5) Description of health product/service offering: The Medicine Wheel Project of A Promise of Health addresses the following health issue: the virtual non existence of everyday primary healthcare, medicine and health education for the indigenous, marginalized rural population of Mexico. The primary beneficiaries are the indigenous Maya and all marginalized rural poor. The innovative solution is homeopathic physicians, schooled and licensed in Mexico, along with homeopathic medicine, manufactured in Mexico and regulated by the government. This plan currently operating in the Yucatan is in full financial partnership with rural community leaders. This plan improves health for low income, no income and marginalized populations because homeopathy and homeopathic medicine is safe, effective, extremely low cost, and accepted by the rural indigenous Maya and village Presidents. Without this successful program now operating in the Yucatan, everyday healthcare, medicine and health education would be non existent for the Maya people now being served. Chronic and acute illness, left untreated,leads to serious outbreaks of disease and epidemics, quickly out of control. Health and well being is most improved by paying attention to the everyday health of people. Health and wellness is one of the greatest reducers of poverty.

6) Description of innovation: The only existing program in the field is the federally funded IMSS health plan which has failed the marginalized rural population of Mexico. Not all rural villages have an IMSS medical clinic. Most do not. One has to have a paying job that also pays social security in order to go to the IMSS clinic for free. Doctors are at the clinics only on certain days. Medicine beyond aspirin is seldom if ever available. The majority of people who live rurally do not have paying jobs that also pay social security. They simply cannot afford to pay a doctor, then take an expensive bus ride to Merida or a big city and pay for a costly prescription at a pharmacy. Before A Promise of Health came to Yucatan, hundreds of thousands of indigenous Maya were without healthcare services of any kind. At a meeting of 17 village presidents in January of 2006, the main discussion was failed healthcare delivery to the rural poor. A Promise of Health was asked to attend and offer an alternative approach. As a result, all 17 rural communities have asked to be included in the current expansion plans of A Promise of Health. A Promise of health does not charge to see a doctor or obtain medicine. The overall cost of the program is shared by the village and A Promise of Health. What is particularly novel and unique is the use of safe, effective and low cost homeopathy and homeopathic medicine. Nothing has to be imported from outside Mexico to make this plan work. Mexico has within itself the valuable resource of doctors and medicine, all at a fraction of the cost of the current failed IMSS system. Also what is unique is the full partnership with the villages themselves and their participation in the program. One example is village support of school demonstration gardens and the resulting home gardens that follow. The goal of A Promise of Health is to have the Medicine Wheel Program completely self sustaining in the next 5-10 years.

7) Operational model: Each Medicine Wheel will have a doctor living in the hub village with the people and traveling on a regular basis to each of the villages on the wheel. A Promise of Health focuses on the following activities in each medicine wheel: the delivery of primary healthcare and homeopathic medicine at no cost to the patient; no cost mental health counseling; no cost nutrition and hygiene education; the giving of free garden seed and planting instruction; the growing of demonstration gardens at secondary schools; free screening for donated cataract surgeries; eye screening for reading glasses and corrected vision glasses; diabetes testing; no cost children's vitamin distribution and referrals for surgery to address life threatning conditions. A Promise of Health reaches out to low income, no income and marginalized populations by maintaining excellent coomunication in the villages we serve with healthcare. As soon as the mobile medical clinic rolls into the village, the line starts to form. Word travels fast in small communities and there has never been a problem in reaching out and finding people who need help. Only a lightning strike would travel faster than the news of a no cost doctor visit and medicine. The village coordinator who also serves as a translator, makes 40 home visits each week to follow up with the families, talk about home gardens, the effectiveness of the medicine and to see what more A Promise of Health can do to help.

8) Human resources: One medical team is currently in place, representing the first Medicine Wheel, serving 6 rural communities and a population area of 50,000 people. The medical team consists of four people: a well known and respected homeopathic physician who has been practicing medicine for 35 years, licensed to practice medicine in Mexico and registered with the Secreatry of Salud; a Maya village coordinator and translator who lives in one of the villages we serve; a medical assistant who lives in one of the villages we serve and a driver for the mobile clinic who is cross trained. The expanded Medicine Wheel Project will include the vast majority of rural communities in the Yucatan as requests for healthcare services to A Promise of Health have already come in writing from 60 municipio Presidents. The new Medicine Wheel expansion project will have 15 operating wheels, each with a 3 member team and serve a total rural population of 800,000 indigenous Maya. The doctors for the project will be graduates from Mexico's national medical schools of Homeopathy. The doctors will train their assistants. Doctors for the next 3 Medicine Wheels have already been hired.

9) Key operational partnerships: The partnerships established by A Promise of Health are central and key to our initiative. Our main partners are the villages themselves who share in the financial cost of the program. Their investment money comes from mandated funds from the federal government to be used for social infrastructure which includes healthcare. The role of the village is an equal partnership in the program with A Promise of Health. Communication is constant as the villages become more self reliant in their ability and desire to improve the health and well being of their own people. In addition, we have developed a partnership with 2 prominent eye surgeons in Merida who have to date donated 51 cataract surgeries for the indigent Maya through A Promise of Health. The program is now in its 4th year with an additional 25 surgeries anticipated in 2006. This partnership resulted in additional partnerships with Alcon Laboratories US and MX who have donated lenses and surgical supplies. A Promise of Health has a working partnership with a respected attorney in Merida who conntinues to give pro bono legal advice. The Hospital O'Horan was a partner in 2005, when 16 free abdominal surgeries were performed by a visiting surgical team from Oregon acting on behalf of A Promise of Health. A Promise of Health enjoys numerous partnerships with allopathic physicians and surgeons in Merida who are part of our growing referral network for the indigent Maya we serve.

10) Financial Sustainability

          • Fees charged to clients?: No

          • How do you assure affordability?: No fees are charged to the Maya people for healthcare services rendered in the Medicine Wheel Project of A Promise of Health. The villages can afford to pay their share of the low cost program with mandated federal funds.

          • Earned incomes as a percentage of operating costs: 50

          • Other funding sources: A Promise of Health's annual budget to deliver primary healthcare to the vast majority of the rural population of the Yucatan (800,000 Maya) is $566,519. Nearly half of the cost of the Medicine Wheel Project is sustained through village partnerships ($266,000). A Promise of Health believes that the Medicine Wheel Project can be self sustaining in 5-10 years. Currently, $100,000 has been raised from foundations, individuals, corporations and organizations to help fund the $300,000 needed for A Promise of Health's share for 2006-07.

          • Strategy for long-term sustainability: The strategy to ensure financial sustainabilty of our initiative in the long term is to continue to build the village partnerships in Mexico which funds half of the program. Next is to find more corporate and individual donor support in Mexico from the private sector. A Promise of Health has already made great strides in this direction in Mexico City by beginning to form private sector alliances. At the same time it is crucial to gain additional scale up support from foundations and world health organizations focusing on third world healthcare, until the Mexican government sees this as its own national solution for rural healthcare. This initiative is being driven from the bottom up and not the top down, starting at the local level and building from there.

11) Current and Future Impact

          • Total number of clients: 25,000

          • Clients in the past year: 6,000

          • Percentage of low-income clients: 100

          • Impact: The greatest impact A Promise of Health has on the rural Maya communities it serves, beyond benefits of direct service delivery, is 2 fold. First, we see growing empowerment of local leaders to want to become more self reliant in delivering health and well being to their own people. Feeling left behind by generations of failed government programs, they now see they have it within themselves to find solutions to age old problems. Through their partnership with A Promise of Health they see new hope and great potential for the future. Secondly, there is an impact of policy change. Never before have the rural villages formed this kind of partnership with homeopathic medical care and a nonprofit organization. They see they can afford it. It's safe and effective. It works!

          • Overall "market": The potential demand for A Promise of Health's homeopathic approach to primary healthcare is nation wide for the rural poor of Mexico. Tens of millions of marginalized people in Mexico live today without healthcare, access to medicine and health education. Mexico respects the practice of homeopathy and each year graduates hundreds of new homeopathic physicians from it's licensed medical schools. There are several manufacturers of homeopathic medicine in Mexico. The prototype of the Medicine Wheel Project from A Promise of Health can easily be duplicated at very low cost throughout rural Mexico and any third world country where homeopathy is practiced. Examples of countries that could greatly benefit beyond Mexico are India, South Africa, and Nigeria. As an article in the World Health Organization's journal, World Health Forum noted: "Homeopathic treatment seems well suited for use in rural areas where the infrastructure, equipment, and drugs needed for conventional medicine cannot be provided." The number of marginalized, no income and low income people The Medicine Wheel Project can help throughout Mexico alone, is in the tens of millions.

12) Scaling up strategy

          • Stage of the initiative: Scaling Up stage.

          • Expansion plan: Over the next 3 years A Promise of Health will have 15 of it's Homeopathic Medicine Wheels fully operational in the state of Yucatan, serving a marginalized population of 800,000 indigenous Maya with primary healthcare. This number represents the vast majority of Yucatan's rural population. Beyond that we want to start duplicating the Medicine Wheel Project in other states of Mexico. We are only limited by the financial resources necessary to expand our low cost, effective program. A Promise of Health has access to a more than sufficient supply of homeopathic Mexican doctors and Mexican made homeopathic medicine. The need is now across all of rural Mexico. A Promise of Health, in partnership with the local villages and municipios has the hands on experience, successful track record, knowledge of local politics and the connections to implement this program statewide and nationwide. In the next 3 years we plan to be fully operational in Yucatan and expand outside the Yucatan as far as our financial resources will allow.

13) Policy change: In the US, a policy change among large healthcare foundations to put more focus on low cost, safe and effective primary healthcare in the third world would be very beneficial. Without paying attention to everyday healthcare of marginalized populations, how does one keep the lid on infectious disease and epidemics? It has been proven by A Promise of Health that it can be done safely, effectively and at very low cost. Why not begin to experiment with this kind of primary healthcare program? This pro active program puts more emphasis on preventative care which will save billions of dollars in the long run. In Mexico, a government policy change at the top that recognizes more of the benefits of homeopathic healthcare and medicine for the rural poor would greatly accelerate implementing the best low cost primary healthcare available for marginalized populations.

14) Origin of the initiative: A Promise of Health began with the founder, Barbara Grannell. After spending years visiting the Yucatan with her husband Bill, who was conducting medicinal plant research in the village of Huhi, a realization was painfully obvious to her about the lack of healthcare and medicine for the marginalized rural Maya population. The energy and passion for the desire to act accelerated when a long time homeopathic physician friend in Merida agreed to help the Maya. When the question was put to the village leadership if they wanted the services of a homeopathic physician and medicine, a desperate cry for help was heard. Barbara and her husband went home to Colorado and started A Promise of Health. A life time of just the right skills belonging to the Grannells proved to be the winning combination to set the wheels in motion. Neither Barbara or Bill has looked back.

Contact Information:
Barbara  Grannell
Executive Director
A Promise of Health
(501 C 3 nonprofit)
419 East Fraser Drive, Pueblo West, Colorado, 81007
United States
Tel: (719) 547-1995
Email: Barb.Grannell@promiseofhealth.org
Website: www.promiseofhealth.org