Las Delicias’ Micro Health Insurance Program

“My experience in Las Delicias continues to linger in my mind and pave my career path. I’ve watched a mother like Lupe break into sobs of happiness after working to earn her family a clean unit to store water for bathing and washing dishes and clothes. I’ve witnessed a community like Las Delicias take charge of their own health when provided with the right kind of investment. I’ve seen an inspired idea turn into something real and beneficial.”

- Maithri Vangala, Former Micro Health Insurance Specialist

FIMRC established the Micro Health Insurance Program in June 2008 to assist the community achieve a higher level of baseline health at Project Las Delicias in El Salvador. Because FIMRC strives for sustainability and innovation, these components are key in the Micro Health Insurance Program.  MHIP is the first non-monetary model of health insurance that combines health education and community development projects with improved access to medical services to provide comprehensive health care for the entire family, all at zero financial cost to participants. Through MHIP, individuals participate in health education sessions, home visits, community-wide health events, monthly wellness visits, and quarterly feces exams to prevent and treat the spread of parasites.


How It Works: Education and Access

Education and improved access to medical services are the key components of MHIP and are fostered through five major initiatives.

  1. Health Education Sessions: FIMRC strongly believes that education is essential to avoiding preventable illnesses and improving overall baseline health. Weekly health sessions presented by MHIP staff and FIMRC volunteers address both immediate and long-term health concerns of individual families and the community at large. Past topics have included nutrition, health and hygiene, upper respiratory infections, and breast cancer.
  2. Home Visits: Once participants are informed of potential health risks and how to prevent them, they must demonstrate application of this knowledge and a pro-active attitude towards health. MHIP staff conducts regular home visits to monitor and reinforce the application of all information shared during the health lessons.
  3. Community Participation: A child’s health is affected by both the home environment and by the health conditions and practices of the community at large. MHIP participants organize and implement projects and health related events that encourage community-wide positive behavioral change.
  4. Monthly Wellness Visits: MHIP participants attend monthly wellness visits to monitor healthy growth and development and to catch any illness before it becomes too grave. Monthly visits also foster trustful and communicative relations between the attending physician and participants.
  5. Quarterly Feces Exams: Parasites and worms are unfortunately a fact of life for many children in the developing world. In addition to education on proper food preparation and treatment of drinking water, MHIP provides quarterly testing of feces and treatment in the event a child is diagnosed with parasites or worms.

Each initiative of the Micro Health Insurance Program is important in developing self-efficacy in the community and increasing knowledge, medical adherence, and skills to achieve a better health status. Because of active participation, the individuals place more importance on their own health as well their family’s heath status.

In return for adherence in the various components of the Micro Heath Insurance Program and positive health changes, participants accrue health credits, which can be used to “purchase” tangible goods that improve baseline health. Examples include water filters, mosquito nets, and concrete floors.

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This month at Project Las Delicias, the Staff has been working with community to teach charlas, or health education lessons, about the prevention and maintenance of diabetes. The group is planning more initiatives as the summer goes on, including a group focused on preventing parasites in school-aged children.

FIMRC’s former Micro Health Insurance Program Specialist, Maithri Vangala, shares her experience working with the community in Las Delicias, El Salvador to achieve better health. Her personal account shows us not only how the community is positively affected by the program, but also how we as Volunteers, Ambassadors, Fellows, and public health professionals can learn and grow from teaching and interacting with communities like Las Delicias. Read her post on Medium to learn more about the Micro Health Insurance Program and to stay up to date as she posts about events and new ideas from the GBCHealth 2013 Conference and Awards May 15-17th, 2013.

Maithri’s Post on Medium

GBCHealth Conference Site

Interested in replicating this program? Please contact FIMRC at

March Madness – Project Peru for the Win!

March was a very busy and exciting month at Project Peru with Volunteers from University of Michigan, Penn State University, Purdue University, Missouri State  University, University of Texas Southwestern Medical School, and Indiana University of Pennsylvania!

During the first two days for Volunteers at Project Trujillo, the Volunteers split into two small groups and each group visited a different clinic – el Bosque and Club de Leones.  Volunteers were able to shadow a variety of doctors, including nutritionists. The group also gave two charlas in an extremely impoverished neighborhood outside the city – Nuevo Jerusalem; one to a group of children about dental hygiene and one to women about high and low blood pressure signs and symptoms. The following day the group spent the morning at a local hospital – La Noria; some Volunteers observed in an emergency room, others in a dentist’s office. That afternoon back in Nuevo Jerusalem, the Volunteers spent the afternoon taking heights and weights of children to determine which children were malnourished. On their last day in Trujillo, half of the Volunteers returned to the hospital from the day before and the other half visited a physical therapy ward in a large hospital. In the afternoon, they went to orphanage with sports equipment and played with the kids.

In addition to touring Huancayo and shadowing doctors at Carrion Hospital, Volunteers in Huancayo were able to visit immobile patients in their homes with the staff from Concepcion Health Center.  They visited 26 patients and aided in exams such as taking blood pressure and temperatures.

One of the biggest successes Project Peru had in March was with their partnering agency, United People, when they were able to provide fluoride treatment to 3,000 students! In addition, the Volunteers gave talks about dental hygiene, donated toothbrushes and toothpaste.


Other activities included a hygiene charla at an orphanage, which included an interactive hand-washing demonstration. Since the hospitals were on strike, the Volunteers spent one morning campaigning with Peruvian medical students for donations for a jungle medical health brigade they are planning.



With such an exciting month of March at Project Peru, we are excited to see what else can be accomplished at the Sites of Huancayo, Trujillo and Agallpampa! Thank you to all of our Global Health Volunteers who helped to make March at Project Peru a success and aided in created healthier communities surrounding the Sites!



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Thanks to the girls of Indiana University of Pennsylvania for the photos!




Site Update: Project Kodaikanal


It has been a busy Spring for FIMRC’s nine Project Sites! Throughout the Spring, we try to highlight our Chapter’s Global Health Volunteers on their Spring Break trips but we are so excited about the progress of children in the crèches and health education at Project Kodaikanal, we just had to share! Enjoy!

Our Site at Project Kodaikanal in India has seen many patients recently at the rural clinic for follow-ups from initial check ups. As a result of a new, in-clinic pharmacy patients are able to receive their medications directly from the clinic instead of visiting a pharmacy after their check ups which makes it easier for patients to adhere to their doctor’s suggestions and better health outcomes.



Doctors were able to visit children for routine examinations in the crèches and have noticed positive development in the children, although there were some cases of the common cold and upper respiratory infection. The crèches are vital to Kodaikanal’s community. The crèches are a combination of school, day care center, and health center for children between 2 and 5 years old. The crèches provide basic shelter, food, education, and care for the young children in the surrounding communities. The Staff at Project Kodaikanal provides comprehensive health care for every child in the Nathanael and Joshua crèches each week for routine checkups and treatment for illness. The crèches are so important for the community because they allow for older children in the families to return to school instead of watching after their younger siblings. FIMRC has found that attendance in the crèches has increased after our medical and nutritional interventions that ensure that children are receiving an adequate amount of calories each day in addition to their weekly check-ups.

The Site held a workshop on dermatological conditions common in the Kodaikanal community. Due to overcrowding and living in a congested environment, many skin infections, such as impetigo and contact dermatitis, are common. The dermatological workshop had 85 participants and was followed by a quiz competition for the participants! Although learning about skin conditions is not the most glamorous subject, incorporating the quiz with small prizes for those who have scored the highest allowed for a fun competition for participants!


Because of crowded living conditions in the community surrounding Project Kodaikanal, it is especially important the community to learn about basic health and hygiene. FIMRC’s Field Operations Manager was able to meet with the teachers in health education sessions and the teachers are now conducting health education sessions for students and their parents. We are excited to see how the information is used by the community and are hoping for a decrease in communicable diseases as a result of increased education!


Project Kodaikanal

Community Health Educators Program – Project Bumwalukani

Nate Cohen was Project Bumwalukani’s amazing FIMRC Ambassador last Fall. He has shared his experience working with FIMRC’s Community Health Educators Program as well as the Program’s success in empowering the community at Bumwalukani! Enjoy!


The first thing you notice is mud. Mud is everywhere in Bududa district. The combination of heavy rainfall, clay-like soil, and high elevation makes it a daily fact of life in this remote corner of Uganda. Though they seem to be locked in an almost Sisyphus-ian struggle against the mud, the heat, and the ever-encroaching jungle, the roughly 150,000 people who live in the foothills of Bududa manage to scratch a living out of the mountainsides. The Foundation for International Medical Relief of Children (FIMRC)’s Project Bumwalukani is nestled on one of these mountainsides overlooking the Manafwa river. The clinic is small, less than 1,000 square feet, yet sees about 1,200 patients a month, more than any of the local government facilities save the district hospital about 15 kilometers away. Four clinicians, three staff assistants and two lab technicians manage this patient flow, providing both pediatric and adult services.  In attempting to address the vast health needs of the communities where they work, FIMRC uses a two-part approach, one component of which is the actual hands on medical care provided by clinic staff. The other element of FIMRC’s approach is based on community outreach and education.

            To this end, Project Bumwalukani has created a network of health volunteers. This program, the Community Health Educator (CHE) program, has been expanding and growing in Bududa district since 2009. There are now 24 CHEs based out of FIMRC’s clinic. These CHE’s are each responsible for their own individual catchment areas, usually incorporating 3-4 small villages (about 600-1000 people). While this only scratches the surface of the districts needs, it has had a vast impact on FIMRC’s ability to engage with the community and address its health needs and concerns. The CHEs are a diverse group, about equal split between men and women, varying in age from 19 to 74. The group includes 3 teachers, 4 pastors, 2 village elders and a taxi driver.

The CHEs are trained on a wide variety of health topics, primarily nutrition, sanitation, maternity and child health issues, malaria,immunizations, and wound care. This training allows them to serve as a first-line of treatment and evaluation for many of the members of the community, and about ¼ of the patients seen by FIMRC’s clinic on a monthly basis are referred by CHEs. FIMRC’s CHEs are equipped with basic first aid supplies, as well as low-level painkillers like paracetamol and ibuprofen and deworming medications like Albenazole. As the name would suggest, the CHEs also frequently participate in outreach and education efforts in their communities and at local schools and churches.

The day-to-day working of one of FIMRC’s CHEs involves an impressive amount of walking. CHEs are frequently sought out for medical assistance, but the most substantial part of their job involves home visits and health check-ups in their catchement areas. Given the lack of digital and cellular communication options, sending a CHE on a follow-up visit is often the only way for clinic staff to get updates on a patient’s condition. This can sometimes involve upwards of 20 km of walking up hillsides between 1500 and 2500 meters of elevation. I once hiked 12 km to do a follow-up on a child we’d seen at the clinic a few days before with one of our CHEs named Penina, who was 32 weeks pregnant at the time. Many of the CHEs also lead community groups sponsored by the clinic.

The idea of the CHE program is to empower members of the community FIMRC works in to address as many of the health needs of their families and neighbors as possible, while at the same time reaching an ever-increasing number of people in need of care. I had to cancel a training session with the CHEs in late November because of an emergency at the clinic, and they decided to meet anyway so they could discuss how their communities were doing. This is demonstrative of the most compelling and sustainable aspect of this model: the dedication with which the CHEs approach their work. Despite being unpaid volunteers, many CHEs frequently put in 30-40 hours a week of work, and their commitment to their communities is absolute. By creating an environment of ownership and investment, FIMRC has been able to engage the local community in a way that would be impossible for international workers to accomplish.


Community Health Educators at Project Bumwalukani

Community Health Educators at Project Bumwalukani

Ambassador Nate Cohen

Ambassador Nate Cohen