Proyecto Puentes de Salud

2008-07-30T13:41:00.003-05:00

Sadly our year has ended and we are all making our way back to the states :(

Thanks for all the help and encouragement, we are all going to miss little Juventino Rosas. Attached is the picture we printed, framed and gave our many hosts in Juventino before we left.

Zacatecas

2008-07-15T18:07:00.003-05:00

This past weekend we traveled to the old mining town of Zacatecas where the majority of Mexico´s silver comes from. We climed La Bufa (a mountain overlooking the city) and then took the teleferico down to an old mine where we witnessed the depths and caverns where men would work 15-18 hr days at around 115 degree temperatures. The city is also known for its colonial architecture and beautiful cathedral pictured on the right.

Time of the Rain

2008-07-15T17:41:00.002-05:00

The summer is the time of rain in Guanajuato and as a result the roads have become even worse which is a feat we thought impossible. The fields are flooded and everyone retreats inside from around 4pm until the rain stops.

One of the communities we visited last week is called Rosillo and is pictured above with our fantastic pickup truckthe padre loaned us.

Fiesta 4 de Julio

2008-07-15T17:26:00.003-05:00

We had a large celebration to honor our nation´s independence day and share some very american traditions with our mexican friends. We required eveyone to come in red, white and blue, we facepainted, ate watermelon, grilled hamburgers and hotdogs, loaded the place with little american flags and banned tequila. It was a large success and if only we had been able to find some fireworks I think we would have felt like we were home.

San Jose de las Pilas

2008-07-03T16:28:00.005-05:00

Today we finished our time in the booming San Jose de las Pilas. We had to take a 1hr siesta for a special kindergarten graduation mass that the community had. the best part was that after the mass the kids were dressed up and preformed some dances in front of their school. It was fun to watch the little guys run around without much rhythm or care for what they were supposed to be doing.

We are also sad to say goodbye to melissa and joseph who head back to the US on Saturday :(

PPS at World Congress of Cardiology

2008-06-27T15:47:00.003-05:00

PPS recently presented on our findings at the World Congress of Cardiology. Lorene, Kristoff, & Charles went with Dr. Cohen to Argentina to make the poster presentations and oral presentation. Lorene´s slides can be found here. Congrats to all who contributed to this work!

Ojo de Agua de Otates

2008-06-26T16:10:00.004-05:00

Many thanks to our fearless advisor Dr. Mauricio Cohen, who performed EKG testing on high-risk patients even at the tiniest chapels with no electricity. And who can forget his thoroughly moving fire-and-brimstone diabetes and heart disease pláticas?

La Huerta

2008-06-26T15:55:00.004-05:00

Helen found time to exercise her motherly instincts in La Huerta in addition to her rip-roaring interviewing and testing skills. Perhaps a career in Pediatrics is in order?

Thanks to Dr. Baker for the picture.

PPS @ Mandujano and La Huerta

2008-06-18T15:59:00.005-05:00

PPS found itself waay up in the mountains of northern Juventino Rosas this week at the city of Mandujano. Right off the highway and snuggled in between some new houses (perhaps of people who made it big in the US?) is a very small and welcoming community. They were very enthusiastic to receive screenings and health information. And the kids asked for and got a basic first aid class down by the river. Ian served as a very animated ¨victim.¨

We were also welcomed in La Huerta, another small town with a few more people and a teeny tiny chapel that is about to get a lot bigger.

We´re Back!

2008-06-12T18:44:00.002-05:00

The 7 students arrived in Juventino Rosas this week and are planning for a successful series of screeenings. We have a very ambitious schedule to visit around 13 communities, plus some of the neediest colonias nearer to the city center. More posting to come!

PPS at St. Thomas More Feria de Salud

2008-04-13T22:59:00.000-05:00

Today, PPS visited the Feria de la Salud at St. Thomas More Parish in Chapel Hill. In addition to offering glucose and cholesterol screenings and a brief survey, some PPS friends provided dental clinic assistance and even helped coordinate a "soccer clinic" for the kids!

We were fortunate to meet a number of people from the Guanajuato area, as well as parishioners from elsewhere in Mexico, Colombia, Peru, Ecuador, etc. Chapel Hill is quite an international town!

Still Chugging Along

2008-02-01T22:04:00.001-05:00

Thanks to everyone for making last Wednesday's meeting productive. We will be returning to Juventino Rosas in summer 2008 and including new and old communities and friends. Right now, we are nailing down logistical details. The dates for the project will likely be June 9-July 26, though some folks may possibly go down earlier to start setting things up.

We expect to continue with cardiovascular and diabetes screening, and possibly add a urinalysis component. A focus on more robust women's support groups will target depression in the Juventino Rosas area. We are exploring the idea of a community garden project as a health intervention and would appreciate expertise that any agricultural experts in the Chapel Hill, NC or Juventino Rosas, Gto. regions can offer.

PPS at Sustainable Community Development Conference!

2007-08-29T21:48:00.000-05:00

Proyecto Puentes will be presenting a poster at the Duke/UNC Sustainable Community Development Conference on Sept. 5, 2007 from 6-8 PM at the Nasher Museum of Art. We would love to see our supporters there! You can register (free) for the conference here.

End of Summer 2007

2007-07-22T06:21:00.001-05:00

The work for this summer has finished and over 440 people were screened in 9 communities in the Juventino Rosas area. Thanks to all who helped. The gears are still turning, though, and we're looking forward to 2008!

More Success

2007-07-10T16:45:00.000-05:00

Proyecto Puentes is proud to say that we have now screened over 315 people so far, and week 4 is not yet over! Congratulations team!

A River Runs Through It

2007-06-28T21:00:00.001-05:00

This week's impressive number of participants served is made even more impressive when we consider the state of affairs in Pozos. The town may be famous for its pozos (wells), but it is currently rather infamous for its drenaje (sewage and drainage), which backed up and created a lake of sorts in front of the church. Luckily, the sewer is under construction and will hopefully be completed along with new paved roads before any future projects arrive.

We are also very humbled by the generosity of the people in Pozos. In one day, we were brought lunch by 3 separate people in succession, and then brought dinner by someone else before finally being invited to another person's house for dinner again. The local church delegate and his friend were also nice enough to provide transportation for us when we were stranded in the town one evening. This week has been an extremely educational experience and I'm sure we have each taken some vital lessons to heart. One of the most important: We can never predict when the tables will turn and the people we are helping will turn out to be helping us. There are remarkably dynamic relationships in this project, and everyone has something to contribute.

I'll finish with a picture of Kristoff and Dr. Steiner taking a needed break to do some studying after the screenings and consults.

¡Hasta el próximo!

¡Vamos PPS!

2007-06-28T10:12:00.000-05:00

Hola Todos,

We are finishing a terrific week in Mexico, week three for the project 07. Let me fill you in with a brief update. First off, we lost our great ally from a different shade of blue, Joe. He returned to Duke on Wednesday for an ethics class, the ethics of which I think are questionable at best. He will be missed immensely, his love for public health, service, and Latin culture was a huge asset to the project.

We completed a successful week in Las Pozos, one of the larger communities we will be visiting this year. The group took the challenge in stride, I don't have the final tally quite yet but I know we ran out of supplies, a testament to the volume of participants we saw. Yesterday alone 54 screenings were completed by 1pm. Dr. Beat Steiner served as our attending this week, providing patient consults for all those participants with abnormal lab values . He provided sound leadership and expert advice. He was one of the founders of the Honduran Health Alliance, and thus has valuable experience from which to provide us guidance. Personally, I have been very impressed by the organization and maturity of the rising second years that are leading the project. But more importantly Dr. Georgette Dent, Dean of Student Affairs at UNC, who is visiting the project this week is also very impressed.

Dr. Dent has a long time interest in public health, and is helping to lead the initiative at UNC SOM to advance opportunities for medical students to work on international service projects. In her own words she claims to have "missed her calling" to work in public health. But I feel that the difference she is making as an administrator, supporting the growth of international service at UNC, will be far reaching and long lasting. Upon her return, Dr. Dent will be meeting with several of the other leaders in Global Public Health at UNC such as Mike Cohen, Doug Morgan, Martha Carlough, and our own Beat Steiner.

Prior to visiting el Proyecto Puentes de Salud in Juventino Rosas, Dr. Dent visited the PACEMD program, in San Miguel de Allende. She met with Dr. Haywood Hall, a colleague of Judith Tintinalli from UNC's Emergency Medicine department, and some of the leading health care administrators from the state of Guanajuato. This experience will help her to promote new opportunities for UNC medical students to do rotations with PACEMD in medical Spanish and emergency medicine and to experience the health care system from which many of our future patients first receive care. The program will be especially beneficial to students seeking to acquire a functional proficiency in clinical Spanish.

Check back soon for great photos from this week!

Cohetes

2007-06-24T10:58:00.001-05:00

One of the first things that surprised us when we first arrived was the frequency of loud explosions. Actually, ¨surprised¨ is a light word; for the first two days or so, I was ready to duck under the table every time I heard them (and they were fired at least 3-4 times per day, usually on the hour). It turns out that the explosions are actually fireworks (rockets or cohetes) being launched in celebration of saints´ feast days. The situation reminds me of the retired navy captain firing his cannon from the roof in Mary Poppins. As one religious leader noted, ¨It´s always a fiesta here.¨ This week has been quiet as the feast days have passed for now, but I am sure the avid rocket-firers are busy hoarding up more explosives for the next opportunity.

It´s this spirit of communal celebration, I think, that has contributed to the support for Proyecto Puentes. People have been genuinely excited to push the project forward and contribute to the health of their neighbors. I am humbled by their work and I think it serves as a model for our own community commitments in the US. It´s a good thing we have so many people coming in this week for our work in Pozos, because given its size and level of interest, they will likely be quite busy.

More Newbies

2007-06-24T10:30:00.000-05:00

We welcome Anita from Duke this week and also Dr. Steiner from UNC and his son. Their work is greatly appreciated! We are excited about the many physicians and students arriving today in preparation for our huge week in Pozos.

Going to the Chapel

2007-06-21T12:24:00.000-05:00

On the right is a picture of the chapel in Romero where we held our first health fairs. Romero is a very beautiful town in the mountains. It also has no cell phone service, no running water, no bathrooms or outhouses in any of the homes, essentially no access to education beyond primary school, and virtually no young men (they are all gone working in the United States, usually referred to as just ¨allá¨). Nonetheless, the people were extremely kind and glad to have us there, and we stayed in a very nice room with real beds and a real floor that is usually reserved for traveling teachers. On the left, you will find a picture of (left to right) Lorene, the person in charge of the chapel, Kristoff, another gentleman who was around the chapel at the time, Charles, and Dr. Dan Reuland. And we´ll finish up with a photo of Charles keeping some children entertained (and vice-versa) near the chapel in Xoconoxtle. We tested over 75 participants total in the two communities and gave a ¨health chat¨ in Xoconoxtle about cholesterol, blood pressure, diet, and diabetes. Despite our study focus on cardiovascular disease and a small screen for depression, we were really wishing we could have a psychiatrist, a dentist, an OB/GYN, and a pediatrician with us given the kinds of issues that came up repeatedly.

First Week Reflections

2007-06-16T14:07:00.000-05:00

Thanks to Lorene for contributing this post:

It has been a great first week. We got to Juventino Rosas on last Saturday and were taken to have lunch with the Padre at the parish here in in JR. It was the first of many meals that seem to begin and end with tequila. It´s a cultural sin to have an empty glass, so I have had to learn to SLOW DOWN when drinking. We went that evening with the Padre to a festival in one of the neighborhoods around here, and then to Celaya, a nearby town where we had a nice dinner. The next day, we were invited to meet the mayor of the town (El Presidente) and have lunch with him. We walked to the center of town, and were surprised to find a stage, microphones, and seats for about 100 people. It turns out they were having a welcoming ceremony for us. We were all given a token of their appreciation--- miniature wooden violins for the boys and a shawl for me. The violins are a symbol of the city, since Juventino Rosas was named after a famous composer who was born and worked here. As part of this surprise, I had to give an impromptu speech, microphone and all. I basically stammered in Spanish as quickly as possible, but it seemed to go over well. In the days since then, we have visited the community hospital, a nearby technological institute, and several of the communities that we will be working in. We have eaten lunch (the biggest meal of the day) every day with a different member of the local delegation supporting us. The food has been awesome, and only one of the tequila lunches completely wiped me out. (Lesson learned: no soy un pollo de primavera (I`m not a spring chicken) and don't try to keep up with Mexicans).

We are renting a house in Juventino where we will be staying on the weekends. We have been outfitting it with various things-- one night we even tried to cook, and it was very good (although what started as beef tacos turned out to be pork quesadillas :) ). Anyway, it has been fun.

Tomorrow, we leave for the first community. It is called Romero. It is very small and has very limited resources, so our work there will be well appreciated. It is far into the mountains, we have to borrow a large van to be able to get there. We will be staying there for two nights and then moving to Xoconoxtle (pronouced Ho-Co-Nose-Clay), also a small town in the mountains. We have all of our supplies together, and have practiced all the tests on each other. It should definitely be an adventure, but we are thrilled to get started with the work that we´ll be doing here.

Road to Romero

2007-06-15T10:26:00.000-05:00

We recently went to the very remote towns of Romero and Xoconoxtle, to see the chapels and meet with the delegates who will be providing local support for the health fairs and chats in the first week. The closer we got to the towns, the drier things appeared (though the wet season is apparently right around the corner). Here, you can see the beautiful countryside from the road to Romero.

New Hospital

2007-06-13T11:02:00.000-05:00

Here you can see the entrance to the shiny new hospital in Juventino Rosas, with Shannon, me, Kristoff, Lorene, & Charles in front. Past participants in Proyecto Puentes will be amazed at the new building, and I assure you it is even more impressive inside. It´s touted as a model community hospital for Mexico and offers more services than most hospitals of comparable size that I´m aware of in the U.S. The new building doesn´t solve the problem of rural residents lacking transportation to get there, though.

New Crew

2007-06-12T20:31:00.000-05:00

Greetings dear readers,
I am happy to be able to update you all on Proyecto Puentes 2.0. Our initial crew, including Lorene, Kristoff, Charles and myself, has arrived in Juventino Rosas and been quite overwhelmed with the warm welcome here from the parish and municipal government (We were even recognized at the town hall meeting!). Since last year, the city of Juventino Rosas has been able to build a brand new and very advanced hospital. We are busily reviewing the target rural communities for this year and preparing for the fairs. More beautiful pictures should be coming once we get better at using the camera!

Taxi Anyone?

2007-03-19T20:47:00.000-05:00

Tripp and I served as an airport taxi service for all of the Docs last summer. This year they won't be so lucky.

T Rock

2007-03-19T20:46:00.000-05:00

Trista is an All Star

BFF

2007-03-19T20:44:00.000-05:00

Amanda and Juanita
Best Friends Forever

2007-03-19T20:42:00.000-05:00

Taking a minute to eat. Tripp and Dr. Cohen pause from patient visits.

Colonial Guanajuato

2007-03-19T20:41:00.000-05:00

Group Foto (minus Amanda). We're enjoying a weekend vacation in Guanajuato.

More Fotos

2007-03-19T20:27:00.000-05:00

A rewarding meal following a long days work in Cuenda. Cuenda was the largest of the communities that we conducted screenings in. It was also the most urbanized. The response there was overwhelming, and our supplies quickly ran out. The group in the photo led the charge while Tripp and I travel to the previously visited communities with Dr. Cohen to conduct follow-up visits, which included EKGs for individuals with risk factors implied by abnormal lab values.

Some Fotos from last summer

2007-02-06T18:55:00.000-05:00

Tripp Nanney glucose screening, Juventino Rosas, GTO, Mexico

Placing the PPS Banner, Cerrito de Gascas, Guanajuato, Mexico

Ready for game day, World Cup 2006
Cerrito de Gascas

You try and write a blog while in Med School

2007-02-06T17:20:00.000-05:00

It all comes down to priorities and I'll be honest the blog came about last on a long list the past semester. This is going to change (I hope), as we are in the process of a peaceful productive succession. I hope to have a little more time to write about the experiences, pitfalls, ect. of founding PPS and what the future holds.

We are currently hosting the “Delegation” (JR community members who have been involved in the project from the mexico side and are visiting representatives of the church) from Juventino Rosas (JR). We have had several dinners with them this week, which have been both touching and exciting. Dr. Evan Ashkin hosted the first dinner event at his home Saturday, where we reminisced last summer and started planning the next. In attendance were physician preceptors from last year, medical students from the inaugural group, med. students from the '07 team, members of the St. Thomas Moore church, and physician preceptors that will be coming down in ‘07. I hope these experiences will help solidify for the first years who are taking over the project, that this is an amazing cultural exchange. It is more then just our medical project; it is something larger that we are building between two communities.

Moving forward, we are pushing to prepare for this summer, hoping to get fully funded. It would be nice to win a least one of the fellowships the ’07 group has applied for. But fellowship withstanding, Pam has ensured there will be stipends for the med students, and Mauricio will be funding the Cardiovascular research. Fingers crossed our alliance with Maria Farris from UNC Urology will work out; she will help us add urine analysis to the screenings we will conduct. This dimension expands our already productive Cardio research in rural Mexico, strengthens our screening to survey ratio (how much time participants spend helping us answer research questions vs. the benefits they gain from our free health care screenings), and involves a potentially valuable advisor in the project. Maria Farris is a native mexicana on faculty at the SOM who completed her medical education in Mexico. She won't be able to visit the project this year but is sending a research fellow (Scott) down in her absence. We hope our success this summer will motivate her to attend the next summer's (’08) events.

An exciting development of the past month has been the addition of faculty and students from Duke. Even and Cheryl Ashkin helped to organize a talk for Trista and I to introduce to our project to medical students and faculty at Duke. The response following the talk was overwhelming. There seems to be a large and very enthusiastic group at our neighbor institution motivated to get involved in projects like ours. Unfortunately, the curriculum for the Duke med students is not very conducive to summer projects. We are however looking forward to working with an advanced and talented Duke undergrad, a resident in Internal Medicine, and an attending physician in Infectious Disease. It is our hope to nurture this relationship and expand PPS in the future by drawing even more from the wealth of talent at Duke. Additionally, we hope to work towards expanding the project to have multidisciplinary components. There are many opportunities to involve NPs, Dental students, and undergrads; however presently we are still lacking in central resources to organize on a larger scale.

My reflection of the week: our challenges in group dynamics. We have so many enthusiastic and talented people working on the same project with different goals and priorities. This is a multifaceted project and the big picture is easily lost. It is frustrating to see people get disenchanted and opt to spend their energy on other things. However, I respect the position when someone becomes unfulfilled and prefers to prioritize their energy elsewhere. It is a matter of compromise and perspective. Any individual’s vision for this project is one of many, and to impose that vision on others could earn the disillusionment and dissatisfaction people who are valuable to the group’s success. Alternatively, it may leave them feeling valueless if people decide to go a different direction. I think the compromise is to make ones suggestions known but to be flexible; to respect other's priorities with an open mind (admittedly something I haven’t always been the best at; but its a learning process right?).

Finally, in recent exciting news Dr. Dent, a dean at UNC SOM, might visit us this summer! This is not a formal announcement, but if you see her in passing I think a little encouragement would be appropriate. She visited the Honduran Health Alliance last year and had a great time; I think she would equally enjoy and week in Juventino.

If this is not updated at least monthly this spring; someone should fire me.

Hasta Pronto!

The Logo

2006-07-27T23:23:00.000-05:00

Week 1: The Beginning

2006-07-27T21:37:00.000-05:00

Week 1: May 17-28

To introduce the beginning of the project and our trip I have to choose a place to start. As I have explained the purpose and some of the development in the previous post I will jump to May 17 when we finished our final exam for Microbiology and Infectious Disease. The rush of finishing our first year of medical school quickly drained away as we realized after putting off for weeks the final preparations for the drive to Mexico, we had only three days left to pack and prepare. This included organizing a kick off dinner on Friday May 19. Luckily most of the preparations for the dinner were taken care of by Katy. Unfortunately finalizing responsibility for who would bring which supplies was not taken care of, which turned out to be a challenge for all of us over the next several weeks.

Rushed preparations were made and in our free time we said goodbye to our families, much neglected over the busy medical school semester. At 4 am Sunday morning the car was packed, we said goodbye to Ms. Lindsay, Tripp’s mom, and left Charlotte, NC with the sunrise. We made good time all the way to New Orleans, our first layover. The damage from Katrina was still evident in missing street signs, roofs, and other logical objects that most cities would have; in New Orleans things were just missing. It was easy to imagine the severity of the damage immediately following the hurricane. It was the first time either of us had visited New Orleans so we spent the afternoon and evening visiting some of the famous sights and districts.

The following morning we left early for the shortest leg of the trip. The drive from New Orleans to San Antonio was a direct 550 mile shot on Hwy 10. We stayed the night with my cousin and prepared for the border crossing and 12 hour drive the following day.

As anticipated the border proved to be a frustrating experience. However, we were glad the frustration stemmed from acquiring the proper documentation and not from a hassle regarding the medical equipment we were carrying. We had official letters of explanation from both Mauricio at UNC Hospitals and Father John at St. Thomas Moore. The letter from the church turned out to be our key to attaining a work visa in Mexico. The official would not grant us tourist visas because we naively disclosed our purpose in Mexico was to conduct a health project. In the future I recommend avoiding the hassles and just tell the officials you’re a tourist.

After several hours in Nuevo Laredo acquiring the proper documents for our car and ourselves we left for the 10 hour drive to Guanajuato City, Guanajuato, Mexico. We were pleasantly surprised by the quality of the roads and road signs, which we basically followed all the way to our destination (our only road map of Mexico was tragically inadequate). Our journey through Mexico went smooth; the countryside was out of an old western flick.

I was Robert Redford and Tripp was Paul Newman from Butch Cassidy and the Sundance Kid as we arrived in the hills just outside of our destination, Guanajuato City. The sun was setting; casting cactus shadows over the road as we passed through tiny Mexican pueblitos. Multigenerational families sat together on concrete porches, watching the two gringos pass in their Japanese automobile.

We were a mere twenty minutes from Guanajuato City and 3000 miles from home when a tope (Spanish for speed bump), jumped out in front of the car. I was driving as cautious as possible in a foreign country, but nothing could be done and we slammed through the tope at 40 miles per hour. It was about 50 feet down the road before I realized the source of the metal on pavement scraping sound. My rack holding two bicycles, formerly attached to the trunk of our car was now being pulled behind us like a water-skier behind a speed boat, tumbling summersaults in the wake of our car. I had to stop the car in the middle of the narrow village street stopping all traffic behind me as the Mexican children laughed and pointed at the crazy gringos hurriedly trying to lash their bikes back on the car. Tripp laughed along with them thoroughly enjoying the situation… It wasn’t till I repaired the damaged bike that I could enjoy the comedy of the situation.

Proyecto Puentes de Salud: The Mission and Purpose

2006-07-02T13:58:00.000-05:00

Our founding goal is to serve as a “health bridge” between underserved Hispanic/Latino communities and needed health services, to ameliorate health care inequalities. To achieve this we are working with community members of Juventino Rosas, Mexico to provide free services to underserved and disadvantaged municipalities surrounding Juventino Rosas. We are conducting primary research through survey and data collection to better understand the risk factors for cardiovascular events and contraction of HIV in the Hispanic/ Latino population both in Mexico and the large immigrant population in the US where the project will continue in the fall of 2006. Our interests our bimodal; we have selected these two topics based on an early investigation in Juventino Rosas where doctors and lay health workers were interviewed about the primary health concerns of the region.

We are currently working to provide accessible HIV screenings to the communities of Juventino Rosas and are presenting original public health classes about HIV and Sexually Transmitted Infection. Our free consults consist of a primary risk assessment followed by the the Oraquick® Advance™ Rapid HIV-1/2 Antibody Test and a discussion of risk reduction strategies. During this interaction we complete an anonymous questionnaire to learn more about the knowledge base and risks of HIV in this population. We are also specifically looking at the relation of risk in the local population and immigration as the majority of the men in the communities we are visiting are working in the US.

With the help of Dr. Mauricio Cohen we were able to add a thorough cardiovascular component where we provide Blood Pressure, BMI, Blood Sugar, and Lipid screenings, as well as counseling and education about diabetes risks and prevention. Following the screening participants are giving a consult regarding their results. During this session we talk about about the risks of hypertension and heart disease, and ways they can improve their health through diet and exercise. When there is immediate need for medical intervention present we are able to directly refer participants into the local medical system. We have close contacts in both the public and private sectors of the local medical services. At least twice a week we are offering classes on Cardiovascular Health.

This project is intended to promote the long term Sister-City relationship between Juventino Rosas and Carrboro, NC, and to establish a long term medical affiliation between UNC School of Medicine and the medical community of Juventino Rosas. Our project will allow medical students motivated to work with Hispanic/Latino populations in North Carolina to experience the culture and medical system of Mexico (where many of their future patients first experienced health care).

We hope to reduce the incidence of new HIV infection among the underserved populations of JR by providing culturally sensitive HIV/AIDS prevention education, community outreach programming, and HIV screenings. We hope to strengthen and facilitate knowledge and understanding of the risks of diabetes and hypertension among Juventino Rosas community members, by providing free screenings and consultations. Finally, we hope to reduce the risk of a cardiovascular event and reduce the complications of long term diabetes for the hundreds of participants that will benefit from our screenings.