Carmen Granados

Carmen Granados is demonstrating new techniques in primary and preventive health care that take into account the severe pressures that affect very poor people living in cities.

Good health is more than staying free of diseases and ailments. Good health is also reducing one' s susceptibility to illness by living healthily. Medical practitioners and researchers increasingly understand that this is more than getting frequent exercise and cutting down on fats. One's health and susceptibility are also linked to the mind. Those living with depression, fear, poor self-esteem,
or constant stress fall ill more often, and recurring illnesses perpetuate the mental turmoil.

Carmen is heading an innovative health project that focuses on the urban poor. Often overworked in poor working environments, and subject to the stresses of trying to provide food, income, and safety for themselves and their families, the urban poor especially require forms of attention not
offered by typical public health programs.

Carmen's project in Cuemavaca, called Spaces of Health (Espacios de Salud), combines medicine with psychology and social work. Carmen focuses heavily on human energy, a hard-to-measure but influential determinant of health. This energy, which comes from one's genes, nutrients, and the environment, is a system that can be thrown off balance by conflicts in the social, political, and spiritual aspects of a patient's life as much as by a virus or inadequate food. In order to treat the patient, therefore, Carmen's group seeks to find these sources of conflict and help the patient resolve them, thereby bringing the human and his or her energy back into "equilibrium. "

Carmen sees this approach as one part of an integrated health program that must include both medical groups and social organizations. She has spent five years developing and refining her methodology and organization. Although members of Mexico's PVO health community now come from all over the country to participate in Spaces of Health weekend workshops, she has to date remained cautious about extending her model nationally. Now she feels she is ready.

Even as medical technology advances, the growing stress and tension of late-twentieth-century living creates new health problems for individuals and societies. The poor must deal with critical life problems that become seemingly more and more dif6cult to resolve, ranging across nutrition, housing, education, and employment. The pressures wear on their lives physically and emotionally, and a host of ailments appear as a result. Labeling many of these ailments psychosomatic will not solve the problem — nor will ignoring the classical physical illnesses that cluster around poverty be they parasitosis, malnutrition, or tuberculosis.

Too often, however, doctors and health clinics overlook the full history of a person's sickness and seek to cure only the physical symptoms. They fail to grasp the important relationship between the psyche and the body, and how bodily sickness often is an expression of a deeper malaise.

Carmen is winning support for her broader approach by first consulting those parts of the national health care effort that are open to her ideas. If the government's national health care organization will not respond, many others will. This is because they, too, sense the need to serve the whole patient.

Consequently, Carmen and her organization now give a series of training programs, gradually building up a core cadre of practitioners and teachers across an ever broader area. Her training program lasts a year, and while medical and psychological training are its cornerstones, she places great emphasis on developing the therapist's style so that he or she can establish honest and trusting relationships with patients. After a year, they may begin consulting, but they continue to receive practical advice and training. One of the important qualities the program seeks to instill, says Carmen, "is for the therapists to identify their therapeutic limits in order to dIrect their patients to the proper medical specialist or to whatever types of services they require which lie outside the scope of their abilities. "

Over the last five developmental years, Carmen has run the Spaces of Health program in different areas of Cuernavaca and the state of Morelos, providing a low-cost alternative to medical and psychological care. Now, as she looks nationally, she has begun to contact organizations to help them establish centers in other cities. Recently Spaces of Health have expanded to Guerrero, with a base in Tonalapa del Rio. A new training center in Colonia Ruben Jaramillo, Temixco has also been established.

Carmen is also forming a national council, composed of prominent members of the national PVO health community, to provide her organization with analysis, critiques, and a broad flow of suggestions and ideas.

Carmen is a social worker by profession who has worked both in the PVO and public sector. She headed the "educacion popular" program in the Centro de Encuentros y Dialogos (CED) in Cuernavaca, a PVO dealing with community issues. In this role, says Carmen, "I felt great anguish and a sense of impotence in seeing how exhaustion and sickness were accelerated among a people without recourse to dignified, quality service. " She found the approach she is now championing as a product of her search for an integrated approach to providing individual and group health.

Carmen works closely with the Ecclesiastic Base Communities {Communidades Ecclesiasticas de Base), reflecting her deep Christian beliefs. These grassroots Catholic groups provide one of the avenues through which she's spreading her vision of a society that helps its citizens to the healthfulness that comes from a full life.