy. There is special education for resident
children who require pervasive care. These children have been at the program from the
beginning and the project is not accepting any new resident disabled, other than for a short
term period and early stimulation. (This is working with children from birth through toddler
years in the area of range-of-motion exercises, acupuncture and massage.) There are also
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sign language lessons for deaf people. This takes place both at the center and in the villages.
The center takes children to hospitals in Pochutla, Oaxaca, or Mexico City and, when
necessary, arranges for operations. It also sponsors children that need orthopedic leg
braces, hearing aids, wheel chairs, etc. To obtain services, people pay what they can, in cash,
or in kind (e.g., by doing construction or maintenance work).
The center also has a carpentry workshop making adaptive devices and special
seating, as well as furniture construction and toys for sale. The carpentry project provides
employment for disabled and non-disabled children and adults. There is a garden-nursery
that composts and recycles waste, sells seedlings and works as an extension agent in the
villages. It takes roughly eight hours for fresh produce to reach the area by truck from the
Oaxaca valley. Many villagers cannot afford the high prices. Pina has obtained vegetable
seeds from other countries and distributes them to these people.
The center conducts a community-based rehabilitation program. This involves
people from the center going out to local communities that have requested assistance, and
helping them to organize themselves into volunteer rehabilitation committees. The
committees select local volunteer promoters in the communities who identify disabled
people there and help treat them at home.
Functional treatment at home achieves a higher quality' of rehabilitation. This CBR
work uses methodologies adapted from a manual by the World Health Organization. These
have been applied in a number of projects in a variety of countries. The center also draws
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from other publications and experiences on village-based rehabilitation. Staff from the
center have tried and tested its rehabilitation techniques over the last five years and have,
therefore, acquired practical ability in their application.
Local promoters receive supervision from Pina Palmera supervisors and can bring
more complex or difficult cases to the center for short intensive stays in order to receive a
more advanced rehabilitation, if necessary. The ability' to keep local promoters in place and
to send trainers to work with them has been problematic. This aspect is pursued further in
the sections to follow.
This CBR Program goal is to reach more disabled persons and to significantly
contribute to achievement of die center’s main objectives: the non-dependency of those
who have received care and training, and the sustainability' of the project. (The sustainability
of any project, which involves the disabled, is also at issue). The future development of
CBR in the communities depends on the needs of each community. They have to indicate
the pace and direction they want to take. (One problem was the lack of concern or
recognition of problems that needed to be identified, addressed, and resolved.)
Again from the website information the following is published. “The center has also
started an environmental education and ecotourism venture to give opportunities to the
children, parents, staff, and visitors (including people from overseas) to take part in a range
of activities which will raise awareness of the important biological and cultural diversity of
the coastal region of Oaxaca.” (There was no evidence of this in existence during the
fieldwork, other than a visit to the Sea Turtle Museum in Mazunte. Volunteers conducted
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their own ecology education sessions during the Curso de Verano. However, there was no
systematic approach.)
“Pina Palmera was registered as a non-profit, tax
exempt organization in 1989. It has received support from a
number of charities, institutions, foundations and individuals
in Mexico, the USA and Europe, including in 1994:
Patrimonio de la Beneficiencia Publica (Mexico), Slade
Child Foundation (USA), Save the Children Foundation,
Sweden Liliane Foundation (Holland), SIDA (the Swedish
Government aid agency), Les Amis de la Palmeraie
(Belgium), and Evelyn Grace (Great Britain), as well as
other supporters.”
“The center is itself run as a community, with the
sharing of decision-making power and broad participation of
community members in organization of daily work and life.
The board is made up of representatives of each of the
working groups at Pina Palmera.” (Pina Website)
One of the challenges in funding that Pina and all other groups face in Mexico is that
the government has removed itself voluntarily from being considered a developing country.
USAID money, for example, cannot be spent in Mexico even when there is a pressing need in
the poor areas. The activities of foreign NGOs are limited and have been forced to leave
areas where there are political changes occurring such as in the State of Chiapas. So projects
like Pina have to opt for different approaches to gaining monies.
These projects in Mexico are representative of projects that are independently run.
There are other projects that are operated by religious organizations and other private
agencies as well as government run projects in the major cities. The concern of this review is
with projects that are operating in the poor rural areas that are not normally targeted by the
schools and other agencies.
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Foreigners instigated Projimo and Pina both, but have long since transferred most of
their operations and decision-making powers to the local people. With the advent of
computers, e-mail and the Internet, these projects no longer operate in isolation. Both
Projimo and Pina have extensive websites now, and both lobby for support and publish their
accomplishments on the Internet. It is probably, easier now for projects to publicize their
existence than any other time. Easier except for the possible competition with other similar
projects around the world to obtain funding, as has always been an issue for not-for-profits.
All of the Mexican projects examined attempt to work at the child-to-child level. This
means that they recognize that for real change to affect the cultures and for change to take
hold, children’s attitudes must change. It’s too difficult to change the minds of adults. As the
studies earlier described have shown, when both disabled and non-handicapped children
grow up together, they accept each other. Segregation causes fear and prejudice.
The projects acknowledge that the training of local promoters, preferably those from
the ranks of patients, is most important. These are the people who have greater opportunity
to testify to their peers the efficacy of the programs. The challenge they face is that foreigners
and their magical medical practices are easier to believe than someone they know.
Finally, a democratic, bottom up approach to needs assessment, project design and
implementation are recognized as being crucial to the ability to empower the local people.
Foreigners may have the expertise in medical and development areas, but Projimo and Pina
both recognize that getting the people they serve to participate as fully as possible at many
levels is necessary to promote project sustainability. Projimo and Pina Palmera both have
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gone through major changes in techniques, change in type of patient, financial circumstances,
political change and natural disasters - in the case of Pina. Staying on the ground with the
people they serve making the decisions has allowed them to adapt to the changing times.
They have not had to depend on the presence of a single charismatic personality. It is this
fact that both projects are being run by Mexicans that attracted me to researching them. They
are an important contrast to foreign NGOs that are developed and operated by foreigners.
As will be seen from the data gathered at the project, there can be quite a difference
between the goals and accomplishments of the project. But goals have to be articulated first,
and it is equally important to imagine that goals are obtainable in a world of apparently limited
opportunity. The following section looks at how this importance of conscientization is when
developing a program. The limitations on a persons imagination are created by ones world
view. That is to say that it is bounded by their concept of what is possible. The realm of the
possible expands with contact with the outside world. BRAG, Projimo and Pina Palmera all
have had to deal with the issue of expanding the imagination of those they want to serve.
2.7. I n d i g e n o u s W o r l d V i e w a n d S o c i a l S t r u c t u r e
Local cultural issues may influence the feasibility of community based rehabilitation.
The indigenous people and their cultures vary and those variances go back to the era before
the conquest and continue today. Occupation of the Oaxaca Valley goes back to about
1400 BCE.
“In the southern Mexico State of Oaxaca, two large adjacent areas were occupied by
speakers of Zapotec and Mix tec. Though both are languages of the Otomanguean stock,
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they are as different from one another as Germanic is from Romance, perhaps as much as
Romance and Slavic” (Wurm, Miihlhausler, Tryon 1996).
Zapotec is the predominant language grouping in the region. However, there is an
isolated Mixtec area in the coastal mountains among the predominately Zapotec region.
There is a variation of Zapotec, Chatino, which has a low intelligibility rating which renders
it difficult for promoters from one village to work in villages other than their own (Wurm,
Miihlhausler, Tryon 1996). Spanish may be the lingua franca of the area, but mostly in the
area of business; therefore, the domain of men who trade services and do business with
outsiders.
According to Jared Diamond in his book “Guns, Germs and Steel, the Fates of
Human Societies” (1998), the greater the differences between languages and dialect within a
given area, the longer the cultures have remained mostly unchanged, and the longer the
precursor language has been established, allowing time for greater variation over time. This
variation also indicates the lack of commerce and intercourse between the various peoples
living in the area. As can be seen in the appendix, the State of Oaxaca has a very wide range
o f languages that may share some similarities, but are different enough to make
conversation extremely difficult.
In the cities Spanish is the common language of business; in the villages, the first
language is used primarily for private and family matters. With the current political upheaval,
there is also an increased distrust of outsiders, particularly of any quasi-govemmental
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organization asking questions under the pretext of providing services that the local decision
makers did not identify themselves.
O f the four million people who speak only indigenous language in Mexico,
approximately one quarter live in the region of Oaxaca (Cuaron and Bartholomew, 1996).
Mountains, desert, jungle, and ocean separate this region from the rest o f Mexico, making it a
cultural island. The mountainous geography of the area where the people live as well as the
deserts to the north and the jungles to the south has inhibited the flow of commerce and
culture for most of the area’s history. Even the influence and force of the Aztecs and the
Spanish have not been able to effectively change the culture. Tributes to conquerors, mostly
through the supply of labor had the only significant effect. The conquerors never stayed in
the area in numbers or influence great enough to affect or influence the language and culture.
The traditional village structure and culture of the Zapotec people who predominate
in the area where Pina Palmera is located made it an ideal location for this type of
community-based rehabilitation project to exist. The Chatino are also found in the same
coastal and mountain area of Oaxaca. Both tribes are in the primary area served by the Pina
Palmera community-based rehabilitation project. The tribes’ worldview is important to this
study because it dominates the way individual members perceive what can be done in terms
of development and change. These beliefs influence their cosmology, sense of social
obligation, and attitudes towards strangers.
The villages have a history of community obligation on the part o f citizens to work
on village projects, to share decision-making responsibilities, and to help each other. Each
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person, particularly among young men, has to serve in different roles of responsibility as he
goes through life. He must also attend town meetings, donate to municipal funds, and serve
in the governmental structure. When he has served in these offices, known as “cargoes,”
completed his other obligations, and lived until sixty, he acquires the title of “principal.”
These social positions and obligations serve to bind the Indigenous community together.
However, with the increased presence of different outside religious organization
making efforts to convert villagers, the unity of the villages has broken down. Among the
cargoes was the obligation to maintain the local church, and to plan and to fund fiestas for
various times of the year. The new believers in other sects generally refused to participate in
the activities. Members of these sects do not drink - a major social activity7 . This increased the
animosity and suspicion towards outsiders.
According to George Foster (1979) who has been studying the indigenous people of
Mexico since die early 1940s, the most difficult thing for a potential development project to
overcome is die worldview of the people. The concept of a “limited good” colors all die
dealings that villagers have with each odier and particularly with outsiders. “The reason for
the inability to associate in major communal efforts now becomes more clear: since more
Good than already exists cannot be produced, cooperation is a pointless activity, the whim of
outsiders who doubtless have some ulterior motive.. .Consequently, reluctance to cooperate
is, with a Limited Good view of the world, highly rational behavior, just as the other
behaviors described also make sense when seen as reflecting the belief that everybody is in
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direct competition with everybody else, and where advance on the part of one is thought to
be at the expense of others.”
Foster worked with the Mexican development agency CREFAL over several decades,
and found this to be the case over and over again. People he worked with viewed everything,
from health to potential profits from skills, as part of a very small pie. If women had long
hair, it was at the expense of their health in other ways. People might comment she appeared
too thin and unhealthy. Women cut their hair short to restore their health balance. A skilled
potter would not share his techniques with others because he believed there were only so
many potential customers out there, so that sharing his abilities would weaken his ability to
earn a living. By extension, it might be guessed that for a disabled person to become well, it
would be at the expense of another person in some other way.
In the sphere of traditional belief, health is determined by the presence of two major
forces: susto and aire. Susto is a sudden startling encounter. It can occur from unexpected
confrontation with other people, animals, supernatural forces, and physical objects. Susto was
declared to be the cause of death of a young person after the hurricane Paulina struck. This
conflicted with the medical explanation of complications due to tuberculosis. Susto is the
ultimate cause of disease. A person must be cured of susto if he or she expects to be cured of
any disease. Disease is viewed as the logical outgrowth and symptom of the presence of
susto.
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A re, or sometimes aigre in the local dialects, could be described as being akin to the
Force or rather the dark side of the Force as depicted in the Star Wars films. The aire is ever
present. It is what people and things exist within. The aire is filled with malevolent beings;
natural disasters, and illnesses, and finally death, are just waiting to occur. It is inevitable that
something bad will happen to everyone eventually. Life is menacing. In the ‘ Vocabulario
Chatino de Tataltepec’ by Leslie and Kitty Pride (1970), it is interesting to note that the
second definition of aire is ataque de paraiisis. This may be a reference to fright such as susto.
One becomes frozen with fear and therefore defenseless before these powers. The mal aire
can cause susto. The mal aire causes the susto that causes the following: physical paralysis,
such as quadriplegia, cerebral palsy, or other debilitating conditions that prevent people from
leading normal lives. In short, people become sick because mal aire opened them up to the
attack of illness.
There are different types of aire and different ways that it is manipulated or occurs.
Aigre natural refers to illnesses that can be like colds and aches and pains. Aigre puesto refers
to that which can used against an individual by another. Just as with the classic voodoo doll,
the practitioner creates a figurine representing the victims and sticks pins in it, causing the bad
aire to enter the victim and producing disease. Treatment by a curandera or traditional healer
is required. Aigre de hora is that which can be inflicted by supernatural beings, particularly at
night. ‘Fire Witches’ - flying balls of fire, the spirits of the dead, and Naguales - people who
transform into animals, can all inflict disease and harm to people. These entities also can
protect a village as well, keeping bad aire from entering the village (Kearney, The Winds of
Ixtepeji 1972).
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Both the Zapotec and Chatino people live in predominantly closed societies, the
Chatino possibly more so than the Zapotec, as they are the minority Indigenous community
in an area surrounded by the Zapotecs. Both prefer to use their own languages among
themselves and use limited Spanish with outsiders. There is little contact between surrounding
villages and there is great fear and antipathy displayed toward their neighbors.
The approach of community-based rehabilitation has to contend with these strongly
held beliefs. Even when people profess to believe in the various Christian denominations,
they may still hold to these traditional worldviews. An approach to development and healing
has to recognize and respect these cultural beliefs. The traditional government structure and
beliefs go underground when confronted by the presence of official Mexican government and
outside medical experts and missionaries. Yet, for the promoters to be successful and have
influence they must work in both worlds.
The world of the indigenous person in Mexico is changing rapidly. There are now
satellite dishes or parabolicas on the walls of many adobe one- or two-room homes. People
may not be able to afford a car or an education, but they are finding ways to afford the twenty
dollars a month to pay for the “Sky” television. It is perhaps possible to imagine that villagers
may be more open to promoters from other cultures and from the government if they
provide an incentive or means to earn more money to pay for things they want. Traditionally,
the indigenous people would hide their wealth, not wanting to arouse envy among their
fellow citizens. With the advent of intrusive world media, where differences and affluence is
celebrated, their worldview may change. Foster notes that the firmly held beliefs are changing.
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He also observes that the conditions of life in the village have changed much more rapidly
than the worldview of the indigenous.
To understand how the community-based rehabilitation and other development
programs can assist people in indigenous villages, it is first necessary to have a clear
understanding of the sociology of the people to be served. As demonstrated by the studies in
orthopedagogy in the United States and in other countries, the attitudes of either the client or
student need to be modified as well as the attitudes and beliefs of their families and the
communities in which they live. When children were allowed to be mainstreamed together,
and the general population of the disabled was more fully integrated, there was a greater level
of acceptance and hope of rehabilitation and of being able to function in the common world,
Lynn Fox, “Peer Acceptance of Learning Disabled Children in the Regular Classroom”
(1989).
This literature review illustrates the incident rate of disabilities around the world,
particularly among the children of the developing world. It also shows the wide range of
approaches to explaining both attitudes of the wider population towards the disabled, in both
the European and North American world, as well as those found among the Asian, African
and Latin American world, most particularly in Mexico among its indigenous population. We
have seen how treatment and the attempts to bring these children into the wider populace
have been constrained by economics, culture, and natural conditions.
Finally we have seen how the practitioner of rehabilitation must first leam how the
people they intend to serve view their world, how they truly view and structure their world
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despite what may be displayed on the surface. Traditional societies are wary of outsiders
entering their world to do them good. (Foster 1973) If the worldview of the indigenous
Mexican is inherently suspicious and doubtful towards outsiders, then the probability of
creating a self-sustaining and growth oriented project may be hindered from its inception.
(Kearney 1972) We will see in Chapter Four, how those at Pina Palmera have addressed the
issues of education, health and worldview.
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Chapter III
3.1. Research Design and Methodology
The social phenomenon of this project may have been as important as the actual
educational and social outcome; a qualitative method seemed the most appropriate. How do
volunteers, workers, disabled children and their families change their lives through their
involvement with Pina Palmera? How are the participants, their families, neighbors, and the
surrounding community affected by the presence of the program?
Getting involved as a volunteer and a researcher the Pina Palmera project took me a
while. There were several months of letter writing and logistical issues to resolve. I had to
determine when would be the time of greatest need for volunteers. During the winter there
are many ‘snowbird’ Swedes who come to the project to escape the cold weather back home.
So, the spring and summer were considered the best times for me. When I first heard from
Ingrid Olsen, the directora, she requested a CV and was very cheerful and welcoming when I
described what I wanted to do. However she seemed more interested in my special education
experience than my research interests. After spending time at the project I learned why; they
had a shortage of experienced and trained people working with their children.
The period of participation was for approximately 8 months. This allowed a long
term observation of the project and its personalities over the changing seasons. A serious
hurricane struck the area. (Force 5- the strongest on the West Coast this century, surpassed
only by Hurricane Mitch in its death toll. Over 2,500 people were dead or missing in the
States of Oaxaca and Guerrero.) It virtually destroyed the village and the homes of the
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participants, the researcher’s residence, and research materials. When working with the
disabled, growth can happen rapidly between long periods of little apparent change. The
researcher has to wait and be there when that happens.
It was possible to interview participants who had grown up at the project. Some
began as patients and later were trained as health promoters. Others learned trades that
allowed them to become financially independent.
Interviews were conducted in and taped Spanish and English. The interviews that
were originally done in Spanish are translated and edited for presentation in English.
Subjects who were volunteers, paid employees, staff, patients both current and those
who had been involved in the past were interviewed. Transcripts were then made, coded, and
analyzed during the field research with additional questions being generated out of the data as
warranted. During the research, the additional issues of the indigenous worldview and the
administrative style of Pina gained a prominence not predicted before the time on-site. This
was because of the unique management approach to operating the program. The issue of the
worldview became evident because of the different ways interviewees viewed the program’s
efficacy. The interviews that were originally done in Spanish have been translated and
paraphrased into United States English tor clarity.
Educational materials used by participants were gathered, copied, and coded to find
convergence and/or divergence with interviews, journals and observations. Newsletters
published in several languages and on the Internet were excerpted for articles and
testimonies by participants that included volunteers, patients, and employees. These
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newsletters had been written and published in countries where financial support and a
major volunteer pool existed.
These newsletters allowed the researcher to access testimonies by participants in
years previous to the fieldwork and to obtain information and observations of events that
have occurred between the winter of 1997-1998 and the date of this writing. As with most
fundraising newsletters there is an emphasis on the accomplishments and the needs of the
program to the exclusion of the failures. However, they do provide a rich resource of
material that can be balanced against the interviews and other material. A final note: All the
material in the newsletters are written, edited and translated from Spanish by Ingrid Olsen,
the Directora. No changes or corrections were made for any of the material from the
newsletters and Website pages. All spelling and phrasing remain in the their original form
except where clarity was an overriding issue.
Photographs and illustrations of locations, activities and participants were made and
donated by others at the project. However many of the photos were destroyed during the
hurricane, some pictures have survived but are of poor quality. Photos taken with a
disposable camera immediately after the hurricane were of limited quality.
The timeline of the fieldwork is from June 1997 though late January 1998. It was
not until after the hurricane of October 8* that most of the interviews were conducted with
indigenous and Mexican participants. This was for two main reasons. First, the researcher’s
Spanish speaking skills took time to improve, and second, it took a while to develop a
trusting relationship with participants. After sharing the disaster of the hurricane, together,
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a definite bonding occurred and previously uncooperative individuals were willing to
converse. The hurricane of October ended up being a great treatment in itself of the
efficacy o f the project and its impact of the programs on the participants.
A qualitative research approach was chosen for several reasons. According to Best
and Kahn, Research in Education (1993), a case study is the most appropriate way to
discover the “element of typicalness”. The use of long-term observation, interviews,
gathering of documentation that consists of financial records, published and internet
materials, e-mail and biographies of participants provide the element of triangulation and
balance to the participant observations that Borg and Gall, Educational Research (1989) say
are crucial criteria for evaluating qualitative research.
The Pina Palmera CBR project is a community in itself, and it overlaps and enters
into several other communities at the same time. There is the international community that
participates through providing volunteers, financial support and the interchange of ideas
and training developed outside of Mexico. Within Pina there are the communities of the
indigenous people, expatriate workers, volunteers, patients, and others. Surrounding it are
the villages that it works in. Because the culture of Pina is complex, only a long-term
participant observation approach was appropriate. In addition, to research Pina, it was
necessary to be a volunteer to justify my presence at the project.
There were approximately sixty individuals at the Pina grounds on an average day.
These individuals consisted of patients, promoters, volunteers, children and workers
involved in a variety of tasks. Because of the length of time spent at the project, eight
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months, forty-five participants were interviewed. This provided a selection from the sub
groups at Pina. This variety provided an opportunity to adjust the interviews to bring out
beliefs and perceptions not only about Pina and their level of participation, but also their
feelings about the significance of the other groups participation at Pina.
In summary, the advantages of a qualitative approach allows for a more complex
portrait o f the Pina Palmera. The issue of external validity was not to be a significant
problem because such large samples were used, that generalizing to the rest of the
population was not so important. The issue of internal validity was a more significant
challenge. The personality and skills that 1 brought to Pina placed me directly in positions
of responsibilities that led to my activities having a significant effect on the project itself. As
the only computer expert at the site, I provided training, maintenance and communications
via e-mail and the Internet? Secondly, as the only volunteer with significant training and
education in orthopedagogy, I became very involved in working with both promoters and
children in this area. My actions in these areas effected the population I was studying.
I began corresponding with the people at Pina Palmera about a year and a half
before going to study there. My resume determined for them the best time to arrive. They
wanted a person skilled in computers and special education during the times when there
were fewer volunteers available. It was also a requirement of volunteers to spend at last six
months at the project. People were very happy to talk with me for the most part, and this
willingness increased dramatically after we shared the hurricane disaster. I was given copies
of reports, proposals and the financial records of the projects since its incorporation as a
not-for profit organization in the early 1990s. In the obtaining of interviews, I agreed to
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change the names in the final published dissertation. I offered to send back transcripts of
interviews to those who wanted them. A copy of the dissertation has been offered to the
project upon completion. Throughout the actual writing of the dissertation, I have been in
continual communication with the project through e-mail and have been able to augment
the fieldwork with recently published newsletters.
The QSR NUD*IST software was used to code the interviews, offline documents
as well as photographs, and other artifacts. Most of the interviews were conducted in
Spanish, some with a translator, which actually proved more troublesome than helpful,
because of the translators’ propensity to anticipate the questions after a point. The Spanish
and English edition of the Globalink Power Translator program was used to do the first
translation of the transcripts. There were some differences in features available in the
programs available in Mexico and the US, as well as some word choice differences. This
technique was used to quickly transfer the files tor coding into the QSR system.
The interviews were then retranslated by the researcher and paid assistants into
English for greater accuracy to overcome the limitations of the translation software. This
saved time and money as only the most important text units had to be carefully translated,
and not the entire transcripts. The computer program gave a general translation that
allowed a quick identification of these important units. An employee of the Summer
Institute of Linguistics who had spent almost twenty years living and working among the
Zapotec Indians in Oaxaca translated the crucial interviews of the indigenous participants.
She was able to further note dialectical and idiomatic nuances between interviewees that the
researcher was not experienced or trained in identifying. This was useful in identifying
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those indigenous peoples for whom Spanish was a second language and who may not have
used regularly at home, but only used it at Pina and with those outside their home culture.
N ot being more than merely functional in Spanish myself, I had no way of knowing at first
who was a native speaker and who wasn’t.
In the appendix of the dissertation is a breakdown of the coding used as well as the
number of documents and the text units cited. There were approximately seventy online
documents and many other offline documents used. The text units used were at the
sentence level, and expanded outwards as contextual understanding required. I used a
hermeneutic approach to analyzing the interviews, making sure that any text units that were
coded together, were aligned as much as possible in terms of the mode of use, background
and experience of the speaker. This was especially important in understanding the strong
variance in opinions between foreigners and the indigenous Mexicans regarding the efficacy
of the programs at Pina Palmera
The initial coding consisted of placing subjects into subgroups of the Pina
population. These consisted of foreign patients, volunteers, administrative personnel, and
workers. Other categories consisted of program areas within the project. These included the
special education, carpentry, garden, office, village outreach, lifeguards and other areas of
activities. Participants were linked to the areas where they had their involvement. The
interviewees’ opinions regarding the outcomes at Pina were sorted. Interactions between
members of the subgroups were also organized, including their opinions about the
members of the other subgroups. The history of Pina as told by the various participants was
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gathered and sorted as to harmony or divergence. Key words and phrases that were
discovered in the course of analyzing the data were recoded and organized.
Certain issues that did not seem so important during the initial field work, such as
the worldview of the indigenous peoples and their acceptance or rejection of the
opportunities at Pina were re-investigated through reanalysis of the interviews and
documentation. The issue of who were the de facto leaders as differentiated from the
official leaders is something that only came up in the interview process and was an issue in
the original research design. The impact of the indigenous cultural traditions was not
apparent at first, and was only discovered during the interviews with the indigenous
participants and then made clear through the updating of the literature review in recent
months particularly in the area of cultural anthropology. The coding and analysis was a
dynamic event that changed and grew over time. Certain patterns of values, thoughts and
opinions made announced themselves only through the re-reading and gathering of the
interviews. The most important pattern was that of the strength of traditional values
inherited from indigenous culture that were imported to the scene and in the activities of
Pina. There were values and structures that the non-indigenous people at Pina in some
cases were not aware of and of whom some interviewees strongly denied. To conclude the
analysis process consisted of reviewing the interview tapes after the interviews, making
initial notes for later coding, adjustments made for follow-up and the next interviews, fast
translations and first pass coding, more comprehensive translations, new literature searches,
and a final recoding and analysis consisting of a careful contextual re-examination of the
text units.
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3.2. Limitatiom and Delimitations
D elim itations: This study was limited to the coastal village of Zipolite in the State
of Oaxaca, Mexico. The interviews were limited to individuals involved currently or who
had past experience in the program and to members of the community who have observed
its effects on their society.
Limitations: The primary limitation was that because as a foreigner, from the USA
the indigenous and Mexican people were hesitant to open up in conversation. It was not
until after hurricane Paulina and the shared experience of that disaster that trust was
established to be able to conduct meaningful interviews. It was not until the sixth month of
time at Pina that the bulk of the interviews were conducted. Another limitation was the
ability to converse in Spanish at a level to catch all the nuances of the language. Therefore,
cues may have been missed. One of the transcribers, who had spent twenty years n
Southern Mexico, pointed out many cultural aspects of language and communications that
were missed during the actual interviews.
A translator was used for many of the interviews and this added the additional
problem of the translator anticipating the direction of the questioning and interrupting the
flow of ideas at different times. The on-the-job training of the researcher in the participant-
observation setting no doubt led to corruption of data, missed opportunities and missed
evidence by the untrained eye.
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It was not possible to visit all the villages where the CBR program was conducted,
and therefore not possible to interview villagers who were actively engaged in the CBR
project or rejected involvement. The only people interviewed were people who had
benefited from the project, became part of it and would work at the center in Zipolite.
3.3. Biases
The main bias of the researcher is that of advocacy for the rights of the disabled.
Disability can include both physical and social challenges. Being excluded is something the
researcher has grown up with and continues to experience. This has included health, and
learning challenges caused by childhood illness, dyslexia, and hyperactivity. This is also why I
have been attracted to the problems of learning and disability7 .
This study was also conducted with the idea that what was learned could be applied to
other countries and situations. There is also the concern with increasing equity and access and
recognition of the human rights of the disabled regardless of degree and regardless of origin.
After the impact of Hurricane Mitch on the countries of Nicaragua, Ecuador and the
Caribbean, the study of community based rehabilitation and development is very timely.
Transcripts of interviews were sent back to the interviewees through e-mail and
through public mail for their use in editing, corrections, and amplification. Anonymity of the
interviewees and their location, level of participation was maintained in interviews, note
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taking, and analyses. This was maintained for the dissertation and will be for any future use of
the material with the exception of material from newsletters, which had public attributions.
The names of the participants were changed for the released versions of the dissertation.
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Chapter I V
4. F indings
4.1. I n t r o d u c t i o n
For most of its history, the coast of Oaxaca has been remote from the rest of Mexico.
One of the dreams of the first president of Mexico, Benito Juarez, was to construct a road
from Oaxaca City to the Pacific. There are now super highways connecting it to the rest of
Mexico, to the capital and to both coasts, but it is still in many ways a forgotten and isolated
area of Mexico. Once it provided Europe with the distinctive dye that was used in the British
armies red coats. Now it is primarily a place of tourism because of the Monte Alban ruins.
Other than hauling a trailer to live in once during the field study, the main reason for
driving to Zipolite from Los Angeles was to get a real sense of how separate the people in
Pina Palmera are from the rest of the country. In many ways, it is probably easier to get there
from Europe or from the US than from Mexico City. For the average person living on the
coast a trip to the capital is very expensive. It probably costs less for the foreigner to come to
Oaxaca than for the Zapotec native to visit Mexico City.
This geographic isolation is changing today. There is a brand new toll highway
through the mountains between Poza Rica and Oaxaca. There is also a new toll way between
Acapulco and Mexico City. This road has brought much more tourism and business to the
coast of Oaxaca than was previously possible. Both highways are nearly empty of vehicles as
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they roll across a dramatic Grand Canyon like landscape. Most of the cars sported Canadian
and US licenses. There were also giant Mercedes luxury buses ferrying tourists and travelers
from the Gulf Coast to the Monte Alban ruins. I towed my forty-year-old trailer with my
twenty five-year-old car slowly and not always surely across the American desert, down the
Gulf Coast, and then up and through the winding mountain roads. I wanted to get a feel for
the country from the ground and in the two and half weeks it took to reach my goal I got just
that.
4.2. GETTING THERE FROM HERE
Driving through the desert of the Western United States to the Mexican border at
Brownsville took five days. Zipolite is almost directly south of Chicago, therefore quite a
distance east of Los Angeles, my starting point. The desert also strikes southward from
Arizona and New Mexico deep towards the capital, Mexico City, itself. Immigrants, that are
anyone, who moved into the area since Columbus, have found the reasons why the continent
has been under-populated, when compared to h e history of continuously populated Oaxaca.
It is the desert that makes up much of the central and western areas of the continent. Nature
has made daily existence very difficult to live without the intervention o f modern invention
such as paved roads, electricity, air-conditioning, and communications in the desert. These
were the very things that disappeared from the western coast of Mexico in about five hours of
the passing of Hurricane Paulina on October 8, 1997. Del Rio, Texas, and the Gulf coast
would experience a similar event in 1998. The people in Oaxaca have been living through
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with the realities of storm, volcano, and earthquake for thousands of years. They have lived
simply, yet successfully, through agriculture, trade, and by fisheries.
I had spent three days on the road to Mexico and over 1,000 miles from Los Angeles
through to Del Rio, TX. Driving through El Paso, I was struck by the realization that Mexico
was across the stream that was the Rio Grande or is it Rio Bravo? The houses on that side
were irregularly scattered across the landscape. The houses were made up from what
appeared to be bare cinder blocks. A quadruple row fences line a no-mans land along the
river. The amount of radio stations broadcasting in Spanish increased until they were now in
the majority. I could not escape making comparison between East and West Berlin. The
immense empty landscape of Texas contrasted to the overcrowding on the Mexico side is
difficult to ignore
In Mexico beyond the border the density of the population seemed to have thinned. I
had an empty road to drive when one of the wheels on my trailer broke off. All the studs
holding the wheel snapped, and the wheel itself had huge wear holes from the studs moving
back and forth, but the roads in Texas were so rutted the trailer moved back and forth fish-
tailing. The trailer dragged me to a halt with a rooster tail of sparks from the axle digging into
the asphalt.
Soon after I stopped, a green truck from the Office of Tourism arrived and one of
the men, Constantino, helped me and spent the entire day with me searching for old hubs,
studs and a tire that would fit. His partner stayed behind and guarded the trailer. When,
several hours later we finally did find the needed parts and repaired the trailer, he invited me
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to stay with him and his wife in the Madero colonia near Tampico. His wife made a nice
vegetarian dinner and he kept me entertained all day by singing songs while we drove. I then
visited his church - une Advestista Templo, on Saturday. It was built by Canadian, Philippine,
and Korean volunteers who neglected to consider that a corrugated tin roof during the rainy
season makes the sanctuary almost useless (because of the noise), but it was free and built in
less than a month and tire congregation was as happy as can be.
He and his family wanted me to stay longer, but the urge for moving on called. So off
to Poza Rica. The next night I parked out side a bar, where the proprietor, his only other
customer, and I engaged in hours of political discussion that the owner, Luis picked up again
in the morning. He emphasized to me to write the truth about Mexico (in his view). It's run
by Mafia, people only make 24 pesos a day so at three pesos for a Corona, how can anyone
afford to drink, the Cambio (the Change or Revolution) is coming he warns. There is a lot of
construction on the roads that lead to the United States but in the places off the regular path,
there is little going on apparent to the visitor. On the toll roads that seemed to contain only
foreign cars and luxury buses, the only businesses were the Pemex station guarded by soldiers
with automatic weapons. These were also the only places for food and communications I
found from the East Coast to Oaxaca.
The eight-hour drive on a long, narrow, winding road is through the cloud-covered
mountains from the City of Oaxaca to Zipolite on the coast. The West Coast of Oaxaca is
like an island separated from the rest of Mexico by mountains, jungle, and ocean. Until the
last ten years, the only way to enter the village of Zipolite was by walking a trail from Puerto
Angel, a fishing village at the end of the highway a few kilometers south. The trail was up
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and down through brush and swamp. To go for groceries and supplies was an all-day journey.
The entire coast was said to be the refuge of pirates up until recent times. There is an area just
to the north called Punta Negra, where black slaves allegedly mutinied against their leader and
beached their ship and escaped into the jungle. This is the reason according to folk tales that
some of the people have dark African features. Seasonal streams become torrents in the rainy
summer. During the hurricane, this geographical reality asserted itself in destructive power.
The people who live there are an aggregate of indigenous, mestizos, tourists, and
wanderers who have reached the end of the road. Walking along the beach one is as likely to
hear French, German, English, and Hebrew spoken as well as the expected Spanish. The local
languages of Zapotec and Chatino are spoken mostly among the older population in the
isolated mountain villages that are nearby as the crow flies, yet very difficult to reach.
Language patterns show that some villages that may be within miles of each other show
distinct differences in pronunciation and vocabulary (Cuaron and Bartholomew, 1996). This
is because the terrain is so difficult to traverse that very little commerce took place between
villages before the construction of good roads. Zipolite is at the end of the main road
originally envisioned by Benito Juarez, himself a Zapotec Indian.
Today the region of southern Oaxaca and northern Chiapas is an area of much
struggle and controversy. The popular indigenous Zapatista movement for regional autonomy
has been engaged with the central government for five years to assert its quest for regional
sovereignty. At the same time, the area geographically has been identified since before the
construction of the Panama Canal as one of the top five areas for a new canal, and for a ‘dry
canal’, a corridor for rail transport of freight from the Caribbean to the Pacific. Therefore,
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the issue of who rules the area is of great economic and social importance. The local people
feel that their needs and voices are being ignored and the government is identifying potential
development of the area as crucial to the future of Mexico as a whole.
On my drive from Oaxaca to the coast, I had to slowly climb the very steep and
winding but well maintained highway 175 (towing a trailer). After filling my tank at the
bottom of the hill, early in the morning, I drove from the sunshine into the pouring rain of a
cloud-enshrouded mountaintop where the visibility was nil. Near the top, I was quite worried
about my fuel and I was forced to buy gas from a restaurant/hotel that served it in plastic
water and milk cartons. The price of course was adjusted to demand, being about twice the
cost on either side of the mountain. The journey was so difficult that I decided not to use that
route to leave Mexico at the end of my eight months but took the longer route along the
coast to the new super highway linking Acapulco to Mexico City. This road, after the
hurricane, was closed for weeks due to the washing away of entire sections and the landslides
that buried other parts. The coast was separated from Pochutla, the next largest city, for
about four days until the military engineers opened a one-lane passage.
When I came to Pochutla, I discovered a very busy place; the main road through the
center of town was narrow enough that westbound traffic was rerouted around the center of
town to by pass it. The street was not sufficiently wide for large trucks to pass each other. At
this point, I was searching for signs to indicate where Pina Palmera was found. Their
literature said it was located in Pochutla, but I could not find it. I drove around and around
asking people for directions. No one seemed to know; finally, I found someone who had
heard of it and said it was west out of town. I did not realize it was another 15 kilometers
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away and not even in Pochutla. Later I discovered the reason for this different address. There
is no mail delivery in Zipolite. Secondly, Zipolite is not shown on most maps, so Pochutla
served better for locating it and the project.
I drove on, and came to Puerto Angel, and I learned I still had to go farther. I had to
drive over sections of repaired roads that had been washed out by floods. They were narrow
and there was no place to turn around. I kept asking for Pina Palmera, and people here
seemed to know of it and said to keep driving this same road, again I was near the end of my
fuel. A retired American greeted me and commented on my rig and gave final directions and
distances. There was no fuel to be had in Puerto Angel or Zipolite, so when I finally arrived, I
was there for good. In fact, later when I drove back to Pochutla for refueling, I ran out of gas
before I even made it up through the hills back to Puerto Angel.
At last, I came to a small bridge over a stream. Next to it leaning up against a tree was
metal sign that read, Zipolite. It had evidently been knocked down and propped back up by
someone. On the opposite side of the bridge was an iron gate with a barbed wired fence
stapled to palm trees and posts on either side of it. At the road was a hand painted sign
indicating that this was Pina Palmera. By the time I arrived, it was well after dark and I had
been traveling about 14 hours out of Oaxaca. It took much more than the 8 hours claimed by
those who wrote to me and in the travel brochures. Maybe in a sports car on a clear day it was
eight hours, not this day.
As I entered, I had to carefully thread my way through a deeply rutted dirt road that
wove between leaning palm trees. It was indeed a palm grove. They were arranged in a large
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matrix with each tree separated by about five meters. I parked in a clearing near the house of
the directora. I was parked too close to the outhouses, which made sleeping that night a bit
fragrant.
The next day I would have to work to find just the right place to park my car and
trailer where there would be no danger of coconuts bombarding them. This proved difficult
and whenever wind kicked up around the area, one could hear the sound of coconuts
bouncing off the ground with a thud. Even parking between the trees was no guarantee of
safety. I discovered that during the hurricane. The palms shallow roots gave way and they
toppled over onto my trailer, slicing through the ceiling.
This is the main entrance to Pitia Palmera. The home of the directora is on the right
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I parked in an open spot between some buildings and a housing compound encircled
by a short barbed wire fence. This was the house of Ingrid and Ernesto, the directors of the
project. Their house was strategically located where they could view all that entered and left
the project grounds. As soon as I parked, small children immediately greeted me. I asked
them for directions to Ingrid, and they grabbed my hands and led me to her front door. Her
home was a large round adobe hut with a peaked roof. Inside there were three beds and desk
spaces and bookshelves that followed the curve of the wall. She got up from her computer,
smiled, and welcomed me. She invited me to some coffee, and we chatted for a time. As it
was late, I retreated to my trailer for well-needed sleep.
4.3. T h e P r o j e c t
The Pina Palmera Community Based Rehabilitation in Zipolite reminds one of the
classic communes as depicted in the early 19* Century New England such as Brook Farm or
Twin Oaks in the 1960s. It is a mix of modem hippie commune, resort, halfway house,
school, and clinic. The people living there share a goal or creating something special and
making a difference in their community. From its informal beginnings in the seventies, it has
grown into a more complex and comprehensive project providing a variety of services.
Providing these services are people who rely on a mix of different operating philosophies,
medical practices, and beliefs. Their training, education, abilities, and skills also vary, as do
their ethnic and national origins. The people who are Pina Palmera have come for different
reasons and have different perceptions and opinions regarding the results that hatT e been
achieved by being involved with the project.
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The people who were at the project when I was there were from many parts of the
world and many cultures. Their observations and feeling are related throughout this chapter.
In the next section, I will introduce the reader to the people who were interviewed and whose
opinions are quoted from other materials such as the newsletters and video project. Upon
their entry into this narrative, they will give a brief description of how they entered the life of
Pina Palmera.
The people who are served by the project include the employees, their children, both
disabled and non-disabled, the volunteers, patients, and the surrounding community. The
definition of community should be expanded to include the homes in other countries where
the volunteers come from. Much of the resources needed to keep Pina running come from
those places. Those who have been volunteers have brought their experiences home and have
increased the awareness of the living conditions of the disabled among their fellow citizens.
The most prevalent disability that is found among the patients and others at Pina
Palmera is poliomyelitis. There are about ten young people who spent most of their
childhood at Pina and who are now living together m a house m Oaxaca so that they can
attend college and preparatory and professional schools. All of these young people had polio
and received care and support from Pina. Other problems that are common among patients
are Down syndrome, cerebral palsy, spina bifida, blindness, and deafness. Among those who
came down from the villages to receive services during the summer, was a family whose
children displayed a unique nerve disorder that had symptoms similar to Parkinson’s. As each
child approached adulthood, they became thin, spindly, shaky, and less able to talk and move.
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There are also the social problems such as alcoholism, drug abuse, and under
employment in the villages surrounding the project. .Many of the people who have worked,
are working and are patients have had difficulties with drugs and alcohol. There are no drugs
or alcohol allowed on the grounds of the project, but there certainly have been those who
have struggled with some problems who have spent time at Pina. In fact, it was the wives and
children of alcoholic men who came to Pina at first for shelter. It was from their plight that
many of the features unique to Pina arose.
Frank Douglas was an itinerant healer who studied ayurvedic, holistic Indian health
philosophies and techniques under the system of Sri Aurobindo of Pondicherry, India. He
also spent many years examining the techniques of deep trance channeling as well as various
forms of spiritual healing and development, under various teachers m New York and in
California. In addition, heltraveled in England to learn under mediums and spiritual leaders
there. The images of calling of Mexico came to him over and over again while in England.
This was when he decided to come to Oaxaca State. There the indigenous people as someone
who had the power to heal identified him. This was not something he sought consciously but
something thrust upon him. The story was related how an Indian with a sick child stopped
him as demanded that he heal his daughter. Douglas initially denied he had such power, but
eventually submitted and visited the child and by the laying of hands on her, she was healed.
The word of his gift quickly passed through the community.
He and a small group of associates began the project in the early 1970s. The training
and philosophy of Sri Aurobindo regarding ayurvedic health concepts would explain why
Douglas and his associates gained the indigenous peoples’ confidence and support. The
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Indian system parallels the worldview of the Zapotec people in several ways. Most closely,
they share a similar sense of existing in a living world. That is to say, the air, the earth, and
energies that permeate existence all have a bearing on a person health. A person can achieve a
balance within this environment and optimize his or her health, happiness and prosperity by
following a regimen of diet, meditation and developing ones consciousness.
Douglas and his friends lived together and wandered around the area of the coast
near Puerto Angel and what was too eventually become Zipolite. They were also part of a
commune in northern California called the Church of the Gentle Brothers and Sisters. They
would offer healing sendees at no cost to the poor people in Oaxaca. Supporters from the
USA would send them money with which they helped people with medical and food supplies
as needs arose. About twelve years later in the early 1980s, these efforts became
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institutionalized into the private volunteer organization that became known as Pina Palmera,
in honor of the dominant feature of the land they had been donated to build their project on.
This was a large coconut palm grove. Regarding pineapples, the other feature in the name,
there were none to be seen growing when I was there, though when entering the area from
the hill road leading down to the grove, the tops of the palms resemble a field of pineapples.
The preceding picture depicts the palm grove with tire library on the left. Just beyond the
trees is the ocean. O ff the screen to the left is the stream that become a flood and dangerous
river during the hurricane. The rising waters came up to the windows of the building,
flooding it and destroying the books inside.
Douglas developed a group of followers as well as detractors during his time in the
area. As a curandero (healer) he helped heal people through non-traditional means. He would
help those who could not or would not go to the regular medical clinics and doctors in the
area. The local doctors felt he was threatening their livelihood, and managed to get the local
police to go into his living area where he and his group were living. There they found
marijuana and he was then deported.
Because a foreigner cannot own coastal land in Mexico, a local person was found who
assumed the title to the project land. After a while, when things began to develop around the
area and values increased, this person decided to keep the land. There was a fight over this,
and the community as a whole banded together and had the land officially donated to the
project as a corporation. During this same period, absentee landowners owned the land
throughout the area. Squatters took over the land, and as a way to appease the majority; the
government gave them the land, allotting a certain amount of property to each squatter. The
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government compensated the owners, but at a minimal price. Since then, many squatters have
sold their land at bargain prices, other have gone into partnerships with foreign investors.
There was quite a movement in the 1970s against the big landowners; Pina may have come
around at just the right time.
While Douglas was in California, his followers, ‘ the Church of Gentle Brothers and
Sisters,” continued his work of working with the poor and disabled in the villages in the area
of Zipolite and Mazunte, while he raised money in the US. This group still maintains itself in
the San Francisco area. I discovered his interest in Sri Aurobindo after the hurricane while
trying to preserve his books that had been damaged by water. When I was in college, I had
worked with people from the Ashram (a Indian monastery which to support its spiritual
endeavors manufactures and sells items) in their warehouse and as a salesman myself, selling
various imports from India. I was familiar with the philosophy and the background.
Aurobindo was very? big in the U.S. before the sixties. His influence can still be found in
places such as Sedona, Arizona. This was a different generation, one that discovered eastern
philosophies long before the Beatles. The people who were part of this now are in their
sixties and seventies. They very much believed in using their lives as ones of service to others,
not just for their own individual development.
I think this is an important point because it reflects a difference in emphasis and the
use of a non self-centered philosophy. The current generation seems to still be very much a
“me generation.” (A phrase deriding the seeming selfishness of the 1980s. The phrase used
often by members I have met from this older generation was that they were trying to live a
“life of service”). Douglas was in it for the long run, and had to wait almost a decade before
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he could return to Zipolite which he did and where he died. He is buried in the pantheon in
Puerto Angel. I think he passed this concept onto Ingrid. Projects rarely have success in only
a couple of years, but require a life of dedication. Missionaries who also spend a lifetime living
with people not their own of culture also follow this belief. In addition, it is precisely the lack
of this hill time dedication that makes development projects and community-based
rehabilitation so difficult. Because the people with the skills, the foreign volunteers, do not
dedicate their lives like Frank and Ingrid and Bob have, there are problems with operations at
Pina. I can also add this is the problem with Peace Corps and other well-funded
organizations, because the individuals do not stick with them. The volunteers are in it for the
short-term experience or view the time as an entry level to a career in development. Most
volunteer dependent organizations have staffs that have been with them for many years, and
many of the staff members first joined as volunteers. So it is with Pina Palmera.
In this chapter, the opinions of each of the participants are shared regarding a variety
of topics regarding the life and work at Pina Palmera. The first time their interview excerpts
are used; they are introduced with a brief description of who they are and how they became
involved with Pina Palmera. The following sections will discuss how people became involved
in the activities of the project. It will examine how the goals, objectives, operations, and
administration have evolved over time.
In many ways, just as important as programming at the project was the unique
manner in which the program was operated. The way projects were conceived, funded and
implemented at Pina Palmera had changed over the years. In the early years it was foreigners
for the most part who conducted assessments, looked for monies.and began projects. Over
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time the administrative techniques developed from a top down system under the direction of
a single person to an approach that is more bottom up. This chapter will explore this
development as well, because since different cultures have different governmental traditions
and systems, it was interesting how a small egalitarian system traditionally found among the
small indigenous bands of the area was re-asserted at Pina Palmera.
The operating method of using juntas, or democratic meeting and decision groups,
came from the plight of women feeling they were not participating in their own recovery at
Pina. They wanted a voice in how decisions were made. For most of the early life of Pina
Palmera, it was the directors, first Frank Douglas, then Ingrid Olsen de Martin who made
most of the decisions and controlled the administration. In the last five years this has changed
to the point where even after the hurricanes, no single person controlled the policy and
implementation of Piiia. Over time, the people at Pina have become independent of outside
experts in most areas of concern, from fundraising to problem identification and potential
solutions. This contrasts dramatically to the approach used by most development and relief
agencies that are strictly top down in their operations, featuring management by expatriates.
How are activities and goals developed? How are the different philosophies and
methods of addressing the needs of the community approached? Flow is the participation of
disabled people in the administering and operating of the project addressed? There are
differences of opinion among the participants regarding the effectiveness of Pina Palmera.
The outcome of involvement in the project will be described as well as the different points of
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view between the Mexican and foreign-born participants. What are the resources for
techniques, expertise, and additional training available and how are they utilized?
4.4. WHO IS SERVED BY PINA
There are two main populations served at Pina Palmera. There are those families and
individuals that live and or work near or at the project site in Zipolite. These number about
80 individuals. These included workers families and dependents, patients, and workers. There
are also the people who live in the mountain villages who are served by the community-based
rehabilitation efforts. These number about 1,000 and encompass about seven villages in a fifty
kilometers radius of Zipolite. These numbers have grown through the years and fluctuate
considerably with the seasons and the availability of promoters to serve villages. A third
significant group comprises those who attend the summer camp and live at Pina Palmera for
about four weeks. These number from 60 to 80 disabled people, mostly children and young
adults accompanied by family members.
The group living at Pina is those who have had the longest association with Pina.
They were there at the beginning. They were the first patients, volunteers, and workers. By
virtue of that fact, they may be figured to have earned the right to live at Pina. Most of the
women who are there with their families were those who originally came for shelter from
abusive living situations. The most severely disabled children who live there are those who
came when the program was considering the orphanage option and before it was decided to
engage in CBR. The less disabled children are those who came later under the CBR program
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and stayed for treatment that is more comprehensive and eventually stayed for the
opportunity for an education in the City of Oaxaca.
The people in the villages are reached and served by the paraprofessionals who make
rounds of these sites providing therapy, health screening, and various types of training. Some
of those who now live and work full time at Pina first came to the project attention during
these village visits. Many of the children who now live in a house in Oaxaca City together
while they go to college first arrived at Pina for extended treatments and therapy when they
were young children. The stays turned into residency and into a sort of adoption by the
project.
There has been an increase in the number of people served over the years and
expansion of services provided. The growth was not just at the project grounds itself, but also
in the villages accessed by the CBR program or through Pinas work as a distribution agency
for other NGOs such as the Red Cross. This role grew and took on greater importance
during the post-hurricane recovery.
Promoters never know exactly who will show up when they conduct visits to a
community. Transportation and communication problems make it also difficult to have a
regular schedule of visits that villagers can depend on. The only truly dependable regularly
scheduled health event is the Wednesday morning free clinic at Pina itself. Women and
children and elderly would come hours early to be first in line and seeing about thirty
individuals there every7 Wednesday was not unusual. They received health screening,
acupuncture, and physical therapy when they are there. In the villages the promoters meet at
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the town center and then will make home visits to see families unable to bring the patient to
the center. The families usually send a child over to get the promoters attention to let them
know the family did not forget about the meeting.
Casa Nueva, die reconstructed building that houses the special education, clinic and therapy units
The interview with the promoter/patient Manuel shows the growth over a couple of
years from three towns to seven towns. “CBR work has been started in three neighboring
villages and towns, Nopala, Pochutla and Huatulco...” “We are working in Benito Juarez, in
Candelaria, in Palma Larga in the Crucecita. There are seven communities.” The last would
include Puerto Angel and Zipolite together. Some of the towns have volunteer promoters
who are separate from Pina who work 1 1 1 those villages, where there are no current
volunteers; the promoters from Pina come and make visits. The promoters come and go, so
numbers fluctuate. Because a promoter has worked and lived in a village, it appears that
community is more open to becoming involved in CBR. Some of the larger villages,
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Pochutla, Nopala, and Huatulco (a larger tourist town) already have other non-governmental
organizations in them, so the addition of a CBR program into these communities was easier
to initiate. The groundwork of making the idea acceptable was already accomplished in many
of these villages.
These villages are on the main roads and have existing programs. For example, Dr
Ernesto had a thriving medical practice in Pochutla, so many of his patients already knew of
the services that Pina provided. These people all had relatives in the more remote villages so
being known and respected through the mainstream medical services offered at Dr. Ernesto’ s
office, people were receptive to CBR. In addition, Ernesto, Ingrid his wife, and the workers at
Pina maintained a weekly radio program that fielded telephone calls from the audience, as
well as informing listeners about events -at Pina, services that were offered, and when village
visits could be expected. In this way, those served by Pina and its ideas constitute a much
larger population than individual promoters could ever visit. When they do get to the villages
that have heard the program, they are ready to receive them.
In a report printed in the newsletter of Pina Palmera, the social worker Anita wrote
the following description of the program growth, examples of syndromes and conditions
treated as well as statistics of who is served by the program. This report was published in
1996.
A social work program area was formally introduced to Pina
Palmera in January 1995. In this program area, a numerical system
has been introduced to keep a check on all the files of patients who
attend the centre for consultation purposes. At present there are 634
persons registered on file, of whom 40% are actively receiving
attention in the different program areas of Pina Palmera. It covers all
kinds of handicaps, including Cerebral Palsy, Epilepsy, Down's
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syndrome, mental retardation, the consequences of poliomyelitis,
deafness and various sorts of deformities etc. 80% of those cases
come from very low social economic groups, for whom Pina
Palmera must absorb nearly the total cost of the medicines and
rehabilitation that they need. From May 1995, to the present time, 1 1
handicapped patients, under 18 yrs of age, have been sent to the
Shriner Hospital in Mexico City from which Pina has already
received much important and valuable help. They have generously
offered consultations, operations, and orthopedic apparatus, all free
of charge. It has also been a great help to these children and
members of their families have been able to stay in Sonia’s house
[she was the chief fundraiser and director of the CBR program] in
Mexico City during their consultations and surgery, and especially
during the period of rehabilitation which they underwent there.
Sometimes they had to stay for some months in the city and,
although the medical treatment was free, Pina Palmera paid for
transport, medicines, and food. I came here, to Pina Palmera, 3 and
1/2 years ago. At first, my work was developing in the area of
education with groups of children and adolescents who live here.
Now my relationship with the patients and their families is much
closer. I have learned a lot about handicapped people, thanks to the
Physical Therapy team and the recently formed Community Based
Rehabilitation team. Since my arrival, the process of learning about
what has been going on here has been very' exciting. Finding out
about the customs and traditions of this area has already been an
important factor in an ongoing process. Pina Palmera supports and
encourages these local traditions, unlike many other institutions. The
results, which we achieve here, are based principally on the love and
respect of our fellows. It could be said that here the human aspect of
life far exceeds the material, although this objective does not allow
anything to be more important than the continuation of our work.
(Report from the Social Work Program Area.... Anita, social worker,
Newsletter # 3 3 March 1996)
After three years, the amount of active patients had not changed very much. The
number of programs had increased due to the increase in volunteer participation and support
by outside agencies. Between 1993 and 1996, the CBR program began to gain more
recognition; the lifeguard and first-aid training- programs were created and grew. The first of
the European therapists began to work and train paraprolessionals at Pina during this time.
Though the amount of people being served had not increased significantly, the quality of the
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personnel able to provide services had. In the years between 1996 and to through the
hurricane of 1997, the comprehensiveness and variety of services provided as well as the
experience and training of the staff developed greatly. The amount of patients being served
grew from 300 patients in i996 to over 1000 in 1998.
As usual the Palmgrove is buzzing with activities. The
weather is very hot and sunny but that doesn't keep us from
working. We now have 38 employees and about 18 volunteers who
work here and over 300 active patients. [Not all the 500 - 600
registered patients are active with receiving help through Pina] Every
month we receive 10 to 15 new patients. (Ingrid Olsen de Martin)
Newsletter # 3 5 Dec. 1996
Thank you, owing to your help we were able: not only to
survive and get the Palmgrove re-functioning quickly; but also to
distribute life saving food, clothes and medicines to over 1150
families in over thirty' different communities.
Our work in the communities started in January' and we are
now vmrking mainly in four places: Candelaria, (8111 inhabitants),
one hours drive away. Tiltepec, (1670 inhabitants) three hours drive.
Benito Juarez, (1179 inhabitants), one and a half hours drive from
Zipolite Palma Larga (392 inhabitants). We also work with
communityr-based rehabilitation in Pochutla, La Crucecita and we
are introducing the program in Puerto Escondido. As well as our
community-based work we also see patients who come to the
Center, take patients to hospitals in Oaxaca and Mexico City,
support and supervise the seven young students from the
Palmgrove who live in the city of Oaxaca. (Ingrid Olsen de Martin,
Newsletter # 3 8 A p r 1998)
The following newsletter excerpt from April 1998, describes the living conditions o f a
disabled boy as encountered by a Mexican woman who has returned to Mexico after living in
California for many years. She is concerned about how7 the simplest living conditions that
Westerners take for granted may not exist in these villages. She had grown up in a middle
class environment, and though she suffered a disability herself, she had not encountered the
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conditions that the severely disabled had to live with in the poor mountain villages. She is
writing to describe the conditions to those reading the newsletters and on the Internet web
sites. The idea of having specialized equipment such as ramps, toilets with handle bars on the
walls, etc., are unthinkable because the whole village is struggling to survive.
When I visited Tiltepec, a mountain village, one hour from
the hot international surfing town of Puerto Escondido, fifteen
hungry women gathered at a literally "sticks and stones" rudimentary
kitchen at the town's square. They cook soy meat for 200 people and
that will be the nutrition for the day. A simple tortilla here is a luxury.
The normal menu sits on the floor, offering one skinny pile of dried
corn on your left and a large one of rotten husks to your right. Up
the lull, we find Raymundo on the floor, moving as if he was
swimming about the red clay floor. Raymundo is a 22 yr old epileptic
Indian boy that has never sat, walked, talked, is brain damaged and
with gingivitis that does nothing for his timid smile. Raymundo
weighed 28 kilos. Knowing that one cannot survive solely on corn
tortillas one wonders how do they keep living? No cement floors.
The toilets? Say what? Handicapped facilities for Raymundo? Only
80 miles to Pina Palmera. Their transport? Rough and callused feet!
. No food and much pride. Yet Tiltepec is one of the better villages,
so they say. (Tina, Mexican American volunteer).
Pina serves three populations. Those who live on site, those who live in the villages
served by the CBR program and those who visit briefly in the summer. The summer camp or
Curso de Verano in Spanish is conducted ever)7 summer around August. It is attended a by
about 120 people from different villages who come and stay for four weeks. N ot all of these
attendees are disabled. About a third are, and the balance is their family members who come
to attend die camp with them. The biggest change that I observed was in the attitude of the
attendees over the four weeks. Many came not feeling very capable and quite shy. They were
not assertive or confident. At the end of the session, everyone was enthusiastic and excited
about die possibilities in their lives. When they went home to their villages, these people were
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followed up on by visits through the CBR program. Some of the people who showed greatest
potential were then invited to stay for an extended time at Pina itself for further training.
In addition, volunteers who come from other countries receive an education and a
consciousness raising about living disabled in a difficult world they would never experience in
the segregated European and American cities. The patients, workers, and volunteers all
receive something unique by their participation in the project. How to serve them best had
been debated over the years and the objectives and methods designed to meet their goal of
changing the lives of the disabled in their region have evolved through the years.
4.5. OBJECTIVES
4.5.1 Objectives as Portrayed by the Administration
Since the 1970s, the objective of Pina Palmera has changed, and the programs created
to meet those objectives have changed as well. At first, it was the singular work of a
wandering healer, who traveled about assisting the disabled. His objective was simply to be of
service to the people in the area through using his unique talents and abilities. Through these
efforts, others became involved. Then in the early 1980s the project became institutionalized
through a gift of land. The people now were faced with the decision of what to do with the
land. After acquiring land, it became an orphanage and a refuge for battered women.
Objectives had to be articulated or the community would impose one on Pina in a
sense. Since they had not defined themselves, the surrounding community did, an orphanage
was the one that came to mind. [According to Bob, Ingrid and Dr. Ernesto, in the early days
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Pina Palmera was perceived by the community only as an orphanage]. To avoid becoming a
dumping ground for the human discards of the region, the project had to seriously discuss
what their reason for being was. The following section discusses through the words of those
people who were there from the earliest days how the objectives evolved through the years.
The objective had to be understood and articulated by all at Pina. This was and is not always
possible as will be seen. As the project grew from being dependent on the vision and work of
individuals to an institution, the objective had to become clear and defined.
There were several instances of disabled people and children who came to the project
and stayed. N ot necessarily because there were no alternatives. One of these disabled
children, for example, was taken on after conversations with the relatives and without viewing
the child. The child was in the State of Chiapas, and was sent up by public transportation and
when he arrived,'they- discovered he was much more severely disabled than previously
described. Since then, the relatives have severed their communications with the project
leaving the child with only tire people at Pina as his family. Other children too have been
effectively dumped at Pina. Some of the children who are working on disabilities related to
polio still maintain connections with their families but stay at Pina and work there. The main
problem faced by the project, shared with others around the world, is the tendency of people
to drop their problems and responsibilities at the doorstep and leave them there.
With the creation of the CBR program, there has been an emphasis in attempting to
train promoters within the villages to conduct screening, treatment, and therapy. Many of
these villages are too remote for them to bring their children to Pina or to the doctors in the
larger towns. The project has changed its goal and objectives over time, shifting from
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providing care and housing on the Pina site to providing training and offering an advisory
capacity for villages to do their own work independent of outside experts.
The objective of the program is to improve the quality of life
of disabled and their families in the area of Pina in Zipolite and in
the surrounding mountain villages, without creating a dependency on
outside experts and resources. (Pina Palmera Website, text written by
Ingrid Olsen de Martin)
Ingrid elaborates further on the objectives of Pina:
An important objective is to promote acceptance of the
disabled and integration into the larger community by the non
disabled. The objectives and areas of interests have changed over
time. In the beginning, it was more of a shelter for battered women
and their disabled children. The people in the area wanted to dump
their children and disabled relatives on the project. Being
overwhelmed by the burden of caring for a disabled relative, the
opportunity to hand over their loved one to others who would do it
for them is often too good to pass up. The project recognized tins
danger early and made the decision to emphasize training families
and the community to care for their own instead. [According to the
interviews with Dr. Ernesto, Bob and Ingrid] O f the children who
are severely disabled living at Pina Palmera, some are there because
they had initially been “dumped” on the project by the relatives and
abandoned. A change had to be made to keep this from becoming
the norm. No one wanted to run an orphanage and take the
problems of a community onto themselves; they wanted to make the
community responsible.
There are different approaches to creating acceptance of the disabled by the
community and promoting independent living for them. Over the years, Pina Palmera has
seen an increase in the number of programs it supports within its boundaries as well as its
outreach to the villages and local communities. It has increased the amount of people it
serves. Since its formal inception as a non-profit organization over fifteen years ago, it has
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served over 500 people. It has grown from a place where a few families of battered and
abused families lived together to a diverse population of over 150 people consisting of
workers, patients, therapists, volunteers, and children all living and working together. Over
sixty people live together on the project grounds year round. During a four-week summer
course, the population nearly doubles as villagers and their disabled family members come to
stay and participate in workshops and summer camp activities. The project started with a
small clinic and housing project. Now it is home to a carpentry project, and garden nursery, a
blind and deaf training program, a care facility for severely disabled children and adults, and a
para-professional therapy and training program that goes out into the mountain villages to
work with disabled families.
Dr. Ernesto Martin, in addition to being the president of Pina Palmera, co-directs the
project and is responsible for the medical services. Pie operates a small general practice in
Pochutla about 25km inland from Pina. Dr. Ernesto started working under Frank and then
with Ingrid in the early years of Pina He is now the president of Pina. During most of the
time at Pina, he was very much hands off as fir as operations were concerned. In the
aftermath of the hurricane, he supervised the juntas, directed distribution of supplies, and
prioritized the reconstruction goals.
He has his own retreat at Pina; a two-story tower of reed and thatching that rises
above the dome that Ingrid occupies most of the time. He is tall, has blue eyes, and curly
reddish hair, -very European looking. He towers above most of his patients and even above
most of the volunteers. He has a friendly, joking way of talking and relating. He also lives very
simply. Though his family home is quite different in appearance than those of the rest of
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the structures at Pina, it is unadorned. There is a cheap stereo playing European popular
music. There is a big red Boxer dog that runs about, occasionally chasing strangers. In the lot
near the house, between the palms are the old red Volkswagen that Ingrid drives and the
doctor’s older Dodge pickup truck.
In the following, he describes how people who now are active leaders and
paraprofessionals came to be at Pina Palmera.
Karen arrived. She was the first professional therapist that
we had with a title, a graduate of Germany. We begin with the
rehabilitation for the children that we had living here— Silverio, with
Marlena, Jose... the son of Milo.... Then we begin with the other
children here. And we expanded little by little, because we didn't
have the capacity to take in all people, some children of Puerto
Angel, some of Mazunte, some children of Pochutla. And by means
of the newsletters and the grant applications, we begin to request
professional therapists, and mainly foreigners, because in Mexico
there are not enough. In Mexico, there was not— or if there are, we
can’t afford them, because they needed wages, and we could not pay
it or they are working in the cities and they don't have the time to
come and work. Therefore, we had only the foreigners- and
ourselves, volunteer foreigners, who came for three months, for six
months, for one year. This was the way that the project was growing.
(the problem of paying promoters and qualified workers is a problem
for all social programs in Mexico.) (Interview: Dr. 'Ernesto)
Because Ernesto is busy with his own practice, he does not take a dominant role at
Pina, although this did change briefly in the aftermath of Hurricane Paulina. Instead, it is his
wife, Ingrid who is the main force that lias driven Pina Palmera for most of the last decade.
He does conduct the Wednesday morning free clinics, but for the most part, he takes a
hands-off approach to administering the project.
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Ingrid Olsen de Martin, as director, is the one who acts as the window to the world,
and the chief archivist ot Pina Palmera. As the director, she controlled the information
coming out of Pina in the form ot the newsletters and being tire one who, having the only
computer capable of E-mail, handled that as well. She goes back to Sweden every year for
fundraising events. After the founder of Pina passed away, she became the driving force,
articulating the objectives of the project.
She came to the area when she was in her late teens from Sweden and stayed. She
encountered Frank Douglas who was a traveling healer, who had come to the area himself in
the early 1970s and began informal healing services, working with local disabled residents and
traveling into tire mountain and beach villages bringing different supplies.
She worked as an assistant to him for about three years before he passed away. By
that time, the project had secured land and construction on several buildings had been
complete. Many of the other long time participants had joined the program or would within
the next couple of years. She and her family live on the grounds of the project. She spends
much of her time while I was there at her computer, writing e-mail and composing
fundraising proposals. She has relinquished much of the day-to-day control of the decision
making to the juntas in the last three years. She also has two youngsters and an infant, being a
mother also serves to take up much ot her attention.
She spends most ot the day in her round dome shaped house working at
correspondence on a donated lap top computer. It’s carefully propped up against a book,
because the hinges of the computer screen are broken. Throughout the day, there is a steady
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stream of visitors, some stopping in for just a minute or two, the others staying longer, sitting
on the edge of a bed or in a chair and discussing the affairs of Pina. In a small crib near by is
her infant daughter, Manuela. Scurrying about is one of two servants, a young lady who acts
as a nanny for Manuela and another woman who helps with cleaning. This second woman
also works in the tortilla kitchen, and because she spends so much time with Ingrid and her
family, her own children go mostly unsupervised.
Ingrid is a gracious hostess, offering coffee, tea to visitors. From her vantage point,
her house, strategically located near the front gate of Pina she can see the various visitors to
Pina. She does not seem to make note of the vehicles that come and go, but her location puts
her in a position to be an important gatekeeper for Pina. She, as the only person with e-mail
capabilities, offers the volunteers the opportunity to spend time writing e-mails on her
computer. Again, this serves as a gatekeeping opportunity7 as well as she controls the editing
of the newsletters contacts with the outside world and the image of Pina, at least the official
image. However, she does not do this with a heavy hand and with humor admits that it is
difficult for her to let go of the control, acknowledging that it is important for the other
people at Pina to take on these roles. The continuing burden of family may7 make that letting
go easier, and or more necessary.
Ingrid describes the change in perception by the community regarding what Pina was
and is trying to be.
The center is not an orphanage, although it has sometimes
felt obliged in the past to take in abandoned children. Many people
still think of the Palmgrove as an oiphanage. It is with a certain pride
that I can tell you that we have long ago left that model behind us.
Fewer children live at the Palmgrove now than six or seven years
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ago but we have developed into a resource centre for many more
children, with or without disabilities, and their families. We started
out as a children's home twelve years ago, but since then we have
realized that as a home and/or orphanage, you have very little
opportunity to influence the surrounding communities, and can only
reach a very limited number of children. Instead we have increasingly
opened up to the outside community and we are convinced that
children need to be with their families and in their communities. We
try to show the parents how they themselves can work with and
support their children, with or without special needs. Our goal is to
make sure that as many children as possible in this area will have
access to education, rehabilitation, and the possibility7 to grow up and
actively participate in the social and productive life of the village.
Bob was a US expatriate who has lived in Zipolite for nearly 12 years. An ex-actor, he
still works periodically in Hollywood in set construction and carpentry7 to subsidize his ability
to live in Mexico. He has a family there with three stepsons. Initially they all lived together on
the grounds of the project. He started the carpentry project and has been very involved in the
Salvavida Jr. program, providing transportation, assisting the instructors and practicing with
the young people. His youngest son also is participating as a jr. lifeguard. Bob was not shy
about sharing his observations.
He is tall, about 6’4”, in his late ‘40s, good natured, enjoys beer and conversation, and
is always telling jokes and making people feel welcome. Getting him to share his views was
not a problem, getting a question in was. Possibly because I was the only other American and
a person who had experience in show business as he did, we were able to get along quite well
and had a lot of conversations before the actual interview. He was very assured that the
Salvavida jr. and carpentry programs were the best and most successful programs at Pina.
He has a home on a hill above Pina His wife and her three boys live with him. He is
very devoted to his family and to Pina. He is another example of the core group that is so
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important for a project like Pina to exist. The group lived together and sacrificed their privacy,
their health at times and spent years to get Pina going. He has said he feels that elements of
the project, particularly certain operating aspects of the carpentry project could be ‘franchised’
to other places and brings results to other disabled people in other places. He had come to
Mexico looking for something to do with his life after becoming disillusioned with pursuing
an acting career. He was in jail for a traffic violation and while there was informed that he
won the lottery. He decided that was a message to him, and after paying off his debts he went
to Mexico where he had previously encountered the Pina project a year or so prior and now
with money, he decided he could afford to live there and help the project. I asked Bob about
when, how and why the project changed from its initial stage of being a sort of orphanage:
Bob said:
“It changed in about 1992. It got to the point that one group
of volunteers wanted this place to be a center for children like
Silverio and Maribel. They wanted to take severely disabled children
and this would be a hogar [home] where these children would be
attended to for their lives. And there was another faction who
decided that they didn't want to do that. It went on for about four to
five months. It was a pretty heated discussion. Finally, the group who
didn't want to have this as a hogar (just a home for them and a
orphanage).... The discussion came down to that they wanted to have
children they could work with that they could put back into society
as functioning human beings, as opposed to having a place where
you tend somebody until they die. That's the bottom line.
“M., C., P., J., K. from Germany, Aaron he was the only
Mexican on the team. We had meetings under the tamarindos (the
grove of tamarind trees) to decide what was going on. That was the
first core group of people who came to give two years. There were
like seven of us for two years. We had an opportunity to make
decisions of the future growth of Pina. One of the decisions was we
weren’t going to have any more children like Silverio and Maribel
here. These were all discussed. These were big moral discussions by a
group of young people who were for the most part first time
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experienced in the world.” (Intemew: Bob)
This was their first time away from home and in another culture accorSding to him.
Bob said at another time that they felt they were really part of a revolutionary, new idea and
project.
The official line was that there would be no abandoning of children at Pina. It did not
stop it from happening anyway. Some of the families live right in town within walking
distance but do not visit. Many disabilities come not just from genetic and environmental
causes but also from lifestyle choices of the birth parents. Alcoholism and drug abuse are
common features in the lives of the parents ot the disabled children at Pina and these have
harmed the quality of life of their children. These have made themselves known in the lack of
follow-up to opportunities presented to them and haphazard support for the patient family
member.
Finally, the objectives that guide Pina are not based on any theory that would be
recognized by international development organizations or academics. It is very much an
amateur run project. They are amateurs in the classic sense, being very enthusiastic non-
professionals. They are learning how to do the jobs as they go, as far as the features of a
PVO, grant writing, reporting, accounting. There is no one at the project that can say that his
or her program is based on any specific development theory. The fact that the CBR program
is similar to others in Guyana for example is because they encountered these other projects
through written materials and at conferences. The objectives were created through a desire to
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serve and create a viable program, not to emulate a particular philosophy and none of the
prime movers at Pina have had any education in this area anyway.
4.5.2. Objectives as viewed by Patients and Workers
There is some difference of opinion between what the leadership states and what the
workers view to be the objectives. This may be due to one or more of several reasons. Many
of the salaried workers do not have formal educations, beyond basic education and are of
limited literacy. Secondly, there is a social class and ethnic distinction between the leadership
and the workers. The Mexican leadership class at Pina is primarily of European racial origin,
and the workers are primarily local indigenous stock. The members of the leadership group
are not the types who give carefully detailed instructions. It could be that being children of
the 1960’s they would rather give everyone a free rein. The workers complain that no
direction is given and that directions are vague. Often volunteers who come from Europe
complained about the apparent lack of direction given them from the top.
One of the long time employees of Pina stated the following during the interviews.
Elena had been at Pina for over five years. She was a 20 year-old woman who worked in the
special education area caring for Silverio, Maribel, and the other severely disabled children
who cannot care for themselves. She had a brother who is profoundly deaf, and he too
worked as an assistant. She walked several kilometers to and from the Project down from the
hills where she lives in a cinderblock house with her parents. Her father worked with the road
patrol of the national tourism agency providing assistance to travelers.
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She was undergoing a difficult transition from being a teenager living at home to
trying to find a way to live in the world independently as possible. She also worried about
spending the rest of her life working at Pina. Many of the other young women her age were
having children or leaving for Oaxaca and other larger cities. She had hopes and dreams of
one day having a profession, but seemed not to be able to cut away from her own family yet.
She had left once a couple years ago and spent nine months in Mexico City7 but came back. It
was too difficult for a small town girl with little formal education to become established.
One day she arrived at work her eyes red from crying. I was working with her in the
shower area, cleaning one ot the teenagers, and I noticed she had red welts on her arms.
When I asked her about it, she broke down, crying that her father had beaten her with a belt,
calling her bad names. It later turns out she had a sister who ran away from home years
before because of the abuse of the father. 1 did not know if he drank, but apparently, he was
quite a terror for her. She wanted to move out on her own and have her own place. However,
her parents take almost all the money from her paychecks. After this event she took a week
off and went up to visit a boyfriend in another village. When she came back, her family
agreed to build her a place of her own on their property. That would mean a one-room
cinderblock and cement building, which would still be considered very upscale for the area.
She represented for me a part of the different class structure at Pina. She and her
coworkers were not replaceable. The skill levels they had and the hours that they were needed
were such that not just anyone could do the job. If she or any of her co-workers were sick or
missing, the remaining trained workers who were left had to fill the gap, working overtime to
take care of the children who needed to have someone near them at all times. The only time
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off was at 8 p.m. at night when the last shift went home, and when Dr. Ernesto was at the
project for the evening, so if there were any emergencies, he was available. Their biggest
complaint was that there was never enough trained help. They had to work six days a week
and sometimes seven. They attempted many times to get volunteers to help, particularly on
Sundays, when there would be only one trained worker there. Six days a week there were two
workers at Pina for the children from seven a.m. to about four p.m. She has expressed a lot of
frustration with the program with responsibilities and opportunities going to others at the
project.
Another woman who worked in this same program area also complained that they
received no support from the volunteers. The volunteers wanted to do the more enjoyable
work, particularly in the garden or carpentry. Another problem with the volunteers, she
expressed was their language difficulties in Spanish. The problem of not being listened to by
the leaders was a complaint of the both women, that when they requested materials or
assistance in the program area, they didn’t feel that their concerns were as important as those
of people in other program areas. At the same time, Elena stated that although it took her a
long time to learn how to do her job, she was happy now that she had the skill and was doing
the teaching.
Elena commented: “I am not clear on what is the objective.... When you are clear on
the objective, you have it. I think that you have to fight for the objective and not leave it
aside...” She had no idea what the objective of Pina really was. For her it was a job and she
certainly recognized it paid better than other jobs in the area did. The developmental theories,
if any, of the leadership group, which would include Ingrid and Soma, did not concern her.
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For her it was a job, a special job, and one very different from any other in the community.
Some of the older workers I suspect did not care so much as long as they received their
paychecks.
4.6. TH E JUNTAS
The main objective of Pina being to promote independent living for the disabled in all
areas of their lives has resulted in the operation of Pina through the use of juntas, or
committees. No leader could say, “Now you are independent, go and live that way.”
Becoming self-reliant had to encompass all aspects of living. The meetings allowed people to
make their own decisions and instead of depending and expecting experts to make decisions
for them. They learned to use them as resources, and retain their own empowerment. This
did not happen overnight, it took place over many'years and still is an ongoing process. The
use of the junta is the key to Pina and its approach to rehabilitation.
The goal of promoting autonomy and independent decision-making was felt to be
crucial by tire foreigners who had been at Pina through most of its history. Bob and Ingrid
were both very knowledgeable about David Werner and the Projimo Project and his
philosophies of development. While acknowledging the differences between Pina Palmera
and Projimo they felt it was crucial for Pina to eventually be run by its participants. That is to
say by the Mexican Indians, not by foreigners. Projimo through Werner’s directives would not
let foreign experts deal directly with patients and neither did Pina. The paraprofessionals were
the ones to make contact with patients when doing village visits. The foreigners would go
along, but did not make direct assessments or recommendations for treatment or programs.
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Where the foreigners did have considerable control of things was in the meetings at the
program area level. In the small juntas for physical therapy and carpentry and particularly after
the hurricane in reconstruction, foreign advisors tended to guide the discussions more as well
as provide direct instruction.
Pina Palmera attempts to be democratic in its operations. It was not always so. It has
changed and evolved over the last decade. For the first 10 -15 years of so of Pinas’ existence,
entry to the project, employment or awarding of services to an individual were generally made
by the directors of the project, Frank Douglas (1970’s through 1986) and Ingrid (1984 until
the time of this writing, 1999.) The project was not registered as a not for profit organization
until the mid eighties. It is for this reason that perhaps it is not important to dwell on the
administrative structure as it existed during the early years but to concentrate on how it has
evolved while Ingrid was at the helm. Since 1992 there has been a change in administrative
structure that brought in the use of the juntas. Before that, it was more autocratic.
Once a week employees get together and discuss how they are doing at the job and
provide feedback for each other on their evolving abilities. The main junta on Tuesdays is
held in a thatched dome (the corned or), a room without walls that is about 20 meters in
diameter. There are benches placed around the perimeter and everyone squeezes in or stands
around the outside bamboo walls that were added to try to keep out the stray dogs. (It did not
work) There was no smoking allowed in Pina, but after the hurricane, those rules went into
abeyance and the smokers, mostly foreigners stood around the edges.
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The administrative structure of Pina Palmera is a unique example of a bottom-up
decision-making. It uses a series of full member meetings of the entire population as well as
the different areas of activities. The method of getting everyone who is involved to contribute
their opinions and participate in open discussion serves Pina in several ways. It trains people
in participatory democracy. By having a requirement in smaller groups to talk, it helps to
discourage demagoguery by more powerful personalities. It offers away to identify and train
leaders, by giving them practice in public speaking and articulating their observations, feelings
and ideas. This was particularly important for certain women, who did not speak up for
themselves in group settings, but after experiencing these meetings where foreign women
particularly were vocal, they began to speak up themselves.
Decisions about the entry, approval, or rejection of potential employees and those
patients who might be invited to stay for longer stays for therapy and trainihg take place in
the junta of coordination. These are brought before the Tuesday meetings final approval.
Within the different activity areas within Pina, each has its own junta that makes decision
regarding employment and participation. Since each area has its own needs and attracts
different people, they handle the first phase of entry. Individuals, say in the gardening area,
might have a friend who like that kind of work will introduce them to the others in that work
area.
The most difficult challenge the junta system faced while the research was occurring
was when a severely disabled teenage girl was discovered to have had sex. It was at first
thought that it was rape. She could not speak but was able to point to a man in a line up of
tire various males who were around at the time. He denied it. The administrative junta
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comprising the leaders o f each area within Pina decided to make him leave Pina and not bring
charges before the law. When this decision was presented before the general junta, all agreed
except for a few who felt that he should not leave until more investigation could take place.
Some weeks later she withdrew her accusation of this man, but failed to point out anyone
else. Those who knew her well generally felt it that it could well have been consensual sex.
The reason this incident was difficult for the administrative process was because of
the way the situation was handled. When it was brought to the attention of Dr. Martin he
gathered the information himselt and made a decision and presented it to the group as a fait
accompli. There was agreement with his decision amid discussion. Members of the carpentry
program presented disagreement, because the accused man was someone being groomed to
manage the carpentry project that had gone through several years of training. However, the
risk of having the government involved was too great so the doctor and others m the
administrative or coordination junta chose to get rid of the man. Several weeks later, when
questions arose as to whether he really was the culprit, it was decided to continue to provide
him with healthcare in his home village. Bob had taken me to visit him and we found him
lying in bed under a thatched covering; a room without walls. He seemed depressed but was
encouraged when told that he would be able to receive care again at Pinas expense.
4.6.1. Positive Reactions to the Juntas
Those who felt the Juntas were beneficial and positive experiences, these were
exclusively Mexicans, administrators, and volunteers who had worked before in other
cultures. Experience in participator)' democracy, such as union and student representation
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and understanding and appreciating the local culture made a difference in how people saw the
aspects of the participants coming together in consensus as a good thing or whether it was
just a waste of their time. The complaints towards the juntas centered more on the
unpleasantness of the time involved, rather than their effectiveness.
There seemed to be juntas for anything, anytime, anywhere. The volunteers had their
meeting every couple of weeks. The carpentry, garden, office, therapists, special education, all
had weekly meetings. There were the biweekly coordination meetings consisting of
representative from every7 group. Again, there was the Tuesday meeting of the entire Pina
family. Having these continual communication lines open made a difference in the ability of
Pina to adjust to circumstances, to make adjustments as necessary. The times of the pay
problem (when the funds for payroll weren’t released by the bank) in the summer and the
hurricanes were excellent examples of being able to quickly call together people to keep them
informed and to allow everyone to participate in the decision making as things arose. There
was no need to have ‘someone take charge’ because the people had been used to dealing with
crisis in a democratic manner. When Dr. Ernesto took over in a sense in the week
immediately after the hurricane, he did so more as a moderator. He did not tell people what
to do, only facilitated.
Dorcas, Ricardo and Bill were college students volunteering at the project during the
summer. Dorcas and Ricardo were from the Ibero-American University in Mexico City.
Dorcas had visited several times over the last three years. She was a psychology7 student at the
time working on a research paper for school. It was the first visit for Ricardo and Bill. Ricardo
played the clown; enjoying making the children laugh whenever possible. He also had a
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disability; he stuttered, and was a favorite of the young kids at the project. Bill was an
exchange student from DePawe University, Indiana, in the US on a yearlong cross-culture
program at the University of Guadalajara. These were the last few months of his time in
Mexico.
We sat on the porch in the front ot the special education building where three
disabled boys shared a room. In another room of the building was the nurses’ office. Across
the porch from the nurses' office was where a quadriplegic woman in her twenties stayed.
Where we sat was the location where every Wednesday morning young mothers would bring
their infants and toddlers for health examinations and physical therapy. This building was
made of cement and raised up about a meter or more from the sandy ground. During the
hurricane, it was in this same area where about 30 people gathered to ride it out.
While discussing how it is to be with the project, the three described how brave the
disabled children were in trying new activities. They also described how it was in the juntas
when presenting an idea as a volunteer from the outside. They also discussed how long it
takes an idea to take hold. Often, it takes a very long time. Referring to how the people in the
juntas react to people offering their opinions, Dorcas said the following:
They listen, If you have an opinion to make they’ll hear you.
They like to hear the opinion of the newcomer...and you can give
them another point of view. OK, it takes a lot, a long, long time, to
understand what you are saying, (because of the foreigners poor
Spanish) they’ ll get it - it’s a very.. .1 think it’s very good, it’s very
healthy. That’s what Ingrid wants. She wants to be able to leave.
(Interview: Dorcas)
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She is referring to how Ingrid wants the junta system to succeed, so that Pina can
take care of its own affairs and not depend on a specific leader like she has been.
Guillermo was one of the people described by Ernesto at the beginning of the
chapter. In an interview, he said nobody was “in charge” but that the people had inner
motivation, and that was important. When asked what would happen with Pina after Bob or
Ingrid left, he said with confidence, “Mexicans would run it.” He was one of those who
facilitated the general junta on Tuesdays. He felt very confident in the Mexican’s ability to
manage the project and its’ activities on their own. He had initiated the first aid training and
rescue demonstrations on the beach by himselt without any outside guidance or aid. So it
seemed natural that he and the others should be able to continue the programs at Pina
Palmera without foreign leaders.
In the following selection Bob talks of how the original group of volunteer dreamed
and planned and worked to bring Pina to the next step from being simply the work of a single
individual. That person being Frank Douglas, “Panchito,” or “Sashwa.”
My advantage or disadvantage was that I was 42 and
everybody else was in their 20s. I had been around in the world. I
knew a lot of tilings. I didn’t know about Mexico, but I knew about
life pretty much and these people didn’t even have a clue about life.
From that group, we always said, why are we making decisions, we
want to teach Mexicans to make the decisions. So then more and
more started to have different meetings, but the Mexicans didn’t
want to make any decisions. They wanted someone to tell them what
to do and give them a paycheck at the end of the day. Tia Maria [The
chief cook at Pina] now speaks at meetings. She’ll defend herself.
She’s under lots of pressure. She doesn’t hear how everybody is
saying what a horrible cook she is. (Interview: Bob)
We just completed a planning meeting for the summer camp
coming up. The Mexican employees conducted it. A large sheet of
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paper showing each day and hours from 8-5pm for the four weeks
coming up were displayed. The groups of about seventy campers are
organized into three age group's: 1-5, 6-10, 11-18. There will be
activities ot painting, carpentry, theatre, gardening, as well as
excursions away from Pina. The budget was displayed, the people in
charge of each activity, logistics all were discussed over an
approximate two hour period with about twenty people attending. I
(the researcher) was asked where I would work, and chose painting.
(.Researchers Log)
The next entry further describes the juntas and how they were used after the
hurricane to address the pressing needs of reconstruction and other issues.
The first thing was organizing ourselves. Juntas occurred
daily in the morning and the evening, to project the needs and review
progress. Carmen and Armando took over the group at the hospital,
the severely needy kids, the elderly and homeless Pina associates.
They could teach the militaire (army) about schedules and systems!
We’ ve basically had to split our energies between Pochutla and Pina,
one team caring for the kids, the other restoring what’s serviceable at
Pina so we can get mem back ASAP, (Reseatvb Log)
The preceding log accounts illustrated the various ways in which the juntas were used.
People brought up ideas to consider, issues that needed attention, or announced activities
they wanted to initiate. The group would then discuss the proposals and announcements.
Both the general meeting and small meetings were the nodes where participants met and
made the choices that would determine the course of the project. The juntas controlled both
individual and corporate directions arid provided the communication channels needed. The
following excerpts from the newsletters are arranged in chronological order demonstrating
how the junta introduced the volunteer to the program from entry on through project
approach to dealing with the emergency of the hurricane.
1 am proud to tell you that we were the most democratic
organization that participated in the conference. A big interest was
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shown in the decision making process ot Pina Palmera. The days
after the conference we visited 15 or 20 different places, everything
from non-governmental organizations to the Nicaraguan Health
ministry. We found many similarities between the way we work and
how they work in Nicaragua. ( Soivetg, Therapist from Sweden.
Newsletter #55 Dec. 1996)'
Consensus is the chief way of arriving at decisions. An executive or chief is the
figurehead or unifying figure for the decisions made by the group. According to Laura Nader
in her book “Harmony Ideology: Justice and Control in a Zapotec Mountain Village,” the
Zapotec are “intensely egalitarian” (p 275) the villages have used consensus to arrive at
decisions since long before the conquest. The Indians used juntas to reach decisions and to
assign responsibilities as part of their traditional social structure. The technique in how they
were to be used may not have been the same as that promoted by Pina Palmera, but the
system at Pina certainly was not unfamiliar. The primary difference would be that in the
traditional village, only members of that village could participate, strangers and other villagers
could not. At Pina the junta system invited people from many different ethnic and national
origins to work together. The biggest change over the years of the implementation of the
junta system was that of the indigenous people becoming more and more vocal and
participating in the junta system. They still had their own leadership and social structure
within Pina that was not evident to the foreigners, but they were beginning to do more than
just sit silently in the juntas.
Irma who worked in the kitchen was the one I went to when I wanted to find out
who were the people who held the most influence and respect among Mexicans and
indigenous people outside of the official leaders. It was she who first told me about Alma, the
curandera who most of the Mexicans went to first with their ailments and problems before
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approaching Ernesto or any of the regular health care givers. It was through her that I first
discovered the different layers of culture and class at Pina. This was an interesting example of
the prismatic view of leadership, the difference between the leadership on paper, Ingrid, the
informal leadership, (Alma, Armando and Juan) and the effort to create a third leadership
form, the juntas.
The rotating of leadership at Pina is a natural outgrowth of the “cargo” system that
demands that all citizens in a Zapotec community participate in municipal government,
contribute labor for community projects and participate in fiestas and other celebrations
which further serve to maintain community ties. (Kearney, The Winds of Ixtepeji 1972) Most
of the activities and obligations in a village serve to keep the society together and deepen the
connections. Anything that serves to weaken these links or that might be feared to do so is
found to be threatening and suspect. '' 1 .
These cultural acts and offices are found in among the other Indian groups as well.
The degree of traditional consensus democracy may vary. The incorporation of the junta
system at Pina just institutionalizes and uses an existing system with which many of the
participants are familiar. The need for consensus resulted from the hundreds of years of
conflict with other villages and with other tribes and outsiders. The need to maintain unity in
the face of these outside forces that work to divide the village is very strong. The presence of
other religious sects and political groups and efforts are strongly resisted for these reasons.
(Kearney 1972) The system at Pina could be said to be a recasting of the mayordomfas system
that existed in the villages. A system that only healthy men could participate in. The
mayordomias was the name for the system that assigned social obligations, responsibilities
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and status among the men of the indigenous village. The juntas in the villages would assign
cargos or roles to men and in Pina; the juntas did the same for all the participants. (Foster
1979)
Just as with Pina Palmera, the various juntas take as much time as they need to
address all the points in the agenda. People are not permitted to leave until all issues are
settled. At both as 1 observed at Pina and in the traditional village, (Kearny) fines are imposed
on those who purposefully avoid or come significantly late to the assemblies. Because this
system of local government is something that just about everyone grew up with in their home
villages, the use of the junta system at Pina was understandable to the indigenous members
and did not require much explaining or efforts to institutionalize.
A conflict with foreigners arose because of how the meetings are conducted and how
the decision making process occurs. Even though many of the foreigners were familiar with
parliamentary procedures from their own cultures, many of them did not have the patience
for the junta system. They would get very frustrated from the slow pace of the meeting and
from the repetition of statements by many of the Mexican participants. It was very much a
cultural feature of the meetings that the Mexican people would speak, and often repeat
themselves in variant phrasing and then when they felt satisfied that they had said their peace,
they would defer to the next person, who if also agreeing with the previous speaker would
continue to echo the same sentiments again with repetitive styling.
The neo-colonial development approach effectively teaches people to defer to the
foreign experts and wait for them to make the executive decisions. This may act in conflict to
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the traditional ways of conducting business. At Pina, there is a concerted effort to get people
to use the ways familiar and natural for them to address these issues; using them in ways
maybe they had not thought of before. Hence the effort m CBR to get villagers to use
“reflexive thinking” as Sonia calls it. Sonia is the Brazilian woman who is the chief fundraiser
for Pina and is the person who initially brought the concept of using juntas to administer the
program.
What strikes me most is how democratically the community
functions, and how the local people are involved in all areas and all
levels of decision making. This is reflected in the interest the local
workers and families show in their work, one can see it everywhere
in Pina people helping each other and not counting hours. ( Yves
Rioux, a French post-hurricane volunteer, Newsletter # 3 8 A p r 1998)
Indigenous people and foreigners who had experience in democratic institutions such
as unions or had more socialist theory felt generally pleased by the way people were allowed
to participate in the open system of the general meetings on Tuesdays. Caucuses took place
informally where volunteers or other groups would plan for making presentations. During the
Curso de Verano. there were for each activity planning meetings and debriefing session.
During the aftermath rebuilding of Pina there were also two daily meetings that planned and
reviewed. This went on for more than two months after the hurricane. There was a general
feeling that this helped efficiency and targeting resources. By January, some volunteers felt
this was taking away from their work time. It is difficult to separate the cultural factor from
any of the respondents’ opinions.
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4.6.2. Negative Reactions to the Juntas
Those who did not like the Junta system were mainly the foreign volunteers. It should
be noted that there was a division in the opinions of foreigners. Those who had experience in
other cultures before their time at Pina and those who had received systematic cross-cultural
training supported the junta system. It was the volunteers who did not have the above
training and experience that experienced the greatest frustrations. Another factor with
foreigners is the cultural impact. Europeans and Americans were very frustrated by the pace
of change that was dictated by the consensus building process. Individually they would
identify a problem and want to solve it immediately.
There were also complaints from those Mexican and indigenous employees who feel
that the majority7 is ignoring their work area or project. Some demagoguery took places during
the juntas. Certain individuals did regularly dominate the proceeding. As is pointed out in the
evidence below, most felt they were able to receive a full hearing of their needs and opinions
and were pleased with the system because of this.
Klaus was a volunteer from Switzerland. He was an electrician and worked with the
maintenance crew repairing all the wiring as well as installing new electrical systems after the
hurricane. He had visited Pina about two years before. During that first visit, he had worked
more with the severely disabled children. Now, in the aftermath of Hurricane Paulina, he was
cross-training Abel in electrical maintenance that is to say they would work together on the
repairing of systems on the ground. He would begin a repair and then have Abel do another
part of it. Klaus would correct and instruct and demonstrate throughout the day, very much
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in the manner of master and apprentice. Abel had been shot in the head during a robbery
attempt a year earlier, and though he could now walk and talk, he had difficulty following
complex instructions and following through with his duties. Teaching Abel was not always a
successful operation. Klaus was conscious of how much easier it would be just to do it
himself and then leave it for Abel and others to figure it out later. He very much wanted not
just to leave a legacy but also to leave a trained person who could do the work. The problem
was that Abel, maybe due to his problem, maybe not according to others, did not seem to
have the interest in digging deeper into developing the skills required for the job.
At one junta Abel was to have said, when questioned about the new electrical system
being installed after the hurricane, “Don’t worry, after the gringos leave I’ll put things back to
normal.” At this, Dr. Ernesto was supposed to have said, “Don’t touch anything.” This was
very much a blow to his self-esteem but also pointed out one of the issues at Pina. The
standards of what is considered ‘ good enough’ expected by foreigners were not the same as
some of the local people.
Klaus described his own frustration with the junta system, particularly the part of
waiting and taking up valuable work time. “The junta is for all the people- - but when you
listen to the junta...on Tuesdays, you start listening, listening, and after an hour, I get bored.
Because it’ s like this and this and this and this, and naturally I’m not interested in, ah, how
they clean the banos or how they do that,” Bob added his opinion about the juntas as well.
We had all these personality conflicts. There’s so many
dynamics. Margarita, Carmen, Manuel...because they really didn’t
want to work. They were here for the money. It’s not a lot, but as
Tina loves to say, they make just as much as they would working in a
restaurant for 12 hours a day and that would be nothing. [The pay
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they would receive at another job couldn’t compare to that at Pina.]
Where do you go if you don’t want to do anything? I'd like to cry
sometimes. I watch Abel walking around here and want to cry. We’re
not doing him a service... Everybody’s got their niche and nobody
wants anybody to fuck with their niche. All the people who are lazy
band together. They don’t like Juan because he’s a hard worker and
makes them look bad. And it’s just a whole insidious psychology
going on here. It goes on so much that you’re missing the point;
you’re missing the boat. We’re here to work with these people.
Solveig was angry with me because Manuel was in charge of
hydrotherapy and I’ ve never seen him do anything. (Intem en: Bob)
The use of these juntas to arrive at consensus to deal with problem solving seems to
go very much contrary7 to the Western approach. For all the talk of democracy by Westerners,
when a pure democratic process takes place, without time constraints and other rules to
streamline the process, many of the foreigners got very anxious and agitated. They really
prefer quick direct action. In this way the juntas may have exposed a fallacy of the Western
approach to development, that one line, democracy is preached, but another, autocracy is
preferred.
Judy was an American volunteer who had been at Pina several times over the last few
years. This time, after the hurricane, she had come back with financial backing from the
Canadian Embassy. She had brought an expensive and complicated water filtering system.
This caused some consternation, because she had not consulted with the participants as to
whether they thought it important, which they did not. This in turn caused her to become
frustrated with the reconstruction process. Although very driven and energetic, she alienated
both Mexicans and volunteers. She did not seem to understand why others did not share her
enthusiasm or ally themselves to the issues she felt crucial to Pina. Her interviews contained a
lot of bitterness about not being appreciated or recognized for what she felt she had
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accomplished. She admitted in her interviews that she did not have any cross-cultural training.
This lack of training before engaging in development resulted in the frustration that many
volunteers expressed with their experience at Pina. Those who had this training, particularly
the volunteers from Belgium, had much different experiences that resulted in positive
evaluations. As seen in the following selection, having an understanding o f how differently
culture view time would have helped her. Judy had among other frustrations, related that she
felt that people didn’t act on her suggestions, or that the teaching she had provided in
previous visits didn’t seemed to take hold. She makes a very interesting point about how
people from the USA value time and the people in Pina value peoples expressing themselves.
It might have seemed that once people had talked, there was no need to act. It was as if
talking about something was as good or equal to doing something.
Firs*t of all, nobody came on time. So, obviously, it’s not r
something that they (value] ...there’s something missing. The
enjoyment of it, the feeling that they’re really getting something-
done. There’s something lacking at the moment that I see. People
made decisions and they brought stuff up and the other thing is that
what I taught was meeting facilitation when I was here and now 1 see
that it’s all been forgotten. Because what I try to teach is that it’s
important, and again, this is coming from our culture where it’s
important to respect people’s time. And here, it’s important to
respect people’s talking. So those are differences and so I can let go
that what I had to teach wasn’t so important. But what I tried to
teach them was to make an agenda, which Pm sure they do now and
they did that before, but to put a time limit on it. Because otherwise
they end up talking about garbage for half and hour. (Interdew: Judy)
The point of this is to show that although people had increased their ability to talk
about things, they hadn’t yet refined the system of conducting a meeting in a manner that met
with the satisfaction of the foreigners. Roberts Rules of Order was not a book to be found in
the library at Pina Palmera. However, their system, which as pointed out, earlier was a
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modification of the traditional system, had its own rules of order, just not printed out in book
form. The conflict between the cultures could have stemmed from the fact that both
foreigner and Mexican had their own concepts of what a good parliamentary or junta system
was.
The Galician volunteers from Spain had arrived shortly after the hurricane to
volunteer. Lucia, Nicholas, and Azana operated a fishing import company in Spain but
decided to take a break for a year and travel. Lucia worked with the women in the Cocina
(kitchen), Azana in the carpentry- project and Nicholas assisted with translations both for the
project documents that needed producing for fundraising as well as assisting in the interviews
conducted for this research. Because of their abilities to move between both other volunteers
and with workers they had a unique viewpoint and were able to bring out opinions,
particularly from the women workers at the project, that neither were brought to the
administrators’ attention or in the research interviews. Bothersome to them were the
women’s sense of being disregarded by the others at Pina and their resentment of not
receiving day care for their young children, when for example, the Directora received maid
and baby-sitting services. They were very conscious of being at the bottom of a class system
within Pina Palmera.
The three of them were quick favorites with all the kids and people at Pina. Lucia
brought a new menu to Pina, and did so in a gracious way' that did not offend any of the
women working in the kitchen. Instead, they were glad to have someone support them in the
desire to augment the cuisine beyond black beans and rice. Azana was a very good carpenter,
and was quite a clown and great entertainer. He would play guitar and sing what he called
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“English Batua” he would sing songs in English, but if he didn’t know the words he never let
that get in his way, He made up sounds and words that sounded right, even if they made no
sense at all. By the time 1 finally left 1 had the lyrics of “Country Roads” and other songs
permanently destroyed in my memory. Nicholas helped me in my interviews. People, mostly
the indigenous workers, who would not be comfortable one on one, felt reassured by his
presence and were more willing to speak openly because the felt they were among
sympathetic listeners.
They rented a house in the village a kilometer from Pina. We were gathered together
at a table underneath a porch. Most of the houses are built with cement or adobe with cement
coverings and have a covered porch area facing the ocean. They were very animated, speaking
over each other. They were not reticent about giving their opinions. Sharing the language
does not mean they share the country, and like Judy, they were frustrated by the time spent
on the meetings. Azana described how he felt shut down from. speaking at the juntas.
When I protest in the meeting that people don’t w ork...
(He was scolded by another volunteer and told not to talk) I am not
entitled to speak because we haven’t been here enough time. Let us
miss the meetings; there are so many things to do. Let us make
meetings when there is not anything to do. I said at the meeting they
lost 30 people’s working hours every 'Tuesday that they go to see two
people that speak. (Intemem A^afia)
It should be noted that the situation with juntas they objected to occurred after the
hurricane. After Paulina the population of foreign volunteers grew from about three to
almost twenty. There was a difference sense of urgency during the juntas of the winter of the
hurricane restoration and during the summer. In the summer, the paid employees had the
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problem. In the winter, it was everyone. There was more of a tendency among the foreigner
to want to abandon the use of the juntas to make decisions after the hurricane than before.
They felt compelled to act first and discuss later. Again, this points out the cultural difference
between the people of the West and the indigenous peoples. The notes following are from
the summer.
Another reunion this morning. The first without Ingrid, it
was very disorganized. The woman who led last time did not have
Ingrid’s support so she did not control the meeting. Only 35 people
arrived for the meeting, and many came and went during the
meeting. It lasted approximately 1 hr 15 min. People talked about the
problem of toilets, showers, dogs running loose, children without
things to do, becoming aggressive and not having parameters.
(Researchers Log)
This is reference to the lack of supervision and organized activities for the children.
They had no one actively coaching them on what behaviors were acceptable and which were
not.
To recap, those who did not favor the juntas were skewed heavily to the foreign
volunteers. However, in many aspects, I think the junta process is for me the most valuable
aspect of Pina Palmera that can be exported. It was one thing to read about these types of
systems in textbooks, but to see them actual work; with all the difficulties they posed, were
different, and affected me. In contrast to Pina when, only a month out of Mexico, I went to
Africa to assist in a NGO that used a traditional top-down approach and saw all the problems
they had. Among these, lack of enthusiasm, ownership of the concepts they wanted to
inculcate and the constant catch-up the administration had to do because their employees had
no incentive to anticipate and troubleshoot problems before they occurred. They were just
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paid employees, like the civil service, and 1 wondered what would happen if the NGO pulled
up stakes and left the country. I tended to feel that after a time, it would be as if they had
never been there. I do not think the same will happen with Pina.
4.7. ALTERNATIVE POWER STRUCTURE
There was a hidden power structure in Pina. It was the existence of a leadership class
among the indigenous stall members that was unknown and was belittled by some foreigners.
On Christmas Eve, a deaf couple staying briefly at Pina was having trouble with their
newborn, which seemed to have a fever. The doctor and the nurses were not present and
among the foreign volunteers who were conducting the party, there was worry because they
didn’t know what to do and where to find a medical person. I had learned that one of the
women working in the laundry was a curandera. so I suggested to the volunteer leader that
she contact this woman. She refused at first -and ridiculed the idea that the laundry women
knew anything about medical issues. 1 then went and found the woman, explained the
situation and she came and looked at the baby. She reassured the parents and was able to
make the baby relax and go back to sleep. The foreigner was amazed and talked to the healer.
She then apologized and later established great interest in learning more from the curandera
in the lavanderia.
Irma is not a member of the administrative staff. She is an employee, but because she
and her family are favorites of the volunteers, and because of this relationship, it makes her a
very influential person. When approaching and examination of power structure, it is
important to differentiate between what the declared power structure is what the actual power
structure is. The two can be the same and they can be different. In the case of Pina Palmera,
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there is a declared and official power structure of die junta and the leadership of Ingrid and
doctor Ernesto. Another power structure consists of certain personalities at Pina who may or
may not hold official titles. Alma works in the laundry, Irma in the kitchen, Juan in the garden
and Aaron with the children. They may not have the titles that Ingrid and Ernesto have, but
in many ways, they are the essential decision-makers at Pina. They are the ones that workers
go to. Ingrid is the first person that volunteers go to.
The limited good issue among the indigenous explains why the healer in the laundry
did not announce her status. She wanted to keep her gifts and status a secret so as not to
endanger it. That one of the real leaders of Pina worked in the laundry was completely
keeping with this concept according an interview I had with Joseph Benton, a researcher on
the Zapotec who works with the Summer Institute of Linguistics m Catalina, Arizona. That
none of the foreigners knew about this other power structure at Pina would exactly the way
the Indians would prefer things to be.
The fact that foreign volunteers including the researcher did not know about this
power dichotomy is telling. It was not until the interview process, where Mexican subjects
directed me repeatedly to Alma that I discovered her influence over the project and its
participants. There is nothing in the documentation from Pina about her or her position.
Even in the face of the junta system of administration, there were two other power structures
at work in Pina, possibly more if one considers the fluid state of volunteer’s presence. They
would form and reform their own social structure continually with their continual coming and
goings. The Mexican and indigenous people had their leaders who they recognized and
deferred to. The project itself had its leaders as presented on paper and as recognized by the
world at large. It could be questioned whether the junta system didn’t in fact rubbers tamp
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decisions that the other leaderships made already and used the junta to present them. This
certainly was the case in the situation of the supposed rape and in how the administrative
junta presented its decisions at the general junta for assent by the total group of participants.
Pina attempted to be democratic, but was it? Ultimately it may be hard to decide given the
presence of this alternative power structure.
4.8. RECRUITMENT
4.6.1.Rectruitment of Patients and Workers
People encountered the Pina Palmera project several ways. There was no apparent
formal entrance procedure into Pina. There were examinations and medical tests for patients,
but nothing formal to screen and enroll people into the program. It seemed that many came
and some stayed. Those who received care for the most part sought out that care. The late
Frank Douglas, the founder, an itinerant healer, regularly walked through the area, visited the
isolated villages looking for disabled and sick individuals, and offered his services of healing.
The people he worked with were people who could not afford to go to the doctors who lived
in Pochutla. When the land on which Pina is located was donated, and housing constructed,
many of the first people to come there were battered women and their children.
There are several methods Pina uses to bring people into its sphere of influence. The
Curso de Verano. village operations of Community Based Rehabilitation, the Wednesday
morning free clinic, the weekly radio program, Salvavidajr. Program and the office practice in
Pochutla of Dr. Ernesto all bring people into contact with the sendees offered at Pina. The
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presence of volunteers and their leisure activities on the beach and in the community provides
an informal way for people to learn about Pina. But most of all in interviews it seemed to be
the recommendation of a friend or relative who had experience with Pina that was the most
common reason for becoming involved with the project
All of the following stones are from people who entered Pina Palmera because of
meeting someone who knew about it, a relative or during the village visits. No one I met
entered Pina from learning of it through the media or through a formal process as people in
the West might regard them. By the West, I refer to those who are from Europe and the USA
and Canada. There are in a sense two different communities involved in Pina. There is the
community of the West linked by the computer and the development community and the
immediate community around Pina Palmera. The latter include villages of Zipolite, Puerto
Angel, Pochutla, and other smaller mountain villages. There are no government resources or
public and popular media making announcements as to services available. The weekly radio
program conducted by die staff at the project may be considered as a way of using the media.
But the content of the programs are more informative and in the area of self-help, aimed at
those who wouldn’t necessarily come to Pina for services. The following are some of the
testimonies from those who have come to Pina. They describe how and why they are
involved with the project.
Ezekiel is a paraplegic man in his early thirties. He came to Pina first through the
CBR program in the villages. He is the brother of Armando, and together they run the
carpentry project, initially under Bob’s supervision. Ezekiel was paralyzed in a hunting
accident, and moved from village to Pina and by the end of the fieldwork had moved to a
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home in a nearby village. He and his family have been associated with Pina for about five
years.
He could often be seen outdoors under the shade of a tree, laying stomach down on a
tilting table, which allowed him to distribute his weight more evenly, it also helped with the
healing of his pressure sores, or ‘ ilagas’ as they are called. Around him were children,
volunteers gathered at a table outdoors under some trees. On the table were the various parts
of die toys the carpentry project builds and sells. Young kids were sanding wooden turtle
shells. Volunteers were painting wooden bird wings.
Sitting in their wheel chairs nearby were some the children of the special education
area and their assistants. They were happy to be around the group and not separated. Their
caregivers could be found chatting or working on their own learning. Inez, the girlfriend of
Manuel sat next to daughter of Ezekiel. They worked togedier to help Inez learn to read. Inez >
is middle aged; Ezekiel’s daughter is about 11. She shared her school materials with Inez.
Ezekiel, Armando, and Inez all went to the same church. At Pina when they were between
activities, they had informal sessions under the shade of trees copying out verses and reading
aloud the Bible to improve their literacy skills.
On Sundays they meet in a hot cement block house near the beach. The church
sendee itself was unique. Ezekiel and Armando were the elders. Ezekiel sat in his wheelchair,
held the microphone, sang, and lead prayers, and Armando played the guitar. They gathered
in the living room of a cement house near the ocean. The steaming congregation of 40 or so
divided themselves up along the walls by sex. Women and girls sat on one side, the men and
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boys on the other. The singing and prayers rose and fell in waves that mirrored the ocean
location. When they prayed, each of the people said aloud something different. Some chanted
repetitious phrases; some pleaded for healing, laid hands on a member in a wheelchair. It was
loud and confusing for the outsider, and difficult to follow, so many different things going on
at once.
This description was added because the indigenous Protestants represented a large
and influential faction within Pina. They represented the group with the highest literacy rate
of the indigenous and mestizo groups at Pina. Because their church had connections to other
churches in Mexico and outside the country, they used this support network to aid with their
projects at Pina. They viewed their presence and involvement at Pina as an outgrowth of their
faith as well as an opportunity to reach others with their point of view. They viewed Pina
Palmera not only as a place of work and therapy but also as a mission held to reach both
Mexicans and foreigners. The friction between them and the other Mexicans at Pina was
duplicated throughout Mexico. It was the Protestants who refused to participate in the
mayordomias system of the villages and contributed to the breakdown of social cohesion.
They brought these issues and this history with them to Pina
I already spent have 11 years being disabled due to a hunting
accident in the field with a firearm. They shot me in the back (he did
not say who, but it is assumed his hunting companions) Since that
time I have been disabled. I went six years without making any
money in the country or in tow n... For me it was very lamentable
because of my desperation. 1 felt that I could no longer do anything
because I was no longer able to work. But the time passed. My
brother has a boy that is disabled. He was born with a severe mental
retardation. He wanted to look for a center to send the boy to. A
person knew about this center. He came to bring some of the
children that were sick there so that they would cure them and here
they assisted them. That person told my brother that there was a
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center for childcare here in the Palm Grove. He came and talked
with Dr. Ernesto. They came to an agreement. They would take his
son but he could not leave him here alone. He told him that he had
to stay in the center so that he could train them how to assist the
boy. My nephew likes therapy. After that, my brother decided to
come here with his wile. They have already been here four years. At
the beginning, he didn't work in carpentry; he worked in vegetable
garden. They grew fruit trees. He then became a supervisor for the
children. He then was teaching the children. (Intervieiv: Ezekiel)
This is a very typical example of how patients and relatives of patients became
workers at Pina. Because the reality of disability is that therapy is a life long process, the line
between patient and employee can be difficult for the outsider to see. In the case of Ezekiel,
he was both a patient and a worker, during my stay he was at the hospital for the first several
months, a stay funded by Pina. When he came back he went through therapy and worked
when he could. For most patients, their economic situation precludes them from being able
to pay cash for the services they receive, so it was expected that they repay in whatever service
they could render,P,ina. So some worked in the kitchen, some in carpentry, and for some that
became long-term employees, they began in one area and eventually found their calling in
another.
One thing that was noted m the conversations particularly with tine Indians and
people from the mountains is that they would rarely answer questions about themselves
directly. Ezekiel was more concerned that 1 understand that his family was involved and had
benefited from Pina. He wanted me to know how his brother and his nephew came to Pina
and gained health and training before he would talk about himself. According to his friends,
he had radically changed his point of view on his disability from one of despair and
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hopelessness to a very positive and productive life. His testimony also describes this change
of attitude.
Julia is a 19-year-old girl who grew up at Pina and for the last year has lived in Oaxaca
City going to preparatory school. She lives in a group home with other older kids from Pina
who are now in high school. She has severe leg deformation due to polio. She has spent most
of her teen years living at Pina and going to the local schools. She is now, with the others
going to the equivalent of Jr. College. She is learning to be a beautician. Being very gregarious,
at ease with people, as well as sympathetic and willing to listen - she seems to be the big sister
for many of the girls here, the one they go to for help and advice — I think she will be very
successful. She started at Pina through the GBR program in the village and came to live at
Pina while she went through a long series of operations and treatments.
My name is Julia 1 have been living in Pina 8 years. 1 came to
Pina for physical therapy. I am now in Oaxaca City and I study there
how to be a beautician. I could not walk before with my crutches. I
walked on my knees on the ground and (when they met me) they
told me they could give me crutches if I wanted to work and that
since I didn't know anything, 1 didn’t know that anything could be
done, 1 was pretty ignorant? No? Then they told me they could give
me an operation and physical therapy. That’s good, No? My mother
no longer believed anything could be done but she gave me the
opportunity. Then they brought me here. I met with specialized
doctors who come here every three months. Fortunately, they said
that there was a little possibility that 1 could walk with my crutches.
The problem was that I had polio but I was very strong. Then the
doctor could see the possibility because I had great desire, no? Then
they took me to Oaxaca to operate on me and....My feet! After the
operation, they continued giving me physical therapy very strong and
so finally, so finally, until I was able to support my self standing... and
they were able to stop. [The therapy] {Intmvieiv: Julia)
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Julia was an example of a patient, who though very seriously disabled and disfigured
by the effects of polio, had such a strong will, that she was felt to be a good investment of
Pinas efforts. While I was there, she did not use her braces vety often. She told me that it was
extremely painful to stand for long periods. She used her wheel chair much more often. She
had a very strong upper body. When she used her braces and crutches, one could see how
much more developed her upper torso was. Her arms seemed to float her legs above the
ground.
Manuel works as promoter and para-therapist in village visits for the community-
based rehabilitation project. He also docs odd jobs around Pina. He has been here many
years. He came initially as a patient. During the Curso de Verano. he displayed great joy
bringing the campers out into the water for the hydrotherapy. He and Margarita as well as the
Jr. Lifeguards, worked together to provide a safe environment for giving many kids their first
experience in the ocean. He is tall, lanky, and friendly. Like may people at Pina, he seems to
find himself divided between tasks at the project. Sometimes a village promoter, sometimes a
therapist, sometimes a maintenance man. This seeming lack of focus caused some of the
volunteers to feel Manuel and some of the others were not even trying to be professional. For
me, living at Pina was like living on a ranch, there is always something that needs to be
repaired or something needing attention. Nor having people specifically trained meant having
to accomplish the task, the best one could. He said:
My name is Manuel Mendoza I arrived to Pina to work in
construction. I was working in the house where Ana lives. I was in
an accident in a van. 1 fractured my knee and directed the other
people in the accident to bring me materials tor a splint. When I
came home, I built my own wheel chair. When Ingrid and Dr.
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Ernesto saw what I had done they asked me to stay for therapy and
work with other patients. (Interview: Manuel)
Manuel is an example of how most of the workers are actually patient-workers. Out
of thirty workers, 11 were disabled and another two had disabled children. Five of the female
workers had come to Pina in the early years to escape domestic abuse. Pina offered a
sanctuary from many problems they faced in the outside world.
Irma works in the kitchen, cooking and cleaning. She grew up with polio and could
not walk before coming to Pina. She still wears a small molded plastic support on her calf and
ankle. Her husband, Juan works in the garden and fruit tree nursery. She has been at Pina for
about four years and married tor about two. They have two children. She is also very
articulate and she looks forward to operating her own hotel some day for tourists at Zipolite.
She and her family are a particular lavorite with volunteers. Her toddlers are very precocious.
Her boy insists on helping his father do the watering of the various seedling and plants. He
also has helped his mother in the tortilleria. (the little shack next to the kitchen where people
make tortillas) imitating her and the other women, rolling, forming, and making his own
tortillas.
In the hours after the hurricane, there were almost fifty people in Irma and Juan’s
two-room house that was up the hill from the flooded project. We sat there shivering in the
cold, and dodging drips from missing roof tiles. With the dawn, after a sleepless night sitting
in a chair, I watched people file out into the sun, and it reminded me of circus clowns
climbing out of a tiny car. It was hard to believe so many people had been squeezed into the
tiny house.
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She had described how she had gone from being a shy person who did not have
much hope of a normal life, to one with a happy marriage, and great respect from her peers
and from the foreign volunteers. Irma stated the following:
My name is Irma and I am here to get some help so that they
can operate on my foot because it's been kind of hard for me to walk
because I always used to walk without shoes and the floor was too
hot for me and one day my mom came here and she informed herself
about my problem and then she talked to Ingrid and then they sent
me to got get operated on and then I got shoes and that's when I felt
like a real person. (Inlerimr. Im a )
Lazaro is a young man in his late teen that has a serious case of polio. He also is one
of the strongest swimmers in the Salvavida jr. program. When he is in the water it is hard one
would not know he had a disability. When he exits the water his pulls himself out and moves
like a sea lion, pushing with his rear legs as one unit and holding himself upright on his arms.
He works in the carpentry program when he is at Pina. This autumn he moved along with
Julia and several other young people up to Oaxaca City to go to school there. He wrote in a
newsletter the following about himself:
I have lived at Centro cle Atencion Infantil “Pina Palmera”
for seven years. I fell ill with polio [sic] fourteen years ago, when I
was four years old. My parents lived in a small village in the
mountains together with my grandfather. It is a very isolated village
where there are no doctors or clinic so 1 never got vaccinated against
polio. After the disease I could no longer walk. I had to crawl in
order to attend school. Sometimes my father earned me.
When I was eleven years old, I went to Pochutla with a
friend to get a copy of my birth certificate. There I ran into the
physical therapy assistant Araceli and Ingrid Olsen, who told me
about Pina Palmera and what they do there and how they support
people with disabilities. They offered to take me to Oaxaca City for
corrective surgery on my legs to make me able to wear bandages and
learn to walk. I was very happy when they told me about getting
surgery in Oaxaca, but when I explained this to my parents they
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didn’ t readily agree because they didn’t have enough money to send
me to Oaxaca City and they were afraid I would die from the
operation.
Two weeks later Araceli came to my house in a village called
Santo Domingo de Morelos. She came to take me to the Palmgrove.
I really wanted to go and I wasn’t afraid to go through surgery. My
parents now agreed to it too, because my teachers from school
explained to them about surgeries. They also didn’t want to see me
like that anymore. Araceli explained to them that Pina Palmera would
cover the expenses so that they didn’t have to worry about the
money. Lazaro, teenage patient at Pina Palmera. Newsletter #37, Fall
1997
Lazaro goes on to describe the out come of his surgery and how' his life has changed
since coming to Pina. He certainly is a popular guy with the other kids at Pina; he enjoys
playing wheel chair basketball, and plays sports using crutches. He is looking forward to
having a regular life after school, and is very thankful for his involvement with Pina. The
following is an excerpt from a newsletter m reference as to why a patient is at Pina rather than
somewhere else:
.. .he has had [polio] since he was eight months old. Two
years ago he was operated on at the hospital in Oaxaca and he
probably has to have more surgery next year. Another reason is that
Pina Palmera is the only rehabilitation center in this area. If we don't
help someone, that person has to travel all the way to Salina Cruz,
four hours away, or to Oaxaca, seven hours away. Most of our
clients cannot afford to go that far. (Newsletter # 34, Summer 1996)
Lola is a young quadriplegic woman named who lives at Pina. She had gone through
many changes over the time she has been here. She had lived m Santa Ana, in Orange County
for several years as well as living in the southern USA. Sometime ago she was involved in a
serious car accident that left her paralyzed. Where her family was, and why she was here in
Pina rather than in the US was never determined, and she never explained it.
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She was a particular favorite of Bob who was always trying to figure ways to get her
out into the water safely. One day he had the idea of using weights on her feet and a life
jacket to make her float up right in the calm water. He had tried various ways before, but
without success. This time however, it was different. We drove down to the bay in Puerto
Angel where the waves were calm and brought her out into the water. There was a little
creeping up of the jacket around her face, but for the most part, she floated safely and it
allowed her to move her arms and propel herself about in the water. She was very excited and
very tired by the end of the adventure. She does have some tiny movements in her fingers
and toes, and works hard in therapy to get more movement. Although it is not known and
hard to predict that she could recover independence, she has regained a lot of hope that she
didn’t have when she first arrived, three years before, where she asked Bob and close friends
to allow her to overdose. Suicide is not an option now.
In my notes from the field research I observed: “Today after quite some delays and
organizing I was able to get some of the Belgian volunteers to go to La Chose [the local disco
and gathering place] with Lola. I think she was very excited. This was because her nails were
being done; her hair was having beads put into it by her helper, Hilda, who also worked in the
Special Education program area. She even had a lifeguard swim suit on. Although she did not
show it too much, she was very happy to get to go. She had a fruit juice drink, papaya in a big
round glass, Hilda held it while she sipped if. She was just one of the crowd and she enjoyed
it very much. I think it might be a breakthrough for her, because she says she is willing to join
in the summer camp activities where she wouldn't before. Bob said, when I checked with the
volunteers after the aforementioned reunion about going, "That a year ago she wanted to die,
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and didn't want anyone to bother her. So they didn't. And then she changed her mind." She is
much different now, she can move here limbs to an extent, independently and is much more
social.”
4.8.2. Recruitment of Volunteers
There are means to bring awareness of the program to people outside of the region of
Oaxaca and outside ol Mexico. In Sweden and in Europe active support groups publish
newsletters, promote and publicize, raise money and even engage in exchanges where
disabled people from Scandinavia and Europe come and visit Pina. On the Internet, several
websites give information on Pina. (Use Pina Palmera as search terms and you will find results
in Swedish, English, and Spanish within the first ten selections) They are available in several
languages. Most of the volunteers decided to come to Pina after hearing talks by some of
these support groups or from other volunteers. A smaller group of volunteers learned of Pina
through touring in Mexico. These are young people from different countries who are
backpacking through the area without an itinerary; mostly bumming around and open to what
opportunities arise to allow them to have a richer experience (and a cheaper stay)
Most of the employees and those who exercise influence as staff members first came
to Pina as patients. Some came as refugees from domestic violence. During the period of
treatment and recovery, they came to the attention of individuals who had the power to
promote them as potentially useful to the efforts of the project. It was felt that those who had
experienced the suffering of disabilities would have a better chance of reaching and
encouraging families and individuals who live with these problems. One of the big problems
with the CBR program is that visits by foreign professionals undercut the credibility of the
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Mexican paraprofessionals. There is a fascination and higher level of respect for foreign
medicine and its practitioners. Although local people will rely on curanderas for the screening
of problems, many will be drawn to Western artifacts ot medicine. Pills are valued over herbs,
medical procedures over adaptation, and trained Western medical personnel over locally
trained personal. Given the choice between someone trained in Mexico with equal ability and
training, most people will gravitate to the foreigner. This is why Pina Palmera, Projimo, and
other projects will use foreign experts only as consultants and have the locally trained
paraprofessional conduct exams, initial diagnosis and deliver treatment. The foreign expert
would operate behind the scenes.
White foreigners and Ladinos have a harder time entering the lives of the Indian
people. There is a larger gap between Ladinos and the indigenous than between foreigners
and the indigenous. Young Ladinos from the Mexico City often experience a shock that in
their own country such divergence in living conditions, education and expectation can exist in
their own country. This is what several ot the Mexican workers and volunteers had stated.
There was antipathy and disrespect between various Mexican factions. The people from
Mexico City were resented, as were the poor people from the mountain villages. There were
divisions between the Mexicans along racial and social lines that the untrained foreign eye
may not have been able to detect. Foreign volunteers expect to come to a different world and
expereince some culture shock, but the people trom the rich urban area of Mexico City did
not expect to find such poverty in their own country, or that there were people who didn’t
speak Spanish in Mexico.
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Solveig was a paid volunteer from Sweden who worked as a physical therapist and
trained the promoters. Because she spent the bulk of her time visiting the villages and
training, the promoters she had a perspective on the problems of bringing people into the
project that no one else had. None of the administrators at Pina went to the villages regularly.
She went with each ot the different promoters, so was able to observe them and their
challenges in a variety of situations. So, although she is a foreigner, her observations were
unique and valuable.
She describes some of the difficulties ot the job, becoming accepted, getting the
villagers, promoters and others to buy into the concept. Being an outsider makes it harder in
several ways. In addition to the problem ot training the promoters and instilling her work
ethic she also suffered from illnesses. She had dengue fever and malaria on four occasions.
She only had one kidney from a childhood illness, and this weakness made her effectiveness
during her two-year stay at Pina even more difficult. Herself and others noted her illnesses,
and the inability to have continuity in her work. She had expressed regret that because of her
illnesses and periodic absences from the project that continuity of training and practice for
her “students”, that is to say the paraprofessionals, Margarita, Carmen, and Manuel were not
of the quality she had wished. She felt that they had not achieved the level ot mastery in the
therapeutic techniques she expected of them.
Her fiance Ken worked in maintenance at Pina. The two of them along with Joaquin
the Amencan expatriate lifeguard helped keep the Salvavida Jr. program going acting as
coaches and trainers. They were following the lead of another Swedish couple that had started
the project before their arrival and had contacted Joaquin where he was running a program
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in Puerto Escondido. What Ken and Bob wanted to do was incorporate the disabled young
people in addition to the beach youth into the lifeguard-training program.
Yeah. When I went here the thing was that, I was going to be
the last one to come. [The last professional therapist] To finish and
give them all the responsibility to them...to give them more
responsibility and to tell them that they really can do this and I think
just because of the hurricane now they need more people now.
Because there are so many people that haven't had help for a long
time and everything but even if we didn't have the hurricane, I think
it would have been time to let them be by themselves for a while.
But then, there are always volunteers arriving. [All year long
volunteers come and go] And I think one problem with that is that
many volunteers that come they don't speak Spanish, they don't have
any special education or training, and they come here more or less
because it's a beautiful place. (Interview: Solmg)
A problem that occurred at Pina and in Projimo as well was that between the skilled
foreigners and the para-professional learners. At Projimo it was discovered early on that
patients would prefer to have the foreigner attend them. So Werner and company stopped
the patients from meeting directly with foreigner medical personnel. At Pina that problem still
continued, because the foreigners like Solveig went to the villages to observe and work with
the promoters, but their presence in the village visit created problems and often the patients
refused to see the paraprofessionals or rhe paraprofessionals would simply let her do all the
work. In some ways the fact that she was ill so often forced the promoters at Pina to become
more independent. They had to make visits alone. The increase in their confidence and
independence came at a price of lessened quality of skills. Solveig said to me that she had to
many times re-teach certain therapy techniques after her absences because the promoters had-
gotten lackadaisical. O f all the volunteers only a few such as Solveig and the nurse had
professional skills, the rest had little skills of any kind applicable to the situation at Pina. They
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were there to learn and experience. Pina did not have a systematic way to determine who
should be there as a volunteer. After the hurricane there was discussion ot this, screening and
accepting volunteers who only had specific skills and language ability. At the time I left in
January 1998, nothing had come of this.
One of the realities of the project as with working with disabled children in general is
that because so much time and effort are required ot caregivers and teachers one has to
informally employ at triage approach. The people at Pina have to make decisions as to who to
invest their time with. Some disabled people have much greater chances of accomplishing
growth and education than others. This is not to say that the more severe the disability the
less chance of a quality life. Many times, it is the power of the individual personality and their
desire that makes the difference. Pina used a couple of different ways to identify those worth
investing their efforts in.
In the Curso de Verano. there is a systematic effort over a four-week period to screen
individuals who have a higher probability of successfully participating. In the visits of
promoters to the villages in the CBR efforts do the same. Having people who have come
from the villages themselves and are now a promoter visiting other villages is a crucial plank
in the operating platform of the CBR program ot Pina. The experiences of the promoters of
Pina will be further explored in a coming section. They also help decide who has the best
chance of benefiting from being at Pina.
The people who eventually began working at Pina often were employed as a means to
offset the costs of their treatment. Some of the work may have started as a token or symbolic
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action and as they recovered, they increased their involvement and the level of their work.
Over time, many of the employees moved trom simple entry-level jobs to greater
responsibilities. Examples of this are those who began in the carpentry project by sanding the
wooden cutouts for toys and then moved on to more complicated tasks such as building
furniture.
All of the promoters, some ot whom were originally patients, and who currently work
in CBR originally worked at the project doing things such as maintenance or cooking and
when they showed their skills in accomplishing these simpler tasks, they were given the bigger
challenges. The eventual goal was that those who first came to it as care recipients would run
the entire project and the foreign founders such as Ingrid would be phased out. Whether this
is a realistic goal is subject to debate by the participants. They certainly do not agree if it can
be done. I think it is necessary and that it can be done, because the people ot the area have
handled their own affairs successfully and independently for thousands of years. If it can’t be
done, then development is pointless.
If there is an employment need or an opportunity to volunteer or a therapeutic
benefit, people in the administrative junta will discuss it among themselves. It everyone agrees
that the newcomer has potential they will then bring it up to the general meeting. In a sense,
all the successful people have sponsors who have championed them through the entire
process from recruitment to enrollment. Someone in power, such as Dr. Martin or Ingrid or
the leaders in the carpentry7 project saw potential in them. None of the different areas
interfere or influence each other in the opening phases of entry. The CBR group handles its
own screening and taking on of participants in the villages. The carpentry project, special
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education, and the rest do make their own choices about hiring, operational issues and goals.
It is only when spending money on someone, in terms of salary, therapy costs and
accommodations, that it becomes necessary for the assent of the general assembly. The
separate program areas as much as they can are responsible for their own decision-making.
The issue for volunteers is keeping an equal distribution of them in the various program
areas. The carpentry and garden areas are perennial favorites among volunteers whereas
working and caring for the disabled children is difficult and often unpleasant. This includes
the changing of diapers, washing, dressing, and feeding of disabled children and adults.
The people who are employed at Pma tor the most part are outgoing, gregarious and
personable types. Those who are disabled are not embarrassed by their limitations and are
very willing to talk about them with others. Although some of the employees have had to
overcome serious challenges, they are positive and it could be that this personality type has
been selected consciously or unconsciously. It certainly helps to have people who exhibit
positive and happy attitudes regardless of their handicaps representing the project in the
communities and working with foreigners.
4.9. ADMINSTRATIVE STRUCTURE
The role of the staff is to see that the project goals are carried o u t In the coordination
juntas, they discuss the various participants, their progress and potential. The various juntas
discuss their own goals, needs and budgets that they bring to the coordination junta for
submission and approval. There is an office staff that handles the bookkeeping and daily costs
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of running Pina. There is one person who devotes most ot her time to fundraising and
therefore spends most of her time traveling.
The office that the employees spend their time in is a small 5-meter by 7-meter
cement box. Inside there are two apple Mac SE computers, and a typewriter where the two
women who take care of the billing, payroll, and correspondence work. O f the things I noted
was how they used adding machines to tally up the numbers and then would enter them into
Claris worksheets, although the computers had Excel with its own formulas, templates and
ability to tutor them in the use of the program. It was interesting how they did not want to
learn more than was absolutely necessary to do their job, even though learning might have
made their job easier, and increased their future employment opportunities. I was very
puzzled by this and then I saw my semi-retired parents display the same behavior.
y , v
Another thing that took place in the office was how the two workers managed to
control the distribution of incoming donations. They would open boxes and determine which
things were valuable and which things were not. I remember one incident where several heavy
boxes arrived, and while initially excited, as they opened them up and discovered books in
them, they grew disgusted and eventually set the boxes outside, losing all interest. When there
were donations of clothes, especially after the hurricane, they were the first to go through
them and take their pick. Their children were the best dressed at Pina, even better dressed
than Ingrid’s. By contrast, the poor women who made tortillas ail day had the last pick, and
had the most poorly dressed children.
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4.9.1 Paid Employees
The paid staff tor the most part starred as volunteers and or patients, albeit Mexican,
not foreign born. The director and her husband the doctor worked first as volunteers, as well
as all of those who head the various areas within Pina, other than special education. A
number people were hired without being either volunteers or patients first. These were those
hired for some of the jobs that absolutely required a person who could be depended on to be
there when needed, that is someone who depended on the salary. These were those who
worked with the disabled children in the special education area and those who worked in the
office handling the important paperwork.
Working for a non-profit organization does not ahvays guarantee regular pay. There
was a wooden box on the wall containing checks near the door of the office where people
would lineup on paydays. For about a month the box was empty and there was no one
standing in line. During my first few months, during the four-week period of the Curso de
Verano and while Ingrid and her family were in Sweden, there was a problem that kept
salaries from being paid. During this time, when the population of Pina was at its height
during the year, with close to 150 people living on site, and expenses also at their highest, the
staff stayed on until the money came through. There was a separate account, as 1 understood
it to allow money for food and costs. Pina provides housing, food, and medical care on site.
So all the people received the necessities, but people were in danger of not paying rents and
other bills if they had not saved the money. During that entire time, only one staff member
left. In that case, the manager of the carpentry had to go up into the mountain and prepare
his bean field. He was back about two weeks later. During this trying time not receiving pay
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seemed not to have any effect on the program. This was a short term and unique occurrence.
The Curso de Verano was the summer residence camp for children, young adults and
their families. They came to live at Pina and would participate in various activities throughout
the day, very much like an American or European summer camp. This was because the
volunteers mostly operated it and the activities were based on what they felt should be
included in a summer camp. Part ot the theory of the project was to get potential long-term
participants to buy into the concept of Pina and what it was trying to do with the CBR
project. The promoters would recruit disabled people and patients they worked with or that
they met during their forays into the villages during their CBR visits.
This is also the first week of the ‘Curso de Verano’ four week
long summer camp. We have over 50 disabled children on site who
we also take swimming, hence another reason to continually practice
these lifesaving skills. We had a campfire last night;, we sang songs
and danced with the kids and their parents. Over the week we have
sessions with the children who are divided into three age groups and
move from activity to activity, 1 have been assisting in the wood
shop. There also is an art program, sport, and gardening and theater.
All the volunteers and project employees are exhausted. In the midst
of this, the project has run out of money. No one has been paid fora
week. [This was the event described in the previous paragraphs]
There are people here desperately writing for money to organizations
in Sweden and m Mexico, some of the money has come m but only
about a third. Everyone is taking it very well, but I know what my
school would be like in L.A. if the teachers and other employees
hadn't been paid for two weeks; there would be a riot. (Researchers
Log) [Phis account was written in the first week of the camp, three
weeks later a crucial member of the carpentry staff left to tend to
bean fields to earn cash] (Research Log)
As this log account points out, there were many activities to participate in. Many of
the activities were initiated by volunteers, and did not require a lot of cash to make happen.
So even with the pay problem, the project was able to keep going. Among the paid
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employees, no one seemed very concerned. This episode demonstrated how crucial it is for a
project to have a solid core of dedicated workers who view their involvement as more than
only a source of income. Having a facility, a campus like the grounds of Pina not only
provided food and shelter for everyone to get through hard times, but also created an
environment that separates those who enter from the rest of the world. There is a
psychological atmosphere that helps everyone involved stay together. It certainly is different
than being at an average American School or hospital. It may be somewhat similar to a
college campus, but smaller and lacking anonymity — everyone knows everyone.
4.9.2. Volunteers
It may because Pina began as a volunteer effort that it has continued to rely heavily
on the efforts and support of volunteers. The support comes in personnel needed to get
things done creation of programming, training, fundraising out ot the country, and to obtain
equipment. As pointed out before it is in many ways the volunteers who have kept the
program invigorated. The volunteers train the Mexican promoters in the methods of CBR,
lifesaving, carpentry, agriculture, electrical and mechanical systems, and basic health care.
There was not an area at Pina where first there was not a foreign volunteer who initiated the
activity. Certain activities such as the carpentry and the garden have been taken over and run
by Mexicans and these are the successful example of the goal of turning over the ideas to
local people who will make the projects their own.
Volunteers who have participated have also received important benefits from their
participation. They have received educational credits, a sate living environment where they
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could experience a foreign culture, and they have learned a lot about the capabilities of the
disabled. Certain schools such as the Ibero American University and some foreign institutions
allowed students to gain class credit in cross-culture or other courses by volunteering for a
time at Pina Palmera. All these experiences they have brought back to their home cultures.
An exchange between these different cultural approaches to the treatments of disabilities is
developing and will continue to grow over time. This is the long-term view of volunteer
involvement and benefits. The short-term reality is more difficult.
Pina experiences the same difficulties any program depending on volunteers does.
There is a recommended six-month minimum term of service. It take a considerable amount
of time to gain the work skills, make friendships and built a trusting relationship with co
workers, and feel comfortable with the language and cultural differences. Often, by die time
your term of service is up, you have finally begun to feel you might be able to accomplish
something. The learning curve in overseas development of any kind takes time.
In addition to these problems are the health issues, mental, emotional and physical.
There is usually a period where volunteers are sick from malaria, dengue, or other problems.
Pina does provide what medical attention they can, but the volunteers are responsible for
their own financial accountability if they get sick. So other volunteers will run to the pharmacy
Or as in one instance, I drove a volunteer to the hospital. There are the culture shock and
communication problems. People became homesick, lonely, and frustrated. They blamed and
were angry with the Mexicans they felt did not work as hard as they should. There was not a
single prevailing mood or attitude but rather a course that ran almost predictably during their
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stay. In the beginning, fascination, then frustration then sentimentality about having to leave
Pina behind. It reminded me a bit of my Peace Corps experience.
The work of the volunteers that I saw during my stay consisted mostly of
augmenting the regular working staff, filling in the gaps where necessary. In special education,
volunteers aided in the care of the disabled kids, pushing wheel chairs, feeding, bathing, and
keeping them company. In carpentry, they prepared, built, and painted toys along with the
disabled people. One of my difficulties with the carpentry program was the ethical issue of
toys marketed as being made by the disabled, when there was more of a chance that what a
person bought could have been built lay a Swede. Several of the long time foreign born
workers and volunteers suggested that the number of volunteers be limited, or eliminated or
screened for the skills and experience necessary to ensure their time at Pina is most
productive.
After the hurricane, it was foreigners who did the initial repair and cleanup. I went
into Lola’s room and began cleaning it out. Everything had a three-inch layer of mud. I felt
that if I could begin the work, others would see that starting on one little part would make
everything else seem less overwhelming. I felt that since the Casa Nueva was the one intact
building that it was the place to start. (The “Casa .Nueva” is the building where the special
education activities take place, Lola and the severely disabled children live, the office for
therapy and CBR; the medical clinic office is housed.) We needed a place to put people, so
they could come back from the hospital. After I cleaned out her room, others took over the
job and did the rest of the buildings. This took several days to pick up momentum.
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The second priority was clean water for washing dishes and clothes and bodies. With
that in mind, I cleaned three 300-gallon cement cisterns for washing water and one 500 gallon
one for kitchen water in the first tew days atter the storm. They were filled with debris and
the thick, silty river mud that settled on the bottom. The cisterns had drains on the bottoms,
but the mud filled them up, so I had to continually shove a stick through them back and forth
to keep the flow going. I couldn’t get anyone very interested in helping at the time, but as I
worked, Jose and Elly the boy with the poor eyesight and the little girl 1 was teaching how to
use the computer noticed me and offered their services. We used old rags and ruined brooms
to scrape away the hardening mud. It was a nice experience to have the littlest ones wanting
to help, when the older kids and people just wandered about. In another couple of days,
people climbed up to the roof of the iavanderia (the laundry area) to clean out the cistern for
showers. I think people just felt so stunned they were immobilized.
Later, I repaired the barbed wire tence, much by myself but also by organizing a crew
of visiting college student to re-dig post holes. In addition, foreigners arrived from out of the
country after following the storm on international TV. They repaired the basic electrical
system, brought electrical generators. They dug the hardened mud out of rooms and prepared
areas to live on the site. The biggest complaints one heard at the end of the day was that the
foreigners did all the work and the youth played football. 'There was debris littering the entire
ground, cloths, wood, medical supplies, equipment of all kinds. For the first week or more,
except for the foreign volunteers, most people were perceived to just be standing around.
O f course, this was how foreigners perceived it. At the hospital, Carmen and
Armando supervised over 50 people from die area who were homeless after the storm, they
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had them and others sleeping on the floor of the hallways, and made sure everyone stayed
healthy, warm and fed. She walked back and forth around the hospital carrying a clipboard
and kept people busy, organizing the food, blankets, water, and warm clothes. During our
time in the hospital, ranks of doctors and officials from the Red Cross and other agencies
would tour the halls, asking questions and looking important in their fresh suits and white
coats. Nevertheless, it was two people from Pina who were in charge and no one dared to
mess with them.
Back in Zipolite, many of the workers who the foreigners felt were absent, were
actually at their own homes, repairing their own shelters and trying to care tor their families.
Rebuilding Pina came second to fixing their own homes. Indeed, there was a junta the day
after the hurricane. It was decided that everyone needed to go home take care of his or her
immediate needs first.
How could a person feel 100% at their job if they were not sure of their families’
welfare? However, as volunteers poured in, they were not privy to this information or
witnessed the emotional impact of the actual event on them or had the devastating and for
some immobilizing, experience of the hurricane themselves. In fact three weeks after the first
hurricane, another, weaker, but still packing an influence, hurricane came. A month after that,
an off shore earthquake arrived. They brought down all the homes thar were weakened by the
first hurricane and not strengthened before these next plagues struck. This experience had a
devastating effect on the local population. There was very much a wariness to rebuild
anything, lest one wasted their efforts. They wanted to feel completely sate before committing
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themselves again. This apparent inactivity and lack of enthusiasm drove some foreign
volunteers crazy.
4.10. FINANCIAL SUPPORT
To be able to pay for running Pina and to support the projects, a variety of sources
are sought. Grants from international agencies are the main resources, and a small percentage
comes from the Mexican government. There is central funding for the project as a whole and
the various activities have their own sources of support from interested individuals and
organizations. There is one person who spends most of her time actively seeking financial
support in Mexico, that is Sonia, the Brazilian woman who introduced the CBR concept and
junta administrative style. Sonia had learned them in Brazil and had been in contact with the
CBR program in Guyana and was knowledgeable about a program in Belize. 'These programs
all used paraprofessionals and trained volunteers.
Ingrid concentrates on funding in Europe through yearly visits to Sweden and
through the written materials on the web, e-mail and newsletters she edits. Sonia rolls in like a
tornado without warning and gives her lengthy reports to the juntas and would produce
checks, boxes of donations, and other surprises. I timed one her speeches at well over an
hour, but packed with info about all the people, places and promises that she had put
together during her peregrinations around Mexico.
The following excerpts are from the latest newsletter describing the types of resources
Pina has received and what they are currently requesting. Following that will be an excerpt
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from the budget from 1997 showing the income from supporting organization and how it
was distributed within the project.
After the hurricanes, we received a lot of generous
donations. Through Slade Child Foundation alone we received from
our friends, and friends of friends, over $40,000 USD. Thanks to all
of you we were able to repair and start reconstruction of our center.
But since then donations have dwindled and are now down to a
record low. We have had ro borrow money for the last two months
in order to meet our daily expenses. We have no idea of what we will
do in December.
We need your help, without your loving, generous and
constant support we will not be able to continue to offer
rehabilitation to the children and adolescents on the coast of Oaxaca.
Thanks to you, we now have close to 300 clients who are in the
process of rehabilitation and on their way to integration in their
communities. The average cost per client runs close to $960 USD a
year. Make a monthly commitment of $10 to $50 dollars a month! A
constant monthly contribution will make us able to keep on
promoting health, integration, well-being and love throughout the
year in Zipolite and surrounding communities! (Neirsktter # 3 9
December 1998)
The following are excerpts of what the plans were for income and expenditures for
1998, before the hurricane, of course. It can be seen how the costs for operations are
reasonable, actual cost for administration was to 9.0%; the largest cost was for food for the
people at Pina at 19.5% and 14% for taking care of the severely disabled kids. The CBR
village category when combined with heal rh, and deaf education that are related to each other
add up to 36% of the total budget. After the hurricane, 1 would imagine these percentages
changed quite a bit.
In the years since 1991 the accounting skills of the office staff have developed. The
first budget copied below was released as a single type written page. By 1998 they were
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including pie charts -and using Microsoft Excel. However, in the preparation of the proposal
for 1998 I observed the two office workers using ten key calculators to do their figuring and
then entering the results into excel just as they would on a ledger page. They were still more
comfortable adapting the new technology to their familiar way of working, rather than using
the advanced features just yet. I was just beginning to teach them at the time how to use the
formulas and templates built into excel.
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T a b le 2. E co n o m ic R e p o rt from 1991
Economic Report
1991
Expenses
in Pesos
Income in
Pesos
1 Food and Water 141,964,653 1 U-assist 68,347,831
Salaries 197,981,540 2 Slade Child
Foundation
31,009,068
3 Hygiene articles 18,227,752 3 Rad da Barnen 271,240,000
4 Diapers 7,078,390 4 Forenmgen Palmeras
Vanner
106,936,311
5 Medicine, X-Rays,
analysis, EEG and
consultations
8,933,469 5 Gentle Brothers and
Sisters
35,528,038
6 Orthopedic apparatus
and operations
12,566,355 6 Friends of the
Palmgrove, Belgium
10,920,000
7 Gasoline and oil 14,268,310 7 St Johns international
school, Belgium
4,645,217
8 Maintenance of
vehicles
15,933,745 8 ASBL Enface Tiers
Monde
13,989,961
9 Education of
personnel
9,409,860 9 Hope for Children 5,311,080
10 School material 5,826,123 1
0
Scandinavian
Women’s Club of
Mexico City
2,500,000
11 Clothes and shoes 3,457,190 1
1
The Fossenden
Foundation
11,216,450
12 Electricity and Gas 4,923,045 1
2
Private Donations 42,645,107
13 Telephone, mail,
telegrams and fax
4,231,432 Totals 601,289,063
14 Wood for the
carpentry
3,248,285
15 Construction material,
finished works
6,028,500
16 Film rolls and
development
2.937.838
17 Photocopy 1,454,187
18 Contribution to the
sick, poor and
students
6,757,500
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19 Transportations,
passages
2,625,159
20 Parties, balloons,
presents, movies
entertainment, etc
2,740,870
21 Food articles [frets] 1,298,898
22 Things for Pina
Palmera, furniture
1,791,900
23 Office supplies 2,301,982
24 Building maintenance
and works in progress
18,154,142
25 Taxes, social security
etc
58,154,076
26 Medical supplies 10,289,335
27 Tools and wall
enamels
1,015,347
28 Irrigation equipment 2,750,000
29 Van and fire
extinguishers
6,490,000
30 Vehicles security 2,335,529
31 Office furniture 2,380,000
Sub Totals 574,741,412
I liquidate in bank
bills
29,662,534
Total 604,403,943
Table 2. continued
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Table 3. Budget Proposal 1998, prior to hurricane
Project Thousands of Dollars
USD
Thousands of
Pesos
%
Nutrition 66,470 452.0 19.5
Special Education and Resident
Patient Care
46,176 314.0 14.0
General education 12,941 88.0 4.0
Education of Deaf 5,882 40.0 2.0
Health 69,117 470 20.5
Carpentry 18,382 125.0 5.0
Administration 31,764 216.0 9.0
Community Based Rehabilitation
(village outreach)
5,294 36.0 14.0
Construction and Maintenance 37,647 256.0 11.0
Ecology 3,382 23.0 1.0
Subtotal 341,176 2,320.0 100.0
Vehicle for R.B.C. 17,647 120
Total 358,823 2,440.0
'Fable 4. in c o m e E stim a te s for 1998
Thousands of
Dollars USD
Thousand of
pesos
Foreningen Palmeras Vanner (Swedish Fund) 44,117 300.0
Slade Child Foundation 5,294 36.0
Enfance Tiers Monde (Belgian Fund) 7,347 52.0
Patrimony of the Public Charity (Mexican Fund) 70,588 480.0
Private donation 11,764 80.0
Church of Gentle Brothers and Sisters 2,205 15.0
Diverse donations 29,411 200.0
Scandinavian women club of Mexico, D.F. 5,882 40.0
Liliane Fonds, Holland (Netherlands Fund) 5,147 35.0
Secretary of Social Development (SEDESOL) 14,705 100.0
Other: (Requests to: European Union and Caritas 58,823 400.0
Uncategorized income 103.235 702.0
Total 358,823 2,440.0
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Since the hurricane, the above distribution of funds and the search for monies has
had to change to concentrate on rebuilding facilities. It has been a slow process to make
these repairs. The budget described above shows the trend of funding and distribution of the
funds in the seven years or so since the project became a recognized not for profit
organization. In the first year, CBR (or RBC in Spanish) was not a separate item in the
budget, but in the last few years; it has monies earmarked for its operations. It went from
nothing to becoming a major feature of Pina Palmera. There was also much more money for
startup and construction in the 1991 budget. This also follows a trend in development
towards supported village oriented projects. One of the problems faced by Pina, which is also
a funding trend, is the tendency not to fund salaries, but for sources to target specific
activities. This is also a problem for construction because agencies do not want to fund
buildings. They want to tund ‘people’ but still they do not want to pay salaries. Various
devices in accounting need to be used, making food, per diem, housing and transportation,
the components of salaries included in the budget without using the word salary. This was an
issue the people at Pina Palmera, and other agencies are wrestling with and dealing with in
their own ways. It was discussed with me but it was not announced how they would
incorporate salaries into the budget in the future.
4.11. EDUCATIONAL KNOWLEDGE
One of the chief objectives described at the beginning of the chapter was to train
promoters in how to conduct community-based rehabilitation. To achieve sustainability of
the program not only at the Pina campus but also among families and people out in the
villages it was crucial that Mexicans learn to conduct all aspects ot CBR. The people Pina
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depended on to conduct these trainings were volunteers. Because of this, there has been a
lack of continuity of programming and educational goals over time. Most volunteers only stay
for six months or so. Some subsidized volunteers have contracts that call for them to stay for
a period of two years. There have been a series of Swedish physical therapists over the last
years that have worked in the area of training promoters in paraprofessional therapy
techniques. Their stay with Pina had been subsidized by the Swedish Government or by the
European Economic Community. As with many volunteer baseci programs, the efforts and
energy devoted to running these projects are dependent on the energy' ot the volunteer and
when they end their term, the project often leaves with them.
Training has also been gained by sending participants to specialized schools in Mexico
City and to other projects, such as the Projimo Project in Sinaloa. These small groups went
for training in specific work areas, such as therapy and carpentry. They learned how to build
different kinds of toys that could be made by disabled people. There were courses in physical
therapy in Mexico with DIF, (Desarrollo Integral de la Familia - the federal program
responsible for disability issues) which the wife of the President ot Mexico, Mrs. Zedillo,
heads. Some of these courses, which took place at hospitals, were criticized by those who
went because they had nothing to do with life in the villages.
They were frustrated that they were learning to use the hospital equipment that they
would never have access to outside the city. These included electronic equipment, expensive
therapy devices such as traction tables and other things they would never hope to have access
to. The villages and the promoters who would serve them had no access to the materials,
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information, and equipment that a city hospital would have. Finally, the training program at
DIF was not able to adapt itself to the rural needs the Pina representative presented.
People view the value of knowledge and what is considered important as data and
skill differently. As will be talked about in a later section, a public library project, where two
Swedish volunteers catalogued over a thousand books in the Dewey decimal systems that was
trumpeted with great fanfare in the newsletters was thrown into Pinas’ trash pit by the young
man, (Aaron) who was the chief tutor for the children. He saw no value in the books and
acted on his own to throw them away. W atching the people from the village pick through the
piles to retrieve books for themselves was encouraging, yet.. .It seemed that knowledge that
you could do something with, show a profit was more important than education and learning
for its own sake. There certainly was a mistaken assumption on the part of these volunteers as
to how their efforts would be received. The Europeans felt that -artifacts of their culture such
as libraries were crucial to education and some of the Mexicans and indigenous peoples had
different ideas. The following excerpts show how differently those from the West (Europe,
USA, Canada) view the importance of books to education. Volunteers who saw this and
heard about it were furious. Angry people in the general meeting and on the grounds of Pina
Palmera confronted him. All this confrontation he took in stride, never betraying any emotion
over it publicly.
The library in the Palmgrove. Our library keeps on growing
and as the books are pouring in our work is also increasing. During
this past year we have classified close to 2000 books. Good enough
for a small beginners library. Now we will concentrate our efforts on
training and motivating everybody at the Palmgrove. These courses
are very important since the library will be of no use if nobody cares
for it. The most frequent visitors so far have been the children. Kids
that like to look at storybooks or find animal pictures in the
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encyclopedias, it would make us very happy to see the adults and
teenagers visit here more often. Our dream is to see them discover
new worlds, new lives and to marvel over all the wonderful
experiences you get from reading, when new horizons open and
minds expand. The first course is planned for this fall and everybody
that lives and works at the Palmgrove is invited. We will explain how
the library works and what you can find here. We will also try to
arrange different activities in order to make people more interested
and to make the library a place where they will enjoy spending time.
A place that corresponds to their needs and that can contribute to
their development. For the library to survive, a volunteer that can
help take care of it is needed. There have been some problems
already. Some of the shelves and books have for example been eaten
up by termites and many books have disappeared because nobody
knew who borrowed them. We are looking forward to receiving an
interested volunteer that can dedicate time to the library and
continue our work. R S., founder of the library. Newsletter # 34
Summer 1996
I described from my log how the excitement about books was not shared by
others at Pina. “Today, several large boxes arrived in the office. One by one, the
women of the office opened them and showed dismay and then disgust as they said,
“books”, “more books”. Afterwards there was a box full of things to be thrown away,
and it contained books and other paper items of use tor teaching. One of the
volunteers didn’t want to remove things from the garbage because she was told,
allegedly by Aaron that it was of no use. Armando has returned and he found a
colored picture photo book on frogs that he kept for the Carpentaria....
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The book crisis cime to a head. Aaron threw into the trash
and into a ditch approximately 200 books. These including
encyclopedias, picture books, classics, and other books, mostly in
Spanish, but some in English and Swedish. I first noticed people
walking off with piles of books from the trash area on Sunday, and
then mentioned it to some volunteers who were as devastated as I
was. One British volunteer confronted Aaron and did in front of a
bunch of people so I don’t know how that helped things. But
tomorrow during the reunion there is sure to be more fireworks.
Aaron replied that there were bugs eating the books, and I did see
one of the encyclopedias that looked chewed on, but only one.
(Researchers log)
The above selections show the precarious balance between foreign initiated projects
and the actions or reactions of host country nationals. It is always simpler for the outsider to
identify problems because they have a fresh point of view. However, they do not as readily
understand that it is quite possible these problems have already been addressed, such as the
continuing issues of trash, toilets and children’s behavioral problems and may have proven to
difficult to solve or were decided by the local people as not being a priority. Indeed, these
issues were brought up again and again in the general junta to the groans ot those who had
heard it all before. A library is something that looks and feels great as an accomplishment by a
volunteer. I cannot help but wonder if those who created it had careful identified it as
something that was really needed. It became a point ot division between workers and
volunteers rather than something that brought people together. However, it was a real loss to
Pina and the community7 .
The City7 of Mexico is also a different world from coastal Oaxaca. Manuel describes
how different his expectations were from the reality presented in a course in therapy he was
to take in Mexico City7 . The course was geared to those who would work in a well-equipped
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urban hospital, not for those like Manuel who would he working in poor rural villages with
families lacking most modern conveniences.
I also went two years ago to Mexico in the month of January.
I was with Guillermo (another CBR worker) in Mexico... and it was
when we went to Mexico with the intention that they train us in how
to work with patients in the community. But when we arrived in
Mexico, it was not like we expected. Because they began to teach me
as if 1 would work inside a hospital. In the hospital one works with
X-rays, laser, with electric apparatuses tor stimulation. Then we said
that isn’t applicable to us. We wanted to learn to work with spina
bifida, muscular dystrophy, and the other disabilities, cerebral palsy,
and in that hospital people don’t do therapy but rather one works to
cure patients that had been operated on. {Interview; Manuel)
This is an important distinction to emphasize. Those in the CBR program faced a
continuing problem in the villages. Patients wanted cures. They didn’t want training in howto
do long term processes such as physical therapy. The hardest thing to teach was that change
was needed in away of life. In the summer camp there were attempts at this through theatre
courses modeled on the techniques of Projimo, illustrating a problem and then use acting and
story telling to show the different possible solutions as well as getting audience participation,
particularly from children to identify the best approaches to problem solving.
Pina has hired consultants to come to the project it to train the people in
communication, spiritual trainings, and sensitivity training. They have had people come to
train them in how to create a mission statement for the project and themselves. They learned
how to meditate and create visions to help them conceive project ideas from start to finish.
They were trained in how to articulate and communicate these things for themselves and each
other using drawing, writing, and in conversation. They have had curandcras come to conduct
counseling and healing sessions with individuals and groups. This last session was several
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weeks after the hurricane when people were very depressed and worried that their lives would
never recover a sense of normality. These special events only occurred every few years, and as
pointed out earlier, not only training of promoters hut also maintaining their skills was very
difficult.
Each of the different areas has its own educational and skill requirements. Different
areas have different ways of training people as well. In carpentry, there is more need for a
range of fine motor skills, which preclude certain kinds of disabilities from having full
participation. Those who are impaired in their use of their hands, or those not able to use
head and mouth devices are not usually found working there. They do participate in
preparation of materials such and sanding and base coat painting of wooden parts. Working
with the severely disabled children requires patience and an ability to deal with often-
unpleasant physical working conditions. Maintenance and Garden require certain physical and
knowledge skills and abilities that are unique to those areas.
Otherwise, there is a no central criterion ot qualifications for participation and
employment at Pina. At the most, there is a discussion in a junta as to whether a prospect will
have a high probability of success by participating. In the junta discussions that determine
whether a person can enter, people will ask questions to determine if the person can really
grow and gain new abilities. They do not want someone who will become dependent on the
system. They want someone who ideally will stay a limited time and then fake those new skills
back to their home with them. The only regular systematic training is that for volunteers, and
that is not really training but giving them a chance to sample the activities that go on at Pina.
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They receive two weeks of orientation that allow them to work a day in every area
before they decide where they want to work for the duration of the period of volunteering.
Each day they spend time in carpentry, gardening, maintain, the laundry, the kitchen, working
with the disabled children, going on a village visit with the CBR promoters and other
activities.
The volunteer coordinator will arrange a two-week or so
orientation into Pina for you. Mostly this serves two purposes. One
is to expose you to the workings ot Pina by having you spend a day
or half a day with the people, and helping with the work of each area.
Secondly, this is a way to get more familiar with the folks here. If it’s
unclear what work you’ll do here, you should use this time to feel out
where, and what you might like to do. [Volunteers do choose where
they want to work, with the exception that when there is a great need
in certain areas, such as special education, then people are expected
to take turns helping in that area] Later along with the coordination,
this can be worker out considering Pina’s needs at the time. Most
often, the orientation does not proceed as well as planned — for one
reason or another. Don’t get frustrated, remember: flexibility.
(Volunteer Pack, page ten)
Volunteer coordinators are volunteers who are committed to stay for a longer period.
They become coordinators when they have already been at Pina tor generally longer than six
months already and ‘ know the ropes’. Their job is to act as a liaison between volunteers and
the staff. They also are supposed to help solve problems that might arise without having to
trouble Mexicans who have more than one occasion complained about having to answer the
same questions by volunteers over and over again.
In the carpentry area, patients receiving occupational therapy begin with simple tasks
such as sanding parts. Even the most severely disabled person can successfully prepare parts
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for assembly and painting if they are attentive enough to details. Time, as a function in
efficiency is not considered. One of the goals is to had people who can have work sent to
them to be cione in their own homes. Much of the preparation of materials is mundane. For
example, the sanding of parts for toys is repetitive and needs to be done well. How fast it is
accomplished is not so important. One of the ideas during the Curso de Verano w-as to have
families be able to take box load of parts home and have the disabled person do the work
there in comfortable, familiar and supportive surroundings. Then when the promoters from
Pina come to visit they can pick up the completed work and drop off more materials for the
next month.
In the special education area, there is more on-the-job training. This is a function of
understaffing, because there is no opportunity to release a trained worker to cross train new
people. Much of the work does require two people. It takes two to lift in and out of wheel
chairs, for washing, changing clothes etc. So new- employees and volunteers are paired up with
an experienced worker.
The main method of instruction and learning seemed to be silent undeclared
demonstration by the teacher, that is the person would do their job. N ot answering questions,
but just allowing the learner to be there to watch and being willing to put to use when called
upon. The learners quietly observe from the edges and practices on their own. When learners
demonstrated mastery ot the skill, they were invited to join in the regular work. There did not
seem to be an age difference here. As was seen with Juan and Irma’s two-year-old sons, who
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was allowed to water plants and make tortillas, not sent away out of the working area — which
might be expected in the US culture.
However, there is no text or systematic training provided for working with the
children in special education. I wrote a handbook at the time for this purpose, but I do not
know if it is being used at this time. Many volunteers had identified needs during their time at
Pina; put together materials only to have them fall in to disuse. The main reason for this as
stated earlier is that it is when the idea is generated and carried out by a foreigner and there is
no ownership, accountability, and incentive for the patients and Mexican workers to continue
it after that foreigner has left, the activity falls out of favor and use. The following selections
were from the newsletters after the hurricane written by the British contractor hired to
facilitate reconstruction. This illustrates how Pina wanted to use the reconstruction as an
educational and therapeutic opportunity.
Running concurrently with the construction work will be an
educational program. The aim is to give local youths, both male and
female, disabled and able-bodied, trade apprenticeships in the
following areas: general building, carpentry and cabinet making,
electrical and plumbing.... going to merge the construction process
into its every day life. It is not only important to involve the existing
community but also to incorporate the Centre's fundamental
ideology into the project. It has been decided that the construction
should run jointly with an educational project. The aim is to provide
young people; both able bodied and handicap with trade
apprenticeships in general building, carpentry and electrical work.
The course will last for the duration of the construction and be made
up of both classroom-based theory and practical experience on the
construction site. The theoretical part of the course will teach
construction techniques but also literacy skills, mathematics,
technical drawing, health and safety and small business management.
It will also be compulsory for all workers in the construction to take
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courses in both health and prevention of accidents and disability
awareness; employees from Pina will give these courses. (Newsletter
# 3 8 A p r 1998)
A big problem with written guides such as what I tried writing is that the people I was
asking for information were not culturally geared to answering the kind of direct questions I
needed to ask to put together a guide. Secondly, they have a different learning and teaching
style, one that is essentially non-verbal and based on observation and imitation. The new
worker in special education follows along with an experienced worker for a day or so and
gradually takes on tasks as assigned. The talking was usually not about the job or the activity
taking place but about gossip or what was happening in the lives of the people doing the
work. Very little instruction was given or expected. So creating a guidebook was something
foreign in several levels for them. However, the aim of my guidebook was not to provide
training and information for the Mexican worker but tor the to reign volunteer. I had to learn
the same thing that the women who built the library did; that not everyone shares the same
beliefs about education and how it is acquired. One has to bring up the needs in a genuine
way from the hearts and lives ot the people one wishes to help, it cannot be imposed from
the top and in the manner the potential helper would prefer.
4.12. PHYSICAL RECOVERY
One of the main ideas behind Pina is to go beyond simply recovery of health. Because
most people who are disabled have multiple and chronic problems, being brought back to
‘ normal’ health is not realistic. Nevertheless, what can be done is to attempt to get people to
be less dependent on outside health service providers. Where children cannot be treated, or
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where surgery or more involved care is required, there are arrangements with The Shriners'
hospitals and other institutes outside the area. Pina pays tor the transportation and costs of
living for the child and family during these times.
The therapy encompassed a variety of techniques from “New Age”, Asian, to
Western medical sources. There was acupuncture, Raikie massage therapy. (This is a form of
massage where the hands of the practitioner do not touch the patient. Instead, the hands
hover about closely, massaging the energy field that is believed to surround people.) In
addition, there was traditional religion, flower nectar therapy, meditation, range of motion,
and normative physical and occupational therapy from Swedish trained therapists. It was a
smorgasbord of techniques. There was something for everybody it seems. If one approach
did not work, maybe another would.
There was a great interest in visual meditation. This included ‘ imaging’ colored lights
that would bath the seeker and protect them from illness and depression or other problems.
There was a definite effort to combine and balance the local beliefs with the new medical and
sociological approaches. After the hurricane, the local churches were filled to capacity and
people were more open about their interests in traditional and new age beliefs. Moreover,
curanderas came to heal the entire population of Pina as the susto. There also was a ‘ temescal’
conducted. This was an indigenous sweat lodge, but the participants were expected to remain
for several hours until they had achieved a vision or some personal psychic event. I
participated in a temescal with about 20 other people; I lasted about an hour or so before it
was too much for me. Nevertheless, some stayed in it for nearly four to five hours.
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In the Casa Nueva, Margarita, Manuel, and Guillermo would give a range of motion
exercises and physical therapy work to the patients. Guillermo, being interested in the
traditional healing techniques, used Raikie in addition to physical therapy. Solveig would
observe, demonstrate, and coach these three in therapy. For the most part they conducted all
this work unsupervised, except by each other. The workers in the special education area,
which shared the building with them also, performed exercises and some therapy on the
children they cared for. Lola would receive therapy along side the children who came to visit.
She could be found lying on her back, her arms and legs suspended by towels, and she would
be straining to lift her legs and move her fingers. It was very exciting to see her be able to
move her toes. It certainly was a surprise for me, and gave a lot of hope to her and those
working with her. Along with the children, she shared a large covered porch that was covered
with blankets and foam pads.
On Wednesdays, the village parents would bring their children for therapy and
examinations. Dr. Ernesto would use this day to run a free clinic for poor people in the area
to come. There would be a crowd ot thirty people, children, and babies waiting patiently early
in the morning for the chance to lie seen and treated.
For a period after these treatments, patients live at Pina until they are ready to go
home. During the time at Pina they are given whatever tasks they can complete as they
recovery. The idea is to get people to be accountable for their care, every step along the way.
It is during this time that they are screened for possible work at Pina and the areas where they
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might progress are explored. This was probably the most common story told by most of the
employees at Pma.
After the hurricane curanderas were brought to Pina to heal the people of the susto.
As depicted in the review of the literature, in the indigenous community there is a strong
belief that the symptoms of disease and the diseases themselves are the symptoms of susto.
This fright that throws people out of balance occurs when they have a sudden dramatic
experience such as the hurricane, but more commonly when they are startled by coming
across a person or animal at night or unexpectedly. To cure someone of an illness or any kind
of injury, a patient must first be cured of the susto by a curandcra. This issue of the susto
never came up or was mentioned until after the hurricane and a young boy passed away a few
weeks later from complications due to tuberculosis. However, most of the indigenous people
attributed his death to the susto. That event caused Pina to enlist the services of curanderas to
heal anyone who wanted it. This incident revealed how deep the traditional worldview lies in
the lives of the people who both work and are served at Pina. It also showed how the
program was sensitive to the preferences of the local community and the people of Pina. It
was not until a climactic event that it was brought out into the open.
In growth and recovery, people demonstrated their newfound strength in their
behaviors at the project. They became more assertive; they initiated interactions with other
people, whereas before, they would wait. Their growing confidence manifested itself in how
they talked at the juntas, and finally how they endured the power of the hurricane, baring up
through it and the aftermath with stoicism. They were cautious about moving back to Pina
after the hurricane, just incase something happened again. They wanted to wait and see
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what would happen, to let the earth settle down first before they put all their efforts into
reconstruction.
4.14. EMOTIONAL GROWTH
All the goals ot recovery, skills acquisition, and learning described above are
integrated into the idea of promoting self-help and independent living. An obvious key to
doing this is promoting a sense in the patient that it is possible. Coming to Pina, people meet
others who have living experiences similar to theirs. They receive mentoring and modeling
from other disabled people. In addition, for families, they can see successful examples of
living with a disabled person. It is just as important for families to see that living disabled is
not a hopeless situation. In the work areas, they are given tasks they can complete, and
gradually given greater challenges. Thus, the tie between accomplishment and emotional
recovery and strength building is bound together.
Ezekiel described in his testimony how he felt very hopeless after his hunting accident
that paralyzed him. When he began working again through the CBR program and discovered
he could contribute to his own care and his family, his optimism returned. Irma, Esperanza,
Lazaro, and others all described how their feelings of self worth and sense of autonomy grew
with the care and training they received at Pina, in the case ot some of the women, they
admitted that growing up they never thought they could have normal relationships with men.
Their freedom at Pina to explore relationships and sexuality gave them a greater self worth.
Apparently they did, because one of the first educational programs brought to the project was
to give sex education to the young girls.
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In an experiment to see how children would react to access to computers I restored a
couple old Macintoshes and set them up for use by the disabled children. Other youngsters
got to use them as well. In my observations of the non-verbal behavior, heavily involved
disabled kids when using a mouse to operated an ‘ air hockey’ game on an old Macintosh
computer for the first time without hand over hand assistance from another person, they
laughed and screamed with joy. Their eyes would turn to those around them to make sure
they were being seen using the computer without help. The sight of these kids, that even
people who worked with them everyday and thought they knew what they were capable of,
changed their ideas.
Aaron, who was very vocal in his opinion that kids did not need a computer, was seen
several times watching these kids from outside the building as he walked by. When he realized
he was being observed, he moved on. 1 laving these computers destroyed in the hurricane was
a big blow' to the program. At this time, it is not known if they will get other computers to
use. But the event did occur, and it is now undeniable what can be done, and how it changes
even the most involved kid, like Silverio, who usually cries himself to sleep at night.
Elly and her two little sisters were the daughters of one of the women who made
tortillas everyday. They were almost feral in their behavior. 'They would pick on other little
children who wandered into their play area of the. tamarindos near my trailer. Once I saw
them surround the son of the Irma and Juan and scream at him until he cried and ran off, this
set them into fits of laughter. Another time I caught them, they tried to get him to put a
hairless, eye-closed baby mouse in his mouth. They got very angry with me when I foiled their
trick and smeared spit and dirt all over the windows and the door of my trailer. Over time,
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Elly became a good friend and went from being mean to being my prize protege, wanting to
help with computers and teaching other children and helping me in the clean-up after the
hurricane when no one else would.
“I also got a big hug and kiss from Elly, the oldest girl of
the four who have made my life miserable so many times here. (She
would play prank on me while 1 was in my trailer, smearing dirt and
other unknown substances on the door and windows, as well as
making as much noise as she and her sisters could when I was
napping or working.) Then 1 took her and two other kids to see
how to use the computers. 1 hope they wall learn more and then
teach other kids. Anyway the virus has been spread, they all want to
use the computers for something.” (Researchers Log)
“[In the beginning] the carpentry made only furniture then
with Bob’s help, [they made toys] you design them, you began to
make better toys. They made carpentry activities with the children
who are very disabled as if they were normal.” (Interview: Hector)
(Hector was the son of the chef of the kitchen. He was also the
brother of Jaitne and Abel who also grew up and worked at Pina.)
Being able to feel that it is possible for a person to do all the things that are being
promoted through Pina is important, maybe more important than the specific goals
themselves. Many of the indigenous people and poor Mexicans already have a fatalistic
attitude about what is possible in their lives. It may be more important to change this attitude
first before anything else is possible. One of the aspects people enjoyed about helping during
the Curso de Verano. was watching children’s countenances change over the four weeks as
they grew ever more independent and self-conhdent.
4.15. PERCEPTIONS OF PARTICIPANTS REGARDING PINA PALMERA
The people who are at Pina or have been there in the past have different opinions
about how well it has readied its goals. The difference is between Mexicans and foreigners.
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Those who are either patients or paid staff have a generally positive opinion. Volunteers and
some foreign-born workers have a more negative opinion
The life of a disabled person in rural Mexico is very hard, but with the help and
training received at Pina, disabled people have made a significant change and have eased their
burden. Those who are not disabled but are employed by Pina also have had an improvement
in their lives. They receive better pay, shorter working hours and on site health care, and food.
Compared to those who have to work the tourist trade on the beaches, they are much better
off. On the beach, parents and their children can be found selling souvenirs all day long
walking barefoot on the hot sand. The lifestyle of those working and living at Pina is widely
recognized as being at a higher level than the surrounding area.
For volunteers, living at Pina has brought a change tor them also, but they have
entered a more difficult life, where in a sense they are the disabled. In addition to challenges
pointed out in the preceding section facing volunteers, the pace ot progress, decision-making,
and forms of communication are very different from what they are used to. Some volunteers
are aware of these background differences and temper their opinions accordingly. The
perception of the people at Pina depends on where they are coming from.
4.15.1. Mexicans
The people who receive care, employment, and education through Pina have a much
more positive view of their involvement. They also have a more positive view of the
contribution of volunteers. Many ot those who have been at Pina for a long period of time
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and who have gone through changes in their health and job skills are vocal about the
difference being there has made for them.
One of the serious impacts has been that they have moved from the villages where
they had no services and opportunities to Pina itselt. There they have access to all of these
and a support structure that do not exist in their original homes. This of course poses a
problem for the authenticity of the idea of CBR, if the main goal is to keep disabled people in
their own villages and getting the community to do the work, not outsiders.
The first problem, briefly, of CBR is that of getting the people of a community to
agree that something is first a problem, and that something can be done to address it. The
second problem is that they may acknowledge that caring for the disabled is a problem, but it
may just not be enough of a priority for them to approach dealing with it at the community
level. Instead, they may feel it is a problem for the immediate family to solve. Related to this is
the issue that they may acknowledge the importance of the issue, consent to receive training
and even a promoter from the outside, but still choose not to act to deal with it on their own.
As long as there is a willing volunteer from the outside that does not cost them or obligate
them to contribute or participate more than at a minimal level, they will support a program.
However, when the outside worker or support ceases, so will their efforts. This, even when
they as a community or as a family admit to the importance of caring for the disabled.
(Referring to the multiple roles of women)... Often they are
women, they are very poor, they maybe have another work, they
work doing food selling, they have the kids to take care of and then
they have the work of a promoter and the)' don't get anything, so
that has been a big problem We come to believe like that also, that
the community should pay them. If they get anything, the
community' should pay them. And Pina we don't have money to pay
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the promoter, so we are trying now to get the government to help us
pay them .. .Yeah. And the villagers didn't do their own goals.
Because Pina helped them too much to do their goals. So then the
deal was in other villages it looked like they changed the government
in the community and then the new government heard about us and
things like that. And in another village, they had too much problems
with drugs so they wanted to fake care of that first. It was hard work
and it took a very long firne to get info. It's sort of complicated and
then after half a year everyone was so tired of CBR. [Sic] (Interview:
Solveig)
This may be an issue that will be less important as disabled people are trained at Pina
and become independent enough to move back to their villages. A greater active presence of
the disabled tends to increase acceptance and willingness to interact with them as equals
among the general population. This has been seen in the town of Ajoya and Zipolite where
both the Projimo and Pina Palmera projects display a large public presence on the roads,
through the people in wheel chairs and on crutches who are out and about. There are only
small painted signs that indicate the existence of the Pinas location. Getting the people to take
this change back to their home villages is another issue. The history of education shows that
people tend to stay around the area where they received their education and not return to
their homes.
The Mexicans welcome for the most part the presence of volunteers. They recognize
that they represent an outside form of financial support, and physical presence to help them
achieve their goals. Certain workers have expressed concern about the lack of pre-training
and experience of volunteers. However, they have expressed a general satisfaction with the
growth the volunteers go through during their time at Pina. Only one Mexican leader at the
project has been said not to want volunteers at Pina. (This is the opinion expressed in an
interview) It has been said by some that this is because that person had a bad experience
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with personal relationships with volunteers. Without going into what could be gossip, this was
the only Mexican I encountered or heard ot who resented the presence of volunteers.
Because that person would not be interviewed, I do not have his side of the story although he
has written in the newsletters about other topics.
As can be seen from the above material, there is quite a difference in how Mexican
and foreigners see each other and how they view their experience at Pina. Pina is a step up for
many disabled Mexicans and represents a hardship for foreigners. Pina Palmera has meant an
improvement in quality of life for employees, patients, and a source of cultural dissonance for
volunteers. For volunteers from a society with a complex infrastructure of finance,
technology, educational resources and health, life in Pina means living with the presence of
malaria, untreated water, no air-conditioning and other privations. For the disabled person
from the countryside, Pina and visits rrom CBR promoters means good low cost health care,
training in marketable vocational skills. Both communities come at Pina from different
directions and meet in the middle and reactions and misunderstanding and frustrations are
bound to occur.
4.15.2. Foreign and Mexican Volunteers
Volunteers have pointed out a variety of shortcomings at Pina. Many are critical of
how the decision-making process occurs. The requirement of attending the weekly general
junta on Tuesdays is something very different for most of them. They complain that it takes
them away from activities and productive work. They also complain that a minority
dominates the juntas. There is the complaint that whatever is decided at the junta is merely a
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way to give issues an airing, that the real decisions are made by the directora.
They complain that the people in Pina are laxv, slovenly, and that the children were
unruly and spoiled. It was observed that most ot the children below school age did not have
regular supervision or programmed activities. This became a big issue after the hurricane,
when volunteers became vocal about complaining as to why should they work, when the kids
and their parents didn’t seem to care or show and interest in cleaning up. Many of the
children the same age who live outside Pina have to work both at home and in the
community to bring money into the family. The children at Pina are living a middle class
existence that contrasts to their neighbors. /V s described above, most children the same age of
the non-disabled kids at Pina are working almost fulltime. They do not have the free food,
free time, free clothes, and freedom in general that both disabled and non-disabled children
of Pina have. There is a room with a satellite TV where the boys hang out and watch football.
There was, until the hurricane, a sheltered area with a big TV and video tape player where
movies were shown a couple nights a week. .A ll m all, the foreigners and some neighbors
showed a certain level of jealousy of the amount ot leisure time and lack of responsibility that
the non-disabled children at Pina had.
/Another opinion that is common concerns the sporadic aspect of how efforts at Pina
occur- The CBR program is hampered in its ability to make village visits because of
transportation, weather, and, to an extent, the problem of promoters having multiple roles
and responsibilities both at Pina and m the villages. Although Pina as whole could be
described as a CBR program, it is the ability to make village visits that are crucial to the
program. Otherwise, it is essentially a quasi-orphanage, with those who get the most benefit
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being the ones who live on site or have employment on site. However, the institutional aspect
is precisely what the program is trying to break away from. At least, that is the goal as stated
by most of the policy makers at Pina, Ingrid, Sonia, Dr. Ernesto, Bob and others. Being a
residential program was viewed as a trap and an ultimately limiting role that kept them from
be as effective to achieve their objectives of helping the disabled improve their lives. If the
disabled had to leave their villages to have a better life, then they were not achieving their
goal.
4.16. OUTCOMES/BENEFITS
4.16.1. Growth and benefits to participants and the community.
People who came to Pina benefited from their time at Pina Palmera. This includes
Mexican patients and foreign volunteers. The benefits are in many areas, as has been seen
throughout this chapter, in health, social, emotional, economic aspects and in the spiritual
understanding as well. Patients have achieved an improvement in health and access to health
services. They have gained job skills. They have also benefited by an increase in acceptance by
the community for the presence of disabled living and working among them. Many have felt
they received something in religious and spiritual areas as well. The capilia (chapel) candles
were always lit, and both Mexicans and foreigners could be found sitting in it at night,
praying, and meditating. The surrounding community lias benefited as well by having the
project in their village. They have benefited from the presence of a health clinic, emergency
service, and de-facto hospital in a sense. They also have the extra money that the volunteers
spend as well as the positive attention brought to the community by visiting dignitaries from
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the government and organizations that tour the area because of Pina. There are distinct times
of the year when there are many tourists, in August and December. The rest of the times,
however, there are few tourists, so having an average of 15 foreigners who come to eat at the
restaurants every' day does make a difference to the small town. Black beans and rice, even
when augmented with shrimp and chicken does get old after awhile. Eating at Pina is more a
way to save money.
For the community at large, the presence of a large project like Pina Palmera has
brought additional benefits. In the week following the hurricane, Pina became a distribution
site chosen by the Red Cross and other aid agencies to distribute equipment, building
materials, clothing, and food. It became a de facro civic center. It was the first place people
came for first aid and medical advice. Though it was not a formal hospital or public clinic, it
was beginning to take on that role. Because, these other agencies recognized it as the first
place to bring materials, Pina and its members also received first choice of these items.
Therefore, the benefits increased with recognition and public responsibility.
As pointed out earlier, when introducing the participants at the project, just about all
those whose testimonies are contained herein, have learned skills that have changed their
employment opportunities. The CBR promoters, the leaders in the carpentry, gardening, and
the office staff, have all, without benefit of formal education, gained skills that have allowed
them to own homes and raise families.
The positive outcomes included increased independent living skills, literacy, general
health, and a sense of belonging to a f irmly or community, where previously the participants
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may have felt ostracized, and the opportunity to learn a craft and earn an independent living.
There also was the difficulty in measuring the benefit ot coming in contact with a continual
parade of foreign volunteers that may have impacted on values, goals, and behaviors.
The disabled people I interviewed who came to Pina as patients agreed that they are
happier and living a better life than before participating. In the previous lives, they and their
families were stigmatized by their disabilities. The communities they lived in ostracized the
families, and the disabled were treated as if they were infectious. Living in Pina has put them
in a community where they are accepted and treated as equal members. Outside ot Pina, the
community of Zipolite has adopted the disabled children and has welcomed them on the
beach, in the restaurants and in the discos. (One restaurant gives the severely disabled kids
free juice drinks. Everywhere else, those with polio for example are treated as regular
customers — expected to pay but not discouraged from entering.) Esperanza describes her
expereince of receiving care through Pina -and its associates:
My name ts Esperanza and I’m fifteen years old. I was
operated on at the Shriner Hospital in Mexico City. When I left for
Mexico City, I was very afraid of what the operation would be like. I
was more afraid of the anesthetic than anything else and all the way
there I was thinking, what if I stayed under the anesthetic? What if I
didn’t come our of it? That didn’t happen, however, and I’m very
happy that it didn’t. When if came to twelve o’clock on the day of my
operation, I was nervous and praying to the Virgin to help me. Anita
was with me until they took me into the hospital (.Newsletter # 33
March 1996)
Some participants with disabilities who had to leave the project have also shown great
strides in their independence. One severely disabled young man confined to a special wheel
chair that was kicked out for drug dealing is now operating a successful store in the area (and
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is probably still dealing on the side). Another young man, who uses his hands to walk on land,
is now one of the captains of rite lifeguard program and has performed four rescues in the
treacherous waters off Zipolite during the winter of 1998 - 1999. Others have returned to
their home villages and have applied the working skills they had acquired at Pina to earning
incomes in their communities.
Living in a place where there is a continuous exchange of visiting foreigners has given
them opportunities for “stimulation” (in the special education sense) that disabled children in
the US and Europe don’t have access to. One of the problems with working with the disabled
is the burnout factor. With a constantly revolving door of volunteers there is no shortage of
interested young people trying to communicate, make triends and take them out into the
community. They probably receive more continuously interested care than any disabled
people I have encountered in my professional life do, meaning that the people who care for
them, both paid workers and volunteers, have a higher level of enthusiasm and interest in
both the work and the patients they care for. They have not fallen into a warehousing
mentality or cynicism as to what can be accomplished as can happen in institutions and
schools. As a result (I surmise) the children have a high level of awareness and interest in the
world around them, seem very well balanced emotionally and integrated with the mainstream
community. They do not sit in corners by themselves; they have better muscle tone and do
not exhibit the rigidity and skin problems the children left to lie m bed or wheelchairs for
hour’s exhibit.
Hilda is another long time worker with the special education area at Pina. Her
husband is a teacher at the school nearby, and she was looking for work. He had met the
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people at Pina and they recommended she come visit. She has been there steadily for almost 7
years. She also has a seven or eight year old boy who enjoys being with the disabled kids and
helping out. He is a good example of how early association with disabled people promotes
acceptance.
When I arrived he didn’t walk alone, he was scared. Jose now
(an ambulatory severely disabled boy of 13) likes people to hug him.
When I arrived, he rejected people. We are devoted to him, giving
him love and affection so that he has come out ahead. If we don’t
give them the affection that they need, they don’t learn. Right now,
they have changed. They can communicate. We take them to go fora
walk so that people can be aware of them. Because people here
[usually] hide them. We do not. Because we go out with them and we
walk with them where they want to go they know get to know
people and communicate with them. In these six years, their
education has changed a lot. They know how to communicate.
( 'Interview: Hilda)
Elena describes how it was when she first came to Pina and how it is now.“.. .There
was no activities (for children) my first year here... we only changed diapers ... The children
never had the opportunities to leave the grounds at Pina. Now they go to the beach, they go
to school.” They also go swimming every week for hydrotherapy. The children have
opportunity and access to activities now that disabled children in other countries and other
parts of Mexico do not have.
Guillermo was a Mexican promoter who began the first aid and rescue training
demonstration on the beach. This was something he did on his own. Fie was a beach kid who
had become involved at the project. Dr. Ernesto said that he had overcome an alcohol
problem through his work at Pina. He eventually married another volunteer at the project.
The two of them are still associated with Pina. He had started the CPR demonstration and
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training program on the beach ot Zipolite. She conducted several demonstrations in
coordination with the Salvavidajr. program.
To ensure a captive audience, he would set up a sheet on the sand in front of one of
the popular restaurants. Very hot sand made some of the demonstration difficult and painful.
There was a “Rescusi-Annie” [the life-size doll designed for training people in CPR and
rescue breathing techniques] in the middle. Me would give a demonstration of how to do
Rescue Breathing and CPR. Then he would invite someone from the audience to try. Along
with this, there would lifeguards demonstrating their swimming and rescue prowess using the
fierce rip currents to take them out to the victim, another lifeguard, and then show how to
swim to the side out of the current and use the waves to bring both lifeguard and victim back
to the shore.
He was married to Anita, the social worker on the administrative team of the CBR
program at Pina. He was an example ot one of the promoters who made a conscious effort to
combine his western training in therapy with traditional indigenous medical and spiritual
approaches. During and after the storm, he conducted ceremonies to appease the spirit of the
hurricane. He put a scarf around his head and would toss tobacco into the wind of the storm.
He also would pour beer into the ground and bunt a dried plant that smelled like sage that he
kept in a bag. He would go to different people and children in the home where 60 or so
people were gathered after the storm and place his hands on them and say a blessing or chant
in his home language in an effort to remove the fright. This fright: as pointed out by another
participant is the entry point for sickness after an event. It is believed that people became sick
from fright, not from an actual illness. Cured of the fright or susto. they would heal. After
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the hurricane, two curanderas were brought to Pina to conduct healings on all the participants
who were willing to receive it.
Gertrude was one of the volunteers from Europe. She had come from a university in
Switzerland to do her practicum in social work in a cross-cultural setting. She felt she had
learned a lot from being at Pina in terms of what disabled people were capable of. In her
home, she said, they were segregated from the rest of the community in institutions. It took
her a while to feel comfortable and realize they were not fragile simply because of their
disability and their appearance. She said:
We wanted to (teach them about art)...they had no
experience in painting. They never paint at home. They don't have
the materials, so they were really shy. They didn't make straight lines
or they were ashamed. First, we had to get them more comfortable.
And after a while, they liked ir more and more. We worked with
music. For example, they painted to the music, just fantasy, or we ■ , .i..
tried to do different techniques. 1 can't explain, just that they had to
use their imagination. That was very important for us, not that they
are copying something. That they had to work with colors....
Yeah, some children make really big changes, but other ones
are still the same. One girl wouldn't let us look at her stuff. She's not
living in Pina; she's from another village. At the end, she painted
really well. But I saw that people with the enthusiasm and affection
always you this giving here all were voluntary if there is not money so
that you get paid (Kids did make changes and grow from their initial
reticence to try art) (Inkmeir. Gertnuk)
Gertrude was there during the summer camp in August of 1997. Those of us who
were volunteering at the time saw the gradual blossoming of the patients over the four weeks.
As they became bolder and more willing to take risks in painting and other tasks, they also
became more expressive themselves with new friends that they made. Progressing through
the weekly fogatas (campfire sessions) that included dancing and singing, the visiting patients
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became more animated and vigorous in dancing and singing. On the hrst camp tire, the
visiting patients sat by themselves and the residents sat by themselves. It reminded one of an
American high school dance with the boys on one side and the girls on the other. With time,
this changed. There also was an increased interaction between disabled and non-disabled
children and adults. By the end of the camp, there was no division between the visitors and
the residents. They all sat among each other and mixed well.
Hector is on a scholarship from Pina studying to be a therapist. He is one of several
young adults who grew up at Pina, both disabled and not, who now arc receiving higher
education through the support of Pina Palmera. His mother is a partially disabled woman
who has worked at Pina for many years. The project pays for his tuition to a program with
the government to train him as a professional therapist. In addition to him are about a dozen
other high school and college age students now living together and learning in Oaxaca City.
This is first group of such kids to leave and strike out on their own. The fact that so many
disabled young people could leave Pina and live together and go to school away from home
was a big event and something that made everyone very proud.
As exemplified by Ezekiel, Juan, Irma and others they have acquired not just
marketable skills, but have savings and ownership of their own homes. They are not
dependent on Pina solely for their income, i wekiel and his family are active members in their
community Protestant church and are highly sough t after carpenters. 1 rma and her family are
contemplated opening a small hotel lor tourists. The young adults who have moved to
Oaxaca for higher education can and are looking forward to living independent lives with
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careers that meet their financial needs. None of them felt they would have had the
opportunities they now have before the) came into the Pina Palmera family.
Jacob mixes in his comments two aspects that motivate the objectives and outcomes
sought at Pina. On one hand, it is important for them to promote integration between
disabled and non-disabled. On the other hand creating economic independence is also at
issue. N ot only for the individuals, but he addresses the issue of whether Pina itself can be
independent of outside aid. The reality of working with the disabled, whether in schools or
other programs, is that true self-sufficiency (for the disabled or a program working with them)
is not a reasonable or realistic goal. He states the following:
You might think ot also the chaps who work here in
integration. Able-bodied people work along side disabled people. In
the carpentry shop we have employees who are completely able-
bodied, some people are disabled, so yeah, I agree it you didn’t have
the disabled element to it, it would be far easier to become self
sufficient, because fundamentally you use less money. Also, you have
to ask if in the developed world this is really to some degree a model
in terms of economic productivity and all that shit. How that
changes in the developed world where disabled people work and
they’re self-sufficient. .How that’s actually done, I don’t know
anything about it. And whether Pina would one day becomes
completely self sufficient, 1 have no idea. I think it will. (Interview:
Jacob)
In this selection, Dorcas talks about an employee of the carpentry project and how
involvement in it has changed his life and given him purpose.
He was the first one to come here that knew how to make
things. So they gave him a chance, and they helped him with the
alcoholism and then he became a non-alcoholic, I don’t know how
you say that, and I don’t know, 1 guess they- - Ingrid has a good
eye...because they’ve been in those places from so many years ago,
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they just get better and better I guess. They have more and more
satisfaction of their work, I think, and ot their position. Now they
know it they do a good job, they’ll get better, or more respect and
more responsibility to feel proud of.” (Inlmieiv: Dorcas)
Bob describes the early days of trying to get people interested in the carpentry project.
Though it is now in many ways the centerpiece of Pina, it was nor a guaranteed success at the
start. Many people did not believe that disabled adults, let alone children, could be trained to
build anything that was marketable or the process of creating toys and working in a carpentry
shop could be therapeutic.
Finding something that could bring both the disabled and non-disabled together in a
meaningful activity was important. Discovering what that was turned out to be a trial and
error process. It took the carpentry project about three years of failure before they discovered
an activity and tools that met their needs and made the variety of disabilities the project had
to contend with balance out. To this end, they discovered the scroll saw, a small tabletop
cutting tool that operates and looks like a sewing machine. 'They are able to cut thin pieces of
wood into a variety of intricate designs. A beginner with limited fine motor control could
successfully use this machine after a few simple demonstrations. 'The sanding and painting of
the cut materials could keep everyone busy and allow a high degree of participation by
everyone at the project, both patients and volunteers. Bob told the following story:
I went to Projimo to take this course on making jigsaw
puzzles for education and special searing. The day I walked into their
little shop there, I saw a tool, a scroll saw, and 1 said, that will change
the program. The idea was that 1 needed a tool that would include
everybody. That was the hook, just a simple tool. I went back and
bought 5 of these tools, came back here and in a year 1 developed a
program after that where 98% of the people could do something.
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He continues describing the secondary outcomes ot the
carpentry activities: The other side of that coin is that the carpentry
shop has become a rehabilitation center. That’s where it’s really big
time because that’s one of the concepts ot Pina, it’s not just the
carpentry, it’s the garden, it’s no get the people when they’re here to
be rehabilitated.... Then what do they do for the rest ot the day? So
you put them in the carpentry' shop, they have to do things, they
have to walk to get the piece of wood, so you evaluate what you
want to do for these people.
We made all these toys. Lazaro, Julia, all the kids here were
part of the program. They made beautiful toys. They went out to the
beach and sold like 680 pesos of toys in one day. They all came back
and had hands tull of money. The dreams were there. One ot those
dreams is sitting over there right now. He may be this and he may be
that, but he is out in the world functioning as a normal human being
because Pina Palmera did it for him. Julia is functioning as a normal
human being, so is Esperanza. (bilmnew: hobj
Bob in his frank manner has expressed how the disabled people who participate in
the carpentry7 program not only acquire skills that might bring them employment, but in the
course of the activities they receive all the benefits of an occupational therapy treatment in a
natural environment. The process of working with the wood and creating something that can
be sold helps bring the person who may have been previously isolated and stigmatized to a
new sense o f self, of a higher self-esteem and sense of well being. The visits and mentoring of
a disabled woman from the United States not: only helped these patients but also showed a
way that the disabled with skills from outside Mexico could also find a useful direction for
their lives. Burt the blind American visits once or twice a year and trains young blind people
in how to negotiate their environment. He has said in his interview how good it makes him
feel to be able to do this. That is a benefit that accrues to both patients and volunteers, to
both the Mexican Community and the foreign Community.
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Besides improved working skills, the diet that people receive has changed. The
kitchen at Pina for many years served only black beans, rice, and tortillas with very little
variation other than shrimp and chicken. Getting the cuisine to include more meat was a bit
of a struggle, because the foreigners seemed to have a preponderance of vegetarians among
them who romanticized the diet of the people of the area. The volunteer had a notion that
the Mexican Indians lived an ideal life balanced in nature. They didn’t seem to realize that
given the choice, most people in the area would prefer better food, VCRs, and other
amenities that they associated with the European and American lifestyle. And indeed, there
were springing up dish antennas all around the area stuck to the side of adobe shacks, because
satellite TV was now available for only about $20 a mon th, well within the budget of a family
or group of people who pooled their resources.
The cook told me that the only reason they subsisted on tortillas, beans, and rice was
because they could not afford meat and fish. If they had the choice that is what they would
have. When given the choice between toilet paper and meat for the cuisine, because the
budget was tight, the Mexicans voted for meat, much to the chagrin of some ot the foreign
volunteers. This discussion took place in the general junta and that was the choice that was
made. Hilda continues to describe this change:
The kitchen now is better. The food is better. Before, they
repeated many of the things we were given to eat. They didn’t give
many greens. If is different, not simply rice and beans the whole day.
There is salad in the corner. (Inlenieiv: Hilda)
In the juntas, women and disabled people who did not voice their opinions have
increased their assertiveness over time, in a culture where men make many of the decisions
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affecting community life, and women make family decisions; it is a change for them expand
their influence to the village level. Women are responsible for major funding and
programming choices at Pina, and in the village assembly. Some women who are on the
village government began their experience at the Pina project.
The participants at Pina have learned to assert themselves in the juntas and in the
community as well as identify needs and the means to address them. Over time, the various
areas in Pina have begun to specialize into semi-autonomous sub-projects. The longtime
workers in these areas also have begun to create goals, written proposals, and searched out
funding on their own. They have learned to become less dependent on a single person or
administrative division to find money for their goals. This has led to some disparity between
the different areas at Pina, fo r example, the carpentry, garden, and therapy areas have more
funding and more volunteers than the special education, maintenance, arid operations areas.
The areas of carpentry and gardening arc also the areas where participants are beginning their
own independent businesses outside ot Pina.
Pina has maintained the same administration for well over a dozen years, giving it a
continuity'' of management and growth that tew international aid projects can boast of. It has
managed to grow from within, and on a smaller budget than most private voluntary
organizations or other non-governmental organizations. It could well be a big factor in its
success that its core leadership and constituency have remained loyal for so long. It has never
had to look to the outside for filling major sniff positions. Its leaders have been willing to live
and work at a much lower economic quality of life than their counterparts in more recognized
organizations. Many projects fall apart when the leaders move on. Pina has been able to train
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from within anti pass the mantle on to two succeeding generations ot leaders. From the 1970s
and through the early ‘80s under Frank Douglas through that period to the late 1990s under
Ingrid Olsen de Martin and now gradually turning the reins over to members of the
leadership juntas. At the very least Pina may eventually divide into several autonomous
projects that could go their own way. Specifically this could be the carpentry project,
gardening, and CBR projects once they solidify their leadership and tunding and project goals.
It seems very much that Pina is m transition towards a unique future.
The disabled people themselves are a presence on the beach. They participate in the
lifeguard program, visit the restaurants, sell their crafts at the gift shops, and are a regular
presence. One of the interesting things that happens in Zipolite is that tourists will see the
disabled kids eating at the restaurant and assumes they are there to beg, so they will give them
money. They are surprised when the money is refused. Once a disabled person from another
city was dropped off to beg on the beach, and was invited to come to Pina to visit and learn
about the opportunities there. He refused and found that begging was not lucrative, because
all the merchants and most of the tourists who had been there longer than a few days knew of
Pina Palmera, and wouldn’t offer money, but would offer directions instead. If is a unique
fact that Zipolite is the only economically depressed area I have visited where there are no
beggars, disabled or otherwise. It also could be that the tourists from Europe are only just
above the poverty stage themselves and have no money for beggars. In addition, after the
hurricane, there was lots of paid work to do in reconstruction.
Tourists were confronted everyday with the positive images of disabled children
participated with greater levels of integration in the local community than many of them had
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ever experienced at home. Uniformly these people even with a short-term exposure to the
people o f Pina on the beach, restaurants and in the village said they were pleasantly surprised
and felt they learned something new about the disabled. Hector describes how people in the
community view the disabled. They are used to having them around.
Here people already have: this sensitivity towards the person
who is different. Also the form, of coexistence among - the
relationship falls among people, good, non-disabled, and the disabled
people. Coexistence - being together, united, and that there are not
groups of people non disabled here and there groups ot people not
disabled, is there an union between them and because of that it is
beautiful — because it is a rich way to think and be? ■ . • You can learn
much from the disabled people. (Intenmv: Hector)
For the villages that Pina works in through the CBR program there are benefits
associated with that program. It has ended the isolation ot the disabled poor in the mountain
villages. These people have for the first time had professionals in health care and education
come directly to them for the first time. Previously, no government or independent agency
addressed his or her needs and circumstances. Although the visits may not be regular,
nonetheless, it has raised the consciousness ot the families as to what can be done with the
disabled, as well as helped remove the stigma of disability within these villages. It seems to be
a law of development that when one project begins to work in a village, then other will
follow, whereas it is very difficult to initiate the first project. These villages are benefiting
from other agencies using Pina and its CBR program as an entry vehicle into the community.
Save the Children of Sweden [many of these organizations have autonomous franchises of
sort in different countries] is just one agency that lvas entered collaboration with Pina Palmera
to address the needs of special populations in the area.
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Finally, because Pina has success, however incremental, in working with rural poor,
they are attracting more support from other agencies, which in turn are giving Pina financial
and resource support. Since the hurricane, and possibly because of it, there has been a
dramatic increase in financial support lor Pina and its projects. Success begets more success
and people will more willingly donate to a project with a recognized record ot
accomplishment. The fact that Pina Palmera has been working continuously in the same area,
and helping the same population of disabled people in one form or another consistently since
the early 1970’s makes it one of the most successful independent disability aid projects in the
world.
The problematic outcomes attributed to the Pina experience are found mostly under
the aspect of dependency on the part of care recipients, reinforcing of gender roles and
irresponsible behavior of the children of Pina were the most common responses. There is
also possible impact on the local economy, particularly by the carpentry and garden nursery
projects that have the possibility of competing with local businesses. There "arc also the
problems associated with the mixing ot several different cultures in the same place and time.
The following picture is of a mural designed by Gino, a severely disabled boy who passed
away in October. It also shows many ot the other children at Pina Palmera
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On the issue of dependency, not only do the children at Pina develop a dependency at
Pina on people cooking and cleaning for them, but also they develop social dependency.
Certain children develop an attitude that they are the center of all attention, and have
difficulty sharing that attention with others. 'Phis is certainly something I encountered many
times in teaching in the USA. New students came to the classroom expecting undivided and
immediate attention. When having; to share that for the first time, they became upset and
would act out in order to bring the focus of the caregivers back to them. The children at Pina
responded to this issue no different than others.
The following is from my research log during the summer. The description deals with
how the children are as individuals apart from their disabilities. It shows how strong and
unique the personalities are. They have dreams, desires and ideas of their own about how to
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control their lives and assert their sovereignty over themselves. These are the resident
patients. They are the children who have lived at Pina all their lives, and probably in the case
of Gino would have died long ago if they lived in the villages without the opportunities
offered at Pina. (He finally passed away at the age of 21 in the fall of 1999 trom respiratory
failure.)
The children: We took five disabled children and young
adults down the dirt road to a beach cafe where they were given
sodas and choco-milks. Gino is a young man of normal intelligence,
great patience, and a severely deformed body whose head kept
plopping over backwards while I struggled with his wheel chair in the
sand. He draws pictures and creates greeting cards winch arc-
mounted on the handmade paper created in the garden and sold for
about 10 pesos [It was about eight pesos to a US dollar at this time]
They are very complex [his drawings were very interesting and
attractive! he should get more money...” But he seemed very satisfied
with the recognition he received. In tact one of his drawing was
turned into a mural on the side ot the main office.
She (Elena, the special education worker) talked about how
Maribel 'interprets' for Silverio. And how she writes letters and
Poems for Maribel and Silverio, She determines the subject, then
selects the choice ot words, and looks tor .Maribel to indicate what
she wants. Smile tor yes, frown tor no. She also said that Maribel is
very spoiled and to maintain the attention of people around her
centered on her, she won't watch TV or learn to read or engage in
activities that might take her ott 'base.' That is, away from Ihh.i. She
won’ t go with us to the restaurant on Mondays for juice or the beach.
This is her little queendoin and she doesn't want to lose it. (Ruseaivbers
Log)
Not all quality of life issues can be limited to access to physical improvements. In the
description of Jaime, the drummer, he is using a skill he learned at Pina as a patient. He has
returned to his village, and fits into community life very easily. He was quite a flirt with the
girls as well. Many disabled people are quite adept at using their disabilities to manipulate
others into doing things for them they are quite capable o t doing themselves. He certainly
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was one, and even the lowest functioning disabled child knows how to cry or misbehave to
gain attention or to achieve their goals. The women in the special education area knew this
from experience and expressed their frustrations wirh foreign volunteers that would reward
acting out by responding to it. If was felt they were working at cross-purposes.
In the following excerpt, Juan, the chief of the gardening project discusses the impact
of foreigners and the cross-cultural issues of how both Mexicans and foreigners view things.
He was one of those very happy with the influence and participation of volunteers. He also
was one who seemed to quietly stand to one side while some volunteers argued between them
as to whose vision ot Pina should prevail. 1 think he knew that regardless of the outcome of
any argument between outsiders, he was the one ultimately responsible for his area of activity
and when they left, he would remain.
He also describes m the following selection the differences in the opinions the
foreigners regarding how thing's should be done and who should be doing them caused some
arguments. There also were problems of a generational kind. He acknowledged that the
children at Pina did not always wish to follow directions and participate in chores. However,
in that they were not so different from kids on the dirt roads and beaches of Zipolite he
pointed out. Juan describes how the foreign volunteers not only bring their expertise and
skills to Pina but also their expectations and prejudices. They seem to expect Mexicans and
the indigenous to share not only their approach to work but child rearing as well. This caused
much difficulty in the weeks after the hurricane, when the volunteer complained that they
were doing the work while the children merely played and ate.
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Klaus was the electrician and when he leaves, someone else stays in his place and that
person doesn't have the same experience as the other person. He said the following:
Sometimes they leave the main person in charge because
that's his job. (idven it a foreigner can do it better.) But life we all
come from different cultures.
Sometimes there are problems because they bring their
different customs. Sometimes the foreigners have very strong
opinions and we, as Mexicans, perceive it as aggressiveness but you
see that is our way of being and that's their way of being since we
both have different customs and come from different cultures.
The parents ot the kids do nut even care, I mean some kids
tire just wandering around the streets by themselves. And they make
their own decisions. They never go to their parents or their parents
to them. Their parents can't tell them what to do because they don't
listen. For example, there are sometimes that you ask a kid
something. Give me a hand with this and they don't help you
because they think that what you say doesn't matter to them, (the
kids are spoiled and don’t participate, (hikiviem Klaus)
4.16.2. Physical Change
The physical aspect of change covers two different areas. There are improvements in
personal mobility7 that the participants have gained, and there also are the changes in
environment to make some areas more -accessible. The latter has not been nearly as important
as the personal mobility. With the large population of polio victims in the area, wheelchairs,
braces, crutches are a big difference for people who never had access to adaptive equipment
before. There are the opportunities for corrective surgery through Pina they did not have in
their villages or on their own. There also is the access to physical and occupational therapy
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as well as training in these areas to help others that do not have medical professionals in their
areas.
One difference between the situation in these villages and in other developed
countries is that for the most part there seems to be an emphasis on not adapting the
environment any more than necessary for the needs of the disabled. There are notwheel chair
ramps except for a few buildings for example. Instead, the emphasis is on the disabled person
learning to adapt him or her to the environment. Since there is little money, and the local
governments cannot afford to create a disability accessible infrastructure, it makes more sense
for them to learn to be mobile in the environment that they live in.
Though the outcomes of Pina have been small compared to a governmental program,
they have had profound effects on the lives of those living in the area that have been able to
access them. The management model ot having programming decisions made by stakeholders
in the projects has helped to keep those who receive benefits accountable. Some who have
been trained at Pina have managed to establish independent lives, making incomes on their
own where previously they did not.
The case of Ezekiel, Esperanza, Juan and Irma, his wife, are examples of people who
through becoming involved with Pina Palmera were able to change the circumstances and
obtain a hope for the future they would not have had without it. Ezekiel was the man who
was paralyzed in the hunting accident, Esperanza was the young girl who lived on her knees
and Juan and Irma were both polio victims whose opportunities for a normal life, let alone
marriage were not great.
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As Ezekiel pointed out in the earlier parr of the chapter, after his accident, he did
nothing for many years. He was completely dependent on others to care for him. It never
occurred to him or his family or his community that he could do anything productive. When
the CBR project first visited his town and lie became involved in the carpentry project
everything changed. He eventually moved to Pina where he co-manages the carpentry project
with his brother. Together they teach others how to build a variety of things, from wooden
toys, coffins, to beds and various kinds of furniture. They are bringing in the majority of
income to the project. After the hurricane, they received commissions to build things for the
community. Ezekiel has gone from stuck in a corner of an adobe room to being mobile in a
good wheel chair and a major player in the Pina project.
Esperanza described how she suttered from polio to such a degree that all she could
do was move around on her hands and knees. That is certainly something I observed many,
times in Africa, where many people suffered from untreated polio. Their legs would be bent
like pretzels up to their chests. From the way she describes her condition as a child, it sounds
very similar. After a long series of operation, where her legs had to be broken and
straightened out, she eventually was able to support her own weight using crutches. In her
condition, as attractive and intelligent as she was, it was doubtful she could h o p e to have a job
in the mainstream society. After years ot care, she is now in school learning a craft that will
support her and lead her to financial independence.
Juan and Irma both had polio, and as with Esperanza, they were not able to walk.
Unlike her, theirs was nor so serious so tlv.it with the care they received through Pina they
were able to walk again without crutches. Irma wears a brace on her ankle and both of them
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have severe limps. However, they arc very mobile and able to do their jobs. They may be
deliberate in their movements but they are successtul. Irma earlier in the chapter described
how she too was condemned to a life consigned to crawling on the ground until she was
brought to Pina Palmera. Both of them are very important leaders among the Mexicans at
Pina. They are planning and working towards becoming financially independent of Pina One
of their goals is to build cabanas for tourists and make their living that way in addition to the
other activities they engage in.
Many of the patients and workers at Pina have similar tales. They had gone from
having little or no hope ot being able to lie part of mainstream life in their communities,
because of their disabilities. Through their participation at Pina, they were able to gain access
to the medical treatments and vocational training that allowed them to achieve the necessary
degrees of independence that they needed. Each of them importantly, gained the mobility and
training that allowed them to function in their own environment without changing the
environment itself. Expensive as operations are, simply adding ramps or better wheel chairs
or equipment could not make as big a difference as making a change in the persons
themselves. The deaf education projects as well as the CBR projects were both examples of
trying to make changes in the individuals that allowed them to function in their own world.
A final example of how Pina brought a change to the community was that o f the Jr.
Salvavida and hydrotherapy program. This project taught young people how to be lifeguards
and established a volunteer program on the beach. Zipolite has treacherous rip currents that
make it extremely difficult to return to shore once a person has been pulled out. Before the
training started, an average of forty people drowned each year on the beach. After the
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volunteers had been trained, only an average of four people a year have drowned. The
disabled children who also attend the beach at the same time the young people are trained in
rescues get to experience being in the water every week. When the hurricane struck and the
water rose, the disabled children who were in this program exhibited little fear. It was the
adults who were visiting and had no swimming skills or experience who panicked instead.
Pina has grown along with the surrounding communities. Since the early seventies it
gone through changes in goals and objectives, its operating structure and its environment. It
has gone from being the work of one individual and expanded to include the visions of many
others. It has changed from simply being- a place where people came for healing, a refuge and
an orphanage to a complete change in the other direction. Instead of being a site where
people came to, it became a place where trainers came. Zipolite has grown from a remote
fishing and camping area to a popular resort. It has gone from a very informal governance to
a town with an elected council providing full city services.
The community-based rehabilitation program has had many difficulties in achieving
this new direction. It has faced failure in being unable to create a cadre of dedicated
promoters willing to live in the villages they serve for an extended period of more than a few
months to a year. There have been the problems of disinterested villagers, the lack of
professionalism and haphazard training on the part of Pina workers, transportation and
scheduling problems. There have also been the problems of callage promoters who have
already too much work in their daily lives without an additional unpaid role. Volunteers with
poor training, illnesses, limited Spanish and short terms of stay also contribute to the
problems. The administrators recognize these problems and there is continually discussion
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on how to solve them. It will take another visit in Future years to see how these problems
have been addressed.
The successes can be measured in the way people get together who previously would
have nothing to do with each other. Not only those with disabilities and those without, but a
variety different cultures came together at Pina. History shows that these casual and
unplanned meetings can in the future lead to larger changes. That is because the preconceived
notions people have about each other have to be thrown away. Volunteers returned to their
homes with a wider view of life. The disabled patients and their families returned to their
home with a larger horizon ofpossibilities. The greatest success in the world of these types of
projects is that Pina has existed tor well over twenty years in one form or another. It started
with a couple individuals working with the disabled people on a deserted beach area. As the
beach became, a. tourist site .and growing town, the work of these wanderers became
institutionalized and changed leaders and finally changed the concept ot leadership. (From a
single person to a democratic social design.) The project now is reaching out to the world
through the Internet as well as sending out those who have worked there to make changes in
their own home community.
4.16.3. What Volunteers learn
Volunteers have benefited from the experience of living with the disabled for an
extended period. Most have never been around anyone who was disabled. In their home
cultures, most of the disabled are segregated. They live in institutions and arc rarely
encountered in daily life. Many of the volunteers expressed an initial anxiety about being
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around them, not knowing what ro do, how much to do, how much ro help. Generally, they
began by helping too much, and then by the time they left realized that there were very few
things, that mattered in life, that the disabled could not do for themselves.
They realized that disabilities did not keep people from having feelings, desires, and
hopes. Some needed help with things like eating and selt care, but they also have self worth,
self-consciousness. Some ot the visiting, volunteers just had no idea what to expect of the
disabled. They only knew that they were there to help, although they did not know how to
help or when. They learned during their time at Pina that the disabled both could andwanted
to do as much for themselves as possible. It was more of a question of the time and manner
involved for them to do things. They wanted to be allowed the time to accomplish these
tasks on their own. They did not do things as they were done in the volunteers’ culture things
were done. Moreover, since that taking time to do things also applied to everyone living in the
Mexican culture, it was possibly easier to accept.
4.17. COMMUNITY REACTIONS
4.17.1. Positive Community Reactions
The community around Pina Palmera has grown up with the project. When Frank
Douglas first began working with disabled people there was not a village at all, only a swamp
at the edge ot the ocean. Over time people began living and fishing in the area and the town
grew up around them. Disabled people had been a feature ot the area for its entire history. It
had been described as a location that the Indians came to for healing long before it became a
tourist location, long before roads brought people in. So Zipolite may be unique in
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comparison to other places because there always was a strong presence of the disabled in the
community.
Some of the most positive reactions were among those of the tourists and volunteers
from Europe. Many came from wealthy countries where the disabled could be segregated
from the mainstream populations in special homes, school, and living centers. For many of
these people, this was the first time they had encountered disabled people and such a large
group of them, particularly youth. They saw them on the beach, in the discos, playing football
and basketball, working, and specifically not begging. Zipolite is the first place I have ever
been where there were no disabled panhandlers. Without exception., all the foreigners
interviewed said they had achieved a new understanding and eliminated any fear or anxiety
about being in the presence of disabled people. One of the greatest affects may have been the
informal consciousness raising occurring in the public places. Who knows what long-term
ripple effects their experiences may have back in Europe?
When this place started with handicapped children, people
were afraid, they saw a deformed child and they would not get near
him thinking that rhe same thing would happen to them. But when
there started to arrive more and more children, people got used to
them, and are not afraid of them now. Right now there is not much
difficulty for the people in integrating, but in the beginning it was
another matter, it was very typical for parents of a handicapped
child to hide him. They would not take their child out on the street
or to the market. That was typical. But not now, you can see parents
with their handicapped children on the street. Because before
(people) would stare wondering what was wrong with the child.
Now people are much more sensitized. (Jntm'lew: Mam ml)
Gertrude, a volunteer from Switzerland, said in an earlier excerpt that local people felt
that the people of Pina seemed arrogant; the tourists who encountered them 011 the beaches
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were amazed. “Also some people say wow, it’s nice what you’ re doing with these children,
when they see us here on the beach” Everyday was a kind of consciousness raising event
when the disabled children of Pina were at the beach, or the jr. lifeguards demonstrated their
abilities. For all the supposed complaints that may have been directed at Pina, it was the first
place the community turned when emergencies occurred. When there were drownings at the
beach people ran to Pina for help. After the hurricane occurred, Pina was a natural dispersal
point for supplies. Here are reports of people’s reactions to seeing die volunteers with the
children on the beach.
“In Zipolite, there is fully successful integration of physically disabled children in the
local school. I didn’t know what it was like in the past before I arrived. There was less
integration out in die country.” (Interview: GttUleimo)
In the following, Guillermo describes in the newsletter how the lifeguard program has
been so successful over the years.
Lifeguards on the beach. One year ago a Swedish volunteer
from Pina Palmera, I.N., helped organize a group of lifeguards on
Zipolite beach. It is with pride and joy (and relief) that we can tell
you that the group still exists. It is made up of young men from
Zipolite, trained by us in Cardio Pulmonary Resuscitation (C.P.R.)
and by a professional lifesaver from USA.; J.V., who taught them
how to swim out and rescue people from the ocean. Thanks to the
lifeguards there have been less drowning accidents at the beach.
During this past year the rescue-team from Pina Palmera only had to
run to the beach ten times and half of die times the lifeguards
managed to bring die person out of the water alive and we didn’t
have to apply C.P.R. (Five people did drown) Usually the worst time
is during Easter-week. Some years over six people have drowned,
just during that week. This year was the second year in a row with
lifeguards patrolling on the beach, helped by staff from die
Palmgrove and marine soldiers (that have taken the CPR course here
at Pina Palmera). It was also the second Easter-week in a row
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without drowning accidents. During this past year we have instructed
45 people in Cardio Pulmonary Resuscitation; many took the course
for the second or third time. The lifeguards have obtained small
radios in order to communicate with each other and with us. (The
beach is over a mile long). Now we are only lacking a defibrillator for
a more efficient rescue. Guillermo Jimenez (instructor in C.P.R.)
(Newsletter # 34 Summer 1996)
“Since January, we have been able to continue our weekly broadcast on local radio
each Wednesday. We talk and give information about health, disability and human rights
issues.” (Ingrid Olsen de Martin Newsletter #38 A p r 1998)
After the hurricane, the local government enlisted Pina as a distribution authority for
the area, Red Cross, and other agencies parked their semi trailers there and turned over the
responsibility of fair distribution of lamina to repair roofs, clothing, and foodstuffs. The staff
assisted in the hospital in Pochutla to organize homeless villagers and their families and
provide health screening for the overworked medical staff. The dynamic created by the
hurricane in terms of social change cemented the recognition of Pina, as a multi-faceted
service center was very interesting to observe.
4.17.2. Negative Community Reactions
Interaction of the community with emerging disabled participation in daily life
brought a variety of negative responses. Many of the problems can be linked to conscienti^ao.
That is to say the level of awareness and acceptance of the disabled within the community. In
one o f the mountain villages, there was jealousy on the part of the able-bodied poor, which
led to violence as described in one of the testimonies to follow. Maybe this can be explained
by the limited good theory, that if the disabled are receiving services, then by consequence,
the able bodied person is denied a service. Changing the worldview of both the disabled and
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mainstream population to one where the existence of greater opportunities and possibilities
that don’t necessitate sacrificing some other benefit is an important goal.
There is the feeling on the part of some of that any money, time and energy spent on
the disabled is value wasted, particularly in an area of scarce resources. This attitude is not
limited to Mexico, but is common in the US as well. If they do not have a disabled person in
their life, it is difficult to imagine what life for the disabled would be like. It is similar to the
problems faced by other minorities.
Ezekiel describes how a carpentry shop sponsored by Pina Palmera could not keep
running up in the mountain village due to the animosity towards them by the other citizens.
People acting, possibly, out of jealousy, contempt or feeling threatened by competition fought
against the project.
The program is not continuing now because the municipal
authority didn’t continue supporting it with the community'. (Because
of this adverse reaction Pina changed its plans about building shops
in the villages and are exploring the concept of creating a mobile
workshop operating out of a van.)“.. .The authorities didn’t support
the local shops and with the local people (who felt threatened by the
presence of a competing carpentry shop, subsidized by foreigner and
operated by disabled people) they demolished it (The original
workshop given to them) and they occupied it.” {To use the space
for other purposes) (Interview: Ezekiel)
The doctor describes how as they started the whole project, like the carpentry that
was a part of it had to limit its scope find its way and to be as effective as it could be. They
found early on that their presence in the community as a place where people could come for
help could also send the wrong signal. People wanted to come and stay or to come and leave
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those they were responsible but either could not or did not want to take care of. Dr. Ernesto
states:
The main issues that continued, were the basic ones of
survival, food... and medical attention. But the rural needs were too
much (and too many potential patients) and we did not want a
warehouse of abandoned children because every day brought people
who wanted to leave their children as if it were to hotel or hostel.
The funds and installations (infrastructure) that we had were only 2
or 3 houses, the dining hall, kitchen and some bathrooms and our
room - which functioned as infirmary, bedroom, kitchen, in other
words in this limited space we carried out a good deal of activity.
So it was that we grew and the situation was such that we
realized we would never meet the needs, the poverty of die region,
giving food to children only, and to educates the people for them to
be able to survive in their own homes, do you see? So then, we
began programs, educational programs, radio programs, community
outreach, and we began to focus on rehabilitation for the disabled
because there was nothing for them in the area. There were no
people dedicated just to helping them. So we began to focus on
limiting ourselves... specializing in helping people with becoming
skilled. Because the rest of the population had services, for example,
medical, hospital, to variety of services, so we didn’t need to do it all.
(They could narrow the focus of die services they wanted to
offer.) (Interview: D r Ernesto)
Julia, one of the young women now living and studying in Oaxaca describes the issues
involved in transportation. “The difficulty it is the transportation. What happens is that here
there are a lot of taxis but it is expensive for us to travel...diere is not a big expense to simply
walk along the roads” In Oaxaca, they have to walk or use their wheel chairs along the paved
roads, in Zipolite it is much cheaper for taxis, because it is poorer and less touristy but there
are only dirt roads and it is very difficult to move the wheel chairs. They could take the taxis,
but they would rather spend their meager allowance on other things.
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Hilda came to the project as a worker in the special education area. Her husband was
a teacher in the local school and she was looking for additional income. She has been at Pina
from almost 8 years. “ There was a demonstration by teachers so there was no school today.
We don’ t have a classroom. Instead we use part of a storeroom.” She refers to how the Pina
kids in special education have been moved from place to place and are now in a damp
storeroom with no lights, that has the main street on the other side of the wall. It is very
noisy. It seems that there are a variety of factors working against the disabled kids being part
of the regular school system. Some of these challenges are logistics, perception, and attitude
of the school officials and other students.
Gertrude, the Swiss volunteer describes her perception of some people in the
community when she takes the kids to the restaurants on the beach. She said:
They have a lot of prejudgments [prejudice]. They don’t like
it. They say, people from Pina are very...they think they are a little bit
better than other people and when they see the children...every
Monday they come here to drink something. One girl told me she
saw how they treat disabled children really bad because one boy he
was really hot and was sweating and she just let them stay in the sun
and he didn’t go to swim. I say it’s too dangerous to swim, but they
just see it from their side. A lot of people say that people from Pina
are...they feel better, they’re arrogant. (Interview: Gertrude)
The following sad article from a newsletter by Ingrid tells of the problems they have
had with members of the surrounding community. There is a certain amount of corruption in
the area as well as the usual thugs and criminals. It is not only the disabled that look to Pina as
a resource. The criminal element also calculated that Pina would be a good location to find
ready cash and goods. In a small village like Zipolite, however, everyone knows just about
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everyone, and the criminals were allegedly dealt with informally through vigilante style justice.
The employee that was attacked has to live with the damage for the rest of his life. His
disability affects him, his family and Pina. The repercussions continue beyond the single
victim.
The past month of December was an unusually difficult time
for us. If you didn’t receive a Christmas card, thank you note or if we
have not yet answered your correspondence please forgive us. It all
started at the beginning of December, when a man in Puerto Angel
sued us for stealing his land. This is of course untrue and besides, all
the land in Zipolite is communal, i.e. it belongs to the community
and cannot have private owners. In 1987, the village of Zipolite held
a big meeting at which all the villagers signed a document which
donated the land to the Centro de Atencion Infan til “Pina Palmera”.
The man in Puerto Angel possesses false documents and now the
case has been taken to the local court in Pochutla. We have two
lawyers, and an architect, who are helping us without asking for
anything in return. Even though the accusation is false we have to
defend ourselves and it is taking both time and energy. On the
fifteenth of December we were exposed to an attempt of armed
robbery. Two men entered our office and threatened our
accountant’s assistant with a knife and a gun. The assistant didn’t
know where the money was (and, as it happened, we didn’t have any
money in the office that day anyway). After asking him three times
for the money the robbers shot a bullet into the floor and ran out.
This happened in the middle of the day and the workers of
the Palmgrove heard the gunshot and many of the men began
chasing after the robbers without thinking. Abel and Claudio, both
24 years old, caught the men but unfortunately both were injured
and the robbers escaped. Claudio suffered a knife wound in his left
side that punctured his lung. He is well and back to work again after
two months of rest. Abel had worse luck. He received a bullet
wound in his head and was immediately transported to a bigger
hospital in Oaxaca. There a surgeon took out the bullet. Abel
remained in a coma for three days. On awakening, he was paralyzed
in his right side and couldn’t speak. Today he is back at the
Palmgrove, well looked after by his family, friends and coworkers.
Everybody is doing their best to contribute to his rehabilitation. Abel
himself has a very positive attitude and is well motivated. Already, he
can walk with the help of a cane and he communicates with signs,
facial expressions and some of the words that have come back to
him. We are all glad and relieved that Abel survived in spite of this
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terrible event. Soon he will return to work on the maintenance of the
Palmgrove together with Jaime. (Maria’s son.) 'Newsletter #33 March
1996
Abel was working with the maintenance crew during this fieldwork. He did not talk
much and was a bit slow, but these seemed to be more on the line of slow reactions to
sensory stimulus. He displayed a subtle sense of humour, and in a slow paced society, he
seemed not very handicapped by his wounds but he did move a little behind His wife, one of
the promoters who worked in the villages and his daughter were supportive. He was the one
who was working and apprenticing under Klaus, the German volunteer doing the electricity.
In the community around Pina that includes the villages where the CBR program
works, the promoters provide continuing education as to what is involved in caring for the
disabled. They do this through their visits and on the radio. They want the average citizen to
have a better understanding of the situation the disabled and their families face. Not much
can be done about the criminal element as they are always looking for targets. In Zipolite, the
biggest problem with crime is petty theft. With all the campers and tourists living out of
backpacks, it provides a lot of opportunity for them. Pina is just another. Only an increase in
security can begin to address that issue.
Overall, the negative opinions on the part of the community are limited. For the most
part as can be seen between the two preceding segments as weighed against each other,
perception and opinions towards Pina Palmera and its efforts are good. Because the children
and other disabled from the project make themselves present in the community, people are
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used to them and have grown to accept them and appreciate them. The friendships and love
among the people of Zipolite and Pina are strong.
4.18. PERSPECTIVES OF PARTICIPANTS TOWARDS EACH OTHER
4.18.1. How Foreigners are Viewed
Both foreigners and Mexican nationals view foreigners in mixed ways. Those with a
stake in receiving benefits from the foreign presence display a much more positive view
towards the presence and contributions of the foreigners. Foreign volunteers did not feel
appreciated and recognized for the efforts they put in. Some of the Mexicans, felt they were
treated like children at times, and the when the going got difficult, particularly right after the
hurricane, that their skills, abilities and experiences were discounted, and not relied on, that all
the lessons and efforts behind the idea of Pina went out the window when things got tough.
The foreigners took over, as they if they were always waiting in their paternal way to do just
that. Hector says: “There are differences in the cultures. The foreigner stay by themselves,
sitting together.”
Manuel points out the different approaches to work:
Notice that I have not had any problem in working with the
foreigners. I like their form of working. They are very
understanding, very accessible. They are not proud. Sometimes the
truth is that the Mexicans are very proud and selfish ...and if we
know something, we don't want it taught to other people.
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He goes on to describe the difference he imagines to exist between in the
children of Pina and other countries:
Perhaps in other countries the children are brought up in
another manner. Perhaps the way of life in other countries is
different. For example, when the child is small he just goes to
school. He doesn't sweep the house, he doesn't go to get water, he
doesn't do anything in the house, he just studies. But when he is big,
he will have an opportunity to work in an office, in a business. He
will not work as a construction worker or a carpenter or in the fields
growing corn. So this is a difference. [Because going to school isn’t
really work to a farmer] A young person has to work in a restaurant
where he has to sweep, clean off tables. He has to work. And if he is
not used to it, he will say, “no, I just want to eat." (Interview: Manuel)
If he doesn’ t work he won’t eat. Manuel is saying he doesn’t think the kids at Pina
know how to work, that they won’t work and they won’t learn unless they get a harsh lesson
on the realities of life. The children at Pina that are accused ofbeing lazy, by volunteers, some
adult Mexicans and by some people in the community. While the kids a Pina are playing other
in the immediate community are working hard to make money for their families by selling
things on the beach.
The volunteers are accused of shirking as well. The agreement that volunteer agree to
in order to serve at Pina states that they will work thirty hours a week and keep a six-month
commitment to stay at Pina in exchange for room and board. But getting the appropriate
amount of work and of a high enough quality desired by some is an issue in itself. The
dynamics of any group endeavor are typical here. Some will always feel others are not doing
their share and some will always try spending energy getting out of doing their duty.
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Azana is talking about a volunteer paid by the Swedish government to work at Pina.
Resentment on the part of those who were volunteering free towards those who were paid by
outside agencies and not perceived to be working as hard:
Sometimes she works, sometimes she doesn’t because she says she is
sick. She is getting paid and she is charging money. If she is so sick why don
they not send to another person that is qualified to replace her? (Interview:
A.%ana)
Bob also discusses the issue of the cliques at Pina based on language and the urge to
separate into factions, even when it can inhibit learning and growth.
“That's another thing. Mexicans can always talk in Mexican. The
volunteers come and sit at their table and talk in Swedish or in English.
English is pretty much the foreign language other than Swedish. Everybody
can speak English and feel comfortable abroad. I thought at one time that
might be a positive thing and people would see how valuable it is to learn
English, but nobody wants to learn English. Because nobody tells them that
if they want to continue to be in Pina Palmera you'll need to do certain
things, or leave.” Nobody threatens them with expulsion if they don’t work
hard enough. (Interview: Bob)
The biggest problem sometimes is that because the volunteers do not have the
language training, they do not mix with the Mexican people. In addition to that, because few
have the cross-cultural training that many organizations require before working overseas;
there are misunderstandings and the problems that naturally occur between people from
different culture who are thrown together.
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4.18.2. H ow Indigenous and Mexicans Are Viewed
This section looks at some of the opinions of the foreigners regarding their Mexican
and indigenous co-workers and children and patients. Sometimes it was as if the volunteers
loved the place, but not the people in it. There was a balkanization at Pina that developed
during the winter when there were so many volunteers. During the summer, when there was
only a couple from any one country, people had to speak Spanish or English to be
understood by everyone. During the winter there were so many Swedes for example, it was as
common to hear Swedish, as it was to hear Spanish. So it seemed. During the
Christmas/Solstice Holiday, people were split up by their cultures to make food or do
something special. This is where I balked because I refused to be in the “gringo” group. I
worked in the kitchen with the Galician and Indian women making deserts. But it was
interesting to see how when the population grew, people divided off into their own ethnic
groups.
Two of the Spanish volunteers discuss the children at Pina. As has been pointed out
in the Outcomes section, because children at Pina don’t have to work as hard as their peers in
the rest of the village, it is worried they won’t be able have what it takes to make it outside of
Pina Palmera. Azana, the leader of a fishing company who was volunteering Pina with two of
his crew, said, “I am very concerned with the children here. What will happen to them in the
future? In Pina they don't do anything”
Lucia, the second volunteer referred to and a cook, added this.
“They are not prepared for a real world, adults ready them
for Pina and this it is not the real world.” They both were indignant
that volunteers were coming from all over the world to help at Pina
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and the children were not encouraged or required to do anything
except occasional picking up trash once a week. It was their, and
others’ perceptions, that the children did not do enough. (Interview:
Lucia)
Ingrid describes the problems with the clash of cultures at Pina.
When people from indigenous stock did not have modeling
of behavior for their learning, they never learned how to do the
necessary things expected of them. But since the Indians did not
teach in a direct fashion, they couldn’t articulate these lessons and did
not attempt to. They just seem to write off the person as not capable,
and did not expect much of them. Foreigners, however, and the
people at Pina were making efforts at least to correct this.
Ingrid further relates:
“That’s a problem we have with some of the Indians here,
because that’s how you learn, via your mother. You copy your
mother. If you have a good mother, that is not a problem, but if you
have a bad mother, you have to learn to try to adjust. But if you
didn’t have a mother, it’s very hard to know how to be a mother
yourself. With T. and C., for example, and L., they basically don’t
have any mothers, and the way T. and C. and L. are failures as
mothers, they’ re totally irresponsible, they don’t know what to do
with children. We’re always on their case and we’re always telling
them to take more responsibility and they’re not interested in it.”
( Interview: Ingrid)
Bob goes into the difference in what he sees between the people who are local to
Zipolite and the coast as contrasted to the people who have moved here from the mountains.
“That's positive. So you have two groups here, the workers
and the non-workers. I like to put it as a cultural thing. The people
never worked here at the coast anyway, so who are we to come
down, if they’re lazy, they're lazy. That's their life. They're famous
throughout Oaxaca for being lazy. You have people who come and
work. The problem is the people from the Mountains, the Yopies.
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They work and so they come here and they always lower their
standards.
“That's the problem in Pina Palmera right now and maybe it
will change, maybe it won’ t. We'll find out in the future. If you're
paying two people the same amount of money and one doesn't do
anything and the other does all the time, who's the fool? Who
knows? But it's obvious that a lot of my colleagues I talk to feel that
they're bitter. Somebody's making money and doing nothing and
they're working hard and making the same amount of money.
Hopefully, this will change. They'll fire some of the lazy people. I
don't know if it's really possible, but I'd like to see something
happen.” (Interview: Bob)
In the following, Judy describes her difficulties training people in the use of
ecologically designed toilets. The toilets allowed the waste material to be processed over a six-
month period and later used as fertilizer. She also demonstrated her perceptions and
understanding of the cultural divisions within Pina Palmera. It was significant that she could
not tell the difference between the indigenous peoples and the white and mestizo Mexicans.
I think they don't understand it because I don't think they've
ever been told really. When I was here I gave tours o f the bathroom
to as many Mexicans as I could drag through there to show them
that it didn't smell and that it was a nice bathroom and to invite
them. But it really was the volunteer's bathroom when I was here
because it was locked because kids were going in and messing it up at
first. So we wanted to separate kids and adults and I guess Juan
figured out the capacity of it should be 20 people and it should only
be volunteers and some decision was made so it would be the
volunteer toilet. And then they built that other one. Actually, the
Mexicans voted on having another one. To me, that was a huge
success...that the Mexicans wanted one. The fact that they're not
using it anymore really....
Sure. To tell you the truth, there’s not that many indigenous
people here. There are certainly a lot of people who seem indigenous
to us, but people who actually speak their language are pretty few
and far between. That's my sense. I haven't done any studies, it's just
from being around for a few years. I would have to say that some of
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my experience in talking about indigenous people is, that for
instance, that person I couldn't get along with who was in charge of
the garbage...in the very beginning when I got to Pina and I was
trying to figure out how to make the ecology happen here, I was
talking about garbage and they were burning plastic here. I said, you
have to teach people to separate it and he said, no, these Indians
can’t learn. That really got my dander up. So we had a little fight
about that and I just really let the garbage thing lag except for getting
them not to bum it here. (Interview: Judy)
She felt people could learn and needed to have the ecological values she promoted
developed within the local culture. She was an example of crusading foreigners who wanted
desperately to make a difference in the world, but didn’t realize how the process of their
imposing it on poor people could be very patronizing and patriarchal. The interesting thing
about Pina was how patient most of the Mexicans were with the foreign volunteers and how
even though they might not have reached out in a sense familiar to Westerners, they remained
open to these strangers to come to them. They were ultimately very hospitable.
4.20. COMMUNITY BASED REHABILITATION
The community-based rehabilitation effort to work in the surrounding villages
brought a mix of opinions. When they were operating, those who first encountered Pina
services through the CBR were very satisfied. Many of the indigenous workers and care
recipients currently in the Pina program were first in the village program and then moved to
the Zipolite to participate more fully. On the other hand, there were the continual
administrative and operational issues of finding, training, and keeping promoters in the
villages working.
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In the budgets from 1994 through 1998 the budget occasionally called for CBR to be
a specific item:
1998
(Budget proposal before
Paulina)
■ ■ ■ ■ ■ ■ ■ I
1996
1995
199|
1993 N;rd ^Mudi-s
1992
I ' * 1 : ; - jr..
N " $ 120.0 [Vehicles for CBR]
.uinuJ rtport fj< ’t
r't.bltsheu cJ,:t t o t to
{ ’e-'-iK'no"
CBR not specified
(HR not spcafiul
N$9312,40
NS4.1-H78
CBR no! .specific tl
USD 8,060/
N$14778G866.91
USD 197451.60
uSD 105,093 60
NS876855J7
690,01" 9U
USD 200,715.00
Table 1 Budgets 1992-1998
4.20.1. Successes of CBR
The successes of the Community Based Rehabilitation program are difficult to
quantify as one cannot point to large number of cause and effect results. However, in terms
of anecdotal affects on peoples lives it has lasting effects, mostly with adults and young
people with disabilities in the area of mobility and sensory area, i.e., deafness, and blindness.
For those with cognitive delays and severe mental disabilities combined with sever physical
disabilities, it has not worked as well.
The CBR programs have also worked best where there is an existing history of other
Community Based Development projects. Individual success stories inevitably must have an
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asterisk placed next to them. There may be many factors working in favor of a person’s
success in the system that may not be directly related to services offered through CBR. There
have been non-formal factors involved in the effects. These may include unique social
conditions such as religious affiliation, educational levels that are different from the balance of
the community, family connection with the CBR projects. For example, one of the children at
Pina has family members who sponsor CBR activities from their home in a mountain village.
Another young man in a college level therapy program grew up at the project and will be
committed to a period of three to five year services (the number depends on who I talked to)
in the CBR program as a promoter. However, it can be a safe bet he will move to Oaxaca
City, Puebla, or Mexico City when he is done, because that is where the money is.
The Curso de Verano. a four-week summer camp, and more that takes place every
August at Pina provides a time when disabled children, and young adults along with their
families, come to Zipolite to live and participate in activities. This time gives the project an
extended period to screen potential long-term patients and future participants. Because the
families are among the poorest, coming to Pina gives them a chance to receive regular
balanced meals, and receive a break from the fulltime care of their children. There were nearly
120 people from the villages at the Curso de Verano during August, 1997. Of these, over 60
were disabled children.
Through the carpentry project, participants were screened to see who might be able
to take on assignments in their homes. These might include sanding, painting, or assembling
toys. Since time of production was not so important, the ability to do a good job was more
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important. People with severe disabilities but who might be very dedicated and assiduous in
their work, were very glad to have this opportunity.
During the period of the Curso. integration between the visitors and those who lived
at Pina, as well as those who were disabled and mainstream, grew closer and developed
friendships. Self-esteem and cheerfulness also increased. One participant compared it a
program called “Outward Bound,” that was used in the first years of Peace Corps training.
Participants were very pleased to learn how well others accepted them, and how much they
could do for themselves. They discovered abilities they did not know they had. Ingrid
describes in a newsletter how the organization of the CBR program came from the
development of the junta form of organization. Promoters could successfully work in the
villages; they had to have a similar democratic system working at Pina itself. Ingrid writes:
Almost a year ago, a new way of coordinating the work of all
the different program areas was established in Pina Palmera. Each
area coordinator has responsibility for informing his/her team about
various problems and discussing possible solutions with them. There
is a weekly meeting of all the coordinators who choose two people,
from amongst themselves, to act as general coordinators for Pina, for
a period of one month. The pair changes each month. Advances in
coordination; among the various benefits, achievements and advances
of this system, attention is drawn to the following:
It has been possible to standardize criteria o f work within
program areas and generally throughout Pina. It has been possible to
resolve problems promptly, with concrete solutions, in a practical
manner, e.g., wheelchairs which require maintenance; construction of
special seats for the adaptation of the toilets for the severely
handicapped children at the special education School in Pochutla;
and the integration of children in the work of the kitchen garden. A
mesa de ninos (children's table) has been set up to guarantee a
suitable diet under adult supervision. The participation of
volunteers has been facilitated according to the needs o f each area.
At present responsibilities pertaining to work are divided, more than
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previously, among all the workers in the Centre.” (Ingrid Olsen de
Martin, Newsletter #33 March 1998)
Sonia is the director of the CBR effort and she describes how the various promoters
have grown through the program. Some are very interested in continuing their studies and
efforts. Others are not but have other interests equally important. The fact that all the
promoters from Pina were originally patients at Pina is particularly a source of pride to
herself, Ingrid, and Dr. Ernesto. She describes how people reacted to the first meetings
during initial village visits as well as how the different promoters who were being trained
measured up to the challenge. She has assessed the skills and current abilities o f the
promoters and estimates their capabilities. Sonia said in her interview the following;
After forty minutes, we had most of the town’s 500 people
all wanting to speak.. .In the case of the therapists, seriously different
from the other areas. I believe that Manuel and Margarita can do the
same work that Marlene (Swedish Therapist) does without problems.
Carmen doesn’ t have an interest in being professional. Guillermo has
interests in another types of therapy areas. He is interested in how to
be a trainer of promoters and he could do excellent work” (Interview:
Sonia)
Bob describes how important it was to determine what type of activity should start
the CBR program. In this depressed area of Oaxaca, a project that could bring in extra money
would be the best way to approach people. He said:
“Well, it turned out that Ingrid wanted to do community-
based rehabilitation and they were developing San Mateo Pina and so
the project we decided we would take would be the fund making
project, up there to work. Because nobody was making money, the
coffee prices were down, all the people were poor, and we’d give
kids the chance to make money. And it was a success. Because the
thing that was up there was there was accountability by the parents
of the community and the kids had a work ethic. They worked and
they also had a captive audience because there was nothing else for
them to do. They are 5 hours from civilization and this was better
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than television because they didn’ t have them. But there was energy
there and that’s when Solvario, Ezekiel, Armando, they were all part
of that community. Armando was the first community-based
rehabilitation guy.” (Interview: Bob)
Guillermo, the paraprofessional therapist who also started the first aid program on
the beach, described how there are juntas every week in the physical therapy program area.
They used this time to review patients’ needs and progress, plan for the coming weeks. He
said that they had no problems managing their affairs, and though the juntas were not
enjoyable, they were necessary. In regards to leadership, it seems to evolve among them, as
they become more competent and confident in their abilities. He expanded and began the
CPR program on the beach himself after receiving training. It was not a Pina directed project,
but it arose from the ideas and confidence he gained from Pina Palmera.
He started the CPR program on the beach one Holy Week on his own, because Pina
would not pay for it. He received his training from a Swedish doctor. It was after losing
someone on the beach. He may have been upset that he did not have the skills yet and that is
why he became motivated. He has the skills and the enthusiasm now and is very dedicated.
He patrols the beaches, confers with the lifeguards and business owners, and arranges for
regular demonstrations and training of people who are interested in learning. It is a good
example of someone who started receiving assistance from Pina developing his or her own
ideas and carrying it successfully. The next selection also reflects an entrepreneurial approach.
Aaron, who guided the Curso de Verano and was responsible for tutoring children, developed
an interest in working with the deaf people in the area and learned appropriate sign language
for the region and established a program.
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“Education of Deaf Children.
This year the goal for their education was for the children to
learn basic reading and writing skills. This will facilitate their
communication with hearing people. We started the education of
deaf children five years ago, teaching them the Mexican sign
language. This has made it possible for them to communicate with
each other and to have richer and more detailed communication
within the family. (We taught them sign language in their homes and
always in the presence of at least one other family member.) When
starting to teach them to read I avoided using all the different verb
forms. Instead we start using only the infinitive form, in the same
way that they are used in sign language. Time tenses are indicated
with special signs that indicate future or past time. Thanks to this
system the work with the children has advanced because they only
have to learn one word for each verb instead of many different
words. Little by little when we catch their interest and when they
learn more, we will start to introduce different verb forms.
“Half of the group (5 children) has already learned the basics
and they are now able to write a description of a drawing or a photo
of a person involved in an activity. [They are learning literacy skills as
well as sign language] The other half of the group is making slower
progress. Some of the children have earning difficulties and/or didn’t
receive enough stimulation when they were younger. If the parents
do not support them it makes it more difficult for the children to
learn. (Many of the parents cannot read or write themselves and it is
hard for them to motivate their children.) Another thing that has
helped us to reach our goal is that we have related the teachings to
the daily life of the children. In that way we have been able to
maintain their interest because they relate what they learn to their
own daily experience and they themselves notice the use of reading
and writing. The education of deaf children and teenagers is similar.
It is of course adapted to their strengths and based on sight,
memory, feeling, and body language. It just takes a little bit more
time when you teach deaf children. (Aaron, social worker and
responsible for the education o f deaf children. Newsletter # 34 Summer
1996)
Margarita describes her experiences as a promoter in the CBR effort:
“Despite everything I continued to be preoccupied because
in Azulillo, 15 minutes drive from Candelaria, we work with a family
that has four disabled children [I do not know the exact nature of
disabilities] and who are very very poor. I was really worried about
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them because their house is made out of sticks and I said to myself:
My God, if their house fell down, where have they gone? We
couldn’t go and visit them for the first two months after the
hurricane because the roads were destroyed. As soon as the roads
were repaired we went to see them and I was happily surprised when
I saw that they were doing fine and nothing had happened to their
house. We work with a group of disabled children in Candelaria. I go
there together with Susana, the speech therapist every two weeks
normally. The 8t h of December we were able to go back for the first
time. You can’ t imagine the joy and happiness we felt when we
found that almost all the children had made advances. I give their
mothers credit for this because they really put in a lot of effort in
learning their children’s exercises and they have continued their
children’s rehabilitation and exercise program even though we
couldn’t come and work together with them. This is really a beautiful
group because both mothers and children participate and work
hard.” (Margarita CBR promoter, Newsletter #38 A p r 1998)
Ingrid continued in a newsletter from earlier that year to describe the challenges of
making the CBR program continue after the hurricane. Ingrid wrote:
“In the villages off the coast, where we also have many
people with disabilities that participate in our programs. In Benito
Juarez some houses lost their roofs, among the families that were
affected is the family of Julia. Marino, the star in our video about
CBR (Community Based Rehabilitation) can no longer get from his
house to the village plaza. The little path up to his house was
destroyed but the house he lives in made it without problems. We
were not able to visit the villages during almost two months and we
did not have a clue of the situation of the disabled children there.
Our surprise was great when we finally were able to visit them and
saw that most of them were doing quite well (at least not much
worse than before) and that many children even had advanced in
their rehabilitation! A BIG SUCCESS FOR OUR COMMUNITY
BASED REHABILITATION PROGRAM! The mothers (in most
cases, sometimes the fathers our grandparents and/or siblings) had
continued to work with their children and carry out their training and
their exercises, even though we had not been able to visit them. One
of the goals with this program is to make the families independent. It
was so wonderful to see the results of our work and to see that the
families carried on by their own in spite of extremely harsh
conditions.” (Ingrid Olsen de Martin, Newsletter # 3 8 Jan 1998)
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The success of the village component the Community Based Rehabilitation is tied to
outside support. If the enthusiasm and interests of the promoters can be maintained and
those being served remain satisfied, the program can continue to grow. Unfortunately, there
are several factors working against it. The chief among these is the economic realities of living
in a poor rural community. People may have enthusiasm and give support to the CBR
program, but the economic problems and the amount of other obligations they have, as
parents, workers and citizens don’t always leave room for an additional project.
4.20.2. Criticisms of CBR
There are problems with continuity of services and quality of operations in the
rehabilitation programs both at the Center and in the villages. Some of this, as described
below, can be found in well-funded programs simply due to the realities of working with
people who are not whole, physically. Some problems are amplified by the problems of
culture, economics, geography, transportation, and weather.
A major problem to overcome before any program can take root is overcoming
mistrust of the outsiders coming in. Generally, the first people to come are foreigners. The
second problem is the perceived value of the services and activities to be promoted. There is
a classic scene in B. Traven’s novel The Treasure of the Sierra Madre.’ when the American
prospectors are asked to receive flu shots in the public square where a young doctor is trying
to distribute vaccines. It is not until the foreigners receive the shots and do not suffer pain
that the indigenous villagers agree to take part. Mexican villagers have a long history of
distrust regarding outsiders bringing programs, ideas, and activities into their world.
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Consciousness raising is the first thing most of the promoters spend their energies on. This
has been very successful in Zipolite as described
There has been a continual problem retaining promoters who were living in the
villages because they do not receive a salary. Few outside charities would pay for salaries. This
is compounded by the financial disaster Mexico has suffered over the last few years. The New
Peso dropped two Pesos to the dollar during the period of the fieldwork, from about six to
eight pesos to the US dollar. Now the ratio is ten to one.
Finally, as in any institution, politics, gossip, pettiness and alliances come into play.
People are ostracized from the program occasionally for irrational causes. Long running
family disputes also affect who receives access to care. All these issues came up in the
interviews, and their existence and deep animosity had serious affects on the program.
Bob related how the CBR program was stopped in its tracks shortly earlier in 1997
because of the absence of important leaders due to a variety of problems. During my
fieldwork, this continued to be a problem for short-term continuity o f efforts due to
absenteeism. This is a reality to face when working with the disabled; they are more prone to
illnesses that can keep them from working. People also had to leave to work their field or
other short-term jobs for a week or more so that they could make more money. Bob
describes this problem:
“ Just as you came here is when the project started to go
downhill because everybody started to be sick. (In June, 1997)
Ezekiel was sick for 8 months. A year ago, there were eight people
working in the shop all the time, Julia and Lazaro were working in
the shop; there were very talented kids. It comes down to what the
goal was...is the goal to make money, is the goal to rehabilitate, what
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is the goal? And there are so many different goals. So the project has
so many different aims. We make money. We’re down this year, lots
of problems with the hurricane and everything, but I think once we
get this new shop built and we get everything back to an
organization, then we can go back. The people who were working
before are still there and so you can bring them back and try to get
energy back into the project.” (Interview: Bob)
One of the arguments that could be made against CBR is that even though it is
considered to be better to work directly in the villages, there are serious problems with getting
everyone together at the same time and place to accomplish the task of education, therapy or
whatever other objective promoters have. The success of the Curso de Verano is that by
having all the concerned parties in one place at one time, you are guaranteed solving the
problems of coordinating services and service providers. Because so many people — patients
and their families, promoters, and volunteers, all were living together at the same place
twenty-four hours seven days a week, some kind of change in lives was inevitable. In the case
of the summer camp, it was a positive change. Bob describes a failure of the CBR approach
to the carpentry project. The people in the carpentry program area attempted to bring the
carpentry equipment and training to the villages without success. Bob stated:
“Right. But there was no place to teach anybody up in the
mountains. There was no housing for students and you could only
work with a small group of people because everybody else lives two
hours away, four hours away, how do you get to them? I realized that
didn't work, so I convinced Ingrid to bring them down here and then
we could start to bring people in here. We have a couple dormitories
or stuff and we had room for them. And that worked. That's why
when this whole reconstruction thing, it had dormitories to bring
disabled people in and let them spend some time here for some
therapy.” (Interview: Bob)
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Ingrid offers another interpretation of the difficulties promoters face when going to a
village. She felt it was the cultural differences that posed the challenges:
“If you have the same values.... if you look at things the same
way, although you can’t communicate very well, you have the same
references, so you know what you’re talking about, more or less. But
the biggest problem here is that the people that live in this village
have another belief system and have another view of morality, and
cause and effect is a whole different thing for them.” (Interview: Ingrid)
The following is from a newsletter describing some of the issues that confronted the
CBR program inl995. During that time there was growth, and expansion of the programs
into the villages. The following selection describes both the numbers of those served by the
program at the time, but also the problems facing the team as they worked within the
community. The CBR team at the time of this report would have included Anita, Margarita,
Guillermo, Carmen and Manuel.
In September 1994 we introduced Community Based
Rehabilitation (C.B.R.) using the model in the manual from the
World Health Organization (W.H.O). We started by revising the
manual in order to adapt it to the region. We presented the concept
of C.B.R. in three different communities. In all three places, we
participated in big general meetings during which we talked about
what C.B.R. could bring to each village, our main contribution being
the training of local rehabilitation workers. Rehabilitation committees
responsible for carrying out the project were formed. The idea was
that these committees should include people with disabilities,
political and religious leaders, doctors and local authorities and that
through these committees, the survival and continuity of the project
would be guaranteed.
“None of these committees worked out and the project in
San Mateo Pina has suffered a temporary setback largely because of
this. In Pochutla and Nopala the work flourished thanks to the
enthusiasm of those training to be rehabilitation workers (local
volunteers). We received a request from a group of people from
Huatulco (a tourist resort 50 km away from the Palmgrove) to set up
C.B.R. there too. The group from Huatulco mostly includes well-
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educated middle-class women, some with disabled children, and
greatly differs from the two other groups. Pochutla's group consists
mainly ofhigh school students, providing them with the opportunity
to carry out their obligatory social service. In Nopala the volunteers
are somewhat mixed. Many of the rehabilitation workers there are
teachers, some are students, and others are people with disabilities or
parents of children with disabilities. Due to the disparity of the
groups and the different structure of the communities (see
Newsletter # 31), the project has taken on a different form in each
of the three communities. During the fall of 95 the rehabilitation
team from the Palmgrove trained altogether 40 local rehabilitation
workers, who now have started to visit families with disabled family
members in order to show them how they can conduct rehabilitation
in their own homes. In cases where a person needs more advanced
rehabilitation he/she can be referred to Pina Palmera. Another task
for the local rehabilitation workers is to develop ways of successfully
integrating disabled people into their communities, preferably with
the help of teachers and local authorities.
“Pina's rehabilitation team is responsible for the instruction
of the local volunteers and it meets with them regularly in order to
answer questions, give advice, and generally support them in their
work. The team also takes care of patients referred to it and remits
them to specialist care and operations in Pochutla, Oaxaca, or
Mexico City, whenever necessary. Pina Palmera is responsible for
informing people about C.B.R. Pina pays the rehabilitation team and
make sure that its members receive training. The Palmgrove also
finances trips to, and treatments at, hospitals in the highly frequent
cases where patients or their families prove unable to pay the costs.
The local rehabilitation workers have just started to work in their
communities. What will happen with this project in the future
remains to be seen. In many cases things don't work out the way we
planned and we are constandy reviewing our ideas, depending on
how the project develops in the different communities.” (Report
from the C.B.R team. (Community Based Rehabilitation))
In the following selections, in addition to the logistical problems diere are the cross-
cultural challenges that promoters meet. As with the problem volunteers had with the juntas
and the polychronic approach to life of the indigenous, Ladinos had equal difficulties when
visiting the countryside. They had problems of language, time, and expectations. They had
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expectation that people in the villages shared their concern about the plight of their disabled,
but this was not necessarily true.
According to Guillermo, another problem is that of weather and infrastructure. “We
were due to go to Tiltapec yesterday and it was canceled because of rain and fear of boulders
in the road.” When asked about other problems that may have affected the success of CBR
he added that each place had its problems. He said language and culture were less of a
problem on the coast than in the mountains. The farther you went the more people attitudes
differed towards the disabled and their motivation to help and accept outsiders coming to
help and train.
“CBR has been going on formally for the last three years,
meaning that they consciously sought out and attempted to train
local promoters. Before that they went themselves into the villages
and did the work. They wanted to do it differently, so that people in
the villages would not depend on them. But that has been a problem
because they lose motivation, because working free they need to see
some results from their work. And the results are very slow. So they
give up. So do the families and parents. ...They train families and
parents at Pina but then when they go back to their homes, the
conditions are not the same. As with children getting toilet training,
they can have success here but then they regress when they return
home.” {Interview; Guillermo)
Elena adds her views as well regarding the immutability of life in the area. People are
brought up in their ways and tend to stay with them: “...to be integrated, to change, these
things could never be changed because it is a culture problem, and it is very strong because
we are bom with these beliefs. [She refers to their world view] for that reason you can not
change something ...[such as the attitudes towards the disabled]
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Anita, the social worker from Mexico City describes how it feels to try to adhere to
the work ethic of the foreigners but how dificult it can be. “There have been situations,
mainly with the foreigners, where we get angry because we are required to follow certain rules
and working hours and are required to attend meetings, but when we do this, [she refers to
Europeans and people from Mexico City] they [people we are trying to help] do not arrive on
time. These are very typical examples of cultural misunderstandings that are experienced.
Regarding the difficulties that face the CBR program, Dr. Ernesto describes how hard
it is for patients to keep up with their treatments. And how much the quality of treatment was
tied to a level of quality of care in the home, and training and ability on the part of those in
the home. He said in his interview the following:
The handicapped patients from the communities had a hard
time coming to the center. In the first place because they did not
have money for the bus. In the second place, they are difficult to
move. There were patients that required two people to take them, so
that required paying a fare for two people and the patient. So then,
we decided to bring them here for treatment. And send them back
home to continue the therapy. But when they returned to their town,
or their house, they stopped their program of therapy. The
conditions in their house were not suitable, or people did not know
what to do with patients while they were in recuperation. So they
returned here (to Pina) ... So we did not continue to have patients
around here, rather we had to go visit them in their house, and in
their house teach the family: the exercises, to improve the house,
how to use the stairs, go up the ramps. That is to say, try to get these
people to improve in their own environment. Because it was not
easy to bring them from here to there. (Interview: Dr. Ernesto)
Ernesto and Bob agree when all the logistics were considered it is sometimes more
efficient to bring people to Pina for short periods. There they could receive basic treatment
and therapy and provide training for those who would work with them at home. But the
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problem is that once back in the village, there are many factors that inhibit successful
recovery or continued therapy.
... When he went to his house and returned to the same
environment, he there again became handicapped. So, that was the
beginning of looking for a rehabilitation program based in the
community, involving people of the community, with the relatives so
that they could continue with the rehabilitation.
The problem, for example, or the success of the CBR
program consists of involving people the community in the
rehabilitation.. .we had to look for voluntary promoters. No one has
the money to pay a salary. We already taught them how to give
injections, provide physical therapy, how to make a serum. And that
gives that person a status in that community. Then one begins to
have a certain status over their fellow citizens. Then they begin to
give injections, for example, and they get paid for injection, and it
augments their income.
Many of the volunteers were women, they were young, and
in the moment in that they marry or they have a husband who may
not let them work or they get another job, or go to another town,
no? The difficult thing to is to find people that would be
permanent... that person has constant activity, then they are expected
to work as a volunteer, without salary, how can we demand them to
fulfill their activities? It will be the grandmother, who cares for, the
brother or another relative to give support to their family in their
rehabilitation. (Interview: Dr. Ernesto)
Sonia talked about how some villages did not want outsiders and did not want
change. She felt it was important to win over the young. One of the problems was drugs, and
it was not just young people who wanted to sell drugs, it was the older people who had
established fields and businesses that dominated the trade. They had more power than the
young did. Sonia said: “We started to give training to young people if they wanted something
for themselves. We decided that perhaps they might try to make changes because the adults
do not permit these things. (The youth were open to change in their society, but their elders
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were not) Communities told us to definitely get out of here. We don't want anything. We
want to sell drugs.
Some communities consist of indigenous populations.
Others are mestizos [mixed blood, Spanish speaking]. The
indigenous communities are very oppressed. They do not have the
capacity of reflection. They want [change], but they do not know
what they want because they could never [be allowed to] have an
opinion. There is the problem of the lack of promoters. We have a
proposal to get scholarships for the young people.... [The incentives
to volunteer] is very low. It is something that they have. [Inner
motivation] Besides, each one of them is given a diploma that says
they participated as a promoter and that helps them look for a job.
(Interview: Sonia)
It is amazing that Sonia and some of the other very hardworking people of Pina
seemed to consciously or unconsciously believe that the people they work with are incapable
of critical thinking. Is this betraying a racist belief they hold or is because they may not have
the education or training to understand the level of reflexive thinking or critical judgment the
indigenous villagers do have and have to develop to live in their difficult environment and
economy? It is pretty difficult to understand that the person who brought the junta concept
to Pina and who developed and promotes the CBR program truly believes that the people she
wants to serve do not have this capacity.
Dorcas is a graduate student and is familiar with all the sacrifices and dues one has to
pay while trying to enter the working world. She describes, as did Sonia before her, but from
the point of view of the young potential volunteer. Certificates are fine, but if they don’t help
you get a job that eventually pays you for the time you spent volunteering, then it is difficult
to find the necessary dedication to get involved. She said:
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“Give them a certificate that has value for the country.
That’s like making a kind of diploma or something. And uh, they
went to many communities. None of them worked, right? [Chuckles]
They didn’t work. That’s too bad. I don’t know why. I was trained- -
I did that project. The idea is that you go to the patient’ s house, you
do the therapy in the house with the things they have in the house.
You have to be very realistic about the problems and about the
family, because you can’t be able - you can’t bring anything that they
don’t have already otherwise it’s not going to work.” (Interview:
Dorcas)
You have to work with what they have. And I think it’s very good but there are many
things that you need. You need the right family, the right promoter, because it’s not just
something that you - you kind of want to do because you would like to help someone. You
have to have several characteristics so that the family really lets -lets you come in, into the
family, and modify some of their activities. So I think that’s why it fails because people here
they don’t want to really get in contact with each other, even in the — in the same community.
I guess they’re kind of lazy, in a way. Who wants to study for a year and not get paid?”
Hilda, the special education worker, talks about often-delayed promises to train her as
a promoter for the CBR program. She and the other women in the special education have
expressed the desire to move up to higher skill levels and to get out of doing the same thing
everyday in the same place. Working with children who cannot speak is not very stimulating.
They wish to learn and do more. However, the trainers, the Swedish therapist volunteers left
before she and the other could have the training. Now with the new people who were to
become CBR village promoters, they have not gone to the villages, or received the training
and it had been many months.
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“We want to teach to parents about CBR. Once we had a promoter
in our community but by the time that they came to work with me I was not
able to do it because there was a problem.” {Interview: Hildaj
Bob brings up an important issue that faces caregivers anywhere when working with
the sick and disabled:
“People are looking for the quick solution that will make
them normal again. They don’t want to face the long continual facts
of lifelong therapy and work involved with living with a disability.
They have to be made to understand that cures don’t happen.” He
continues: “It took a while. That was a big problem in the beginning.
People weren’t going to do rehabilitation because they were looking
for a cure. They’d bring kids like Silverio and Maribel, and think
we’re just making them normal. That’s not going to happen. My
observations were that they came here, they’d go to curanderas. the
hospital, and they went to other services, skimpy services because
there wasn’t anybody to tend to the needs. Nobody cared, I don’t
think, to tend to the needs of the disabled community in the
southern part of Oaxaca.
“If you had a disabled child, that was your problem and most
of the communities I went to and the families I saw, they were
always stricken by the fact that the woman was generally on a guilt
trip. It was her fault that the baby wasn’t normal. The way the society
goes, it’s a mistake. Other people in the community think they’re an
evil family, the devil brought this child, and all these little things you
see in all these horror movies but it was the real life that I watched
here. Little things we helped, really powerful things, like people who
could be cured, cleft palates, clubfeet
“Nobody came here to save any crippled people, pie is
cynically referring to the people being trained as promoters and those
who work at Pina.] Disabled people don’ t mean shit. They’re just a
bunch of people who should be dead. They all came here for money.
That’s all. The Mexicans are here for money, for the most part, and
they don’t really care. I say that because at 3 o’clock they want to go
home. And they’re gone and they don’t arrive on time to meet their
clients. They let their clients wait, it’s just like the people are in the
hospital. So the consciousness of the Mexicans for the disabled is I
think minimal.” (Interview: Bob)
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Not only is the consciousness of the community important to develop, but also
keeping a balance and focus at Pina itself. It’s easier to work with people, who can
communicate easily, have potential to develop, hence the preponderance of those with polio.
If mobility is the only major challenge to overcome, a project can have a higher success rate.
However, there are activities that more involved people can do. To inspire the disabled it was
important to keep the disabled in the forefront of leadership as well. Bob continues to
describe his experience with the CBR programming at Pina in the carpentry area.
So all these years in Pina Palmera have been a double sword,
one side was a wonderful experience and the other side was a
horrible experience. For my sanity and for what I believed in and
because I came here specifically to do something for disabled people,
I decided that if I was going to have a success in my program or
failure, I was going to include the disabled people in my program. If
you go here and look at the therapy program area, there is not one
disabled person among them. There are some people who have
family members who are disabled, but they aren’t disabled people.
[Themselves] In the woodworking shop, the team I started with were
disabled. Most of the people who I have had successful things done
with are all disabled people.
“No, there’s no accountability for anybody. Another
observation I have is that most of the people who come here are too
young to know what they’re doing. They don’t have any experience.
They come here to get experience and so what they’ re doing is
spinning their wheels and leading people on down paths and they
don’t know where it ends. So these people who live here all the time
and work here, the Mexicans, every 6 months there’s another person
coming with another fucking idea and they’ ve never had a chance to
go into a long-term idea. Community-based rehabilitation was a
long-term idea, but there’s nobody coming who understands the
whole thing. (Interview: Bob)
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Bob decries a problem that is not unique to the situation in Pina, but in US education.
That is the problem being in the business only for a paycheck, not being professionally
dedicated to their work and caring for the patients they are supposed to work with. He asserts
that the volunteers who arrive to help have no training or experience in the work they are
expected to do. It was my observation as well, that most of the people who came to Pina as
volunteers not only didn’t have language and cross-cultural sensitivity training, but also were
lacking in job skills that were appropriate for the development situation they were entering.
Certain volunteers such as the nurse, the therapist and her husband who conducted the
lifeguard programs were doing exactly what they were well trained to do, and others tried
their best to apply their skills to the areas where they could best be used. However, I think
that Bob is off base in an important aspect. The experience of volunteering at Pina, as in
many volunteer opportunities for young people who have not had the chance to develop
skills, is as much for them to explore what abilities they do have and make discoveries about
themselves. I think this is something Ingrid and Dr. Ernesto both promote. They are people
who don’t want to say no to those who want to serve. They have different drives than Bob
does. I think Bob enjoyed voicing strong opinions for the sake of creating a little controversy
and to get a reaction from people. He particularly liked to needle ‘ do gooders’ and the new
agers.
Hector describes again the attitude of many patients and their families that they only
came to Pina or participated in the village visits to receive the services they could obtain from
Pina, but were not interested in learning how to do the work themselves. Hector said:
“Because, before anything but they left - they left to go visit
the communities... each therapist went once the week to the
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community. They work with children’s groups. They trained the
parents and that was it? The work, no? I did not see outsiders here;
with their children for programs they were here only for therapy.
They were here a week, and then they would leave. (Interview: Hector)
Charlene was a Swedish nurse who worked with the project for just over year when I
came to it. She spent a lot of time in the villages working with the CBR program. Her
specialty was prenatal care and early intervention of health care problems for mothers and
children. She was quite frustrated with the progress of the developments in the villages. She
pointed out how inadvertent education was passed on to villagers through their observations
of Western medical techniques. Problems arose from uneducated people aping the use of
medicines without understanding or proper training.
She was bitter about the experience working in the community and with the Mexicans
precisely because her expectations were so high. For many of the foreigners without
systematic cross-cultural sensitivity training get very angry about the lack of appreciation for
what they feel are important features of their culture, in this case, her nurses respect for
proper medical training and use of medicine, hygiene, and sanitation.
. .They overestimate the medication. If you get an
injection, it's better than a tablet and if you inject then it's really good.
It doesn't matter what is in it because they have a little different way
of looking at things. And also they are injecting each other without
any knowledge in what they are doing. Anyone or a neighbor is
injecting the other one by giving each other medications. I know one
boy here, whose father died, because he thought he was sick and it
was actually heart attack.. .and then a neighbor gave him an injection
of penicillin — [and he died because of his allergic reaction to the
injection]
“[In a meeting] they pointed out their problems — the lack of
food, lack of toilets. I know there's more than 50 percent who don’t
use the toilet [just go behind the house] and they don't see the
connection with [health and sanitation].. .The men are drinking a lot.
The women don't drink. The men drink. And the husbands decide
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everything and the women have no value... there are good men,
really good family fathers who work and take care of the families as
good as they can but it's hard and if you work like 16 hours a day and
you don't get much money.
“It's not easy to get promoters because they have to work for
free because they need to work to survive and to get money and so
we have a few and then we have (an ex-promoter) who’s now
working I think with tourists or something. He can't work for
nothing and I understand that but this is the problem. In the future
we'll probably have to think of how to concentrate and how to help
the villages to maintain the promoters and much more education
because they can, I imagine they can.” (Interview: Charlene)
The problem of getting people to stay involved as promoters is an ongoing one as she
pointed out. Volunteering, or working as a promoter was seen as means to an end. They
worked for a certain amount of time and then felt qualified to move on to something that
paid better or paid money at all. If they couldn’t turn the experience into something that
would help them professionally in the area of health or public service, they left it for other
careers. O f the people in the villages who became trained, having access to the medicines and
the training gave them new status. They may have felt pressured to deliver a level of medical
service they couldn’t deliver. This created a dangerous situation. They did not want to lose
face and be accused of selfishness, so they did what they thought they could. This
unfortunately led to a death. Ingrid describes some of the problems people faced after the
hurricane out in the mountain villages and in the coastal area of Oaxaca. Ingrid wrote:
Those who lived near riverbeds lost everything while other
families hardly were affected. There are also big differences between
the villages in how much damage were done. Half o f the coffee
harvest is lost, but they say that it was a very good harvest this year
so it is not as bad as it sounded first. On the other hand many many
villages lost the whole harvest of com and beans, and that is very
bad. As always it is the poorest people that are the worst hit. The
roads are in a terrible state and many bridges are gone, not damaged
but pulled away from their place. In some places already temporary
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bridges have been put up and in other places you have to cross the
riverbed in order to get to the other side. (This is only possible if the
water level is low of course.) Almost all the families that we work
with on the coast lost their homes or their roofs.” Ingrid Olsen de
Martin, Newsletter #38 Jan 1998
In my own log I noted the cynicism that some people displayed about coming to Pina
for treatment. Once you had access to the higher quality care that was offered, you would
never go back to a village, unless you absolutely had to. In a conversation with some of the
people in the carpentry project the following was declared: “They also talked about parents of
kids involved. The statement that struck me was that there was “Entry to Pina but no exit.”
The parents, students as well as the community look at Pina as being a moneybag so why
should they do anything? However this cynicism overlooked how many people did go back to
their villages. The participants in Curso de Verano for example did not stay at Pina past the
conclusion of the summer camp. There were other examples as well. The ties to home were
very strong and not easily broken simply to gain access to medical services.
It has been seen that the problems with CBR programs are those depicted in the
literature review. There is nothing original in the challenges that Pina faces. The lack of
money, limited ability to travel to the villages, lack of acceptance by the community regarding
ideas and methods from the outside. There is lack of respect for the ability of the
paraprofessional from the community itself because that person may not be fully accredited
by a recognized agency or university. There is the mystification of the western culture and its
techniques. The science involved is not understood, the medicines and techniques of modern
medicine are seen as another kind of magic. There is also a conflict between the local
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traditional healers and the western approach. One of the things Pina Palmera has done is try
to bridge the gap between the traditional healers and the Westerners.
4.21. C o n c l u s i o n
Patients who received care and training through the opportunities presented at Pina
Palmera had a favorable opinion and were very grateful to be involved. Employees who work
at Pina varied a little more in their opinions. Those who entered as patients and later became
employees had a favorable rating; those who were able-bodied employees expressed a bit
more frustration. Foreigners, both subsidized and unsubsidized volunteers, had a low rate of
satisfaction. Those who had systematic cross-cultural training or had previous experience
working in developing countries had neutral or higher ratings of the project.
4.21.1 FINANCIAL SUPPORT
The viability of CBR type programs differs in other places, cultures, and times. I say
‘times’ because there probably was more eagerness to experiment with collective action like
CBR in the Sixties in the days of Kennedy and Che and Castro. In those years there was still
the memory of the Roosevelt WPA and CCC programs as well as the competing socialist
ideologies of the Russia, Cuba and China. The policy-making generation of the sixties grew
up in the social activism of the Thirties. It was natural for them to expect their children’s
generation to participate in these social movements.
In Europe, China and North America, this heritage may have been lost. These days
are more entrepreneurial and individually oriented. In closed cultures such as the indigenous
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communities there still is a tradition of collective action such as that o f the mayordomtas
system but because of the isolation and distrust of outsiders, the process of education and
acceptance of new ideas and an open system world view are among the first order of things.
But throughout the world capitalism seems to have made people wary of participation in
voluntary action unless there is a payoff for their time and efforts invested. With these factors
in mind, the struggle of Pina Palmera is to maintain the financial support from the world
community while increasing local support and participation.
When Pina Palmera is viewed as a community-based rehabilitation project in itself,
and not simply a sponsor of a specific definition of CBR, that is working directly in a village
through volunteers, it can be considered very successful. It is important to differentiate the
CBR program ofPina from those that might be sponsored by a governmental agency, such as
the doctors who are required to work in rural areas to pay for the cost o f their education. Pina
itself is the community-based program, not simply the administrator of one. It has as its
center a working example of integration of the disabled in a small society approximating the
size of some rural villages (100-200 persons including dependent children) it can be seen as a
model for how CBR might work in other villages. It features vocational training in marketable
skills where there is a demand (carpentry and lifeguard, paramedical and therapy training, and
gardening techniques.) It also contains an important administrative technique, the use of the
juntas to identify issues and democratically devises approaches to dealing with them.
It is equally important to redefine and broaden the concept o f community. The
community at Pina contains the immediate population, the disabled and poor Mexicans, but
there is also the virtual community o f interested foreigners living in other countries that have
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volunteered, supported, and maintain active interest. They are kept aware of the needs and
accomplishment of Pina through the means of e-mail, the Internet, newsletters,
telecommunications, video, and letters. It is not like David Livingston living in Africa without
contact with Europe. It is really an example of the new reality of development (and missions)
where the supporters have access to those they are supporting daily if they wish through
technology.
When disasters occurred, such as the hurricane, as soon as the news was out people
helped. The news came out first on the Internet, as soon as the telephone lines were repaired
in the closest town and transportation was available. Assistance arrived almost immediately
through electronic banking and on jet flights containing medicine and trained volunteers from
around the world. The Internet sent the news about the plight of Pina to every edge of the
planet within hours of the first report. One e-mail description was copied and recopied and
resulted in thousand of dollars in support. If Pina was not part of a larger community such as
this and only had to rely on the resources of its geographic location, it would have failed long
before the hurricane.
Again, there is nothing new in the challenges to community-based rehabilitation
effort. All the CBR programs in rural regions of other countries face similar issues. Dealing
with weather, economics, work force, training and time to perform the work are challenging.
The approaches offered to dealing with them, if not solving them, have demonstrated that
methodical attempts to test the theories and claims put forth in the literature and philosophies
of Freire, Werner and Brock, can yield results worth the continuation of the efforts to
conduct CBR programs. None of the proponents ideas were used as-is off the shelf. The
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suggestions were tried, considered, modified or rejected and tried again with adjustment. The
next promoter working in the village might discard activities that were favored by one
promoter. An example of this would also be how the library fell into disrepair and eventual
destruction because the volunteers who originally created it went back to Europe and no one
else took interest. Things that worked and found root in the community continued.
As pointed out in the literature review, (Foster, Kearney) the places were CBR has
worked are places where the culture has a history of helping and volunteering. The rural
villages in Mexico, particularly among the indigenous groups have as part of their heritage the
tradition of everyone in the villages being expected to participate in efforts that require
community support. In the process ofliving, men and women move through a series of status
defining activities that eventually bring them to elder status in the community.
In conversations at Pina, it was pointed out the Guyana program o f CBR was
successful because there was a more homogeneous community and history of people going
out into the countryside and volunteering. There was also more general acceptance of the
disabled person. Some of the foreigners said CBR could never work in the area that Pina
Palmera was intending to work. Right now, there are probably more foreign volunteers and
aid workers currently in the area of Oaxaca and Chiapas than any previous time. Maybe this is
due to the excitement generated by the Zapatista movement. It is probably today’s area most
closely akin to the spirit of the Spanish, Cuban, and Sandinista revolutionary times. It draws
young dedicated foreigners and with them, money and outside interest. It is an example of the
global community serving the needs of its members.
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The following is an excerpt from a newsletter written by a French volunteer who
arrived shortly after the hurricane. He is an example o f the dedicated young people described
above.
“Pina Palmera is a way of life. We have been here 3 weeks
now; we like it very much and it will be painful to leave. Pina is not
only a "Center for Rehabilitation and care for children with or
without disabilities" as they say, it is a real community, where
handicapped persons are cared for but also live alongside seven
families with children of all ages; young babies, teenagers, and young
adults, with grandmothers and aunts included for good measure. Our
little trailer house, lent by Pina, (It survived the hurricane but not
without becoming "handicapped") is located in the heart of the
centre so we are really part of life here. What strikes me most is how
democratically the community functions, and how the local people
are involved in all areas and all levels of decision-making. This is
reflected in the interest the local workers and families show in their
work, one can see it everywhere in Pina, people helping each other
and not counting hours. Another thing that can't fail to make an
impression is the will of the centre to enhance the life of disabled
people, not only through physical treatment, but also by giving them
the opportunity to participate in the social and economic life of their
community. The construction workers will be local people,
preferably handicapped or otherwise unemployable. They will be
taught on the job, as the project takes form. Pina is now recruiting
volunteers to help with the construction work and teach at the same
time. Since I arrived, I have worked in the carpentry shop, given a
hand with the toy making and repair work, as the son of a carpenter;
I appreciate this type of work. Yves Rioux” (Newsletter # 38 A pr
1998)
People, patients, workers, and foreigners who were at Pina had experiences beyond
just work. The results were a feeling, that many times that made profound impressions and
even changes in their lives. It changed lives not just for the disabled but for those who
volunteered, perhaps some of the most potentially influential, because the changes they went
through they take home with them and take to another culture.
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4.21.2. EDUCATION KNOWLEDGE
The patients have experiences and acquire skills that allow them to live independent
lives. (Irma, Juan, Ezekiel for example) Their children do not feel stigmatized to have disabled
parents or feel stigmatized if they themselves have disabilities (Hector, Julia, Esperanza,
Lazaro). Every year for the last five years over one hundred people are brought from remote
villages to spend a month a Pina Palmera to engage in summer camp, the Curso de Verano
that includes therapy, health screening, and training in basic occupational skills. Out in the
villages there have been over 500 people throughout each year who receive some form of
training and medical care from Pina. It has consistently occurred at the same time with a
similar agenda for throughout the years.
Several hundred volunteers have stayed at Pina over the last decade. They brought
home with them a new understanding of the lives of disabled, where previously they had
never even been in contact them. Pina has made a profound impact on the international
community that supports it as well as on the immediate community o f its locale. After more
than nearly two decades of existence that began with the efforts of itinerant healers and
continued through to its current form as an established institution, Pina can be considered
not only a success for the work it has done helping patients but also as a success for showing
how community-based rehabilitation can succeed despite continual challenges.
4.21.3. PHYSICAL RECOVERY AND EMOTIONAL GROWTH
Patients, employees and volunteers all seemed to benefit from being involved at Pina
Palmera. There were dramatic changes in health and quality of life. People who previously
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would have been condemned to a life of the invalid stuck in a remote village, having no hope
for a normal life or hope for getting married and having a family, through their involvment at
Pina gained exactly that. Children who would not have had an opportunity to gain an
education, either academic or vocational, acquired both at Pina.
The severely disabled children who would have died, or been locked away in the
comer of a room in a village or institution received an abundance of attention from
volunteers, their caregivers and family members. They were able to go out almost every day in
the local community, including visits to the local disco, restaurants and the beach. They had a
much better lifestyle than many American and European disabled children. They had friends,
boyfriends, problematic but probably normal sexual encounters with the opposite sex and
participated in the normal events of life without be stigmatized or forgotten.
Women who suffered from domestic violence, second class status and were never
encouraged to speak up for themselves began the recovery process and learned to be
expressive and assertive regarding their wants and needs in life through the junta system. Pina
probably had the most profound effects on the lives of women as an unintended effect of the
CBR program. Women who became promoters began to become socially active as well as
modeling this behavior for other women in the communities they served. Women who had
been beaten and abused by their husbands and came to Pina for refuge are now communities’
leaders, represented their communities in the local government as well as representing Pina
Palmera in the CBR program. On the other side, some of the men who had been part of the
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macho culture and had been involved in the socially promoted alcoholism of the culture
became sober and were able to become more productive.
Children, particularly young girls who might have left school early through
pregnancies and early marriage, remained and even went to college. Two girls are now in
college, and three other women, in the special education program area who were in their teens
when they first came to work with Pina and now in their twenties and do not yet have
children. There still was the struggle regarding role expectations, but it was no longer
unconscious, because when men or women were found by the volunteers to be enforcing
stereotypical roles, they were made aware of it in the juntas and as these events occurred. This
information may not have always been welcomed by some of the Mexicans but it no longer
was an unconscious channeling of boys and girls to certain activities.
The lessons Pina Palmera has imparted are how difficult yet how possible it is do
conduct a successful and long-term commounity based rehabilitation project. It has shown
that disabled people and their families can contribute to their own care and welfare without
being completely dependent and therefore at the mercy of a govenmentally run program. The
experience has also demonstrated that volunteers alone cannot keep a program in the villages
operating. Promoters, paraprofessional teachers, and therapists must be paid something to
make it possible to do their jobs. There has to be an incentive to keep them in the program.
The learning curve to be a successful promoter takes long enough that they need to stay with
it long enough to use the skills and pay off the investment a project makes in training them.
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Another of the important things we can learn from Pina is that by operating in a
democratic fashion, workers and care recipients have more involvment, and interest in seeing
a program succeed. The system that more NGOs and PVOs use is having short-term foreign
volunteers and management rob the people they want to serve of the initiative to be self-
sufficient. At Pina, if something fails, they cannot blame the outsiders or lack o f support.
They are responsible for raising their own funds, administering and implementing their
efforts. Ingrid is the crucial link to bring in money now and has been since she became the
director. However, planning for the next generation of leaders to take her place is an on-going
issue for the people at Pina. Seeing other NGOs in other countries work and hearing the ex
patriots complain about the nationals and vice versa, makes for me the operation of Pina
through the junta system the biggest surprise of all.
Among the most essential features of Pina Palmera would be the junta operation to
management The second would be the division of the program into separate project areas
such as the therapy, carpentry, and special education units as examples. Not having all its
project eggs in one basket allows Pina to draw talent and resources to different areas, so that
the whole program does not rise or fall on the success of one endeavor. Using ex-patients as
managers and as promoters and paraprofessionals is also a very important aspect of Pina.
This allows them greater credibility when working with new patients, because the patients can
see that rehabilitation is possible and just how exciting the possibilities can be. It encourages
them and gives a great sense of contribution to the ex-patients. That the people who received
care in the villages had to participate rather than be passive care receivers was very important.
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It discouraged the lazy and helped improve the recovery time.
Having the director and the most of the leaders living at Pina or nearby makes a big
difference and helps with the issues of communication and transparency. The drawbacks to
the foreigner are the lack of privacy. However, the Indians and Mexicans have a different
measure of privacy, so for them it is not a problem. When dramatic incidents occur, such as
the hurricane, having everyone there nearby made evacuation and recovery much simpler. In
was equally important to have a ex-volunteers who cared for Pina feel strongly enough to
come in its time of need to lend their skills in rebuilding the things the were absolutely
required to get back to being able to help the community. They brought tools, generators, and
their specialized skills. They did not stay so long that they removed the responsibility o f the
local people to help themselves. Ultimately, and even over the two years since the fieldwork
was completed, the people of Pina stay in contact through letters and e-mail. There is a
feeling o f being part of the family and always being welcome.
4.21.4. The Community and Atmosphere of Zipolite and Pina Palmera
At Pina those who are gaining experience and training, such as Hector, Manuel,
Margarita, and Carmen, have made a commitment to remain and serve after gaining their
training. The difference between the four is that Hector is currently in a professional school
program for therapy and will serve several years at Pina in the CBR program as his way of
paying for his education. The other three are para-professionals, and have found their careers
there at Pina and being older will probably remain at the program as their careers. Secondly,
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they receive a salary, which has allowed them to live out side the project grounds in their own
homes and support their families. Finally, these three also fulfill other functions at the project
in diverse areas as hydrotherapy, nursing support, maintenance, and administrative assistance.
All four individuals have nearly a decade each of association with the program and their
families are deeply involved as well.
If it was religious, one could almost say it was like a cult, in that a significant
percentage of the population focuses on the leadership of a single person regardless of the
apparent administrative structure. It is more properly likened to a commune. It is more than
just a job for people in the program; mostly it is a village in and of itself. It provides a place
where news, gossip, pastimes, friendships, and families occur. It also provides a secure
insulated arena where normal activities of life can occur without the vagaries of the local
economy. Because no drugs or alcohol are allowed on the premises, it has a different feeling
to it as compared to the immediate community which is a low cost resort village populated by
mostly counter-culture youth from Europe. The participants, particularly the volunteers’
behaviors are markedly different on site from their behavior in the village. The smell of
marijuana is prevalent on the beaches, which is said to have the only nude beach in Mexico.
In the one disco, both tourist and gang members can be see doing drugs at the tables and
behind the palapa that shelter the dance floor. As one interview subject pointed out, it is a
continuous party among the volunteers. That is not to say there is abuse of drugs going on
among them, none was apparent to the researcher. There certainly were people under the
influence among the population at large.
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Zipolite and Pina both have a population of seasonal residents. The combination of
tourists staying for a summer, a few weeks and volunteers staying for six months or more,
make for an atmosphere of continual partying. This environment made it difficult for long
term planning, commitment to projects, and discipline in general. Young people see everyone
else at play all day long, and it is hard to inculcate another approach to life. This may have
contributed as well to the problems with children at Pina. Although many of their peers were
working hard on the beach, in restaurants, as vendors, many others were surfing, playing, and
partying.
There have been gang fights in the disco between the drug gangs of the two local
villages; Mazunte, and Puerto Angel. Yet most of this activity is discreet and this area is the
only place where the people of Zipolite can come to dance at night in large groups. It is about
one half a kilometer from Pina yet a world apart. Many old timers have complained that the
area is changing forever, that the wild life of the immediate past and current day is fading.
Indeed, military police and local police have made sweeps of the area more regularly
according to some than before. Construction is growing due in an influx of foreign capital.
Just before the hurricane, streetlights had been installed. It took a month or more to re-install
them afterwards. Many of the more influential business owners want to make the switch from
the bohemian customers to the better paying middle class. The pressure all comes from
investors who want a better return for their money. The place is changing and will continue
to do so.
One of the customs of the area is that of community services, in which all citizens are
expected to participate. Activities including giving a day every month to work at clearing
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weeds from an area, collecting rubbish. If your child went to the local school, you were
expected to contribute to the upkeep and maintenance of the school. Shortly before the
hurricane, for a month or so, every man and boy worked together to construct an outdoor
basketball court. They put in several hours everyday to level the earth and mix cement. It was
not quite finished by the time the storm hit. The area was fenced off after and used a public
bodega for the incoming emergency supplies. The tradition of people working together was
already a recognized tradition. If there was a public service or event that everyone expected to
enjoy or benefit from, there was the expectation to contribute. However, it was seen that
participation for a widely recognized public good, such as a school building or basketball
court is one thing, expecting the behavior of volunteerism to transfer into a CBR endeavor
could not be expected.
Many of the emerging leaders at Pina and in the community were to be found at the
local protestant church. The desire to limit behaviors and enforce more acceptable mores for
the sake of development is becoming more prevalent. One day at the beach, Armando, the
manager of the carpentry project, father of a severely disabled child, the brother of Ezekiel,
and who was a leader in this congregation asked me one day if Christians in the United States
drank - 1 was drinking a beer at the time. Zipolite is becoming more like Pina Palmera, more
children, and family oriented.
4.22. CONTEXT OF THE FINDINGS
The success o f the projects at Pina does not contradict the material presented in the
literature review. Aside from the financial realities, within the project boundaries, the
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sociodynamics of Pina demonstrate the Stainback and Stainback methods or guidelines for
promoting integration between mainstream and disabled children. The six methods are:
special friends, peer partners, peer modeling; social bids, peer reinforcement and peer
tutoring. (Stainback and Stainback, 1982.) I did not find any literature at the site to support
the conscious use of these concepts, but because of the communal living and working
environment, these things just happened on their own.
Special Friends: The kids at Pina, both disabled and regular kids have grown up
along side each other, because 30 or so children have spent their childhood together they
make friends with the children most available, in this case many of them are disabled. There
was in addition, modeling by adults and older people in the project who were married to,
friends with and worked along side disabled and regular people. So the children were not be
expected to do anything their parents and teachers were not already doing.
Peer Partners: In the comedor, the children ate (until the hurricane) in a separate
palapa; they got their food cafeteria style, fed themselves, and helped each other
independently of adults. There were the special education assistants who did the spoon
feeding with the kids who were severely disabled.
Peer modeling: There certainly was peer modeling. However, it was generally
unsupervised play and from my observation point hidden behind the windows o f my trailer
in the tamarind grove, I could observe the children’s activities without their knowledge until
I announced my presence. Their play was very much that of establishing hierarchical order.
Much o f the play consisted of teasing and attempting to get the youngest child, newcomer,
or weaker child to capitulate.
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There was also more peaceful playing that occurred. The children were usually
gender divided through puberty. However, the play was not guided, except for organized
sport such as football (soccer) and basketball. The concepts of ‘nice play’ were not being
promoted by any adult guidance, and consequently there was a certain feral street kid
behavior than went on.
Social bids: At the fogatas each Saturday during the Curso de Verano. one could
observe a definite increase between initiation of play and friendship. The first week the
children at Pina, particularly the girls aging from 6 to 12 acted up to gain attention from
their parents and other adults. The sudden influx of other families, tripling or more the
population of Pina threatened them. The first fogata. which had popular music playing
from a cassette playing connected to a PA, was marked by dramatic separation o f the Pina
kids who danced with each other and did not interact with the visitors. By the forth and
final week, there was a complete mixing of all children and their families with the Pina kids.
There were initiations to dance made to both sides from both sides. In addition, the acting
out behavior of the younger local kids had completely disappeared.
Peer reinforcement: It is hard to say how well this concept may have been
supported. However, I can think of an incident where I was playing my guitar and singing
“De Colores” about the 100* time with the severely disabled kids in the special education
program when one of the teens who had a serious case of polio came up. He was asked if
he wanted to play and looked to Maribel the 15-year-old girl with cerebral palsy but who
probably was normal cognitively and certainly emotionally. She was asked if I should play
and she frowned and then asked if Noe should play and she smiled. He played and played
(the same two chords) but one song after another. After that, if he was nearby I never had
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to play and sing again, the kids would not accept any substitutes for Noe. The point being
is that there was certainly a comradeship of disabled children at Pina and behaviors and
cues promoted by their true peers outweighed anything adults or young volunteer could do.
Peer Tutoring: Older high school age girls did assist the younger children,
particularly younger girls with their schoolwork. There was a problem however with certain
younger girls not attending school regularly. This is where a certain distinction came in
between parenting. The intact families and at least one of the parents had more than basic
education, made sure their children walked to the local school. In one of the interviews, Tia
Maria, the jeffa of the cocina complained that she was up every morning preparing
breakfast for all the children who were going to school, but their parents never got up
themselves. However, these parents were quite aware when their children did not get up for
school. The children who did not go to school came from the single parent, mother only,
family, and these were the women whose job was to make tortillas and do the menial labor
at Pina. They had no education themselves and did not seem concerned for their children.
In the library building during the school year, there was a daily two-hour homework
workshop. Aaron and another volunteer usually conducted this. Here all children of school
age would come in, work under the supervision of an adult, and complete their homework
for the day. This was quite successful, however there was again the same difference between
the kids who were in the library everyday and the ones outside. The educated, more ‘middle
class’ families had children in the library; the women of the torterilla did not.
As with the section on blame for disabilities, nothing at Pina contradicted those
previous reports on Africa and Asia among traditional tribal cultures. In fact at Pina, there
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was the added factor of new age religion, which attributed problems to other metaphysical
causes. This was mostly confined to adult foreigners.
The blending of western and traditional medicines was a conscious approach by
most of the paraprofessionals and by the Doctor of the project, Ernesto. Using either
system, causes for problems were searched for continually, but the underlying method
seemed to be that one was responsible for his or her own condition. The phrase ‘ you make
your reality’ was almost a watchword among the female Swedish volunteers who traded
meditation tapes. The hurricane rendered many of the folks immobile it seemed to me,
perhaps because it threatened their philosophy. How is one responsible for a hurricane?
Was everyone to blame therefore?
In the villages, the community-based rehabilitation program ground to a halt for
most of the year. Even before the hurricane, it was not operating with any frequency or
predictability. Arrangements were made for meetings with village stakeholders a couple
weeks in advance and then the promoters from Pina did not show up. The office
scheduling of the vehicles was rarely notified. Bob complained that the promoters just
assumed the day of their meeting they could go to the office and get a key even though the
vehicles had to be shared by different program areas at Pina. It was first come first served.
There was little follow through or accountability of the promoters and apparent debriefing
of the visits they made to the villages.
In contrast, where activities didn’t require scheduling vehicles and near spontaneity
could work, CBR activities such as the CPR and rescue training and awareness programs on
the beach in front of the restaurants to educate tourist as to the dangers of the local waters
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and the program to train local teens as lifeguards and also the hydrotherapy to bring all the
kids, disabled and not, to the beach to swim, these were all successful.
Word would pass from kid to kid that Saturday if they showed up at a certain place
within a certain time window (nothing ever happens at an exact time!) they could be
guaranteed to receive training. This village telegraph also served to bring young people to
the project and into contact with disabled people. The opportunity and novelty of lifeguard
training was a significant outreach.
During the hurricane, it could be said that the rapidly climbing floodwaters were a
posttest of the efficacy of the hydrotherapy training. None of the 20 or so children, both in
wheelchairs and not, were upset or screamed about the water rapidly rising up to our necks.
It was a child in fact who calmly pointed out that the floodwaters were receding. It was the
adults who did not swim or did not attend the hydrotherapy session that panicked and in
their fright were willing to leave high ground to plunge into turbulent water from the
overflowing river.
The patients, volunteers and employees, both Mexican and expatriate, all view the
efficacy of the programs differently. Patients, and from whom many of the promoters in
the CBR program came from, workers, who also came primarily originally as patients, feel
the program has been very effective. It has been effective in their lives. Each person who
was a patient had a testimony of coming from a very difficult living situation and into a
much better, more secure living standard through his or her contact with the program
conducted through Pina Palmera.
Volunteers, including many who had been living in the area for many years mostly
felt the programs run by Pina, were inefficient and ineffective. They gave several reasons.
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One was the manner in which the decision making process was conducted. The use of
consensus to achieve decisions was extremely frustrating for Europeans and North
Americans. The problems of a lack of professionalism, which included issues of punctuality,
scheduling, and budgeting all made some expatriate working in the health area very agitated.
Those expatriates working in the creative areas such as carpentry, working with children
seemed less concerned, but not to say unconcerned, about the time and behavior issues. All
the expatriates were very concerned about how the children who were unsupervised and
were irresponsible, messy, and destructive. On the other hand, Mexican and indigenous
peoples seemed much less concerned.
There was a concern for religious instruction among many of the indigenous and
poor Mexicans. In addition, those who fell in this group had the highest literacy rate. Both
adults and children could be found reading for pleasure, something not found as much
among the non-religious or non-practicing indigenous and poor Mexicans. This religiosity
in the past caused friction between this group and the expat groups as well as those in the
administrative area. They were ordered not to have prayer groups and other religious
practices on the Pina grounds, by a decision in the junta. There was a small chapel and late
at night one would find several of the people there lighting candles and in meditation. The
chapel was a place that the new-age believers, Catholics, and Protestants seemed to share
equally. After the hurricane, there was much more acceptance for public displays of
religious beliefs.
The opinions generated from these different points of view can have an impact on
how effective a project can be in the future. If volunteers go home and give negative
reports, this is bound to affect fundraising. If patients give good reports, it means more
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people were come to receive services. Indeed, as was seen during the visits to the villages
and on Wednesdays when free examination were given, many people turned up to meet the
doctor and the therapists.
Finally, I would say the most important finding of the program is that outsiders to a
community will have great difficulty in operating a sustainable project. They can secure and
provide the money as occurs at Pina. They can bring in volunteers to construct buildings
and provide training. However, only the local people can gain entry to doors and
encourage people to participate and pass on training and activities that can make a
difference in the end.
In the case of Pina, being Mexican is not enough; the local identity is very strong.
People from the capital, Mexico City are considered as foreigners. These people had the
most difficult cross culture adjustment of all. It was assumed that because they were from
the same country, spoke the same language, even shared political and spiritual leanings that
they would seamlessly move through the area, and be able to make a difference as
promoters. They were very shocked to find how much they were distrusted and almost
vilified by the Indians and local people.
As pointed out earlier, this area of Oaxaca, as Oaxaca is itself, has been
geographically isolated until recently from the rest of Mexico as well as the rest of the
world. It was not unusual to find villages up through recent times where many people did
not speak Spanish. The languages of the different villages in different mountain areas used
variants of the Zapotec, and Mixtec language groups where many have shared only 40
percent of vocabulary, and with significant differences in pronunciation, making
intercommunication difficult.
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There is a paradox at work. The trust and acceptance necessary to open doors
seems only granted to those who have grown up in a community, and preferably to those
whose parents grew up there too. However, even if a local person is trained in the same
techniques that have been shown to make a difference, it is not valued as highly as that of
the outsider. If the foreign expert goes on a village visit with the local paraprofessional, the
villagers want the foreigner to do the actual work, not the local, even if the activity is
something the local promoter is equally skilled in. These problems also contribute to the
promoters leaving for the city when they gain training. The mystification of western culture,
medicine and the skills attributed to them is an aspect that needs to be addressed.
4.23. VALIDITY ISSUES
Internal validity issues regarding the effectiveness of the CBR program can be
among the following. Many of the disabled people who are gaining skills and demonstrating
independence may well have achieved these accomplishments on their own. For example in
the villages where the CBR promoters have not been able to go to, the children are taken
care of as they always have been. The visits of promoters and their better techniques may
only affect the quality of the care, not an actual increase in care. Before the CBR program,
the grandmother cares for the disabled child. Part of the training at both Pina Palmera and
Projimo are to include all family members in learning how to give care. It doesn’t mean that
they will, and the grandmother still s end up doing the work, it just that the rest of the
family may know more techniques than they did before.
There is no real way to know, whether the participants at Pina would have
developed a higher quality of life on their own or not.
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With external validity, one major point to consider is what if any the desirable
location of Pina Palmera on the coast has on the success of the programs. On paper there is
not much different between the work and activities between Projimo and Pina, however,
there is a big difference in what you find when you visit the two places. Projimo is the
center of a major drug producing hard-to-reach mountain area. Many of the participants at
Projimo are paralyzed gun shot victims, the assumption being they probably were involved
in the drug trade. There were only one or two foreign volunteers. At Pina, only one
participant suffers from gunshot wounds, which was described in the previous section.
Being on the beautiful coast of Oaxaca attracts many volunteers, both intentional who have
flown there specifically to serve from Europe as well as those who accidentally came across
it on their visit to the ocean and decide to stay. It’s relatively well kept, looks good in
pictures, concentrates on children, and evokes more positive feelings than the site at
Projimo. In the inner city or at a backward Peace Corps site in the bush, it is difficult to
keep the volunteer long enough to accomplish anything.
At Pina they have their choice of help and can actually turn away volunteers at
certain times of the year. Volunteers can always help themselves and take a break by
walking down to the beach or bar. When people like the area and the people, they are more
likely to achieve results. Therefore, that is why I always finished my interviews with subjects
by asking them to think of what they thought was exportable from Pina to other places, if
they were going to make another project. Most said either the people, or the location or
both. The location brought the people.
Once at the location, people stayed because of other factors as well. These included
the freedom from the closed village societal structure that severely circumscribed their
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behaviors. For those who converted to a protestant sect, living and working a Pina proved
very positive. Although there was here too a certain amount of antipathy for Protestantism
and its proscriptions against drinking for example, there was overall more opportunity to
practice their faith unhindered.
Better pay, a built in welfare safety net, in terms of housing, and food and medical
care on the site, made Pina a very attractive living situation. These factors apart from even
the effectiveness of treatments and therapy programs may have had serious influence on
the opinions of patients and workers at Pina Palmera.
4.24. IMPLICATIONS FOR FUTURE WORK
To answer the question what do I think can be exported from Pina? I would have
to agree with the interviewees. The right location is going to make a big difference in
productivity. If you depend on volunteers, you have to have a place they like to be. If they
are making a sacrifice of potential income to be there, they need to be gaining something
else. A working vacation is a good way to do it.
Secondly, having a communal atmosphere helps achieve the goals of integration.
Being together part of the day and then leaving to a different world works against the
efficacy of any development program. Much of the learning and change and growth occur
during off-hours, in play, partying, hanging out casually. These are things I thought seemed
to make a difference at Pina. Nearly all the interviewees pointed out that it was ‘ The People’
and ‘ The Location’ that made Pina so nice a place to be. Certainly, it was better than many
inner-city locales.
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Promoters need to be paid, but it also needs to be more than just a job. When the
pay runs out, the promoter does as well. Nevertheless, if they have the kind of ties to a
concept and a community such as was seen during the pay stoppage in the summer, they
will remain through the tough times. Many people remarked that in the states and in
Europe that if the paychecks did not come as occurred in the Curso de Verano. most
people would have walked out. Maybe in poor countries it is different. According to the
BBC, in Russia over this last year, teachers were paid in goods and services, not cash,
because there was none and school stayed in session. There just may be something
operating in poorer countries and places that does not and cannot work in the rich places.
I think it is so important to train volunteers cross culturally as well as have some
training in relation to working with the disabled. The attitudes of untrained volunteers
compared to those who had training were very different. Those who had had the cross
cultural sensitivity training and those who worked or had family members who were
disabled felt completely different about their Pina experiences. Those without the training
were frustrated and felt it was a failure. Those with training were much happier, with both
the primitive living conditions as well as the slow pace of change and growth in living and
working with the disabled.
4.25. RECOMMENDATIONS FOR FUTURE RESEARCH
Based on the implications discussed in the preceding section, the recommendation
for future research follows them.
There is a need to reconcile the traditional beliefs and social structures in an area
targeted for the operation of a community-based rehabilitation project to the methods
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used by it. The importance of these two aspects was not acknowledged by those involved in
the CBR projects as much as they might have been. They were recognized, as existent but
not strategically planned for. It would be of interest to discover which features of the
indigenous sociology and anthropology would offer the best receptivity for development.
Because promoters are automatically viewed with suspicion by the villages when
they enter, both domestic and foreign volunteers and aid workers need to have a full
understanding of the society they are anticipating working with. Without this knowledge
and sensitivity, the opportunities for success may be seriously abridged. To understand what
can be done to allow promoters and CBR to seem less threatening as well as how to make
the promise of therapeutic results more acceptable in the face of a pessimistic world view
would be very valuable.
I would recommend that a study be done of volunteers who have this kind of
training versus those who do not. Based on my own observations and experience, I saw
that there was a lot o f unhappiness and sickness both in Mexico and Mozambique among
those without training or experience living outside their culture. However in Mozambique
and in Tchad, the healthiest and happiest people were the Peace Corps volunteers because
they had had three months of intense culture and language training as well as receiving a
skill to implement when they went out on their own. Tchad was much poorer in
comparison to either Oaxaca or Mozambique, but there was not nearly the level of
discontent and illness as among the foreign volunteers and workers in the other countries.
(This is based on my personal observations and experiences)
Another aspect of Community Based Rehabilitation, perhaps the core issue, that
was not possible to research in this fieldwork, is the life of the promoter who lives in the
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village. How does participation in CBR affect their lives? This is particularly important for
those promoters who may be mothers, or other family members and who may have
obligations in their lives to which being a CBR promoter is an added burden. If CBR is
expected to subsist on the efforts of volunteers only, how can they be encouraged and
assisted?
An in depth look at the lives of the children at Pina would also be a worthy study.
The informal and natural integration that occurred because they all were growing up
together at the same site, may have implications for future housing concepts for the
disabled within the mainstream community. The project has existed long enough that a
longitudinal study on their lives could be pursued. One child who grew up is in college and
is returning to serve as a therapist. Does growing up in such an atmosphere encourage
children to go into the helping professions? Do the disabled children who grow up there
also have more of an attraction to work in this area as well? How have the lives of all the
children been changed by Pina and other similar projects throughout the course of their
lives?
Ultimately all these questions revolve about the process and effectiveness of a
community-based rehabilitation program. The subject and treatments offered by a program
may not be possible to carry out unless researches into cultural variables affecting it have
been carried out. The factors that may be found in an anthropological and sociological
study of how the program effects the traditional village itself may also have importance as
to what approach should be used in development.
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Chapter V
J.l Review o f the results
This discussion will look at how the research questions were addressed by the data
found in the interviews and other artifacts.
The study looked at how the lives of people who received care, and others at
program were affected by their participation. Care recipients, promoters, administrators,
and foreign volunteers and workers were interviewed. They were asked a similar series of
questions with variations on follow-up questions depending on their area of participation
• Why did people come into the Pina Palmera program?
People came to Pina Palmera for many reasons. Some came as patients, volunteers,
tourists, and searching for employment. Indigenous people came to the area of Mazunte
and Zipolite for healing long before Pina existed as a project.
• How has the program changed over the years?
Pina Palmera has changed in several ways. It has changed in the manner in which it
delivers its services. It has changed in the way that it governs itself. Its operating budget has
grown. It has gone from being the informal and ad hoc efforts by itinerant healers to an
institutionalized and internationally recognized and supported PVO. It has gone from being
an orphanage and refuge for battered women to a community-based rehabilitation program
offering a variety of services to the surrounding community.
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There was throughout the program some confusion as to the mission of the Pina
Palmera project. Is Pina Palmera a Community Based Rehabilitation project, or was CBR
merely one o f its activities. In the following discussion, the line of thought will be pursued
that Pina itself is the community-based rehabilitation project, and the various activities such
as the outreach to the villages, the Jr. Lifeguard Project, the carpenteria and the huerta,
bringing the children in wheel chairs down to the beach are all aspects of what a
Community Based Rehabilitation striving for success can be.
• What are the resources and examples they have access to? What is the level of
influence of outside agencies, and individuals from foreign countries? What are the
influences of local people and their beliefs, culture and practices?
The projects at Pina have been mostly generated by outsiders. These include the
founder, Frank Douglas, Ingrid the directora, and volunteers. The sources of training and
teaching and learning materials have also come from the outside but have been mostly
adapted for local use. Where the concepts proved irrelevant they were dropped, where they
lacked consistent leadership they also disappeared from the scene.
• How does the participation of members of the community shape the project and its
directions? What level of involvement is in evidence? Has participation changed
their behaviors? Has participation changed their expectations? What is the process
for recognizing and addressing the needs of the community?
Stakeholders had an integral part in the direction the program took. Whereas some
administrator claimed all had been consulted on the direction of reconstruction, the truth
was they had not. To the credit of the program when this fact was brought up as a direct
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consequence of the research interviews the architects and coordinators went back and
contacted the entire project through special activities in children’s and women’s groups -
the two groups specifically neglected.
Ideas and projects were brought before the Tuesday Junta, then went through the
scrutiny of the Junta de Coordinarion. If there were requests for money from the Pina that
is an issue that would be decided there. Seed money was generally available for approved
projects. Projects long established such as the carpentry project received money out of the
general budget but also searched for their own support. Materials such those released by the
World Health Organization, David Werner, and others were studied, experimented with
and then adopted, adapted or discarded.
Plans came from the ideas of individuals and then were further developed in small
groups with the various steps presented to the juntas for further input from the larger
group. Those who became promoters generally started as patients or volunteers. Even
when the democratic aspects of the juntas were eclipsed partially by dramatic events such as
the hurricane that caused Dr. Martin to take a direct hand in coordinating reconstruction,
the juntas had the major result of training the participants to become accustomed to voicing
their opinions and acquire the culture of democracy rather than merely deferring to
authority. The final effect of this is to be found in the future.
• How effective is Pina Palmera and the various program areas within it as perceived
by the participants?
Those whose lives were changed by it considered the program very effective. They
include those who went from being mostly dependent on others for their daily needs to
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developing considerable independent living skills and taking their parts as not just equal
members of the village community but as leaders.
Those who didn’t like the program, who were frustrated by the pace of it’s
operations and decision making process, the behavior of the children, and the standard of
cleanliness; those respondents were usually those from other cultures.
The effectiveness of Community Based Rehabilitation increased through the years.
Occasionally it was not able to send its promoters from Pina to the villages because of
transportation and weather problems. It also had difficulty maintaining a roster of volunteer
promoters living in the villages. This was due to the problems of having to perform several
functions at one time in addition to being a volunteer promoter.
Activities within the project such as the carpentry, garden and special education areas
have provided the employees with skills that they will be able to market outside the area if
they choose. If all funding dried up and the project folded, these participants will have
permanently benefited from their association with Pina Palmera.
Over the last decade, the concept of CBR has gained greater interest world wide, and
at Pina Palmera, it has at various times been given funds not by line item name but by monies
earmarked for transportation, medical supplies and additional services, not listed specifically
for Pina itself. Gradually, Pina Palmera itself has changed its own self-definition to be a CBR
project, emphasizing services out in the community rather than services to be offered at the
campus itself. The CBR label has appeared and disappeared and appeared again on the budget
over the years since 1991 when budgets were first officially published. When the budgets are
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analyzed for where the money is going, it can be seen that a community-based rehabilitation
project is what Pina Palmera has become.
5.2. Discussion
The experience at Pina Palmera demonstrates the efficacy of ideas about integrating
the disabled into the mainstream community as described in the various studies in the
literature review. When children at Pina grew up together, disabled and able-bodied, they
established both bonds of friendship and high levels of acceptance towards each other. When
disabled people served as promoters and workers they also facilitated the acceptance of Pinas
services and concepts by the disabled people they were trying to serve. However, among
certain villages CBR did not have as much success because people in the villages felt that
services brought to the disabled took away opportunities for the main population.
When the money for salaries did not come in for two month during the summer, all
the promoters remained, except for one who had to leave in the final week to work his bean
field in the mountains. This could be considered an exception because there was the
knowledge that money was coming. There was emergency money to keep the project
supplied with food to last for the duration. During the month of August, during the Curso de
Verano. there were nearly 100 people, including disabled children and their families from the
mountain villages along with 15 volunteers and about 30 employees and their families all
living on the site. Because everyone had food and knew that their salaries would eventually be
paid, they stayed. There was no alternative for some of the people; particularly the disabled
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who were in training and developing work skills. They were not at a point where they could
work and live independently of the project.
It can be argued that a CBR program is more cost effective than a government
institution. It is much more economical to train para-professional therapists such as those in
Pina than to find and hire professionals to live and work in remote sites. However, the
problem remains. Without a contract and a commitment on the part of village-based
promoters when they gain skills, they will leave for the city where salaries are much more
substantial.
Participants felt differently about the benefits and effectiveness o f the programs at
Pina. Poor indigenous and mestizo patients at Pina as well as those who were able to acquire a
marketable skills valued Pina Palmera’s productivity significantly higher than those who were
foreign volunteer with no prior cross-cultural training. Volunteer and foreign participants
with systematic training in cross-culture sensitivity training as well as previous experience
working with the disabled rated Pina Palmera much higher in it’s achievements of its goals.
The pleasant surrounding attracted the volunteers that were at the project. For the
most part, none had any cross-cultural training, previous experience with the disabled, and
minimal to no Spanish Language skills. Volunteers were expected to stay for at least six
months and work 30 hours a week at a specific project within Pina. There was a two-week
introduction period where they would spend a day working within each of the projects work
areas. After that period, they would choose the area in which they wished to concentrate.
Because most of the volunteers did not want to work in the special education area, and due to
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the shortage of paid workers, volunteers had to sign up to work for half of the day Sundays to
fill in the gaps in the personnel roster.
After the hurricane there were some families still performing the strategies of
rehabilitation they were trained in. However, even before the hurricane, most of the villages
where CBR had been promoted failed to continue participating when visits by promoters
ceased for a while. This was due to lack of incentives to retain local promoters, lack of follow-
up visits of CBR promoters from Pina, and the difficulty faced by Pina promoters who were
from different cultures in gaining the confidence of potential village participants.
Within the changing system of administration at Pina Palmera, the development of
the juntas brought an increase in participation. There still was a strong traditional leadership
structure, both through the existence of the directora and her husband as well as among the
indigenous people, who recognized leaders among them not acknowledged by either the junta
or the official administration. Women particularly developed a stronger voice and channel for
expression through the juntas. The people at Pina who came from traditional villages
originally, found a familiar system of decision making and assigning of roles through the junta
system. The difference was that there was the participation of women and people from other
cultures who never would have been included in the village mayordomias. The juntas were
promoted with the hope that in the future Pina would be able to conduct its own affairs
without the special leadership of a foreigner, as occurred during most o f its existence. Those
involved in the juntas gained skills in public speaking and democratic systems that will have
results beyond their time at Pina Palmera. For example, a number of women who participated
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at Pina now serve on the town council and are very active in the policy making and
implementation for the village.
The fact that the project owns its land, and that that location is in a very desirable
location for tourism, gives the project a asset that they can use to provide income in the
future, regardless of what happens with outside funding. Participants have discussed the
construction of cabins for tourists to bring additional income. In addition to the carpentry,
which makes money for the project, there has been discussion of creating a Laundromat and
a bakery. These are things that would also provide income. The project is well located and
prepared in material, personnel and capital to ensure sustainability of its existence, if not
necessarily all of its activities.
Several major challenges faced this research project that may have colored the results.
There are the limits of my Spanish speaking ability. Although I waited nearly six month
before I actively began interviewing Spanish only speaking subjects, and used an interpreter
on occasion, I felt there were many cues I may have missed because of the subtleties and
dialectical differences in the use of Spanish. Because all the interviews were taped, it still is
possible for another researcher better equipped to add information from analyzing these
features.
Another problem was length of stay, eight months was a good length of time, but as
with Orthopedagogy in the US, growth and change happen in unpredictable ways, often in
sudden jumps. A stay of a year or more would have been ideal. Possibly follow-up by myself
or other in the futures could bring up information that would give a better picture of how
280
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lives have been affected by participation at Pina. The ethnic difference o f being an American
in Mexico, where, because of a long history of political abuses and misunderstanding created
some difficulties that although may have been bridged through sharing the common
experience of the hurricane still exist. It took a long time before the hurricane to build up
relationships.
In the next decade when the directora, Ingrid, finally takes her leave of Pina Palmera,
it would be valuable to return to the project and see how it continues in her absence.
Following up on the lives of certain patients who received care and left as well as those who
became workers at the project and eventually left would be rewarding in showing how they
feel about their involvment long after it is over. The life of a village based promoter would be
a good case study subject. This was the element that was most difficult for me to get
information about, because I was based at Pina itself. Most of my observations and material
concentrates on the people and events of the home base, not out in the villages served by the
CBR promoters. It was like going to Everest and writing about events at the base camp, and
not being able to summit. Using George Fosters fifty year long study of the people of the
Mexican village of Tzintzuntzan as an example I would love to keep going back to Pina
Palmera over whatever store of years I have left and follow their continuing story.
Comparing Pina to projects with similar goals and operations in other countries and
cultures will eventually help determine what features of a CBR program are transferable. To
distill the most important aspects to a handful of crucial elements would help people begin
other programs. Much of the literature written about CBR is project specific, or of a
theoretical nature that make it hard to pick the most important features. It would be good
281
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to compare a private organization like Pina to a governmental project such as USAID funded
projects or mission and development agencies, where there is not a long term local director,
or one that is administrated from a very top down model. These other administrative forms
are the norm in development but how do they compare to a CBR program like Pina?
Finally, can a CBR project that is designed primarily for a poor rural setting be used in
an urban environment? Are there programs using these same structures and techniques in
places that could be of use in studying for implementation in the USA? With the high cost of
orthopedagogy, unequal distribution of health care providers, and the closing of medical
clinics due to low Medicaid contributions, can paraprofessionals provide good care and lower
cost than doctors and therapists?
Pina Palmera for its challenges and difficulties was a project well worth study. It was
an enjoyable time as well and its people made me feel welcome and part of their world. I hope
that others who read this study will be intrigued enough to want to visit the project and look
into its endeavors for themselves. There were many factors that went into its continuing
operation over the years as well as whatever success it has brought to those who received
care. It would be worth continuing to learn from Pina Palmera and its people.
282
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287
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Index
A
Aaron, 103, 128, 163, 164, 165, 176, 228, 229,
262, 299
Abed, 17
Abel, 120, 121, 122, 177, 215, 216, 298
Africa, 262, 285, 286
Aigre. 57
Aigre de bora. 57
Aigre puesto. 57
Aire, 56, 57
Ajoya, viii, 42, 43, 44, 180
alcoholism, 47, 82, 191, 254
Anita, 91, 92, 185, 188, 234, 237, 299
Araceli, 137, 138, 298
Armando, 115, 117, 130, 131, 153, 164, 228,
259, 298
Asia, 262
ataaue de paralisis. 57
Ayurveda, viii
ayurvedic, 82
Azafla, 124, 125, 218, 220, 299
B
Bailey, 34
Baine, 19, 283
Bangladesh, 17, 18, 284, 286
Bamartt, 283
Benito Juarez, 230
Bicol River Basin Development Program , 22
Bill, 112, 285, 299
blind, 25, 26
blindness, 224
Bob, 86, 95, 97, 102, 103, 104, 108, 111, 114,
130, 139, 143, 177, 183, 192,193, 219,221,
227, 232, 233, 237, 241, 242, 243, 263, 298
BRAC, 17, 18, 23, 26, 52, 284, 285
Buhi-Lala Project, 22
c
Candelaria, 229
Cardio Pulm onary Resuscitation, 210
cargo, 117
Carmen, 115,121,142,153,227,234,256,298
C BR, 16,17,19,21,48,49,225,230,256,263,
267, 274, 278, 284
Centro de Atencion Infantil, 46, 215
Charlene, 244, 298
Chatino, 53, 54, 58, 76, 285, 297
C hiapas, 287
Child-to-Child, 11, 28, 35, 36, 37, 39, 40, 44,
45, 46, 283, 287
Child-to-Child T rust, 283
Christian, 58
Church on Brady, 23
Claudio, 215, 298
Comidor, viii
Community Based Rehabilitation, viii, 11,16,
20, 70, 223, 224, 230, 231, 274, 276, 284,
285, 287
Congo, 25
conscientipao, 211, 267
Conscientization, 18
C PR , 210, 228, 263
CREFAL, 56
C uaron and Bartholomew, 54,297
C uba, 17
curanderas. 141,166, 174, 189, 241
curandero. 84
curenderos, 172
Curso de Verano. 47,50,94,119,129,135,144,
148, 149, 169, 177, 225, 233
C urso Verano, 261, 270, 277
D
Davis, 23
Deaf, 229, 287
Diamond, 53
disabilities, 10,12,21, 25,28, 34,38,46,47,59,
96, 102, 104, 137, 140, 151, 166, 167, 185,
192, 199, 200, 205, 207, 208, 224, 226, 229,
230, 234, 235, 251, 252, 262, 286
disability, 25, 29, 44, 47, 70, 81, 93, 113, 133,
137, 144, 162, 171, 189, 197, 198,203, 211,
215, 241
disabled, 10, 11, 20, 25, 27, 28, 29, 31, 32, 33,
34, 35, 37, 40, 41, 42, 43, 44, 45, 46, 48,49,
61,62,70,185,187, 200,209, 210,211,213,
214, 229, 230, 241, 260, 261, 264,267, 270,
277, 283
Disabled Village Children, 37, 39, 287
domestic violence, 47, 140, 253
Dorcas, 112, 113, 191, 239, 298
Down syndrom e, 41, 81
D r. Ernesto M artin, 299
E
289
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Elena, 105, 107, 187, 200, 236, 299
e-mail, iii, 51, 64, 66, 100, 249
England, 25, 80
Esperanza, 175, 185, 193, 203, 204, 252, 298
Evelyn G race, 50
Ezekiel, 130,131,133, 175,190,203,204,212,
228, 232, 252, 259, 298
F
Fire W itches, 57
foeata. 261
Foster, 55, 56, 58, 60, 118, 250, 283
Fox, 32, 59, 283
Frank Douglas, 82,87, 100,109,114,129,196,
274, 298
Freire, 17, 249,283
G
Gable, 34
G ertrude, 189, 209, 214, 299
Ghana, 25
Gino, 200, 298
Guillermo, 114, 166, 173, 187, 210, 211, 227,
228, 234, 236, 298
G uyana, 20, 104, 155, 250, 285
H
Head Start, 17
HealthWrights, 287
Hector, 177, 190, 197, 217, 243, 252, 256, 299
Hegarty, 284, 286
Helen Keller International first, 16
Helping Health W orkers Learn, 37, 44
Hendrickson, 34
Hesperian, 286, 287
Hilda, 139, 186, 194, 214, 240, 299
Holloway, 18, 284
hurricane, 61,63,211,224,230, 233, 260,263,
264
hydrotherapy, 122, 257,264
I
India, 20, 284, 287
indigenous, 11, 52, 54, 55, 58, 63,69,76, 87,
105, 116, 120, 126, 132, 141, 163, 172, 177,
188, 201, 221, 222, 223, 231, 235, 239, 250,
265, 271, 278
Inez, 131, 299
Ingrid Olsen de Martin, 87, 93, 97, 100, 196,
211, 227, 230, 246, 298
Institut Sante et Developpement, 37
Internet, ii, 51, 62, 65, 94, 140, 207, 249
Irm a, 116, 127, 136, 137, 169, 175, 176, 190,
203, 204, 252, 298
Ixtepeji, 57,117, 284
J
Jacob, 191, 299
Jaim e, 177, 200, 216, 299
Juan, 117, 122, 128, 136, 169, 176, 190, 201,
203, 204, 222, 252, 298
Judy, vii, 122, 125, 222, 299
Julia, 134, 135, 137, 193, 213, 230, 232, 252,
298
K
K abzem s, 283
K earney, ix, 57, 60, 117, 250, 284
Ken, 142, 299
Klaus, 120, 121, 202, 216, 299
L
Ladino, viii, 298, 299
Lazaro, 137, 138, 175, 252, 298
lifeguards. See Salvavidas
Liliane Foundation, 50
Lim ited Good, 55
Lola, 138, 139, 152, 173, 298
Lovell, 18, 284
Lucia, 124, 220, 299
M
m ai aire. 57
m alnutrition, 47
Manual, 298
M argarita, 121, 135, 142, 173, 227, 229, 234,
256, 298
M aria, 114, 216, 262, 298
M aribel, 103, 105, 200, 241, 261, 298
mavordom ias. 117, 132, 248, 279
Mayordormfas, viii
M azunte, 258, 273
Mexican, viii, 11, 28, 41, 42, 51, 56,58,60,63,
69, 73, 88, 93, 103, 105, 108, 114,118, 120,
124, 128, 141, 148, 150, 155, 160, 170, 171,
180, 181, 183, 187, 193, 194, 208,217, 219,
220, 229, 231, 264, 265, 266, 281, 283
Mexico, i, ii, viii, 11, 26, 28, 29, 40,41, 42, 46,
48, 50, 52, 54, 55, 58, 59, 64, 66, 69, 72, 73,
74,75,77,84, 92,93, 99, 102,103,106,112,
114,126, 132,140,141, 149, 155,158,160,
162,165,166,178,185, 187, 193,212,225,
290
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232, 235, 237,250, 257, 266,271, 281,283,
285, 293, 297
Mexico City, 185
M ozambique, 271
N
Nabuzoka, 286
Naguales, 57
National Irrigation Agency, 22
NGO, 17, 18, 37, 126
N L A , 22
Nicaragua, 17,27, 39, 43, 70,116
Nicholas, 124, 125, 299
Nigeria, 29, 285
Nilo-a-Niflo, 44
Nonforatal Programs, 42
o
O’Toole, 20, 285
Oaxaca, i, ii, 11, 44,45,46,48,49,69,215,225,
241, 268, 271
Obiakor, 285
Olowu, 287
Orthopedagogy, 10, 34
Ostrom, 285
Qstrom , Schroeder and W ynne, 21
P
Palapa, viii
parabolicas, 58
Patrimonio de la Beneficiencia Publica, 50
Paulina, 224
Peace Corps, 268
Philippine, 21, 75
Philippines, 21, 22
Physical therapy, 24
Pifia, viii, 198, 210, 223, 225, 228, 246,256,
258, 259, 260, 261, 262, 263, 266, 267,268,
269, 270, 273, 274, 275, 278
Pifia Palm era, ii, vii, 11,12, 14, 20, 27, 31, 45,
46, 47,49, 50, 51, 52, 54,60,61,64, 65,67,
72, 77, 78, 79, 80, 81, 84, 86, 87, 88, 91, 94,
95, 96, 97, 98, 99, 100, 108, 109, 110, 114,
116, 118, 123, 124, 126, 127,129, 130,132,
137, 138,140, 141, 151, 159, 161, 163, 177,
180, 181,183, 184,190, 191, 193, 196,197,
198, 203, 205, 208, 210,212,215,216,219,
220, 222, 226,228,235, 242, 247, 248, 250,
251, 252, 253, 254,255, 259,264, 269, 273,
275, 276, 277, 278, 279, 281, 282, 295
PL 94-142, 34
Pochutla, viii, 46, 48, 77, 78, 90, 91, 93,98,99,
115, 129, 130, 137, 211, 215, 226, 234, 235
Prather, 285
Pride, 57, 285
Projim o, viii, 23, 26, 27, 37, 39, 40,41, 42,43,
44, 45, 51, 52, 108, 141, 143, 162, 166,180,
192, 267, 268
Puerto Angel, 215, 258
R
Raikie, 172, 173
Rao, 20, 285
RBC, 223, 224, 231, 236, 238, 241, 246, 264
Rehabilitation, 20,24,25,80,92,129,160,235,
251, 271, 274, 284, 285
Ricardo, 112, 298
Ronning, 286
Ross, 25, 286
Rotary Club, 44
Russia, 43, 270
s
Salvavidas, ix
Save the Children, 50
Schroeder, 285
SID A. 50
Sierra M adre, 42, 231, 287
Silverio, 99, 103, 105, 176, 200, 241, 298
Sinaloa, 42,44, 287
Slade Child Foundation, 50
Solveig, 116, 122, 142, 143, 173, 298
Sonia, 92, 107, 119, 155, 183, 227, 238, 239,
298
Sordo, 224
South Africa, 285, 286
special education, 12,15,35,40,47,61,65,67,
90, 105, 112, 113, 131, 143, 146, 148, 152,
168, 169, 170, 171, 173, 186, 195,200, 201,
214, 226, 240, 255, 260, 278
Special Education, 20, 261, 284, 285, 286, 287
Sri Aurobindo, 82, 85
Stainback, 286
susto. 56, 57, 172, 174, 188
Susto, 56
T
Tataltepec, 57, 285
Tchad, 271
temescal, 172
the W est, 13, 19, 130
The West, ix
291
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therapy, 11, 16, 20, 24, 41, 47, 89, 90, 96, 98,
109, 110, 113,132, 133, 134,136, 137, 139,
143, 146, 152,162, 165, 166,168, 172,173,
188, 193, 195,202, 225, 227, 228, 233, 237,
238, 240, 241, 242, 244, 248, 252,255,256,
269
Tina, 94, 121, 299
Tzintzuntzan, 283
u
Uganda, 25
UNESCO, 10, 20, 25,28,40, 41, 284, 285, 286
UNICEF, 10, 27, 37, 44, 45, 285, 287
United States, 16,17,25,37,59,62,73,75,193,
259, 285
USAID, 22, 26
V
volunteers, ii, 27,45, 61,62,126,164,165,209,
238, 263, 268, 269, 270, 271, 273, 275, 277
w
website., 46
W em er, 287
W orld Health Organization, 20, 48, 275
Wunsch, 287
Wurai, 53, 287
W ynne, 285
Y
Young and K err, 32
z
Zam bia, 25, 33, 286
Zam bone, 287
Zapotec, 52, 53, 54, 58, 72, 76, 116, 117, 266,
284, 285, 297
Zim babwe, 29
Zipolita, ii, 11,69, 72, 209, 210, 215,223, 256,
258, 273
292
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Appendix
Maps
Mexico
Q csi& m al nonowva
WS»9&, • J1L 4j
| S iR ^ ^ osM ^ V '
. c * ;■
■:'Vvjo:i|fe'::: " • ’• '• • ' *
M E X IC O
f
relta^, clJ .y
* * & p ^ J U , , . . . . . » - #
i j u £ * g
W & & * - &el' Skr . * i < f t - . ' " - :- ' : ' ;:;
, . « . . . .
293
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Zipolite
The town of Zipolite is an hour north of Huatulco and
about three hours south of Acapulco
294
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Map of Pina Palmera
Prom the Volunteer Pack
295
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Research Time U m
May 26 - June 7 Travel to Pina Palmera
June 9 - July 2 Orientation
July - Worked primarily in Special Education. Began work with Salvavida Jrs.
August - Curso de Verano (summer camp for disabled villagers and family)
Directora in Sweden during this month
Funds for salaries inaccessible
September - most of volunteer returned to Europe, began restoration of computers
and began computer training of workers and children
October - Hurricane Paulina struck area. Began oral interviews
November - New volunteers arrived and rebuilding program began.
December - CBR workers returned to village visits after car repairs
January - Carpentry building reconstruction completed. Interviews completed.
February - return to USA.
296
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Languages o f Intercommunication in Mexico
Table excerpt from Cuaron and Bartholomew (1996)
Languages in the research region of Mexico
III. Otomaneuean
B. Pooolocan
a. POPOLOC-IXCATEC
19. - Pololoc languages
Northern part of Puebla 12,310
20. - Chocho
Northwest Oaxaca 1,912
21.- Ixcatec
Oaxaca 119
b. MAZATECAN
22. - Mazatec languages
Northern Oaxaca 124,176
C . Subtiaba-Tlaranec
23.- Tlapanec
G uerrero 55,068
D. Amuzeo
24.- Guerrero Amuzgo
Southereastem G uerrero 16,205
25. - Oaxaca Amuzgo
Southwestern Oaxaca 2,168
E. Mixtecan
a. - MIXTEC
26. - Mixtec Languages
W estern Oaxaca
(206,411), Eastern
G uerrero (64,445),
Southern Puebla (10,766)
323,137
b.- CUICATEC
27.- Cuicatec
Oaxaca 14,155
c.- Trique
28.- Copala Trique
Oaxaca 4,342
29. - Chicahuaxtla Trique W estern Oaxaca 3,428
F. Chatino-Zaootec
a.- CHATINO
30.- Chatino languages
Southern Oaxaca 20,543
b. - ZAPOTECAN
31. - Zapotec
Central and Eastern
Oaxaca
422,937
G . Chinantecan
32. - Chinantec languages Northeastern Oaxaca
77,087
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Pina Pahnera Participant Listing
Name Activity Ethnicity Sex
Bob Carpentry Founder White American Male
Juan Carpentry Manager Indigenous
Mexican
Male
Sonia CBR Founder White Brazilian Female
Carmen CBR Promoter Mixed Race
Mexican
Female
Margarita CBR Promoter Mixed Race
Mexican
Female
Araceli CBR Promoter Indigenous Female
Guillermo CBR Promoter Mixed Race
Mexican
Male
Ingrid Olsen de Martin Directora of Project White Swedish Female
Frank Douglas Founder of Project White American Male
Dorcas Graduate Student
Volunteer
Ladino Female
Ricardo Graduate Student
Volunteer
Ladino Male
Maria Kitchen Director Indigenous Female
Claudio Maintenance Worker Indigenous Male
Solveig Nurse White Swedish Female
Charlene Nurse White Swedish Female
Ezekiel Patient
Co-manager carpentry
Indigenous Male
Manual Patient
CBR Promoter
Mixed race
Mexican
Male
Lola Patient Mixed Race Female
Gino Patient Indigenous Male
Maribel Patient — child Indigenous Female
Armando Patient - Garden
manager
Indigenous Male
Irma Patient - Kitchen Worker Indigenous Female
Abel Patient — Maintenance
worker
Mixed Race
Mexican
Male
Julia Patient - Student Indigenous Female
Lazaro Patient - Student Indigenous Male
Esperanza Patient — Student Indigenous Female
Silverio Patient -child Indigenous Male
298
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Dr. Ernesto Martin President of Project Ladino Male
Jacob Reconstruction Director White British Male
Klaus Reconstruction
Volunteer
White German Male
Judy Reconstruction
Volunteer
Ladino Female
Lucia Reconstruction
Volunteer
White Spaniard Female
Nicholas Reconstruction
Volunteer
White Spaniard Male
Azana Reconstruction
Volunteer
White Spaniard Male
Anita Social Worker Ladino Female
Elena Special Education
Worker
Indigenous Female
Inez Special Education
Worker
Mixed Race
Mexican
Female
Hilda Special Education
Worker
Mixed Race
Mexican
Female
Elena Special Education
Worker
Mixed Race
Mexican
Female
Hector Student Mixed Race
Mexican
Male
Jaime Student Mixed Race
Mexican
Male
Aaron Summer Camp Director Mixed Race
Mexican
Male
Bill Undergraduate Student
Volunteer
White American Male
Tina Volunteer Ladino Female
Gertrude Volunteer White Swiss Female
Ken Volunteer -lifeguard
trainer
White Swedish Male
299
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.

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Asset Metadata

Creator Grant, David Kendall (author)

Core Title Community-based rehabilitation in coastal Oaxaca, Mexico: Projecto Piña Palmera

School School of Education

Degree Doctor of Philosophy

Degree Program Education

Degree Conferral Date 1999-12

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag education, bilingual and multicultural,health sciences, health care management,health sciences, public health,OAI-PMH Harvest

Place Name Mexico (countries), North America (continents), Oaxaca (states)

Language English

Contributor Digitized by ProQuest (provenance)

Advisor Stromquist, Nelly (committee chair)

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c16-389925

Unique identifier UC11340703

Identifier 3180772.pdf (filename),usctheses-c16-389925 (legacy record id)

Legacy Identifier 3180772.pdf

Dmrecord 389925

Document Type Dissertation

Rights Grant, David Kendall

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the au...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus, Los Angeles, California 90089, USA