After much talk with Aníbal, my counterpart in Nombre de Dios, we organized a community meeting to discuss the issues with the water. Before the date of the meeting, Aníbal spent a few days with a megaphone announcing the meeting and trying to get as many people to attend as possible. He invited the Medical Director of the clinic in Nombre de Dios/Miramar as well, a man who I had met due to my chlorine charla training session with the medical staff there. My idea for the meeting was to introduce the ideal situation of a community and its water system, then talk about the problem in Nombre de Dios while clarifying the problem while the community members put in their input. The ideal situation in any rural community is that they have what is called a JAAR, or a Junta Administrativa de Acueductos Rurales (Rural Aqueducts Administrative Committee). This is a group of community members who volunteer and are voted for to manage and maintain the local water system. The fact that they volunteer shows interest in the work and assures that they will do their duty in assuring the proper functioning of the aqueduct. The fact that they are elected serves to give community support to each member of the committee and avoid the problem of special interests among members of the JAAR. There are six positions in the JAAR: president, secretary, treasurer, prosecutor, and the vocals. The president’s role is to represent the committee, authorize the use of funds, and organize meetings. The secretary’s role is to take notes during meetings, keep inventory on all materials the committee has for the aqueduct, and prepare documents. The treasurer’s duties are to collect, administer, and deposit aqueduct funds and keep track of monetary transactions. The prosecutor’s responsibilities are to enforce the rules of water use and payment within the community and help with the committee’s organization. The vocals’ job is to announce meetings and activities to the community to ensure their participation. Once a JAAR is formed it is up to the community to participate in paying their monthly fee, attend meetings organized by the water committee, and be actively involved in the well-being of the aqueduct. After explaining all this in our meeting, it was time to look at the problem from the angle of design thinking.
The three tools I chose to use to get the gears moving in analyzing the problem the people faced in Nombre de Dios were the double diamond, the problem tree, and the brainstorm (see photos below). With the double diamond I wanted to show the community how the art of solving a problem and coming up with a sustainable solution is a process and that it requires investigation and working together. I wanted them to see that understanding the problem is equally if not more important than the solution itself. With the problem tree I wanted people to see how to break down a problem and to better understand where it comes from and what it leads to. And finally as the take-away I wanted people to begin to brainstorm ideas, not only alone but with other community members, to bring to the next meeting. When I talked about the double diamond and mentioned the need for investigation, it got the community members talking about how to understand the problem. One man suggested doing a complete hike of the water system and make a map of it and on the map mark the locations of every repair needed. This was a great example of the investigation phase of design thinking, that first part of the double diamond. However once we looked at the problem tree, the problem began to look a little clearer. The amount of repairs needed was not the central problem to the water situation in Nombre de Dios, but a consequence of a much deeper rooted problem, organization and administration, or rather its lack thereof. This became ever clearer as the meeting went on.
As I was going through each of the three design approach tools, tensions began to rise among community members. It was clear that this topic was the cause of much conflict within the community, and had deeply divided its members. This came to the forefront the more we talked about the water system. What I learned was that there are two water systems that serve two parts of the town. One serves what people call “La barriada” and the other system serves the rest of the town. So Nombre de Dios has been separated into these two groups that tend to blame each other from stealing water from the other. When La barriada has water, the rest of the town does not and vice versa. They accuse each other of tampering with the water line to direct more water to their respective parts of town. During the meeting I was finally able to see this division up close and personal and I felt it was my duty to help them mitigate the problem and come to a solution that would be satisfactory to everyone involved.
I ended my portion of the meeting by leaving the community with the task of brainstorming a solution and to invite me back to discuss the proposed ideas. After I had finished speaking, Aníbal wanted some time to discuss the new damages found along the aqueduct line and why it was important that the community pay the monthly water fee so that these damages could be repaired. He and a select others were the only ones, voluntarily and unofficially, trying to solve the problems of the aqueduct with little to no support from the community. What was needed was an official group of people who were legally responsible and accountable for the management of the water system, and that is what the next speaker highlighted when he took the stage.
I met Dr. Elías when I was organizing my chlorine charla training session with the clinic in Miramar. He is the Medical Director of that clinic and he lives in Nombre de Dios. So for him he is equally invested in the well-being of the aqueduct as the rest of the community. When he spoke he stressed the importance and the utter necessity of a JAAR in a rural community like Nombre de Dios. He explained that without a formal group of people responsible for the water system then they [the community] would be stuck in this endless cycle of finger-pointing, blaming, and band-aid repairs; without ever coming up with a long term solution. They needed to unite as a community and elect a group of people willing to take on the challenge of managing the aqueduct. The lack of organization and administration would forever condemn Nombre de Dios to a mediocre aqueduct and mediocre management. As a representative of MINSA he is able to connect the community with the resources necessary within the ministry, such as legal resources and processes, to help them legalize and legitimize the JAAR. Dr. Elías will be a key player in the formation of a long-term solution for the water system in Nombre de Dios, and I look forward to help make that solution a reality.
We have a lot of work ahead of us in the communities we have worked in and the communities we are being introduced to. This month we will be meeting with the representatives of various communities to establish relationships and begin scheduling design charlas in communities in the Santa Isabel region. For the AGUA COLÓN project I have planned a group trip on the 17th to go and see the water sources for the first time for future water collection. I will go with a collaborator from the Universidad Tecnológica de Panamá (UTP), his two students, and a collaborator from INDICASAT so that they too will be able to see the sources.
2019 is underway and we have wasted no time in working with communities and growing our outreach along the coast. We opened up the month with some more chlorine charla training sessions with health workers in the hospital in Portobelo. Our efforts in Miramar have led to four charlas being done by the staff for patients. We also did a charla at the MINSA (Ministry of Health) clinic in Portobelo, which united clinic directors from other communities such as San Antonio, Cacique and La Guaira. Now we have trained health staff in five communities throughout Costa Arriba: Portobelo, Miramar, San Antonio, Cacique, and La Guaira. On January 22nd we had a meeting with the Nombre de Dios community to discuss the water problem that has plagued the town for so long. All these activities in January reflect our effort to not only unite ourselves with communities in order to help them, but to also unite the very people within the community.
In the Portobelo hospital we gave a charla to the two parts of the staff in the hospital, the medical staff and the administrative staff. It was important that both sectors of the staff showed up so that the whole hospital staff would be informed and able to give the charla to patients. Because of this I had to give the charla on two different days so as not to interfere with the entire function of the hospital. In total I trained 22 staff members in the hospital. Since this is the only major hospital in the region, I am hoping that the chlorine charla will reach that many more people and teach them the importance of treating their water at home.
In Miramar the nurses have been hard at work. The nine trained staff members have now given the charla to 40 patients in three charlas that have been recorded by Future Scientist. They recently asked for more pipettes and pamphlets to hand out, which indicates interest in the communities where the patients come from. We are hoping for more charla success from medical staff in Miramar, where they have been the first in receiving and implementing our Clean Water Access Initiative.
When I was coordinating the charla for the MINSA clinic in Portobelo with Dr. Miranda, he mentioned that at the end of the month the directors of the other clinics would all meet. I saw this as an opportunity to kill many birds with one stone. The directors of the clinics in Cacique, La Guaira and San Antonio were going to attend a meeting in the Portobelo clinic and the plan was to train all the directors so that they gave the charlas in their respective clinics and trained their staff. Just as planned, the directors came and received the charla and I gave them all kits to begin giving the charla to their patients. This saved me a bunch of time and travel and I was able to extend our chlorine charla network four-fold in one fell swoop.
In total 46 staff members have been trained to give the chlorine charla and the six health centers supplied with materials. We will be on the lookout for more clinics to connect with in order to keep spreading the chlorine charla throughout the region to ensure that people receive the education necessary to treat the water in their homes and prevent water borne disease. As we move forward I will continue collecting charla data from the clinics we already have active. I am proud that we have created a education network that is already starting to bear fruit and we are reaching more people than we ever thought possible. Education really is power.