HealthWrights 2015 Report

Prepared by David Werner, January, 2016

This report provides an overview of some of the key activities that HealthWrights and I have been involved with in 2015. Although most of these summaries are quite brief, I’ve written in a lengthier form about two of our newer, more out-of-the-ordinary ventures: 1) A service program run by “disabled former-drug-users”, and 2) Promoting low-cost ecological housing. I do this in part because these are both atypical yet timely projects. (I will probably write about these ventures in future newsletters.)

Preparations for effective sharing of ideas, experiences, and methods of action for people’s health and rights

In 2015 I have devoted a considerable amount of my time and energy into creating a durable, widely accessible public record of my five decades of community-based work and writings in the arena of Primary Health Care, Community Based Rehabilitation, “education for change,” and grassroots action for the common good.

To this end, with help of HealthWrights staff and other friends and colleagues, we have been working on the following:

  • Revision and restructuring the HealthWrights website, for long-term, reliable, convenient access. We want to be sure that the site remains perennially online, with all our books, newsletters, workshop reports, videos and YouTube presentations, and educational materials, fully and freely accessible to a wide range of users. 
  • Many of our reader/users are health and rehab workers in poor countries, who tend to access Internet primarily on cellphones rather than computers. Therefore we are now putting all our new entries (newsletters, documents, etc.) into a “responsive” layout that automatically reformats pages according to screen size (computer, tablet, or cellphone) for optimal viewing. Within the next year or so we hope to get most of the key info on our site in this responsive layout. 
  • Also, after weighing the pros and cons, we have decided to convert from a service provider site to a “static” website, which appears to better for the long haul (no annual fee, less risk of hacking, better or public access of published material). Fortunately we have a committed nerd (Bill Anders) who is working on this at greatly reduced cost. 
  • We are also in the process of updating and reorganizing our site, to make it more user-friendly, not only for readers, but for those you are editing, and entering new material into the site. (We hope to become less geek-dependent) 
  • Organization and indexing of our online newsletters. We now have all 76 Newsletters from the Sierra online, over 1000 pages, with a wealth of material on a wide range of topics. But for readers to find what they are looking for is quite a challenge. A comprehensive but easy-to-use index is greatly needed. After considerable experimentation with different indexing approaches, we have finally come up with system that is promising. We have a gung-ho volunteer in Texas, Nancy Ender, who, has been working on the Index for several months, and is now making good progress. 
  • Autobiography. For several years now, off and on, I have been working on an autobiography. But this last year (mainly during summer in New Hampshire) I have been working on it more intensely. Mainly through a series of stories, much of the content records my long involvement in the struggle of communities (including, in later year, the disabled community) for their health and rights. However it also relates formative events and friendships from my childhood and youth – including my arduous trip, by bicycle, to Orient, where I took part in Gandhi and Vinoba’s Bhoodan (voluntary land reform) movement, and the Nai Talim (new education) alternative school system they set up for Dalit (untouchable) children. These exposures to grassroots movements for the empowerment and rights of the marginalized did much to influence the path I took in later life. The autobiography will be illustrated with many photos, and drawings portraying transformative events in my life. I hope this saga will provide ideas for young people trying to find meaning and a sense of direction in these troubled times. 

At this point the draft of autobiography is more or less completed and several friends have been helping with editing and proofing. But there are still new stories and insights I would like to add – if time allows. 

  • Reports from the Sierra Madre” – being the presentation in book form with many of my photos, drawings, and paintings, of the original four reports I wrote as a novice community health worker in Mexico’s western mountains – is now formatted and ready for print. I have approached both Macmillan Press and Editorial Pax Mexico (for the Spanish edition), and both are currently considering publication. 

To view the print-ready version, handsomely formatted by a friend in New Zealand, see


Notable Activities in 2015

  • Conferences and workshops. As usual, I gave a number of presentations and facilitated workshops, this year mostly in Mexico (Mazatlán, Culiacan, Coyotitán, and Mexico City. In Mexico City – at a national congress on “Disability and Human Rights,” where I gave the keynote address. Both Mari Picos (leader of the PROJIMO-Coyotitán Community Based Rehabilitation program) spoke on the importance of disabled persons playing a key role in programs concerning their inclusion and needs (i.e. Nothing About Us Without Us). This exposure of participants to community-based services provided by disabled peers stimulated so much interest that I was invited to visit and share experience in several community programs, including a blind-persons organization in Oaxaca.
  • A new PROJIMO-inspired program in Nogales. This November my friend Polo Ribota and I drove to Nogales to visit a new disability-aids-making program called ARSOBO (for ARizona-SOnora-Border), which to a large extent was modeled after the PROJIMO programs in Sinaloa. ARSOBO focuses on making personalized assistive equipment, and workers are themselves disabled. In fact, the persons recruited to head the wheelchair shop and the prosthetic shop are both former workers at PROJIMO. ARSOBO’s wheelchair shop is run by Gabriel Zepeda, who first went to PROJIMO-Ajoya for his own rehab after he became paraplegic, and eventually became a master wheelchair builder. Gabriel helped train the first batch of disabled workers in the (at that time) new PROJIMO Duranguito wheelchair program, and later helped disabled teams set up their own wheelchair-making shops in the states of Nayarit and Colima – and also in Guatemala.

Accompanying us to ARSOBO was Tomas Magallanes, a 39-year-old friend disabled by polio who first came to PROJIMO-Ajoya for leg braces when he was six years old, and who, after he grew up, joined the PROJIMO Duranguito wheelchair-making team. Tomas went with us to Nogales in hopes of learning new wheelchair-making skills from Gabriel, and ARSOBO welcomed him to apprentice there with open arms. Thus things go full circle

An account of the ARSOBO program will be included in one of our next newsletters.

  • New challenges for the PROJIMO teams. Both PROJIMO programs (in Coyotitán and Duranguito) have for many years received funds from Stichting Liliana Fonds, a charitable foundation in Holland, to provide children from poor families with the rehab services and equipment they need. However the long economic crises in Europe has caused a drastic financial setback for Liliana Fonds. From having assisted in 80 countries at their peak, they have had to cut back to only 30 countries – and are now pulling out of Mexico. This creates a major problem for PROJIMO Duranguito, which has depended on Liliane funds to help poor families cover the costs of the wheelchairs and assistance for their children. So at present the Duranguito team and its friends are busily hunting for new funding sources, to help destitute families cover the costs of wheelchairs they receive – and thereby the salaries of the disabled wheelchair builders.
  • A new service program run by disabled former drug-users – a potential win-win solution. Another critical issue that the PROJIMO Duranguito has encountered is that a number of its disabled workers have acquired debilitating drug habits – including use of highly addictive psychotropic drugs like crystal methamphetamine. In Mexico today, especially among young people, the extremely prevalent use of such drugs has become an endemic social problem. It is therefore no surprise that some of the disabled workers in Duranguito – a village with rival drug gangs where a substantial percentage of youth use drugs – get hooked. 

Ironically, of the Duranguito team, those with the worst drug problems have been some of the best, most caring workers: those most concerned that the wheelchairs they build meet the child’s needs. But as their drug-use increased, their reliability and the quality of their work deteriorated so much they were asked to leave the program – which for some has been disastrous. 

We (HealthWrights and others) have helped some of these habituated disabled workers to partake in AA-type drug rehab programs – mostly run by former addicts – which abound in urban Mexico. When they get out of rehab, they tend to be strongly committed to stay off drugs. But soon – and repeatedly – they relapse. This is largely because they return to the same heavy drug-use environment. And as disabled persons subject to discrimination, unable to find jobs, they get depressed, seek company of others who are down-and-out, and slip back into drug use. As disabled persons with a history of drug dependency, they have a double handicap. 

In today’s world there are programs for disabled persons. And there are programs for former drug addicts. But there are virtually no programs for disabled former drug users. The need of such programs – preferably run by disabled former drug addicts themselves – presents a clear and present challenge. 

In talking with some of these disabled former drug users – who are trying to stay off drugs, and to earn a living and do something meaningful with their lives – the idea for new sort of program was born. A service program run by disabled ex-drug-users. A program that could give its members a sense of dignity and purpose, help them gain public appreciation, and hopefully lead to income generation.  

So it was that “HABILÍTATE Mazatlán” (ENABLE-YOURSELF Mazatlán) was conceived. (The group added “Mazatlán” to the name because most of the group lives in the beautiful but troubled coastal city of Mazatlán.) 

Since the majority of the new group’s members have a history with the PROJIMO programs (from which a number have been thrown out) they decided to orient their service projects toward helping meet the needs of 1) disabled children, and 2) the PROJIMO Duranguito wheelchair program. So they planned their objectives as follows: 

  • To identify disabled children who need specially adapted wheelchairs, and to arrange for PROJIMO Duranguito to make them the chairs.
  • To initiate a follow-up program to visit the homes of children who have received Duranguito-made chairs, to see how well the chairs are meeting the child’s needs.
  • To set up a repair shop in Mazatlán to repair wheelchairs, from Duranguito and elsewhere. (Already a club of disabled persons has offered the use of a building for the workshop and office. And someone is donating tools)
  • To find socially conscious sponsors (individuals and groups) in the Mazatlán area who will help cover the cost of a wheelchairs for an individual children in need. (This is urgent, since Stichting Liliane Fonds is pulling out of Mexico.)
  • Try to get cooperation and funding assistance from different government programs for the various HABILÍTATE activities. (Already one government office has promised to provide voucher for the of fuel to visit children’s homes)
  • To start a “Child-to-Child” program, visiting schools to help awaken schoolchildren to the importance of welcoming and including children who are different. (Already Rigo Delgado, a quadriplegic psychologist who has facilitated Child-to-Child activities in periurban migrant communities near Culiacan, had offer to work with the HABILITATE group. … See our Newsletter #68 about Rigo: ).

While HABILÍTATE Mazatlán is still in its formative stages, it is showing a lot of promise. It is generating a lot of interest, and its members – who were at loose ends and struggling to stay off drugs, are totally involved and enthused. They are holding meetings, meeting with prospective sponsors, and have already begun their own website – all on their own initiative. The have met with the members of family organization of disabled children (who are now grown up and run the program) which is providing HABILÍTATE with a large building for their wheelchair workshop, free of charge, and who want to become involved. So HABILÍTATE is breathing new life into a group of disabled persons who continue to meet but had largely lost a sense of direction.

For me, all this s a new and exciting adventure – and a chance to be a catalyst in a new, groundbreaking venture – both for and led by persons who are doubly disadvantaged: through disability and (past?) use of dependency-creating drugs. The new program is still partially a dream. It is bound to have its catastrophes, and perhaps even come to a screaming halt. But the same is true of humanity as a whole. Yet the challenge to nurture the best in all of us remains vital and keeps hope alive. Spero spiro. (Where there’s breath there’s hope.)

  • Extension of Child-to-Child activities for inclusion of disabled children. There is expanding interest in Mexico (and beyond) in using the Child-to-Child discovery-based approach to promote the inclusion of “children who are different” in schools and communities. In Sinaloa, this take-off of Child-to-Child is in large part due to activities, workshops, and presentations facilitated by persons affiliated with the work of the PROJIMO programs and HealthWrights. Rigo Delgado’s extensive projects with school children in this area has created a lot of interest, not only in the Culiacan area works at the university, but also with prize-winning demonstration projects he has facilitated in other states and in Mexico City. (See reference to Rigo, above.) I too have held numerous Child-to-Child workshops with disabled children and non-disabled children in several states – including in Michoacan with the Ministry of Education – and in many countries. 

This past spring, in the one-room school in the village of Tablón #2, Sinaloa, we organized Child-to-Child activities around the needs of a very timid child with muscular dystrophy. Since the boy had great difficulty walking to school over a rough trail to the school, the Duranguito wheelchair program made for him an ingenious “spider-mobile” (an all-terrain wheelchair with several long spider-like arms extending from it) so that six or more children could push and pull it at once. This way a group of children eagerly helps transport the boy to and from school every day, and a strong sense of comradery has developed between the disabled boy and his schoolmates. For the full story see our May 2015 Newsletter 76, “Making a One-Room Village School More Accessible for a Nine-Year-Old with Muscular Dystrophy”:

  • Promoting LOW-COST ECOLOGICAL HOUSING. My home in Mexico at present is in the small village of El Tablón Viejo, a half-hour south of Mazatlán. When, in 2009, my friend Polo Ribota offered to build me a house there next to his, we decided to build one that was ecologically friendly (low carbon footprint), comfortable (cooler in hot weather), secure (hurricane and earthquake resistant), and culturally attractive (built with traditional materials and techniques), all at relatively low cost.

Part of our reason for building this “eco-casa” – apart from comfort, aesthetics, and low carbon footprint – was to create a kind of “showcase” or “idea kit” for neighbors to see and muse on. I wanted them to see the benefits, in home-making, of returning to some of the old traditions, so as to live in a more comfortable home while saving both energy and money.

Currently low-cost housing today in Mexico tends to be disastrous on several counts. While the very poorest families live in casas de cartón (cardboard shacks), those a little-better-off mostly dwell in “modern” cement-block huts rooved with corrugated sheet-metal or, for those who can afford it, concrete slab. Unfortunately, in the tropics, such homes are ovens. To avoid heat-stroke, families spend a good part of their meager earnings on electric fans – or even air conditioners – which strains both the family and environment. (The weather gets hotter and water-table lower every year. More sweat. Less to eat.)

Another ecological cost in building with cement lies in its energy-intensive production. Limestone is converted into cement in huge ovens. This burns so much fuel that the huge amount used worldwide for myriad buildings and roads makes the cement industry a substantial contributor to climate change.

By contrast, use of adobe has a very low carbon footprint. It also insolates far better than cement. Traditionally, Mexican houses (and even churches) were built with very thick adobe walls, with tiny, porthole-like windows, to keep them cooler inside. Rooves, when not thatch, were made of hand-made tiles, and typically had an under-roof of woven carrizo (like bamboo) coated with mud. These solid earthen houses kept relatively comfortable inside, even on the blistering summer afternoons.

My “eco-house” in El Tablón is eclectic, combining both traditional and “modern” materials as seem fit. It does use a limited amount of cement. The walls – for safety and durability, as well as good insolation – are made of extra-thick adobe bricks, framed within reinforced-cement uprights and beams. The roof – for insolation that discourages the scorpions, bugs, and rats that infest thatch or tile – is made with large rectangles of Styrofoam set within a lattice of cement beams.

The energy-neutral underground cooling system consists of 100 meters of plastic tubing that twists back and forth, one meter underground. Air circulating through this buried tube is radiation-cooled by the adjacent earth, and empties into the bedroom near the bed. The air is propelled through the tube by a small fan powered by a solar-charged battery.

Large, double-paned windows provide good daytime lighting (and hence less need for electric lights) while insolating against outside heat and noise.

A variety of shade-bearing trees, mostly draught-resistant, insect-repelling neem (from India), surround the house, keeping it cooler and adding to its appeal.

The outcome of this eco-friendly house. The result are fairly impressive. In hot weather the “eco-casa” averages 10 degrees cooler than Polo’s typical cement-block, cement-roofed house next door. It is cooler, quieter, better-lighted, and has a lower electric bill, because it uses less electricity for cooling and for lighting.

Possibilities for replication. Although I’d hoped the coolness and comfort of my eco-house would inspire similar construction by other people, in in the six years since the house was built, the only other buildings I know have incorporated some of its features (notably thick adobe walls and Styrofoam-insolated rooves) have been three of the houses in PROJIMO Duranguito wheelchair program.

However, it looks like interest is picking up. Just this past November I got an enthusiastic message from “MIUAS” (Multidisciplinary Group of Students and Ex-students from the Autonomous University of Sinaloa.) This idealistic group engages in down-to-earth activities to help build a fairer society where people “learn to work, not competitively, but cooperatively for the common good, and to respects one another as equals.”

A current project of MIUAS, called Ciudano Embrión (Embryonic Citizen) cooperates with the impoverished people in a squatter settlement called Bicentenario, next to the city dump in Culiacan (the state capital). One of the group’s activities is to involve the children in working together to meet their basic needs (including health) and to improve the environment.

Another of their projects is to involve families in collectively helping to build their own, more livable houses. These houses are conceived to be (I translate literally):

  1. cheap
  2. ecological
  3. durable
  4. true to local climate and geography of the region
  5. emblematic of the cultural expression of the dwellers (that strengthen cultural identity)

Somehow MIUAS had heard about my “eco-casa” in El Tablón, and were eager to use it as a prototype for building the environmentally friendly casas in Bicentenario. They have asked me and Polo to be advisors on the project, and specifically the design of the first house, for which they already have modest funding. While I have explained to them we are neither architects nor experts on ecological design, they are very eager that we work with them. They have come to visit and photograph the house in El Tablón, and asked us dozens of questions about its design, the building materials, the costs of each component, and what we consider the strengths and problems with different features.

So it looks like, at long last, my eco-casa in El Tablón is becoming the “idea kit” for replicating the concept of ecologically friendly housing that help people live more comfortably with less use of energy and at lower cost.

In today’s troubled world, such environmental considerations should definitely be an integral part of Primary Health Care and the effort to achieve sustainable Health for all.

Plans for the future

In this coming year (2016) I again hope to spend a fair part of my time writing up and organizing the adventures and experiences I have had in 50 years of community health- and disability-related activities. This will include work both on our website and on my autobiography – and hopefully some YouTube presentations of some of my workshops in Child-to-Child and bottom-up Community Based Rehabilitation.

However I continue to be involved in a variety of new projects and exchanges. While I have been trying to cut on international consultancies and workshops, some invitations sound too fascinating to pass up.

The possibility of a workshop with disabled children and their families in the refugee camps of Algeria, is still pending.

And in May, 2016, I plan to visit a project in rural Thailand, with SHARE (the Japanese NGO whose community health initiative I visited in East Timor in 1912 (See our Newsletter #69: ). Several years ago SHARE began working with the impoverished tribal villages in northern Thailand, initially focusing on the common maladies of childhood (diarrhea, etc.) But villagers begged them to help cope with the devastating, rapidly spreading problem of AIDS. So that is what they are trying to do now, as a part of a comprehensive endeavor in Primary Health Care. They would like my input, with possible Child-to-Child workshops – in part because so many children have lost parents. While I have little experience with HIV-AIDS community efforts, I have a lot with Child-to-Child, and I look forward to contributing whatever I can.


As you see, HealthWrights and I continue to be involved a wide range of innovative activities in the fields of Primary Health Care, Community Based Rehabilitation, and the empowerment of disadvantaged people. Our writings and educational materials help disseminate these methods and ideas internationally. As I have explained, at this stage in my life I am putting more time and energy into documenting what I would most like to share.