In Rural Mexico, PIH Community Health Workers Accompany COVID-19 Patients

Each day from 9 a.m. to 1 p.m., Leini Escalante works at a community clinic in rural Chiapas, Mexico, helping clinicians care for COVID-19 patients. In the middle of the day, she returns home to feed her two children. Then, she heads out again to do home visits with patients who are in isolation.

What may feel like a packed day for some is just a typical day for Escalante, a community health worker with Compañeros En Salud, as Partners In Health is known locally. And her work is critical, especially these days.  Since early March, at least 7,874 people have become infected with COVID-19 in Chiapas, a state in southeast Mexico where 76% of people live in poverty.

Compañeros En Salud works with nine rural communities in the coffee-growing Sierra Madre region of Chiapas. As part of that work, CES hires and trains local residents like Escalante to serve as community health workers, helping patients manage their medications and understand their health status. Currently, CES employs 99 community health workers.

Escalante has been a community health worker (CHW) in the community of Honduras de la Sierra for about four years. She was inspired to become a CHW after living in front of the clinic and constantly seeing other women in her community participating in trainings, visiting patients’ homes, and developing the knowledge and skills to provide care. For many years, she focused on maternal health. But in September, when the pandemic reached its peak in rural Chiapas, Escalante’s work took a new turn—she decided to shift her focus entirely to COVID-19 patients.

In the months since, Escalante has spent her time caring for COVID-19 patients in isolation and supporting the community clinic. She is one of two CHWs entirely focused on COVID-19 patients. In Chiapas—a historically marginalized state with barriers to accessing quality health care, few PCR tests for accurate COVID-19 diagnosis, and a three-hour ride to the closest hospital—her work is essential.

When patients have respiratory symptoms and arrive at the clinic, they are screened and sent home for isolation; there, Escalante visits them regularly. If they have risk factors like diabetes or hypertension, she visits daily; otherwise, she visits every 3 days.

Escalante also supports PIH’s contact tracing team in Chiapas, identifying people who have been in contact with a confirmed or suspected case and keeping an eye on them in case they present symptoms.

“I really like my job, because I feel like I’m doing something worthwhile,” says Escalante. “I help my patients, I talk to them, their families, answer their questions, and earn their trust. It has also been very helpful for me, as it keeps me busy. I used to stress a lot at home, but being a CHW has definitely improved my sense of peace.”

Escalante recalls meeting a patient and identifying some signs of depression in her. As she kept visiting her, the patient started to open up and talk about her personal life, mentioning that she was happy to have someone caring for her and taking an interest in her health.

“I felt very satisfied to know that I was helping someone else, and not just physically, but emotionally as well,” says Escalante. “I’m very grateful for my job. I’ve grown and learned so much.”