LEARNING FORUMS

Nurturing a Healthy Border Region: The Potential of Philanthropic Collaboration

BPP COMMUNITY HEALTH - THEMATIC MEETING

October 19 and 20, 2007 - Tijuana, Baja California

EXECUTIVE SUMMARY

VIEW MEETING PHOTO GALLERY

VIEW FULL SESSION NOTES

On October 18-20, 2007 40 representatives from 12 border community foundations, 2 academic institutions, and 9 nonprofit organizations from both sides of the border convened at the Community Health Thematic Meeting in Tijuana, Baja California. The meeting included representatives from the U.S.-Mexico Border Health Commission Ambassador Eleazar Benjamín Ruiz y Ávila as well as keynote speakers Mario Guiterrez from The California Endowment.

The objective of the meeting was to provide border community foundations with information about border health challenges and possible strategies to address these issues. Within this, the meeting agenda aimed to identify two or three top priority issue areas that border community foundations and other border funders could work on together to make an impact on border health. In bringing together a diversity of organizations and community foundations, the meeting also strove to facilitate collaboration and leveraging of resources with other border partners, including the US-Mexico Border Health Commission, health conversion foundations, and corporate funders.

On the evening of October 18th, the meeting commenced with a relaxed and informal dinner that provided participants with the opportunity to meet with colleagues. During the dinner, representative from Fundación Internacional de la Comunidad and the International Community Foundation welcomed participants and shared a preview of a documentary video on border health, co-produced by the two foundations titled ‘Fragile Lives: Blurring Lines: Addressing the Critical Health Challenges in the San Diego-Baja California border region’.

The following morning, the meeting opened with a panel discussion that provided background context for themeeting. Panelists included Dr. James Gerber of San Diego State University, Dr. Lawrence Kline, of the U.S.-Mexico Border Health Commission and  Dr. Maria Gudelia Rangel, from the Department of Population Studies at the Colegio de la Frontera Norte. Panelists describe the statistical data, and characteristics that that define the US-Mexico Border region. Dr. Gerber utilized the results of the Human Development Index, which analyzes the current state of the border through combined measurements of income, health, and education. Dr. Kline presented statistics for the region, which is first in the number of children living in poverty, second in incidence of TB, third in death from Hepatitis and Diabetes, and last in access to health care within the United States. Dr. Gudelia, presented on the role of public policy in addressing border health issues. Dr. Gudelia stressed that the border region is an area of cultural integration, characterized by issues of cultural interaction, urban development, safety, and migratory flow.  Panelists agreed the need for collaborative, cross border and integrative approaches to addressing bi-national health issues. 

The following session provided a unique opportunity for knowledge exchange. This “Learning Bazaar” featured five cases of initiatives that cross international and geographical divides to address critical border health issues. Participants were invited to attend three of these five topic groups, which were held simultaneously in 45 minute increments.

• Blanca Lomeli, Director of Project Concern International’s Border Health Initiative, presented the case of Solucion TB. This project arose from the collaborative work of Project Concern International and Baja California’s public sector health department.

• Alicia Vera and Dra. Remedios Lozada, representatives from University of California San Diego (UCSD), presented on their experience partnering with Prevencasa to reduce the incidence of HIV/Aids in Tijuana and San Diego. On the US side of the border, UCSD researchers are investigating the transmission patterns of the virus, and how human behavior is affecting it. Within Tijuana, several Mexican public health agencies have partnered with UCSD and Prevencasa to distribute information, clean needles, condoms, food, and other health necessities.

• On behalf of the Pfizer Alliance for Healthy Border Initiative, Sally Munemitsu presented on the Organization’s grant program, which was designed to combat the disproportionately high rates of diabetes and heart disease within the border region. In an effort to reduce risk factors associated with these diseases, The Alliance created partnerships with community health centers and community-based organizations in the U.S. and Mexico.

• Claudia Ulloa from the Regional Center for Border health spoke about the innovative nature of the Community Access Program of Arizona and Mexico (CAPAZ-MEX), as well as the lessons they have learned over the past six years. As a Medical Discount Network, CAPAZ-MEX is a medical safety net serving the uninsured residents of Yuma County by providing access to professional healthcare at prices the uninsured can afford.

• Elisa Sabatini, Executive Director of Los Niños International. Elisa shared the story of this organization which has worked in the US-Mexico border region for more than 30 years providing nutrition and ecology courses to women and children’s groups. Following the courses, communities may participate in the micro-enterprise initiatives and or in future education where families develop more financial security with improved income and employment opportunities. 

After the Learning Bazaar, Keynote speaker Mario Gutierrez, Director of Rural and Agricultural Worker Health Programs at the California Endowment, discussed the powerful role of grant making in tackling critical community health issues. Within this, the presentation focused on the importance of knowing the values of your community and creating culturally competent granting guidelines and evaluation techniques.  Mr. Gutierrez closed by commenting on both the potential and imperative of grantmakers to strategically use their grant making power and investment power to influence healthier communities.

Following Mr. Gutierrez’s presentation, participants had the opportunity to choose from three potential site visits to local organizations that both struggle and innovate in order to confront complex border health issues.  The three site visits consisted of Prevencasa, a Mexican nonprofit organization that works on HIV/Aids prevention, Hospital General de Tijuana, and Fronteras Unidas ProSalud, an organization that provides sexual education to teens and bilingual health and human service programs to Mixteco communities.  Participants were deeply moved by the innovation and commitment demonstrated in all three projects.

The following morning, Ambassador Eleazar Benjamín Ruiz y Ávila of the US-Mexico Border Health Commission presented on health as an international right, stating the importance of building vertical and horizontal collaborations in promoting health-based programs. Ambassador Ruiz described how terrorism and 9-11 have raised obstacles and increased fear, leaving some to describe the U.S.-Mexico border region as an area of conflict. However, through collaborative efforts towards a healthier border, Ruiz affirmed that we are creating a new spirit in the border, one of social mobilization and responsible governmental cooperation on all levels. He invited all the community foundations to unite efforts, construct plans and projects, and act jointly in an atmosphere of mutual confidence.

 Building on the knowledge and ideas that were shared during the previous sessions, participants took part in action planning groups aimed at giving border community foundations the opportunity to consider questions that are critical to embarking on, or deepening foundation commitment to community health. The participants decided to break up into two groups. One group focused on access to care in the Sonora-Arizona border region, the other was centered on establishing priorities for Fundación del Empresariado Chihuahuense (FECHAC), Ojinaga.

The access to care action planning group discussed barriers and solutions to addressing health care as community foundations. As part of the discussion, group members concluded that the promotora model was a powerful strategy for education community members about health care issues. The topic group went on to discuss the role of employers in perpetuating health care inadequacies along the border, especially within maquilas. In determing next steps to take, the group concluded that tuberculosis, obesity, and diabetes are critical issues that they would like to focus on and that the promatora model could be a useful way of educating community members about these health concerns. The group also proposed highlighting the effects of maquilas on community health in the next learning community.

The FECHAC, Ojinaga action planning group proposed organizing a meeting between medical specialists living in Ojinaga and Presidio to initiate a conversation and establish a bi-national plan of action. The larger vision would also include working with groups from El Paso and Juarez. The next steps identified by the group included looking for a counterpart in Presidio and concentrating on illness prevention, through health campaigns and by supporting community health organizations. In particular, the group discussed the use of the promotora model and a focus on working with elderly, using the Border Philanthropy Partnership to network with other organizations.

Building off of the energy generated by the action planning groups, the meeting concluded with a plenary session lead by BPP Health Advisory Committee Co-chairs, Claudia Basurto, Fundación Internacional de la Comunidad, Tijuana and Richard Kiy, International Community Foundation and Ann Tartre, BPP Director. During this period, productive conversations were initiated on the implementation of strategies to mobilize communities to insight social change along the border. As part of this conversation participants discussed ways in which to incorporate the models presented during the meeting and establish a collaborative framework for addressing the health challenges that face their communities.  Another positive result was a deepening of the institutional relationship between the US-Mexico Border Philanthropy Partnership and the US Mexico Border Health Commission.