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 Conversations with Leaders in Self-Care: Self-Care In a Mexican Village 
Interview with David Werner
   as interviewed by Tom Ferguson MD

Biologist-educator David Werner has spent the last fifteen years organizing Project Piaxtla, a self-care network run by the campesinos (farm people) among the villages in the rugged Sierra Madres mountains of Sinaloa and Durango in western Mexico. The community-based health program, now run completely by local villagers, none of whom have any formal medical training, provides care for more than ten thousand persons at a cost of about one dollar per person per year.

The main referral and training renter is in the small village of Ajoya, which is accessible only by dirt road. Most of the other hundred settlements are accessible only by mule trails. There are no doctors in the area.

The network now operates an out-patient (and occasionally in-patient) center in Ajoya, complete with laboratory and X-ray facilities. Locally trained dental technicians extract, drill, and fill teeth, and make dentures. All this work is done by the villagers themselves, few of whom have received any formal education beyond the sixth grade.

The network also includes a large number of promotores de salud, village health workers. These workers, like the Chinese barefoot doctors, are selected by their communities. They then come to Ajoya for two months of practical health training in preventive and curative medicine, with a strong emphasis on community organization and concientzacion (consciousness raising), communication, and teaching techniques. When they return to their remote ranchos and villages, they continue to earn their living as farm workers while acting as part-time health workers.

David Werner, who is forty-three, received his bachelor's degree at the University of New England in New South Wales (Australia) in ecology and entomology. A confirmed world traveler, David had come to Australia from Cincinnati, Ohio, because he wanted to study its natural history. He returned home after his schooling in Australia to pursue a newly kindled interest, dramatics, at the University of Cincinnati.

A trip to the Orient followed and a period of study with Gandhi's successor, Vinobhave, "the walking saint of India." During his time walking with Vinobhave, a leader in the land-reform movement in India, David was impressed with the possibility of organizing the poor of the Third World to have some power over the factors that influence their well-being.

Landing back in California, David joined the staff of Pacific High School in Palo Alto and soon began taking the students from this alternative school Infield trips to Mexico. In Mexico he found vet another vocation: medicine.

TF: How did you get involved in medical work?

DW: I took a walking trip by myself in the Sierra Madres one Christmas vacation. One evening I'd been delayed and was passing a little shack about dusk, and the family living there asked if I was hungry.

Well, I was hungry. So I stopped and they pulled a couple of eggs out from under the chicken and cooked them up for me—they were all eating beans—and asked me to stay the night.

It got very cold that night, and the family had only a couple of blankets for seven or eight people. Around two in the morning it got too cold to even try to sleep, so they got up and built a fire in the middle of the floor and sat around it, the older kids holding the younger ones, until dawn came.

When it got light, I noticed that one boy had a badly swollen foot. He'd stepped on a thorn three months before and by now the foot was seriously infected. I was struck by how unnecessary it was for him to have to suffer like that—all he needed was some antibiotics and some knowledge about hot soaks. Also, some of the kids were beginning to develop gaiters, and I knew that iodized salt could prevent that.

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 About The Author
Tom Ferguson, M.D. (1943-2006), was a pioneering physician, author, and researcher who virtually led the movement to advocate informed self-care as the starting point for good health. Dr. Ferguson studied and wrote......moreTom Ferguson MD
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