This article originally appeared in the September-October 2001 issue of the Children's Advocate, published by Action Alliance for Children.

Tackling asthma

Health outreach workers, promotores, teach parents methods for preventing asthma attacks

By Irene Moore

Ana Maria Navarro's nine-year-old daughter, Dulce Andrea, has battled severe asthma since she was eight months old. "Almost any strong smell in chemicals, sprays, or flowers-among many-can trigger an attack," says Navarro. At one and a half, Dulce Andrea was put on a respiratory machine; at age four she was hospitalized for a week. Though doctors have been "kind and helpful," Navarro says she has felt somewhat isolated in dealing with her daughter's illness.

Then a neighbor, Bertha Flores, invited her to a meeting on asthma. "Bertha's class was like therapy for me," says Navarro. "When I met 20 or 24 other people in the same state as me, I felt relieved. I was able to speak up and meet other mothers with children who were suffering."

Flores is a promotora, a health outreach worker for the Healthy Homes Program of the American Lung Association (ALA) of the Central Coast. The promotores hold neighborhood meetings several times a week to educate people in Salinas, Greenfield, and King City about asthma.

Silma Flores (not related to Bertha), Healthy Homes Outreach Coordinator, says the promotores are needed because "it's important to build trust in the community. We're targeting field workers with a low level of education. This program is educating mothers on household irritants that can trigger asthma attacks and is saving them money on cleaning products."

Stressing prevention

Bertha Flores, a promotora since March, emphasizes prevention in her classes, held at a community center, a neighbor's house, or her own home. After everyone shares pan dulce, coffee, and conversation, Flores explains asthma and its environmental causes, then provides lots of advice on reducing asthma triggers.

She points out that parents can save money and improve air quality in their homes by replacing commercial cleansers with natural substitutes, such as vinegar, soap, and water. Since dust, sometimes polluted with agricultural chemicals, is a big problem in the area, Flores says, "I tell everyone to open the windows in the morning for fresh air and close them later in the day when the dust is blowing.

Breathing easier

At the end of the meeting, each participant writes her or his name, phone number and a promise to change cleaning habits. In several months Flores makes follow-up calls. Ninety percent of her "students" do alter their practices, Flores says. "Most frequently they clean and air out mattresses and curtains, clean carpets, and do more laundry more often to wash out dust and field chemicals."

Since Flores's class, Navarro has been watching Dulce Andrea more closely for early signs of an attack-itchy throat, watery eyes, whistling sounds, and coughing. She makes sure that Dulce Andrea warms up before active play and slowly cools down aferwards. And, says Navarro, "Now if I know of someone suffering, I can give them some tips," as she recently did for her niece in Mexico.

Megan Webb, director of the Regional Asthma Management and Prevention Initiative in Berkeley, says, "Asthma is a unique disease that includes environmental, physical, and psychological factors." Doctors, she adds, "simply don't have the time to follow up on the knowledge level and daily practices of their patients. That's why community health outreach workers are so important."

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Resources

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