Carmen's story

	Carmen poses with her MAKI brand honey - named after her daughter, Makensy.
	Not only does Carmen make her own honey, but she's also branched out to making other flavored treats.
	Carmen adds honey flavoring to homemade popcorn.

Carmen was born with a knack for business. "I could even sell stones," she jokes. The key to her blossoming career is personalized attention and persistence – she once spent an entire day marketing honey to a single restaurant. Yet, before Carmen could focus on building her now thriving honey business she had to first overcome a dangerous and often deadly disease – multidrug-resistant tuberculosis (MDR-TB) – a challenge she won with the help of PIH’s sister organization in Peru, Socios En Salud (SES). 

“Even before I was sick I knew I wanted to go into business,” recounts Carmen. Born and raised in Vino de Oyococha, a small and very poor town in Peru’s Huancavelica region, she was keenly aware of the challenges her family and friends faced because of poverty. 

“Everywhere you looked there was malnutrition and tuberculosis,” Carmen recalls. “I worked all the time, for other people, for myself. But I could never make enough money to get ahead.”  

So in the late 1990s, while she still was still in her teens, Carmen travelled the six hours north from her hometown of Vino de Oyococha to Lima, Peru’s capital, to study at the Servicio Nacional de Adiestramiento en Trabajo Industrial, a large industrial training school that prepared students to work skilled factory and apprentice-type jobs. A quick study, Carmen was admitted to the school, and found a job in a local textile factory after graduation. She met her husband, and shortly thereafter their daughter Makensy was born. 

Yet their happiness was short-lived. Not long after giving birth, Carmen was diagnosed with tuberculosis. An already difficult situation was made worse when her husband left her, fearing that he too would become sick. Carmen suddenly found herself homeless, seeking TB treatment, and weighted down with debt. Overwhelmed, she was eventually let go from her job. 

Despite feeling isolated and stigmatized by her illness, Carmen was motivated to recover her health. But by the time she was able to access treatment, her disease was relatively advanced. "I weighed 29 kilos [64 pounds],” says Carmen. “I would walk half a block and be so out of breath that I could not advance." 

Because she was unable to take her medication every day during the required six-month treatment, Carmen underwent treatment three times before finally developing MDR-TB. While TB is curable, treatment requires that a consistent regimen of drugs be taken every day for six months. If a patient only partially overcomes the infection, he or she will develop MDR-TB – a dangerous strain of the disease considered incurable in resource-poor settings like Peru until relatively recently.

It was then, after seeking out care with SES in Lima, that Carmen began to heal. “The doctors told me, ‘This is your last chance to live – MDR-TB will kill you, you’ve been infected too many times.’” 

She agreed to be quarantined, and to take medicine every day for two years – the only cure for MDR-TB, one that often comes with painful side effects. SES offered Carmen medical and social support – a safe and stable home, food, water, and childcare – in order to offer her the best possible chances of overcoming the disease. “I felt sure it would heal me,” says Carmen. “I knew this was my last chance.” 

As Carmen regained her strength and health, SES staff asked if Carmen wanted to enroll in the program’s microloan program, which requires intensive training and mentoring. Carmen immediately agreed. After developing a business plan, she was given 1,200 Nuevo Sol ($432 US). Soon, she began bottling and distributing honey.

Initiated in 1994, SES’s program helps MDR-TB or HIV patients start their own small businesses, gain economic independence, and reintegrate into their communities. Recipients are required to attend trainings in formulating business plans. Staff accompany patients until they solidify their business and are able to return the loans. 

“The most important thing is to listen to customers and provide quality,” recounts Carmen. Driven by this conviction, she was soon running a thriving business. Yet, there was something important she still needed to do. “I also knew that I wanted to create jobs for rural people.” 

So Carmen – now healthy and independent – returned to Oyococha. “You cannot educate without nutrition, and cannot be an entrepreneur without education,” says Carmen. “My goal is to help people in the position I found myself.” 

Built on these relationships of trust, Socios En Salud’s income generation program has been quite successful. In 2008, 55 new businesses were started, and 15 patients reentered the labor market. In 2009, 64 interest-free loans were provided to patients, and an equal number of businesses were started. And in the first half of 2010, more than 30 new businesses were launched, and at least 17 patients reentered the labor market.