EPES After the Earthquake 
Second Phase
Popular Education in Health (EPES)

Introduction: 

EPES -- Popular Education in Health (Educación Popular en Salud) began in 1982 as an ecumenical service program of the Evangelical Lutheran Church in Chile (IELCH) to promote health education and human rights for socially and economically marginalized women and their families in Chile.  Its first projects were in the capital city of Santiago, but by 1983 the city of Concepción and the nearby southern Chile communities of Penco, Talcahuano, and Tomé were included in its work.   Since 2001 EPES is governed by its own board of directors as a recognized Chilean non-profit; however, although it now is structurally independent of the IELCH, it to this day has a significant presence of education and advocacy in church communities of many denominations in the poor neighborhoods and shantytowns where it works in Santiago, in Concepcion, and in nearby rural and semi-urban poor communities. 

EPES trains individuals and communities to identify poverty, violence, powerlessness, discrimination, and other underlying causes of poor health and to mobilize for improved conditions and services.  Its health priorities include community mental health, environmental health, domestic violence, HIV/AIDS and women's reproductive health.  What began as a small emergency response organization now reaches 145,000 families in poor communities each year.   Global Ministries has worked with EPES for over five years directly (indirectly through ecumenical connections) and considers its work a vital Critical Presence among those who suffered most during the harsh years of Chile's military dictatorship and who today continue to struggle for life in abundance and dignity among Chile's poorest social sectors.   

February 27, 2010 and Post-Earthquake Context:

An earthquake of magnitude 8.8 on the Richter scale hit Chile in the early hours of February 27, 2010.  Its epicenter was located some 70 miles from Concepción, Chile's second largest city (pop.  670,000). The quake unleashed a tidal wave that destroyed important port cities and scores of coastal towns and villages.  The earthquake, which struck the central-southern zone where some 80 percent of Chile's population resides, was reportedly the strongest quake to hit Latin America in the last 50 years.

The Chilean government estimates the death toll from the earthquake and tsunami at near 500.  More than two million people were directly affected, more than 200,000 houses destroyed or seriously damaged, and up to 1.5 million houses sustained lesser damage.

Aftershocks continued to rattle already damaged buildings and infrastructure and kept Chileans in a state of alert.   On March 11, a 7.2 magnitude earthquake rocked the inaugural ceremony of Chile's new president, Sebastian Piñera, followed within 30 minutes by earthquakes of 6.9 and 6.0.

In the hardest hit areas, severe interruptions for many days of electricity, water, and telecommunications occurred and massive food distribution aid was necessary.   An estimated 33 percent of the schools in earthquake-affected regions are either wholly or partially non-operational.

The productive base of central Chile has been drastically affected by damage to agriculture, fishing, tourism, forestry, and trade.  The hardest-hit areas, especially along the coast, have suffered massive destruction of infrastructure:  public buildings, ports, highways, roads, bridges, aqueducts, and communication towers and cables have been destroyed.

The "Social" Earthquake":  Reflecting upon the looting, violence, and social upheaval that led to the deployment of troops in Concepción, commentators have noted that the country is experiencing a "social earthquake" that is exposing the underlying fault lines and disparities in Chilean society.  While Chilean macroeconomic indicators point to a growing economy, Chile is also one of the most unequal countries in Latin America.  According to the 2009 U.N. Human Development Report, the richest 10 percent of the Chilean population enjoys 41.7 percent of the country's income and expenditure, while the poorest 20 percent of the population earns 4 percent of the income.  Approximately 17 percent of the Chilean population lives under the national poverty line.

In these dramatic circumstances, writes the Chilean Association of Non-Governmental Organizations (ACCION), organized citizens have proven capable of providing urgent, rapid, and creative responses to the social crisis that millions of families are experiencing.  The most diverse organization . . . are mobilizing, demonstrating the imaginative potential and solidarity of communities.  The declaration concludes by insisting that the incoming President Sebastian Piñera guarantee the right to monitor the plans and models of reconstruction so that they include the full participation of the communities."

EPES after the earthquake:

In some areas that were most affected by the earthquake, EPES currently reaches 6,000 families directly and many more through its collaboration with other regional health organizations.   Within 24 hours of the disaster, EPES-Concepcion director Dr.  Lautaro Lopez had located an emergency generator, opened the well in EPES Concepcion Center patio and began distributing water to some 300 families (nearly 1,200 people) through a community-led system.  To read a narrative and view a short video about this initial work please click:  http://globalministries.org/news/lac/spring-of-hope.html

Dr.  Lopez also provided immediate medical care to neighbors.   Within days, EPES had convened its grassroots health teams to diagnose community needs and determine the most urgent situations.  EPES health promoters visited communities and put together and distributed emergency health kits and thousands of educational fliers on water management and disease prevention.   EPES also coordinated the distribution of food and other assistance provided by the Inter-Church Committee Chile 2010 created by churches and ecumenical organizations, including EPES, to respond to the emergency.

EPES continues to build on its strong, ongoing relationships with individuals, families and local organizations as it responds to the ramifications of the February 2010 earthquake in many ways, and requests support from Global Ministries for the following two specific efforts:

1.  Rebuilding Penco Through Solidarity and Community Participation

EPES now is now concentrating a key part of their emergency response work in Penco, a town of around 50,000 people near the city of Concepcion.  Twenty percent of the population of Penco is classified by the Chilean government as living in poverty.  The ocean is the major source of revenue for Penco and its artisan fisher families suffered tremendous damages from tidal waves as well as the earthquake.   These damages include significant destruction and interruption of the port facilities upon which the fisher families depended and which employed many other workers.   The fisher families also saw the destruction of their boats and nets, warehouses and shops, as well as the restaurants where their products were served.   A large number of houses were also damaged or destroyed of poor families in Penco.   As a result of this destruction, more than 30 percent of the workforce of Penco is now unemployed.

In addition to EPES offering an intense schedule of educational programs for the prevention of diseases which will be far more threatening as winter comes to the southern hemisphere and through psychological counseling for post-traumatic stress for women, children, and adolescents, EPES is working with families to repair and rebuild homes that can be saved as well as building as many new homes as their budget will allow.  EPES is working with the affected families on these projects.  Community members will supply the labor for their own houses and for the houses of the elderly or mothers with small children who will need their help.  EPES plans on working on the repair of 80 houses, building ten new houses, and the rebuilding of a destroyed local community center.

EPES writes, It is almost impossible not to be overwhelmed by the scale of the destruction in these poor towns.  Without a vision of community participation and empowerment, our help would be little more than short-term charity.

Budget for Rebuilding Penco Through Solidarity and Community Participation:

2. Mobilizing Community Resources of Alleviate Post-Traumatic Stress Among Children, Adolescents and Women Affected by the Recent Earthquake in Chile

Five days after the earthquake, a team from EPES-Santiago was able to travel by land (in a borrowed truck and with a government-issued safe-conduct pass) to Concepción and neighboring Talcahuano.  In addition to the catastrophic physical damage, they encountered tremendous emotional damage, with the sequence of earthquake, tsunami, aftershocks, looting, military occupation, 18-hour curfews, neighborhood patrols, and barricaded streets producing an atmosphere of tremendous vulnerability, fear, and mistrust.

EPES has identified as an urgent priority the need for post-traumatic stress counseling to earthquake victims.  EPES has begun to train its network of community health teams to address trauma in children and adolescents, as well as train other trainers (including public health workers) in the community.

The main objective of this initiative is to decrease post-traumatic stress among children, adolescents, and women residents of Concepción, Talcahuano, and Penco who are now suffering from psychosocial distress.  This will be achieved by training adult mentors to use sports and games-based activities to alleviate the anxiety, loss and despair caused or exacerbated by the earthquake and its aftermaths.

Mercy Corps is providing EPES with its Comfort for Kids methodology to help public and community health workers, teachers, parents, and other caregivers understand and address post-traumatic stress in children and adults.  For more information about this work and the first training workshop that took place in mid-April at the EPES Center in Concepcion, please click http://globalministries.org/news/lac/epes-update-april.html

EPES now needs additional funding to expand the program to other communities. 

Each training program includes:

• Three-Day Training Program for 25 adult mentors
• 25 Two-Hour Training Sessions for parents of 600 children
• Workbooks and Backpacks for 600 children
• Implementation of a three-month program with 600 children led by mentors

Budget for Mobilizing Community Resources of Alleviate Post-Traumatic Stress Among Children, Adolescents and Women Affected by the Recent Earthquake in Chile:

To read the latest EPES Update, click here: http://globalministries.org/news/lac/epes-update-newsletters.html