Healthcare. People from all ethnicities, ages, and economic backgrounds are talking about one of the most important subjects of the 21^st century. People discuss the merits of the Bill & Melinda Gates Foundation to United Nations Millennium Development Goals to the United States’ recently passed healthcare reform bill. We tend to focus on healthcare in two main geographic areas: the Western world (US, Europe, etc) and Africa (where poor conditions exist). But what does healthcare look like in another country that falls outside of those parameters, like Paraguay? What do current Vittana students think about the healthcare system? Where and what do they hope to achieve after they earn their degree? Each Vittana student will take a unique path to improve the healthcare situation in Paraguay.

A hospital urgent care facility in La Colmena, Paraguay

Overview

Paraguay ranks near the median among South American countries in terms of major health indicators, but spends less per capita (US$13−20 per capita per year) than most Latin American countries. In addition, a 2001 survey indicated that 27% of the population still had no access to medical care (public or private), according to United States National Library of Congress.

Lack of Healthcare Professionals

The health workforce is underserved, which is where many Vittana students can help one-by-one. Paraguay lags behind the Latin America regional average for number of nurses and midwives (with only 18 nurses and midwives per 10,000 people) versus the regional average (of 49 per 10,000 people), according to the WHO (World Health Organization).

Maria will search for a nursing job in rural Paraguay to help combat the lack of healthcare professionals.

However, students like Maria Dielma will soon enter the workforce and help combat the lack of medical professionals. She will graduate with a four-year nursing degree, and she chose this profession because her father has been sick for many years, and she wants to help people like her dad. She still has a lot of work to accomplish before reaching her goals – both figuratively and literally. She works at a convenience store 7 days a week for a total of 59 hours in addition to her studies. However, the short-term sacrifices will provide her an opportunity to work in the nursing profession. After graduating she will search for a nursing job in rural hospitals.

Disparity in Healthcare

Ceneida is studying to become an obstetrician and is looking forward to educating mothers about the health of their unborn babies.

There are many inequities in healthcare based on two broad factors: economic and geographic (i.e. rural and urban). For example, births attended by a skilled healthcare professional vary significantly between those two groups according to the WHO. In urban areas 87% of births are attended by a skilled healthcare professional versus 48% in rural areas. The economic variance is even larger with 98% of Paraguayans in the top 20% of the population having a skilled healthcare professional present at a birth versus 41% for the poorest 20% of the population.

But Vittana student Ceneida Zorilla hopes to facilitate many birthings as an obstetrician and reduce those statistics for the rural and less economically advanced portions of the population. She is ¨interested in learning more about reproductive health issues.¨ Furthermore, she wants to help mothers by educating them about the health of their unborn babies and facilitating healthy deliveries.

Maria Noguera will take a different path to help the under-served areas of Paraguay. She will graduate in December 2010 with a nursing degree and wants to work in emergency situations in rural Paraguay. ¨Nursing is about taking care of other people’s lives, and through my career I want to help my community; especially since we are far from the metropolitan area and it is difficult to reach a medical facility.¨ You can read her full story and see her photo in my last blog here.

Process improvements

In Paraguay, there is both a public and a private system. The private system is very expensive and is under-utilized by many people. Conversely, the public system is over-utilized, more reasonable from a cost perspective, and even has some limited free services. Neither are ideal.

US Peace Corps Coordinator Lauren McCullough presenting about HIV prevention

According to Paraguay US Peace Corps volunteer, Lauren McCullough, who has been in Paraguay for 3.5 years and is currently the Coordinator of an HIV/AIDS Initiative, the public system ¨works on paper but does not work in real life.¨ She explains that there is a limited supply of medical supplies (plastic gloves, bandages, etc), medicine, and comfort items (such as blankets in winter and functioning air conditioners in summer, when temperatures are often above 100 degrees). Patients often wait for a long time to see a doctor. For example, many patients arrive at 7 AM and wait for several hours or even a full day to consult with a physician.

One student already has experience and success in the system, but she is looking toward the future for more innovation. Gladis Galeano has prior experience as a nurse and delivering babies. She started working as a therapist in a hospital and was promoted in six months later to manage 50+ nurses. She will graduate with a nursing degree in September and will start a two-year business/hospital administration degree in December. Ultimately, her goal is to manage a hospital or a region of hospitals. However, she wants to be ¨more than just a boss¨ and make systemic changes in healthcare.

Gladis already manages 50+ nurses and is looking to make systemic changes to the healthcare system.

Specifically, the Paraguayan public health system does not do a good job with prevention – it is only reactive and not proactive. In addition, the pharmacies are basic and do not offer the necessary medicine. According to Gladis, pharmacies need to expand. In addition, she wants to create medical ¨best practices,¨ so that other medical facilities can leverage those ideas to improve the entire system.

In addition to her professional goals, Gladis is helping on a personal level by purchasing a medical kit to help sick kids in her neighborhood because she just wants to help.

According to United States Peace Lauren McCullough, foreigners ¨can only educate the general public and hospital workers about healthcare overall; but the future ownership of healthcare, ultimately, is with Paraguayans.¨ The Paraguayan healthcare industry will be impacted by people like Maria Dielma, Ceneida, Gladis and Maria Noguera, and it is their Vittana loans from lenders like you that will make their contributions possible.

To provide an opportunity to other Vittana healthcare professionals click here.

To provide an opportunity to fellow Vittana students so that they can improve their respective professions, whether business, education or the sciences, click here.

In the first minute of my conversation with Maria I could sense that she had a tremendous enthusiasm for life and was focused on helping other people.  Both traits will undoubtedly be advantageous when she graduates in December with a degree in nursing.

Meet Maria de los Angeles Noguera from Carapeguá, Paraguay.

Maria de los Angeles Noguera will graduate in December 2010 with a degree in nursing

Along with going to school Maria is also the owner of her own perfume business she started 3 years ago.  She sells her perfume utilizing her network of friends, classmates, and family.  She sources her product from Mercado Cuatro – one of the most famous markets in Paraguay – which is a 2.5 hour bus ride to Asunción.  She provides samples to her customers so they purchase the right scent for them.

She currently lives with her parents and her brother, who is in his second year of studying accounting.  Her parents raised her with a strong set of values and determination.  Her mom recently demonstrated that determination by returning to high school to graduate with the full support of her family.  Maria explains that values are important in order to be successful; ¨You need to be humble and sensitive to other people.  I learned that at home, then practiced at school and now with my work.¨

After graduating she wants to help people in need, both professionally and personally, as a nurse.  In addition, she will utilize her nursing skills to help her parents live a healthy life along with supporting them financially.

Maria is extremely inquisitive and asked several questions about Vittana.  She was concerned that the student loan was a short-term promotion and would not be available for other students including her brother.  I explained that Vittana was approaching funding $300,000 of student loans (check to see the current Vittana loan volume) along with expanding in Paraguay and globally.  She was happy because student loans will be still be available to her brother, friends, and other people throughout the world.  She commented about how important the student loan is because many people have the intelligence and the motivation but simply lack the financial resources to graduate.  She talked about how student loans are a big step forward for Paraguay and for South America.

Her family´s education story is common to many people in Paraguay.  Paraguay is the second poorest country in South America next to Bolivia with $2,365 USD per capita according to the World Bank in 2009.  Maria is the first person in her family to attend college. In Paraguay, less than 1% of women finish college.

Fundación Paraguaya office in Carapeguá, Paraguay where Maria received her loan

Her parents were unable to go to college because they lacked money – the same reason that she was almost unable to finish her studies until she found Vittana.  She understand this irony and is grateful for the opportunity that the student loan has provided.

With the help of Vittana (one of the first microfinance institutions in the world to provide student loans) and Fundación Paraguaya (the first NGO in Paraguay and the first Vittana partner) Maria is rapidly approaching her graduation and her new career in nursing.

If you want to lend to students like Maria, click here.

In a recent entry here on the blog, Vittana Fellow Nayna Gupta told the story of Mercy Marilu, a young woman from Lima, Peru.  Mercy, who works as a primary school teacher, received a Vittana loan to help her finish a degree in early childhood education.  Mercy’s story was inspiring—after finishing high school and spending years contributing to the family income by working as a chicken vendor in the province of Huaycan, Mercy eventually earned a position at a primary school teaching low-income children.  Recently, she decided to go back to school to follow her long-held dream of finishing college.  Even better? Mercy, now 27, is a mother, and her new found opportunity to finish school has inspired an even bigger dream: sending her daughter to a four-year private college.  To get started, last week she opened a savings account in her daughter’s name.

Mercy isn’t alone.  Thanks to loans from Vittana, moms like Betsy (who recently graduated from university), Nardith, Edelmira, Gulnara, and others have gone back to school to achieve their educational goals, improve their professional qualifications, and provide a better future for their children.  With Mother’s Day just around the corner here in the United States, we wanted to take a moment to recognize their hard work and sacrifice.  Already juggling the hectic, often competing obligations of work and family, a deeply held belief in the power of education drives these women to choose an even more challenging path—to take time that might otherwise be spent catching up on sleep or stealing a few minutes of relaxation with their children or spouse, and instead spend it in a classroom, studying and completing assignments, or going to and from school.

Betsy Olivares, mother of two, with her family on graduation day.

Zayda Flores Bravo and Celsa Martinez, whose loans are currently fundraising on Vittana, are two more of these special women.  Celsa lives in Encarnación, Paraguay, where she’s worked as a primary school teacher for 15 years.  Celsa and her husband, who runs his own store, have three grown sons, all of whom have finished school and joined the workforce.

With her loan, Celsa will be able to enroll in the continuing education programs made available to teachers through the Paraguayan Ministry of Education and Culture.  As she says in her student profile, Celsa is passionate about being the best teacher she can be for her students, and these continuing education courses will help her stay up to date in her field.  She also hopes that by earning additional qualifications, she’ll be able to help her family by earning a higher salary.

Celsa Martinez in Encarnación, Paraguay

As a teacher and a mom, this time of year is doubly special for Celsa.  April 30^th was Teacher’s Day in Paraguay, and when Vittana spoke with Celsa last week, she said preparations were in full swing for a big party with her students.  As for Mother’s Day, which takes place on Saturday, May 15 in Paraguay, Celsa says that her boys always take good care of her by preparing a special meal.

Vittana is proud to support mothers like Celsa as they work to improve their lives through education.  This Sunday, when we call our own mothers (or if we’re lucky, give them a hug in person) to tell them we love them, we’ll also be thinking about the millions of mothers around the world whose shared commitment to education is what makes Vittana’s mission possible.  Mothers who help their kids with homework, scrape together money to pay for school uniforms, and, most importantly, encourage their sons and daughters to dream big.  To all of them, we say thank you!

Click here to make a loan to Celsa, Zayda, or one of the many other hardworking students on Vittana.  And when you do, be sure to tell your mom!

Here at Vittana, we talk a lot about the value of education.  And while we may often ruminate on the intrinsic value of what we learned in college–the beauty of learning for learning’s sake–we also know know that simply having an education doesn’t let us pay our bills or (start to) pay back our student loans.

The same is just as true, if not more so, for our students in Nicaragua, Peru, and Paraguay.  Vittana students go to school for a variety of reasons: to follow a passion, to make their families proud, to be an expert in their field.  But, no matter what their passion or profession, every Vittana student sees their education as a means to one common goal:  a well-paying job to support themselves and their families.

With that goal in mind, the team was thrilled to hear last week that Paraguayan student David Antonio Adorno Arriola had become the first Vittana student to land a job because of training paid through a Vittana loan!  David’s passion is computer programming and he used his Vittana loan to pay for a short-course program that awarded him a programming certificate.  The certificate made his resume much more marketable and he quickly found work after the program.

Upon finishing this program and with his new source of income, David Antonio decided that he wanted to continue his education and pursue a bachelor’s degree in computer science.  (Many university students in Paraguay attend night school and have to simultaneously work at full-time jobs to pay for their tuition.)  Given Vittana’s technology roots, we think David is particularly awesome.

Congratulations David!

As of this morning, two new students are online from our Paraguayan partner, Fundacion Paraguaya! Gerardo is attending Servicio Nacional de Promoción Profesional, a vocational school headquartered in downtown Asuncion, for a year-long course to become an automotive mechanic.  Natalia is attending a short 2-month course to become a bank teller, which is considered to be quite the respectable position in Paraguay at a private bank.  Despite how short the course is, Natalia could make up to $300-400 per month when she graduates.

Our microfinance partners are working as fast as they can to bring on new students and, in turn, we’re working as fast as we can to bring on new partners. When we first launched a couple weeks ago, our first 3 students and initial $2140 in loans were completed in less than 33 hours.  We — and our students — are truly humbled by you all and your support.

As always, if you have any questions, no matter how big or small, please email us at questions@vittana.org.