The Many Lives of Georgina Díaz

Posted on Sep 20, 2016

The Many Lives of Georgina Díaz
Georgina Diaz, a community health worker for Partners In Health in Mexico, prepares to cook tortillas at her home in Reforma, Chiapas.
Photos by Leslie Friday / Partners In Health

It was still pitch black when Georgina Díaz’s alarm went off at 3 a.m. The 34-year-old single mother peeled herself from bed and started plugging away at the morning’s routine in Reforma, Chiapas. Roosters crowed, despite the absence of the sun, as she lit a corn husk and touched it to dry wood stacked in the outdoor stove behind her family home.

As the fire grew, Díaz filled a pot of water to boil coffee, which she had grown herself—like most of her neighbors—in fields spread across the arid mountainside. Then she poured white corn, also grown nearby, into a mill. The machine’s metallic grinding assaulted the predawn silence as it chewed the corn into a pasty pulp. She scooped the ground meal into a bucket and kneaded it into a smooth ball.

Over the smoky fire, Díaz prepared refried beans, scrambled eggs, and dozens of handmade tortillas for her three sons’ breakfast. She sat for five minutes to swallow a hunk of sweet bread and a cup of coffee. Then she was up again, hastily running a hot iron over her sons’ school clothes. She packed her bag, rattled off instructions to her mother about the boys’ lunch, and took off down the dirt road leading to the town square.

With a handful of neighbors, Díaz headed to a coffee nursery 30 minutes away by foot under a diamond-studded sky. The sun hadn’t yet peaked over the saw-toothed horizon of the surrounding Sierra Madre mountains. The shuffling of their feet and hushed conversation were the only sounds in the still sleepy village.  

Once at their roadside destination, Díaz and several dozen workers got their assignments from nursery supervisors. Each had to fill 500 squat black bags with a mixture of sand and soil, which eventually would be planted with coffee seedlings. This mass planting was in response to an invasive fungus called la roya, which has been attacking coffee plants and drastically reducing local yields for the past several years. The new coffee shoots were believed to be a resistant variety and symbolized hope for the region’s growers.

Beyond hope, the nursery represented a paying, although temporary, job. And those were hard to come by in rural Chiapas. Díaz was grateful for the work, despite the fact it lengthened her already long day.

Díaz, right, fills bags that will be planted with coffee shoots believed to be resistant to a fungus that's been devastating local plantations for years.

The luchadora

People around Reforma tend to call Díaz a luchadora, or fighter. Having left her abusive husband seven years ago, she supports herself and her sons through any means possible. She grows corn, coffee, and limes, raises livestock, sells secondhand clothes, picks up odd jobs like that at the nursery, and stretches to the maximum the little government assistance she receives.

Two years ago, Díaz took on another role—as one of Reforma’s first community health workers. Compaňeros En Salud, as Partners In Health is known in Mexico, recruited and trained her and eight other women in how to care for and accompany patients with chronic diseases, such as diabetes, hypertension, and depression. She and her colleagues are often the first, and most enduring, link residents have to the local clinic. They build trust, advocate on their patients’ behalf, and often answer questions that patients feel too uncomfortable to ask physicians. They receive packages of food for their efforts, yet many feel a greater reward from helping neighbors and strengthening their community’s health care system.

Díaz is proud to call herself a community health worker, or acompañante. Every week, she visits eight residents to ensure they take their medication and attend doctor appointments. Mostly though, her visits are opportunities for patients to talk about their illness or simply shoot the breeze.  

“You could say that these chats, they’ve really helped,” Díaz says. “Sometimes, if I don’t go to visit, they say, ‘Why weren’t you there?’ … Sometimes, they confide things to you that not even their family knows.”

Family members recognize the difference Díaz makes. She says some have approached her to say, “’Listen, my mother speaks very well of you. I want to thank you for visiting her.’”

That’s why I like this program, because you go along waking people up to how to take care of their health.

These are the feel-good moments of the job. But there are also times when Díaz realizes the obstacles she and her patients face are more than health-related. She often counsels those living with diabetes or hypertension to eat less corn and sugary foods. That’s a hard sell in a part of the world where tortillas are served for breakfast, lunch, and dinner. And where pozol, a sugary drink made from fermented corn dough, is thought to provide strength for farmers facing a long day’s work.

“’The doctor wants me to starve to death,’” Díaz’s patients tell her. She explains that they aren’t expected to completely cut corn from their diet, but aim for a greater variety of foods. Yet living in a household of nine people—including three growing boys, she is aware of the limited options available. Fruits, vegetables, meat, and dairy are hard to come by, or too expensive. “We have to eat a lot of tortillas to get full.”

Diabetic patients also can’t understand how they have azúcar—or sugar, what they commonly call diabetes—when they never drink Coca-Cola. Soda is a luxury they simply can’t afford; they might drink one a year around the holidays. So Díaz explains how sugar is inherently part of their diet, especially when they rely on foods like processed corn flour in times when corn stocks disappear. “That opens their eyes a lot,” she says. “And that’s why I like this program, because you go along waking people up to how to take care of their health.”

Díaz takes the same information she learns in PIH trainings and applies it to how she cares for her own family. She now cooks with less salt and sugar, but doesn’t skimp on healthy fats for her growing boys. Her mother has high cholesterol and her grandmother hypertension, so she keeps an eye on their health too. And she’s ever vigilant of how depression sneaks into the lives of her friends and, quite possibly, up on her.

A dark time

Although Díaz has a ready smile and a chatty demeanor, her eyes glint with steely determination. Her slender frame and veiny arms belie that she’s never been a stranger to manual labor. As a teenager, she met and fell in love with a man whom her father detested. Against her family’s wishes, they ran off and got married. They lived in Tuxtla-Gutierrez, the capital of Chiapas, where they both worked and lived in a modest, but comfortable, home.

Then the drinking and beatings began. For 11 years and through the birth of three children, Díaz says her husband drank away his salary and insulted, hit, and locked her outside their home. He destroyed every possession she owned. And then he tried to kill her.

“He was choking me one day,” Díaz remembers. “The first thing that I thought was, ‘My sons, my sons! What am I going to do?’” She summoned all her strength and fought for her life. “I tore away from him by giving him a kick in the genitals and that was what I used to defend myself.” While he was doubled over, she grabbed her sons and fled to the outdoor patio. She didn’t know what was going to happen, but she knew they were safe under her neighbors’ watchful eyes.

The first thing that I thought was, ‘My sons, my sons! What am I going to do?

For several weeks, Díaz and her sons stayed with extended family while she decided their next move. “I had some savings, but I didn’t know how I was going to survive with that little bit of money,” she says. “I had no other choice but to call my father and ask for his forgiveness. Fifteen days passed, no one answered me. Nothing. I was suffering, and then resigned myself to the fact that I was going to have to stay.

“But then one day, out of the blue, my father arrived with a three-ton truck and he said to me, ‘Come on. Let’s go. Right now,’” she recalls, her voice and composure barely wavering. “I was so happy that my father had arrived, that he had pardoned me, and that I could live in my house again.”

Her motor

 

Before leaving for work at the nursery, Díaz irons her sons' school shirts over a blanket on the cement floor.

For two years, Díaz worked an hour away in Jaltenango while her family took care of her sons back in Reforma. The separation was torture, but it was much more bearable than the hell she had lived in Tuxtla. In a sign of reconciliation, her father gave her one of his cows, as he had done with all his children. The thought of the gift brought tears to her eyes. That cow was her ticket to freedom, and she used it as a line of credit to buy land and build her own house down the road from where she grew up. After seven long years of hard work and sacrifice, the house will soon be move-in ready.

She thinks back to those lost and lonely years and is grateful to have survived. Most days are still hard. Her extended family makes demands she can’t always fulfill. Her boys are mischievous and entering their defiant teens. That’s one reason her community health work is a welcome diversion. “I get to be worried about other people,” she says, “and I forget about my situation for a moment.” She knows her past helps her support other women struggling in abusive relationships or difficult circumstances. After hearing her story, some have even told her, “’If you can do it, why can’t I?’”

They are my motor, they are the ones who move me.

Díaz shared this while sitting, slightly slumped, in the Reforma clinic. She had worked for more than six hours at the nursery before walking back home in the blazing noonday sun and collapsing for a nap. The sun was now finally losing its intensity as it slipped over the crest of the western mountains, bathing the town in a soft, rosy light. Dozens of women sat listening to a local official giving an update about Prospera, a government assistance program, under the clinic’s covered patio. The speaker’s voice mingled with children’s cries, filling the silence left in the wake of her story.

It was a rare moment to see Díaz sitting still. Up until now, it seemed she has been in constant motion, propelling herself and her family forward every day by sheer strength and will power. When asked what keeps her going, she didn’t hesitate.

“My sons,” Díaz says. “They are my motor, they are the ones who move me. Every action I do, that’s why I do it. Even though many people tell me, ‘Don’t work so much!’” They tell her to get herself a husband who will take care of her. Her sons, they say, will only grow up, get married, and leave her without a word of thanks.

Díaz doesn’t pay attention. Especially on days like this, when she was bone-tired from work and her youngest, Giovanni, ran up to her when she walked into the house. She smiled now, remembering his words: “’Oh, Mommy, you’re home. Did you work hard today, Mommy?’ Then he gives me a kiss. Those are the moments when I say to myself, ‘This is my son.’ And I feel happy.”

Dr. Paul Farmer sharing a friendly moment with one of his staff.

Paul's Promise

As we mourn the passing of our beloved Dr. Paul Farmer, we also honor his life and legacy.

PIH Founders - Jim Kim, Ophelia Dahl, Paul Farmer

Bending the Arc

More than 30 years ago, a movement began that would change global health forever. Bending the Arc is the story of Partners In Health's origins.