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Promotoras of the U.S.-Mexico border


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Promotoras of the U.S.-Mexico border an ethnographic study of culture brokerage, agency, and community development
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Contreras, Ricardo B
University of South Florida
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Tampa, Fla.
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Community outreach workers
Lower Rio Grande Valley
Dissertations, Academic -- Applied Anthropology -- Doctoral -- USF   ( lcsh )
government publication (state, provincial, terriorial, dependent)   ( marcgt )
bibliography   ( marcgt )
theses   ( marcgt )
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ABSTRACT: This study examines promotoras from the U.S.-Mexico border. Promotoras are women who live in colonias throughout the border area and who are employed by service provider and community development organizations to do health-related outreach and education with colonia residents. The role of promotoras can be seen from the perspective of culture brokerage; that is, they are mediators between local communities and external actors such as service providers and agencies of the government. As culture brokers, promotoras facilitate the relationship among the local communities, and the system of services and outside resources. The study proposes a conceptual framework through which programs of community health workers in general, and those involving promotoras in particular, can be understood, designed, and implemented.
Thesis (Ph.D.)--University of South Florida, 2005.
Includes bibliographical references.
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by Ricardo B. Contreras.
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Document formatted into pages; contains 267 pages.
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Includes vita.

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Promotoras of the U.S.-Mexico border
h [electronic resource] :
b an ethnographic study of culture brokerage, agency, and community development /
by Ricardo B. Contreras.
[Tampa, Fla.] :
University of South Florida,
Thesis (Ph.D.)--University of South Florida, 2005.
Includes bibliographical references.
Text (Electronic thesis) in PDF format.
System requirements: World Wide Web browser and PDF reader.
Mode of access: World Wide Web.
Title from PDF of title page.
Document formatted into pages; contains 267 pages.
Includes vita.
3 520
ABSTRACT: This study examines promotoras from the U.S.-Mexico border. Promotoras are women who live in colonias throughout the border area and who are employed by service provider and community development organizations to do health-related outreach and education with colonia residents. The role of promotoras can be seen from the perspective of culture brokerage; that is, they are mediators between local communities and external actors such as service providers and agencies of the government. As culture brokers, promotoras facilitate the relationship among the local communities, and the system of services and outside resources. The study proposes a conceptual framework through which programs of community health workers in general, and those involving promotoras in particular, can be understood, designed, and implemented.
Adviser: Michael V. Angrosino.
Community outreach workers.
Lower Rio Grande Valley.
Dissertations, Academic
x Applied Anthropology
t USF Electronic Theses and Dissertations.
4 856


Promotoras of the U.S.-Mexico Border: An Ethnographic Study of Culture Brokerage, Agency, and Community Development by Ricardo B. Contreras A dissertation submitted in partial fulfillment of the requirement s for the degree of Doctor of Philosophy Department of Anthropology College of Arts and Sciences University of South Florida Major Professor: Michael V. Angrosino, Ph.D. Roberta D. Baer, Ph.D. Mario Hernndez, Ph.D. Marlynn L. May, Ph.D. Trevor Purcell, Ph.D. Date of Approval: March 30, 2005 Keywords: Ethnography, community outreach workers, mediators, outreach, Lower Rio Grande Valley Copyright 2005, Ricardo B. Contreras


DEDICATION ngela acompa todo el camino y Paul dijo las palabras que hacan falta. Mi madre ha estado y estar por siempre junto a m. A ellos les dedico este trabajo.


ACKNOWLEDGMENTS I acknowledge the Louis de la Parte Florida Mental Health Institute and the Southwest Rural Health Research Center at Texas A&M University for letting me use the data collected in a study conducted under their sponso rship. I acknowledge the contribution of the women from the colonias in the Texas Lower Rio Grande Valley, who opened their lives to a researcher w ho came from far away. I would like to express my appreciation to all members of my dissertation committee, who advised me on different stages of t he process. Dr. Michael Angr osino deserves my special gratitude for his guidance throughout my car eer as a Ph.D. student. His patience and understanding allowed me the freedom to be creative and to open up new lines of research and interpretation. Dr. Roberta Baers insights greatly contributed in improving the quality of this dissertation. The willingness of Dr. Mario Hernndez to collaborate in this project made possible my participation in the study. Thanks to his open mindedness I was able to spend a year away from the office while conducting fieldwork. My deepest appreciation to Dr. Marl ynn May for inviting me to be part of this research project and for spending countless hours brainstorming with me on many of the ideas included in this dissertati on. Finally, I would like to thank Dr. Trevor Purcell for being a permanent source of encouragement throughout my graduate student years at the Univer sity of South Florida. His enthusiasm and knowledge motivated me to explore my own intere sts in the anthropology of development.


TABLE OF CONTENTS LIST OF FIGURES iii ABSTRACT iv CHAPTER ONE: INTRODUCTION 1 The Research Project 2 Research Problem and Research Questions 4 Organization of the Dissertation 6 CHAPTER TWO: METHODOLOGY 8 Fieldwork 9 Sampling 18 Semi-Structured Data Collection 19 Analysis 21 CHAPTER THREE: LITERATURE REVIEW 23 Culture Brokerage and Agency 24 Culture Brokerage 24 Agency 45 Community Health Workers and Promotoras 49 The Anthropology of the U.S.-Mexico Border 61 CHAPTER FOUR: THE SETTING 69 Colonias Along the U.S.-Mexico Border 71 The Lower Rio Grande Valley (LRGV) 73 CHAPTER FIVE: FINDINGS 78 The Promotoras 78 Immigration Experience of Promotoras 79 Work Experience of Promotoras 84 Work and Autonomy 89 Womens Accounts of Traditional Roles and Division of 91 Labor The Promotora Practice and Changes in Self-esteem and 95 Autonomy Nature of Changes in Self-esteem and Autonomy 103 Community Representation of Roles and Strategies 106 Information and Referral 109 Education 114 Community and Capacity Building 118 i


Emotional Support 125 Advocacy 131 CHAPTER SIX: DISCUSSION 135 Promotoras Configuration 137 Type of Relationship with Community 138 Mechanisms to Establish Relationship Local 138 Community-Larger System Frequency and Intensity of Relationship 140 Nature of Mediators 140 Variation in Functions 143 Kind of Integration into the Local Community 143 Guardians of Crucial Junctures of the Relationship Local 144 Community-Larger System Deficient Infrastructure 145 Language 146 Cultural Competency 147 Immigration Status 149 Discrimination 149 CHAPTER SEVEN: CONCLUSIONS AND RECOMMENDATIONS 151 Conclusions 152 Recommendations 155 Programmatic Recommendations 155 Recommendations to Applied Anthropologists 156 REFERENCES CITED 160 APPENDICES 182 Appendix A: Authorization for Data Utilization 183 Appendix B: Demographic Profile of Participating Promotoras 184 Appendix C: Interview and Focus Group Protocols 186 Appendix D: Informed Consents 190 Appendix E: List of Codes Used in Analysis with Atlas.ti 192 Appendix F: Atlas.ti Networks of Codes 201 Appendix G: Memos Written in Atlas.ti 206 Appendix H: Quotations Associated With Memos 234 Appendix I: Biographies of Promotoras 251 ABOUT THE AUTHOR End Page ii


LIST OF FIGURES Figure 1 Practice 46 Figure 2 Hoggetts Model of Agency 47 Figure 3 Map of the Lower Rio Grande Valley 74 Figure 4 Dimensions of Practice 108 Figure 5 Promotoras Configuration and Crucial Junctures 136 iii


iv Promotoras of the U.S.-Mexico Border : An Ethnographic Study of Culture Brokerage, Agency, and Community Development Ricardo B. Contreras ABSTRACT This study examines promotoras from the U.S.-Mexico border. Promotoras are women who live in colonias throughout the border area and who are employed by service provider and community development organizations to do health-related outreach and education wit h colonia residents. The role of promotoras can be seen from the perspective of culture brokerage; that is, they are mediators between local communities an d external actors such as service providers and agencies of t he government. As culture brokers, promotoras facilitate the relationship among the local communities, and the system of services and outside resources. The st udy proposes a conceptual framework through which programs of community health workers in general, and those involving promotoras in particu lar, can be understood, designed, and implemented.


CHAPTER ONE INTRODUCTION In this dissertation I will explore the significance for community development of a practice of community outreach, health promotion, and education, implemented by mostly Mexican-born women from U.S.-Mexico border communities. Known as promotoras, these women are employed by health clinics, grassroots organizations, educational programs, child and maternal health programs, among others, to reach out to residents who live in colonias, rural areas of border counties that are usually isolated from the system of services because of inadequate physical infrastructure and lack of transportation services. In this context, the hiring of women from the colonias to reach out to their neighbors and connect them to the world of services and resources, has become a key contribution to public health, making it possible for health and human services to reach people who were not being served through traditional forms of outreach. This dissertation inquires into the point of view of promotoras about the construction of their own practice. The dissertation suggests a perspective on the practice of promotoras that differs from the commonly held health promotion and health education perspectives. Although recognizing the value of the latter, this dissertation views promotoras as participants in and agents of community development intervention. There are two reasons for doing so. First, the literature on community health workers, the larger category of practices to which the 1


promotora practice belongs, commonly overlooks the holism of the promotoras practice, reducing the analysis to health promotion, especially in its outreach function. Secondly, the ethnographic work that was conducted showed that the practice of promotoras had a positive effect in terms of a broader notion of community well-being, that includes, in addition to health, a communitys solidarity and agency (Bhattacharyya 1995). Culture brokerage is the pillar of the community development approach to the understanding of the practice of promotoras. Promotoras play a crucial role by allowing for communication and understanding between the local colonia community and the larger society represented by the system of services. Following Wolf (1956), I propose that promotoras are guardians of the junctures at which the relationship between systems is mediated. A central component of the culture brokerage approach to the promotoras practice is the notion that promotoras are agents of change in their own lives as well as in their communities. I suggest that promotoras capacity to find solutions to community problems, through a combination of formal and informal practice, reflects their agency. Promotoras agency is the result of the combination of their own life histories as women who have struggled to overcome the difficulties common to colonia residents, and of their own practice as promotoras. I use Hoggetts (2001) model of agency to explain this point. The Research Project This dissertation research is based on the fieldwork and in-depth interviews conducted with promotoras as part of the of the research project A 2


Comparative Study of Outreach Workers (Promotoras) and Their Organization in Health Promotion on the U.S.-Mexico Border. The Comparative Study was conducted between December 2000 and June 2002 by the Southwest Rural Health Research Center of Texas A&M University School of Rural Public Health 1 which subcontracted the Department of Child and Family Studies from the University of South Florida. Funding came from the federal Office of Rural Health Policy, Health Resources and Services Administration. The research project was conducted as part of a team that included researchers from the Texas A&M University Center for Housing and Urban Development Colonias Program. The purpose of the study was to identify the features of the promotoras strategy of community outreach and health promotion, paying particular attention to the universals of practice despite the diversity of programs that use this form of outreach. Thus the study followed a case study approach, examining six programs in the Texas-Tamaulipas border and six programs in the New Mexico-Chihuahua border. Data for the original research project were generated through semi-structured interviews with 40 women working in six different programs as promotoras. In addition, activities in which promotoras participated as part of their daily work were observed and notes were taken. Finally, focus groups sessions were conducted with a total of 43 community residents, all of whom participated in the activities implemented by the six programs. These three data collection methods were conducted while the field researcher established residency in the 1 See Appendix A for authorization for data utilization issued by the Southwest Rural Health Research Center. 3


Lower Rio Grande Valley (LRGV henceforth) and acquired an office space with one of the programs whose promotoras participated in the study. The approach taken cannot be described as participant observation since the researcher did not assume the roles of the individuals who were studied; it nonetheless allowed for a close, year-long connection between the researchers and the promotoras. Although based on the data produced by this study, this dissertation takes a different approach to analysis, examining promotoras point of view and interpretation of their practice, of the representation of that practice in colonia communities, and of the connections between practice and their life histories. Thus in-depth interviews with promotoras and observations in the field constitute the major sources of information for the dissertation analysis. The dissertation does not examine, except when necessary to provide context, issues of structure and dynamics within the agencies themselves. Moreover, the dissertation looks only at the data from the Texas-Tamaulipas border, ignoring the data from the New Mexico-Chihuahua border. This is done because the sample of promotoras from the Texas sample is larger than the sample from the New Mexico sample and, and as a result of this, the New Mexico data do not contribute significantly enough to the finding of the study. Research Problem and Research Questions The dissertations guiding research problem is stated in the following two questions: 4


How does the practice of promotoras from the U.S.-Mexico border serve to facilitate the relationships between local colonia communities and the larger system of services? How does the life experience of promotoras as border women help to explain their roles as facilitators of the relationship between the local and the supra-local? In order to answer these two research questions I will explore a number of research objectives, which are as follows: To identify the activities which constitute the practice of promotoras of the U.S.-Mexico border. To identify the roles that promotoras play as they perform their jobs To identify the representation in colonia communities of promotoras roles and activities. To identify the elements in promotoras life histories that help to understand womens decisions to be promotoras as well as the specific characteristics of their work. The community development approach to the practice of promotoras entails two assumptions: Promotoras affect their communities in a comprehensive manner, that is, they affect communities as individuals, as members of families, and as members of communities. Promotoras are empowered as agents, as individuals capable of creating change at the individual and the community levels. 5


These two assumptions result from ethnographic work. Since the beginning of the ethnography, the observation of activities, as well as womens discourses about their practice, made it quite evident that promotoras affected their communities through a number of different domains, including providing information, educating, building capacity among residents, and advocatig for residents well-being. Also, early ethnographic work showed promotoras experiencing change in their own lives and promoting change in the lives of the colonia residents with whom they worked. Organization of the Dissertation This dissertation has been organized in seven chapters. The first chapter is this introduction, which is followed by the methodology chapter, the findings chapter, the discussion chapter, and the conclusions and recommendations chapter. The second chapter describes the methodological approach taken in this study, describing fieldwork, specifying the semi-structured data collection methodology, sampling, and analysis procedures. This chapter includes an account of the ethnographic process, highlighting the rapport process, the application of data collection procedures, the interaction with promotoras and community residents, and a reflection on the properties of fieldwork. The third chapter reviews the literature that constitutes the conceptual framework for the interpretation of findings. This includes a review of the literature on culture brokerage and on agency, a discussion of community health workers, and an examination of the anthropology of the U.S.-Mexico border. Chapter Four describes the research setting, including the sociodemographics of the U.S.6


Mexico border and of Hidalgo County, and a bibliographic description of colonias. Chapter Five describes the findings of the study, and is divided in three sections: first, the promotoras who participated in the study will be described in terms of demographic characteristics as well as in terms of their life histories. This is followed by a discussion of the meaning of work for promotoras and of how work contributes to womens autonomy. Finally, the findings include a description of practice and of how that practice is represented in communities. Chapter Six discusses the findings so as to explain how the promotoras practice represents a culture brokerage function and at the same time contributes to the empowerment of women who, before this work experience mainly reproduced traditional roles at home and at the community. In other words, the practice of promotoras is examined from the perspective of community development and change, inasmuch as that practice not only links systems, but also creates solidarity and agency. Chapter Seven consists of the conclusions and recommendations emerging from this dissertation. Recommendations are designed to contribute to program development as well as to applied anthropology. 7


CHAPTER TWO METHODOLOGY Research was conducted in the Texas LRGV, in Hidalgo, Willacy, and Cameron Counties, where I participated in multiple activities in the community, including meetings of program staff, trainings of promotoras, social activities with promotoras, community celebrations, informal gatherings with community leaders, and just walking the streets of colonias and talking with residents. This unstructured approach to learning is at the center of ethnographic fieldwork. Data were also collected through in-depth semi-structured interviews with 26 promotoras 2 In order to complement the point of view of promotoras in the description of the community representation of their practice, I also used data from six focus groups conducted with community residents, and from unstructured interviews conducted with community leaders such as church personnel, leaders of the local association of promotoras, and with staff of the programs where promotoras worked. Following is a description of the fieldwork process. Next, I will describe the sampling methodology followed for in-depth data collection, including the description of the sampling method for participating organizations. Next, I will describe the implementation of the semi-structured interviews as well as the focus groups. Finally, I will describe the analysis of the data. 2 See Appendix B for a demographic description of participating promotoras. 8


Fieldwork In this study I conducted fieldwork, understanding this methodology as intensive and extensive on-going interaction with subjects of research on their home ground (Van Maanen1988: 2). The study involved moving to Weslaco, a town in Hildalgo County, approximately five miles from the border line, across from the Tamaulipas, Mexico, town of Las Flores or Nuevo Progreso. I rented an apartment in Weslaco, where I lived for 12 months, with brief interruptions every two or three weeks. In Weslaco I had an office at the Colonias Program of the Texas A&M University, one of the case study programs. The program rented several offices in a one-story building that housed other local organizations. Meetings were also held in this building, bringing together diverse organizations of the local human services community. The Colonias Program was highly appreciated in the community because of its constructive role in pulling together resources to build community centers in isolated colonias. Furthermore, the programs field director was greatly appreciated and respected as a long-time citizen, leader, and businessman. I shared an office with a colleague from the program and with the research assistant who assisted in fieldwork and who was contracted two months into the process. Having an office at the program was a major factor in facilitating my introduction into the area, into the health community and outreach programs, and into the colonias. The program regularly held meetings with various local organizations, to which I was invited to introduce myself and talk about the 9


research project. As a result of this process, I became acquainted with the people who held decision-making positions in several of the promotora programs. During the first period of my stay in Weslaco, I had to ensure the participation in the study of several organizations that integrated promotoras in their model of community outreach. The director and coordinators of the Colonias Programs gave me the names of other program directors who were to let their staff know that I would be contacting them. This referral process played an important role in early fieldwork since, after all, I was a stranger, an outsider, and (sometimes) even worse, a researcher. Research did not have a very good reception among some organizations based on past experience with outside researchers who did not respond to the expectations of program directors. Being associated to the Colonias Program was an effective way to introduce myself to the community as a researcher who did not conform to the negative stereotypes that had been built by past research projects. Moreover, the Colonias Program had been building an in-house community-based research program, whose director was the Principal Investigator (P.I.) of the study, thus providing legitimacy to my role and facilitating my acceptance by the community. Meetings were scheduled with the directors of six programs the research team wanted to invite to participate in the study. On some occasions I attended these meetings alone, and in other occasions the project P.I. accompanied me. However, since the P.I. did not reside in the area, I did most of the introductory work. 10


The process of securing the participation of community and health outreach programs in the study facilitated the establishment of rapport. During these meetings I was commonly told the names of key players in the community, such as people at the local university and promotoras who were leaders in the local association of promotoras. Meetings and invitation to community activities followed my initial contacts. For instance, I was invited to attend to the meetings of the promotora association, an organization that represented the interests of promotoras from the LRGV, many of whom were employed by the programs who figured in the research project. My first participation in these meetings was to introduce myself, the research assistant, and the research project. At subsequent meetings, I reported to the association about the progress of the research project, including the partial findings. Since the meetings were held in Spanish, my presentations were in that language, something that I felt was appreciated by promotoras. In these meetings I made acquaintances with some of the promotoras who had been instrumental in the creation of the association, a group that was a model for outreach workers in other parts of the state. Appointments were made to continue these conversations in a later date, which we did in the form of recorded informal interviews (Bernard 1994). My host agency had several community centers in colonias located in Hidalgo, Cameron, and Starr counties. Each community center was staffed by a group of promotoras, all of whom lived in the same colonias where the centers were located. Team meetings involving these promotoras were held in the building where I had my office, which meant that frequently the building was 11


visited by groups of women from several colonias who were employed as promotoras. I thus had the opportunity to meet the ladies and to establish rather friendly relationships with some of them. These encounters usually produced invitations to visit the community centers and the colonias. On many occasions during my visits I was walked through the colonias by my hosts. As we walked along, they introduced me to the local residents with whom they stopped to chit-chat. These visits gave me the impression that I was considered a guest in communities that looked like the homes of my hosts. It was during these visits that I started to develop the notion that the job promotoras did was not like any other job; they showed a commitment and a dedication that was unlike that commonly shown by professionals hired to do a specific task. While visits to colonias in company of promotoras from the host program took place throughout the research process, the early visits were essential in providing me the necessary feeling of a world that was radically different from that of the town where I attend college, but that was more similar to many of the slums I knew in Chile, my home country. The border area in general, and colonias in particular, are different in physical, infrastructural and cultural terms from any other place in the United States. After a few weeks I started to feel at home. Before formal interviews started to take place I had the opportunity to talk informally with individuals from different walks of community life. On my own, I met with a priest from one of the colonias where a community center was located. In company with the project P.I., I met with a local university professor 12


who had conducted an important study on border cultural identity, with a public health researcher who was conducting research on border health and on health promotion, with leaders of the promotora association, with staff from programs, with promotoras who worked in several organizations (case study and not case study organizations), and with community residents during my visits to colonias in the company of promotoras. This process, which I would characterize as an extended period of rapport building, was crucial as a way to become familiar with the place, the people, the culture, and the subjects that mattered locally in relation to the practice of promotoras. The interviewing guide was developed based on the knowledge acquired during the first month of rapport building as well as on an extensive literature review. The consequence of building the semi-structured interviewing guide during fieldwork was that the categories included in the guide were based on empirical knowledge and had a better chance of being culturally pertinent (i.e., that would make sense to the interviewees). In a sense, building a data collection instrument during fieldwork makes a pilot process unnecessary, since fieldwork provides the opportunity to identify categories and to check their validity in interaction with people. Following the postulates of grounded theory (Glaser and Strauss 1999), the theory of promotoras practice was built through the description of data and the identification of emerging concepts, categories, and propositions. Early interpretations were validated, transformed, and adjusted in continuous fieldwork. 13


Semi-structured interviews with promotoras were conducted in either Spanish or English, depending on the preference of the interviewee. Switching from one language into the other during a single interview was not uncommon. Although Spanish is my native language, I did not automatically understand the local variation of Spanish. The initial rapport building process was critical in allowing me to learn words and rhythms of the local language. Moreover, the participation of a graduate student as a research assistant was vitally important. She was a native of the area, a long-time resident of one of the largest colonias of the Valley. She was crucial in translating language and culture and thus in helping me to understand what people, traditions, and customs meant. Interviews were conducted throughout a period of seven months, complemented by observation of activities, participation in community events, community parties, and lunch and dinner with promotoras and with staff from programs. Thus learning was a continuous process, not restricted to formal data collection. The relationship I established with promotoras was rather friendly. A group of them was particularly cordial, sharing with me informally throughout the year I spent in the area. A group of four of these women was invited to travel to Tampa to present their experience at a University colloquium, something that they appreciated greatly. Interviews with promotoras were conducted in either their homes or in the buildings of the programs where they worked. The interviews took an autobiographical life history approach, emphasizing general life trends and the dynamics of interpersonal relationships (Angrosino 1994: 26) rather than a 14


simple chronological account of what they do in the job. I started the interview by asking them to talk about themselves, who they are, their families, where they come from. The response to this single question included objective facts such as place of birth, characteristics of the family, education, work experience, immigration. It also involved more discursive explanations of opinions, values, and attitudes. On many occasions the whole interview required asking only a few questions, since the introductory question triggered a very complete account of who the women were, what they did, how they did it, and what that meant to them. Although the completeness and intensity of the account varied from interviewee to interviewee, no one seemed to object to talking about their life experiences. On several occasions they became emotional, weeping as they remembered what their lives had been. I had to learn to react appropriately to these instances of intense emotion, which I did by just letting the interviewee express whatever she wanted to express, not inquiring into details that might trigger further emotion. In fact, most frequently, such details and explanations were given voluntarily, as part of the process of the account. Focus groups were scheduled with residents who participated in activities with promotoras. I asked promotoras to select participants for the focus groups, making sure to include to include representatives of the different activities they do in the community. For instance, a group would be put together consisting of residents who participated in a parenting class taught by promotoras, of residents who were visited at their homes, and of those who have received help with immigration issues. Although asking promotoras to select the group could very 15


well have produce a biased sample, I concluded that this was the best approach to take since the residents trusted promotoras and would not as readily respond to the call of an outsider. Bias did not become an issue because focus groups data were triangulated by observation of activities; extended fieldwork allows the researcher to learn about the subject matter of the research through a diversity of means, not all of which are formal data collection procedures such as focus groups and formal interviews. Unstructured interviews were also conducted with case study program staff and service providers. Program staff included the program director and a coordinator who worked closely with promotoras. They gave a description of the organization, its mission, goals, and strategies, as well as a description of what they expected from promotoras. This information provided the organizational context necessary to understand the practice of promotoras. I also asked program staff to name two providers who worked with promotoras so that I could talk with them. Providers were usually staff from the programs that received referrals from promotoras. These interviews produced data about how useful promotoras were for providers, and how they were able to connect residents to their services. Once again, these interviews were supplemented by the knowledge acquired through fieldwork, observing and talking informally to providers, residents, and promotoras. An important methodological consideration of this research has to do with the kind of observation that I conducted. I would suggest that in this study observation was a context of research. Following Angrosino and Mays de Prez 16


(2000: 676), observation was the context for interaction among researcher, promotoras, community residents, and program staff; it was within this observational context that formal data collection activities, such as interviewing, focus groups, and even focused observation (Werner and Schoepfle 1987: 262-264) took place. Although I had planned for interviewing, focus groups, and observation, I only knew about the particular form these data collection methods would take as a result of being in the field and interacting with the people. During fieldwork, I was a peripheral member researcher (Adler and Adler 1994: 380), meaning that I did not participate in the activities that constitute the core of the promotora practice. I was around, visited with promotoras, visited with community residents, attended social activities invited by promotoras, and even made friendship with several of them. This peripheral membership was enough to allow me to develop the desired insiders perspective. Indeed, I would think that an active-member researcher role (Adler and Adler 1994: 380) would have been very difficult to obtain in this case, since for playing a role in the core of the promotora practice I would I have to have become one, something not doable given that I do not fit the profile of promotoras. There are other roles close to the core but not at the very core, such as coordinator of promotora programs and community residents served by promotoras. Both of these roles would have been virtually impossible to play; the fact that data were collected from several programs made it impossible to play the coordinator membership role, and in order to participate as a community resident I would have to have become a resident needing the services delivered by promotoras, which was not 17


recommendable given my identification as an outsider that did not fit the profile of a regular colonia resident. Therefore I conclude that the peripheral membership role I took was the most appropriate under these circumstances, and that it allowed me to obtain an insider perspective that would not have been possible to obtain if I were to collect data exclusively through formal methods. The fieldwork approach that I took allowed for an in-depth inquiry and an approximation, through talking and interacting, to the subjectivity of culture, without making it absolutely necessary to play a core membership role in observation. Sampling Research for this dissertation corresponds to case studies conducted with four agencies (out of six). Agencies were selected following a combination of what Bernard (1994:89) refers to cluster sampling and purposive sampling. In cluster sampling the participating population is sampled from the natural grouping or clusters in which they live. The selection of agencies took place considering their location along the Texas LRGV, and the individuals representing these agencies were selected following a purposive sampling approach. The study included promotoras who worked in the selected agencies, the personnel of the employing agency (director and one or two coordinators), and community residents. Participating promotoras were identified by program coordinators. The criteria for selection were that: a) promotoras represented the multiples projects of the given agency, and b) had been working as promotoras for at least three months. These criteria insured that the promotoras selected covered the wide range of activities in which they normally engage in the U.S.-Mexico border, and 18


that they knew enough about the work to provide information about the process. In addition, each promotora was asked to identify a group of colonia residents for participation in focus groups. Normally, the members of these groups participated in most activities organized by promotoras. Semi-Structured Data Collection Data were collected combining a set of methodologies and procedures 3 All data collected were analyzed qualitatively. Triangulation included the following: a) Unstructured interviews: Unstructured interviews were used as I introduced myself to the field, as well as throughout the study, as a complement to semi-structured interviewing and to field observation. The purposes of unstructured interviewing were: a) to introduce the research to the community; b) to obtain some preliminary information about the community and the subject of the study that would be instrumental in planning subsequent data collection; and c) to further explore the material discovered through semi-structured data collection methods. Unstructured interviews were conducted with: community leaders, including schoolteachers, priests, and clinic directors; promotoras; the promotoras family members; and residents of the community. b) Semi-structured interviews. Semi-structured interviews were conducted with promotoras, service providers, and personnel from the agencies that employed the promotoras. Promotoras interviews were at the core of the study, while interviews with service providers and with agency staff complemented 3 See Appendix C for the data collection protocols and Appendix D for IRB approved Informed Consents. 19


promotoras perspectives. These interviews aimed at identifying interviewees perspectives on a number of issues related to the object, methodology, and impact of promotoras practice. Twenty-six semi-structured interviews were used in the analysis. Interviews conducted with promotoras followed a complementary approach, i.e., the interviewer allowed interviewees to freely express themselves about topics related to, but not explicitly included in the protocol. By doing so, the interviewees were able to explore a number of issues that, although not directly related to the topics included in the protocols, still constituted relevant matters from their point of view. This procedure was implemented through a life history approach to the interview, so that the interviewees could develop accounts of their histories as promotoras, in which they included descriptions of the different landmarks of their lives. These accounts normally included descriptions of their experience as immigrants and as workers, both in Mexico and in the United States They also involved discussion of their family relationships. These interviews lasted between 60 and 90 minutes and were usually emotional, since promotoras touched on the aspects of their lives instrumental in shaping their identities as border women. c) Focus groups. Focus groups were conducted with community residents who were in contact with promotoras. Focus groups had the purpose of identifying residents perceptions about promotoras work, particularly in regard to how their lives were affected by the women. Focus groups complemented the 20


interviews conducted with promomotoras and were useful as a mean for comparing and contrasting data. Eight focus groups were conducted. d) Field observations. Observations were conducted of different activities common in promotoras daily work: home visits, training sessions, and health fairs. Observations were also conducted in community activities, such as colonia parties and celebrations. Field observations were written in English and Spanish by the research assistant and by myself. Field-notes served as guides to fieldwork as well as opportunities for reflection upon aspects of promotoras practice that could not be easily captured through interviews. Field-notes were coded through an emergent coding system, not using the pre-defined coding structure. Analysis Data were analyzed looking for emergent themes. Following the grounded theory approach (Glaser and Strauss 1999), the theory of the practice of promotoras was built from bottom-up, through the description of data, and through combining emerging concepts, emerging categories, and emerging proposions. However, analysis did utilize a number of categories (represented as codes) that served to maintain data description within the thematic framework of the study, and in this sense analysis departed somehow from strict grounded theory. The analysis was aided by ATLAS.ti (Scientific Software 2004), software for qualitative analysis 4 Using this software, data were coded through an emerging coding system, supplemented by a number of basic codes that derived 4 See Appendix E for codes used in the analysis and Appendix F for a sample of the categorization of codes using Atlas.ti. 21


from the studys research questions and objectives. These basic codes served to focus exploration, while emergent codes reflected the theory of promotoras represented in the data. The basic codes served to characterize aspects of promotoras experience that I knew beforehand needed to be characterized. These included: basic characteristics of the programs, basic demographic aspects of promotoras, basic work experience aspects, and large categories of activities and roles. One of the a priori codes was Workers Activities. I coded every passage that denoted an activity done by promotoras during their workday. However, the specific activity was identified during exploration of the data, thus codes representing those specific activities emerged from data description. These emergent codes became available to be used in the coding of all of the interviews. Complementarily, memos 5 were written along the process of coding data. Memos represent a space for interpretation that insures that the emerging theory is grounded on data. 5 See Appendix G for a sample of memos written in the analysis process using Atlas.ti and Appendix H for a sample of quotations associated with memos. 22


CHAPTER THREE LITERATURE REVIEW This chapter is divided into three sections, which correspond to the three key conceptual elements necessary for the understanding of the practice of promotoras from the point of view of community development. First, I will examine the notion of culture brokerage, including a discussion of agency as the concept that allows us to comprehend why promotoras are culture brokers according to the anthropological literature definition of the concept. In reviewing this literature I describe the theoretical and applied contribution of anthropology to the notion of culture brokerage, identifying the concepts that best explain the practice of promotoras from the community development perspective. Second, I will examine the existing literature on community health workers and promotoras, identifying the connotations of the terms as well as the roles they play as linkages between systems. And third, I will examine the anthropological literature on the U.S.-Mexico border, paying special attention to issues of culture and identity. This section provides a cultural framework from which to understand the practice of promotoras as a form of culture brokerage that acquires its significance within the particular context of the border. 23


Culture Brokerage and Agency Promotoras from the U.S.-Mexico border, as well as community health workers in general, connect residents with service providers and other agents from outside the community (Gomez-Murphy 1998; McFarlane 1996; Sherer 1994; Sanchez-Bane and Moya 1999; Rosenthal 1998). The notion of connecting one entity with another brings to mind two notions that I would like to explore in this chapter as interrelated concepts, and that will become the pillars of this studys conceptual framework: culture brokerage and agency. The guiding thesis of this study, as already described in the Introduction chapter, is represented in two statements: Promotoras are culture brokers because they connect residents with residents, and residents with the external system of services. Womens personal histories as border women shed light on their decision to be promotoras as well as on their performance as innovative culture brokers. Culture Brokerage The concept of culture brokerage was introduced into the anthropological literature by Eric Wolf in a 1956 paper in which he called for a shift of anthropological studies from the study of communities to the study of the connection between local communities and larger encompassing systems (Wolf 1956). Culture brokerage has also been referred to as mediation, and the anthropological literature finds examples of other denotations that are equivalent or at least similar concepts, such as traditional curers (Landy 1974) and even 24


shamans. However, for the sake of conceptual clarity, I will focus on the use of the term culture brokerage to refer specifically to the role of mediator. Wolfs work was followed by several studies that examined the concept and practice of culture brokerage from an ethnographic perspective, including the works by Geertz (1960), Silverman (1965), Press (1969), Loeffler (1971), and Paine (1971). Then, in the 1970s there was a hiatus in the theoretical development of the culture brokerage construct, although in that decade applications of the concept in health services and education started to emerge. Examples of such application include the influential work by Weidman (1978) on access to mental health services by minority populations in Miami, part of the Miami Health Ecology projected implemented by the University of Miami School of Medicine. Other applications of the concept emerged in the 1970s, 1980s and 1990s, particularly in mental health and in education. Some of these works will be discussed in other contexts later in this chapter. Although it may not be crucial for the development of this studys conceptual framework, it is worthwhile to consider why theoretical developments of culture brokerage decreased starting in the early 1970s, even as the multidisciplinary applications of the concept in health and education program planning and development have increased. My view is that of Landy (1974), who believes that the theory of culture brokerage is part of an anthropology of role, which has not occupied a significant place in the anthropological discipline. Furthermore, the study of roles could be connected to a functionalist paradigm within anthropology, a paradigm that lost force and was increasingly replaced by 25


context-oriented or political economy paradigms. Thus Wolf called for a sort of a paradigmatic shift when he said that anthropology needed to look at connections between local communities and the larger system within which those communities exist, and asked the discipline to refocus its attention away from the community as an isolated entity into its webs of inter-relations with surrounding systems. Wolf said (1956:1065): It is more appropriate to view them (local communities) as the local termini of a web of group relations which extend through intermediate levels from the level of the community to that of the nation. In the community itself, these relationships may be wholly tangential to each other. However, the study of relationships is still a structural view, and it does not emphasize on the economic and political context within which those relations occur. In my view, the culture brokerage concept was left behind and replaced with more contextual-oriented approaches. In this study I return to the concept of culture brokerage, not to imply that by itself it explains the practice and impact of promotoras and community health workers in general, but that it certainly helps to clarify the very important role they play as connectors and mediators between systems that before their coming into the scene could not connect and understand each other in meaningful ways. The use of the culture brokerage concept as a prism through which to examine the promotoras practice does not exclude the need to look at issues of ethnicity, work, and gender which play significant roles in defining the identity of promotoras. Indeed, studies that follow this one should shift the focus into those 26


areas in an effort to complement the culture brokerage approach developed I this study. Wolfs call for the study of connections between the local and the macro-local reflected the concerns of Steward (1950: 107), who expressed concern with the functional dependence of local communities upon larger systems, and the ways in which such that dependence modifies communities. Wolf claimed that understanding complex societies (such as Mexico, which he was studying) did not require additional community studies, but instead studies of the web of relationships which connect localities and national level institutions. Wolf examined such a web of connecting relationships by looking at how in Mexicos post-Columbian history there were particular social categories that served as connectors and mediators between the locality and the national level institution. He stated that: in post-Columbian Mexico these mediating functions were first carried out by the leaders of Indian corporate communities and royal officials. Later, these tasks fell into the hands of the local entrepreneurs, such as the owners of the haciendas. After the Revolution of 1910, they passed into the hands of nation-oriented individuals from the local communities who have established ties with the national level, and who serve as brokers between community-oriented and nation-oriented groups 6 (Wolf 1956: 1075). Wolf adopted the term brokers to refer to those who connected and mediated, and were defined as the people who stand guard over the crucial junctures or synapses of relationships which connect the local system to the larger whole. The brokers function is to relate community-oriented individuals who: 6 Emphasis added. 27


want to stabilize or improve their life chances, but who lack economic security and political connections, with nation-oriented individuals who operate primarily in terms of the complex cultural forms standardized as national institutions, but whose success in these operations depends on the size and strength of their personal following (Wolf 1956:1075-1076). Wolf added that those functions are expressed in cultural forms and mechanisms that vary from culture to culture, citing the Latin American compadrazgo as one such form. One of the properties of brokers is that they have to serve the interests of the two groups they are mediating (1956:1076), and as such they have to cope with any conflict that may arise as a result of this mediation. Wolf noted that brokers are in reality buffers between groups (1956:1076). A characteristic of Wolfs brokers in Mexican post-Columbian history is that, although they rise from the local community, they are not exactly the same as the local community. In other words, brokers have acquired some level of specialization that makes them different from other members of the local community. For instance, the post-Revolution brokers were people born in the rural communities of Mexico but who had been able to insert themselves in the political and administrative bureaucracy that came about as a result of the reforms instituted in the work of the Revolution. Thus, the broker acquires new statuses, new roles, and in the process transforms himself/herself to the point of not being exactly as the other members of the local community, although still being able to represent its culture. Thus the broker becomes, in Wolfs Mexican case, a person of in-between social identity. 28


Silverman (1965: 172) used the concept of mediator to refer to the same notion introduced by Wolf a few years before. Silverman saw that the mediator concept is useful as a means to explain the connections between parts and wholes of societies. She introduced the concept of mediator to reinforce Wolfs use of the culture brokerage concept. Silverman agreed with Wolfs notion that the mediator functions as a link between local and national systems but added yet another feature, that is, that of mediators. The author distinguished between a mediator and someone who merely contacts two systems. The mediator generates action from/to the local system and the external system. Thus the mediator not only links, but also generates action, given to it possibly a social change representation. In Silvermans words: The concept refers to a status which functions as a link between a local system and a national system. In interact ional terms, the mediator may be seen as one to whom action is originated from the national system and who in turn originates action to the local system; to some extent, the direction is reversible, the mediator still being the middle element (Silverman 1965: 173). Following Wolfs definition of broker, Silverman (1965: 173) suggested that the mediator would have to comply with two conditions in order to be defined as such: critical functions and exclusivity. By critical functions, Silverman meant that the functions of a mediator should be of direct importance to the basic structures of either or both systems. Silverman illustrated this point by saying that someone who brings awareness of a new fashion in clothing from the national to the local system would not be playing a critical function; thus, that person would not be defined as a mediator. By exclusivity, Silverman meant that mediators have near-exclusivity in performing the functions they perform. In other words, if the link is 29


to be made at all between the two systems with respect to the particular function, it must be made through the mediators (1965: 173). Moreover, Silverman added the very important notion that mediators would cease to be recognized as such if they lost exclusive control of the junctures or functions. Silverman added that the term mediator was developed in the anthropological literature that focused on societies that retain a strong folk element, that is, societies in which the local units are separated from the whole. Silverman added that this would be a trait of pre-industrial societies that is also found in some modern societies in transition. At this point it is important to note that Silverman, as well as Wolf (1956) and Geertz (1960), wrote at a time when theories of modernization were in fashion; that is, social sciences studied change occurring as societies transitioned from pre or un-developed to developed societies, or from rural to urban. Silverman conducted a study in contemporary Italy, in a community with a relatively high level of integration into the national society. She examined the client-patron relationship that served to connect local communities with the larger system. Patrons represented the figures of authority embedded in institutions external to the community, while the client represented the local individual who related with the patron. The connection and mediation between the locality and the external social system occurred, therefore, through the action of the patron. Geertz (1960: 249) agrees with Wolf and Silverman in that it is necessary to examine the connection between groups rather than insist on community studies, particularly in the context of processes of nation-building. In order to do 30


that, he introduces the kijaji, a local Javanese Muslim teacher, in Indonesia. The kijaji is a specialist in the communication of Islam to the peasantry and an established religious leader who directs his own religious school (Geertz 1960: 230). The kijaji combines two roles, both of which implying connecting the local with the national. Traditionally, the kijaji has been the link between an exclusivist Moslem creed and the local tolerant countryside. At the time of Geertz study in the 1950s, the kijaji had begun to play a more of a political role, linking the local communities to the national state; in this new role, the kijaji became the local party leader, with all of the power and prestige that entails (Geertz 1960: 230). Geertz calls for the need to focus on the connection between the local and national levels of socio-cultural integration because such a focus can tell more about the process of nation-building in then-new countries of Asia and Africa, than a focus exclusively at internal processes of local groups. Geertz states that a study of those people whose roles in the community consist of brokering between the local and the national levels, such as village chiefs, local civil servants, petty traders and businessmen, political party leaders, small town professionals, would tell much about the possibilities of national integration of the localities represented by these people. In that sense, Geertz states that the kijaji should be studied in terms of the changing role of the culture brokerage, as the local communities build networks of communication that link them to the nation. This notion presents fascinating possibilities for the study of culture brokerage in contemporary society, where cultural change is rapid thus integrating the local to 31


the global as quickly as not seen at the time when Geertz was writing. Culture brokerage in the U.S.-Mexico border is such a case. Finally, Silverman introduced a very important clarification, resulting from her study of patronage relationships in Italy. She said that the model of the mediator is flexible, i.e., it allows for some variation in its configuration. Thus Silverman (1965: 183) suggested the following configurations: Different type of relationships. The relationship between the mediator and the community can be of patronage (i.e., unequal relationships, like in Wolfs broker), but it does not have to be so. Different mechanisms to establish relationships. The relationship local community-broader system can be established through different mechanisms, including kinship, ritual kinship, employment, or political appointment. Variation in frequency and intensity of relationships. The interaction between the mediator and both systems can be sporadic rather than fairly continuous. At the same time, the quality of the relationship may be more or less emotionally intense than that between patron and client, which was the case in Silvermans study in Italy. Variation in nature of mediators. The nature of the mediators themselves may vary greatly-their history, their traditions, and the manner in which they are recruited and replaced. 32


Variation in functions. There is variation in the particular functions the mediators perform and in the way in which these functions are combined. Variation in size of mediating group. The size of the mediating group may vary, determining the smaller or larger number of channels into the local system. Variation in kind of integration with local system. The kind of relationship of the mediators to the local system and the degree of their integration into it may vary. Mediators may be part of the local system yet not reside in the community, they may reside locally but remain detached from the local system, or they may be outsiders with only tangential relationships to the local system. Silvermans analysis represents a significant contribution to the application of the mediator or culture brokerage notion to the study (and implementation) of concrete development initiatives that integrate a broker as mediator between locality and the larger system. All of the elements of variation are relevant when attempting to apply the concept of mediator or broker. However, I will comment on three of these variations, i.e., the kind of relationship, mechanisms to establish relationships, and types of integration into the local system. Regarding the kind of relationships that the mediator or broker establishes with the local community, Silverman suggested that mediators or brokers can be patrons in a patron-client relationship, but that they can also be part of a more egalitarian relationship. Loeffler (1971) agreed that there are two types of 33


mediators or brokers: those who are part of a hierarchical, stratified social system, and those who have an egalitarian relationship with the local community. He called the first patron-kijaji type; the second was the representative mediator type. The patron-kijaji type represents those cases when the mediator or broker holds a different position in terms of power regarding the local community, either through ritual or other forms of political or economic processes. Silvermans patron-client relationship, Wolfs mediators between the local community and the larger system, as well as Geertzs kijaji, are examples of this patron-kijaji type of broker. By contrast, Loeffler based the representative type on his own fieldwork in Iran, where he found Mahmud, a peasant of the 1930s who advocated for the rights of the community before the national authority, the Khan. Mahmud spoke out against the Khan and Kathodas (authority) and proclaimed that the land that the peasants cultivated was their own exclusive property and the exaction of any tribute was illegal (Loeffler 1971: 1079). Loeffler added that Mahmud is like most of the other members of the same village in his subsistence role. In terms of his personality and attitudes, however, he exhibits traits that are in marked contrast to those usually associated with Persians, peasants as well as urbanites, corresponding, in a sense, more closely to the Persian ideal (1971:1079). Furthermore, Loeffler described Mahmuds behavior being motivated and validated by his distinct social philosophy emphasizing the well-being of the community as a measure of morality (1971:1079). Thus, Mahmud is not different than the norm of his community in terms of social stratification, and at the same time, Mahmuds 34


motivation as an advocate come from his particular desire to do good to his community. This social philosophy of community well-being may indeed contribute to the mediator or broker being perceived by the community in an egalitarian manner. The possibility of an individual becoming a mediator or broker through a variety of mechanisms also strengthens the applicability of the concept. An individual can become a mediator or broker, as in the case of Wolfs Mexican post-Revolution brokers, because of his ability to establish advantageous political relationships with the regional political authority or with the dominant political party, and thus become someone capable of representing the local community before those political structures. At the same time, an individual can become a mediator or broker because of his possession of a particular knowledge that is valuable by society, such as the case of Geertz kijaji as spiritual and religious teacher and leader who, because of his knowledge, can mediate between the local peasant community and larger society while at the same time, protecting the local community from the adverse effects of modernization. Loefflers Mahmud is an advocate, someone with an ethical and moral sense of responsibility for the community in which he lives. Thus, in his case, the motive to become a mediator or broker is his sense of ethical and moral responsibility to the people in his village. In none of these cases, including Silvermans patron, do the mediator/broker acquire their roles as a result of employment, although Silverman notes that such a process might be possible. This is an important concession because it opens the doors for people who are brokers because they 35


were hired to mediate between local groups and larger society groups. Such is the case by bilingual school aides (Weiss 1994), the teacher as a broker (Gentemann and Whitehead 1983; Stage and Manninng 1992), and the mental health aide (Singh, McKay, and Singh 1999). It is also true, with some restrictions, of the promotoras examined in this study. As it will be further explained in the discussion chapter of this dissertation, promotoras may or may not be employed to connect and mediate, but even if they are so employed, there is a sense of responsibility for the well-being of the local community that motivates them beyond the motivation that may be provided by their status as employees. They are much like Loefflers Mahmud, whose social philosophy is at the center of his motivation. The kind of integration of the mediator or broker into the local system is also an aspect of great relevance for the application of the concept to development projects. Silverman suggested that mediators can be part of the local system, but that is not a necessary condition for an individual to be a mediator. The relevance of this element can be directly associated with the case of the promotoras. One of the central conclusions of the study, as will be seen in the conclusions chapter and in the discussion chapter, is that living in the communities where they work is an important aspect of the input of the promotoras, because it allows them to work in a community they know very well, including its social relations, cultural practices, and resources. At the same time, those promotoras who do not live in the communities where they work show similar levels of commitment to and identification with the people with whom they 36


work. I suggest therefore, that in the case of promotoras, not living in the precise community where they work does not constitute an impediment for their roles as mediators or brokers, since there is a social philosophy of caring for the well-being of their communities that responds to a wider sense of ethnic identification, that transcends membership in a specific colonia. The concept of culture broker has been applied as a construct to interpret teachers impact on their pupils, school aides impact on students and the community, the process of mediation conducted by Indian interpreters in the time of colony in the United States, and in the area of mental health services. All of these applications recognize the utility of a notion that entails more than connections. It requires a process of facilitation of cultural understanding between groups that because of language differences cannot easily communicate with one another. Perhaps the first contribution in the area of application of the culture broker concept (or culture broker, or mediator, as it is sometimes utilized), was the work done by Weidman with the Miami Ecology Project. Based on the definition of culture brokerage developed by Wolf (1956), Weidman (1978) incorporated the role of culture broker into the design of a mental health prevention project in Miami in the early 1970s, in a multi-ethnic community made up of Bahamian, Hatians, Cubans, and Puerto Ricans. The culture broker role was introduced and assigned to Ph.D.-level social scientists (medical anthropologists generally), who served as mediators between the local community and the external city system, as well as between the local culture and the western medical culture. 37


Several applications of the culture brokerage concepts in mental health, followed to Weidmans model. Schwab, Drake and Burghardt (1988) presented an interesting application of the culture brokerage concept to case management in mental health services. The model suggested by the authors is for a mental health case manager to serve as a culture broker between the patient and the medical health system. This model is focused on the patient-health system interaction, and from that interaction the case manager is able to broker with different areas of the persons daily life. Schwab, Drake and Burghardt stated (1988: 178): "The culture broker must also offer a knowledge resource for both patient and doctor. Illness and treatment regimens must make sense to the patient in terms of his or her intra-psychic and social worlds; similarly, some of the patient's private and social worlds must be explained by the doctor." In this sense, this notion of culture brokerage is different from what Moldy (1981) described in her article, since the role of the broker is restricted to the medical interaction. However, the culture broker in the model proposed by Schwab and associates is the role attributed to the case manager; hence, the restriction of the role is in reality a condition of the definition of what the case manager can do. In this case, the case manager's role is solely restricted to "help patients negotiate their way through the medical care system. (1988:179). The case manager model is well suited for the culture broker role, because of the case managers comprehensive knowledge of the patient, including his/hers daily routines, social networks, and knowledge of how patient expresses physical and psychological 38


distress, as well as knowing how other factors, such as financial problems and the home environment affect his/her health. Moldy (1981) presents a compelling description of the culture broker role by a community health aide in a health care setting in a Hungarian neighborhood in a United States city. The community health aide was a woman from the same ethnic community, although not from the same territorial community, who in addition to being a health aide was a well known folk singer within the Hungarian community, as well as the daughter of a health care professional. The community health aide, whom Moldy names Mrs. T., worked in a hospital setting with elderly members of the local Hungarian community. Moldy describes Mrs. Ts function as one of a mediator, a go-between, as someone who translates and interpret. In Mrs. Ts own words, as reported by Moldy: I function as kosbejaro, I translate, interpret to the client what is happening to him, what is expected of him by the professionals of the system. At the same time I also explain to the professional workers what the client expresses and experiences and what can be expected of the client in light of his background, his history. This is more than translating, this is interpreting, it is mediating (Moldy 1981: 117). Mediation occurs between the ethnic community and the scientifically and technically oriented culture of the health care system (1981:117). Mrs. Ts role is sustained by the tension existing between the two cultures. As Wolf stated, the culture broker is a buffer that mediates the tension that exists when two different cultural systems are in contact. The attributes of Mrs. T. that enable her to carry out her functions are her bilingual ability, the trust that her clients and the professional staff had of her, as well as the power and authority vested on her by 39


both the clients and the professionals from the health care system (Moldy 1981:117). Singh, McKay, and Singh (1999: 5) identify the skills for an effective culture broker in the mental health care setting: a) the individual must have adequate language skills in both the clients language as well as the systems language; b) the individual must have knowledge of mental illness as perceived by the client as well as by the system; c) the individual must have ability to tolerate what may be seen as culturally intolerable behavior (therefore, must understand the clients culture); d) the individual must have the ability to accurately describe the clients problems; e) the individual must have the ability to keep confidentiality; f) the individual who plays the culture broker role must be able to reduce the clients sense of isolation and must be able to provide social support and solidarity. The concept of culture brokerage has also been applied in education. Weiss (1994) presents a very interesting case of culture brokerage applied to the role of the school aide. The school aide in the public education system, similarly to the community health aide, is a representative of the same ethnic community or social class as the students with which she works. Weiss examines the role of the school aide from the stand point of someone who is in-between two cultures. The central thesis is that people like the school aide, who are not neither here nor there, somewhat betwixt and between, to paraphrase Victor Turners liminality, can use the concepts of marginality-ambiguity, flexibility, and special knowledge-to reduce conflict and facilitate change, a much desired goal for any 40


educational system" (Weiss 1994: 337). Following Frable (1993), Imamura (1990), and Sibley (1981), Weiss noted that marginals had the unique ability to contribute as innovators to both communities and to help reduce the stress generated by opposing philosophies during culture contact episodes (Weiss 1994: 337). At this point, two concepts deserve clarification. First, marginality and innovation was introduced into the anthropological literature on culture brokerage by Press (1969) who suggested that the mandate that sanctions and supports the innovations of the culture broker emerges from role ambiguity (Weidman 1978: 883). Thus, role ambiguity, or that state of marginality that apparently characterizes the culture broker role or the culture brokerage process, is a precondition for the innovation capacity of the individual who plays the culture broker role. The second concept is that of the culture broker capacity to reduce stress or act as a buffer. The buffer notion was introduced in the literature by Wolf (1956: 1076), who said that the position of brokers is an exposed one since they face in two directions at once. Wolf added that, They (brokers) must serve some of the interests of groups operating on both the community and the national level, and they must cope with the conflicts raised by the collision of these interests. They cannot settle them, often act as buffers between groups, maintaining the tensions which provide the dynamic of their actions 7 (1956:1076). Wolf noted, however, that the presence of the culture broker in an encounter between cultures (i.e., between world views) would not avoid the emergence of stresses and conflicts inherent in the interaction. However, the culture broker can serve to diminish the intensity of such stresses or conflicts, and in certain cases, can even eliminate them. This assertion is important 7 Emphasis added. 41


because it signals that the culture brokerage process that is possible through mediation roles played by particular individuals should not be seen as a replacement of local or societal systemic interventions aiming at reducing stresses of conflicts derived from the encounter between cultures. The culture brokerage process should be seen as an important component of such systemic interventions, even though it is not the systemic intervention per se. In the educational field several applications of the culture brokerage concept can be found. Weiss (1994) discusses the school aide as a culture broker. The author defines the school aide in the following terms: ...they (school aides) are tangential and temporary members of a system in which they are neither teachers nor students and are denied access to the privileges and responsibilities of both groups. Thus aides are limited participants in the mainstream of school society; yet they are able to effectively function on both the local community and the school (Weiss 1994:338) In this case, the school aides are indeed tangential members of both communities, that of the school and that of the students. They are tangential members of the school because they are not main players of the system, as teachers would be, and they are tangential members of the childrens community because they are not children, although they may share with them social class and ethnicity markers. This tangentiality and marginality to which Weiss refers as a feature of the school aide may not be the case with culture brokers in general, at least not in relation to both systems. The community health aide described by Moldy (1981) is marginal in both systems, since she is not elderly like her clients, nor is she a player of high status in the health care system. The promotoras examined in this study, on the other hand, are indeed marginal in the social 42


service or community development agency that hire them, since they are low-paid as compared to the rest of the staff and they are fully participants in decision-making (with the exception of one of the agencies, as will be seen in the findings chapter of this dissertation). But they are fully participants of the communities where they work. Even those who do not live in the same territorial communities where they work are fully participants in the ethnic communities where they work. Unlike the community health aide described by Moldy (1981), Weiss school aides experienced a varied degree of trust from the professionals in the system. One aide sarcastically expressed the opinion that the teachers didn't want them to become better educated and improve themselves too much (Weiss 1994: 339). An important point made by Weiss in his paper is that school aides have an impact that transcends the classroom. In this sense, the author is critical of the educational literature that sees the school aide only from an educational perspective, which is well reflected in the term paraeducator that has been created to label school aides. Weiss (1994: 342), on the other hand, suggests a definition of school aides that reflects the impact they have in terms bridging the school with the community, not only in terms of helping teachers teach in the classroom. This appreciation is equivalent to Moldys (1981) finding that the community health aide has in impact that transcends translating, into interpreting and mediating, two concepts that involve much more than linguistic translation. At the same time, the concept of transcending job descriptions is also one of the 43


main findings of this dissertation study, as will be seen in the Findings and in the Discussion chapter. Gentemann and Whitehead (1983) present yet another model of culture brokerage applied to education. The authors describe the Experiment in Higher Education, a college-level program designed to increase the registration levels of high risk primarily black youth at Southern Illinois University. One of the components of the project was to provide the culture broker role to the teachers-counselors of the program. These individuals had the task of helping to keep students enrolled at the university. Criteria for selection included similar socioeconomic or experiential background with the students and demonstrated ability to negotiate the wider social system (Gentemann and Whitehead 1983: 121). The teachers-counselors were expected to be translators of the academic subculture for the student and of the students subculture for the University. In so doing, they provided continuity for the student in his or her adjustment from the ethnic culture to mainstream academics (1983:121). Another interesting aspect of the teacher-counselor as a culture broker is that one of the attributes given to the role is that of role model. That is, the teacher-counselor had to be a role model to students, helping to shape behavior patterns which when exhibited in the appropriate setting will be interpreted as successful by the wider community (Gentemann and Whitehead 1983: 119). This role model attribute assigned to the culture broker role by the Experiment in Higher Education is not commonly found as an explicit goal of the model, although it is feasible to assume that it is an unintended consequence of the 44


culture broker role in general. This statement is based on the recognition and trust that culture brokers have from their local communities, and, as Moldy (1981: 17) found in her study of the community health aide, on the power invested on the culture broker by both systems in mediation. Indeed, one of the findings of my own study is precisely that promotoras exert a role model effect on the people with whom they work in colonia communities. As it will be seen in the Practice chapter of this dissertation, many women have become promotoras after they came in contact with promotoras and after observing them in work. Agency The concept of agency used in this study is defined as the peoples capacity to create, reproduce, change and live according to their own meaning systems, the powers effectively to define themselves as opposed to being defined by others (Bhattacharyya 1995: 61). Greeners (2002: 692) work suggests looking at agency within the context of welfare by combining elements of various approaches to the study of social policies that help understand aspects of the human experience that in real life are intertwined. The elements included in his analysis are the four types of capital individuals may posses as defined by Bourdieu (1990:192). These are: (1) economic: refers to financial resources, (2) cultural: refers to educational qualifications, (3) symbolic: has to do with prestige or honor, and (4) political: has to do with the recognition of power. In addition, he uses Bourdieus concept of habitus which is defined as a set of dispositions that incline individuals to act and react in certain ways. Habitus generate practices, perceptions and attitudes that are not consciously coordinated or governed by 45


rules, but nevertheless are regular enough to appear consistent (Greener 2002: 691-692). Thus, practice occurs in the relation between habitus and the specific social context (see Figure 1). Figure 1. Practice Practice Social context Habitus Another element of Greeners (2002) model is Hoggetts (2001) model of agency in which agency and reflexivity are parts of a continuum of the different positions individuals may occupy at any given time. Hoggetts work draws on Giddens model of agency and structure. Giddens argues that people are reflective agents who are able to explain the reasons behind the decisions they make. Even if people are not able to explain the underlying rules that guide their behaviors, they demonstrate a tacit knowledge of them through their actions (2001: 38). Thus, for Hogget choice is not something that regularly occurs after conscious deliberation, but rather represents a decision made on impulse in response to situations in which people make on the spot decisions (2001: 40). In addition, he points out that peoples capacity to be reflective agents are often constrained by their difficulty in facing their fears and anxieties. As an example, Hogget refers to the inability that people who may have been the victims of torture have in reflecting about it because it is too painful for them to even think 46


about those experiences. Their unwillingness to dwell in these experiences serves to protect their sense of self and in no way should be taken as a lack of power (2001: 42). Consequently, he feels that there is a danger in trying to equate, agency with constructive coping, since there is nothing necessarily constructive about agency and care must be taken not to think in normative terms, that is to see agency as good and absence of agency as bad. Just as people can be destructive agents they can also be constructive in their dependency and powerlessness (2001: 43). Hoggetts analyses led him to the development of an agency model that contains the idea of self-as-object as well as self-as-agent, since it is impossible to conceive of agency without conceiving of its opposite. This model (Figure 2) represents a way of thinking about the different positions people occupy at times, rather than a typology (43, 47). Figure 2. Hoggetts Agency Model reflexivity self-as-object self-as-agent non-reflexivity Quadrant A: reflexive agency. Individuals in this quadrant are not the passive victims of the welfare discourse but the conscious shapers of their history although not in circumstances of their own choosing (Hoggett 2001:47). 47


Quadrant B: non-reflexive agency. Individuals in this quadrant are able to assert their agency but their ability to be reflexive about their behavior is restricted (Hoggett 2001:48). Quadrant C: self as non-reflexive object. Individuals in this quadrant tend to behave in an instinctive manner. They exert little control over the environment and are trapped in their social position from which they are unable or unwilling to attempt to escape due to structural constraints, but because their actions are so ingrained in practice they see them as normal. Consequently, the lack of opportunity not only appears to be the most likely outcome but also the common sense one. From a structural perspective they appear to have no agency (Hoggett 2001:49; Greener 2002:697). Quadrant D: self as reflexive object. Individuals in this quadrant are aware of their powerlessness. They are unable to impose themselves upon their surroundings. Although they are willing to become engaged are trapped due to structural constraints. They lack the right type of capital (Hoggett 2001:49; Greener 2002:695). Two other considerations of Hoggetts model are what he calls first and second order agency. These considerations are concerned with how welfare recipients make out or play the system. In this sense those in need of assistance know that they have to play by the rules in order to obtain the services needed and therefore their agency is limited to being able to bring about first-order change, that is change within a pattern (2001:50). However, for Hoggett a 48


radical perspective on welfare recipients should be concerned with the second order change that occurs when individuals or groups challenge the rules of the game per se. This requires that individuals are able to confront resistance head on in order to break out from the social systems which make up their lives and endure the risks associated with life changes, such as risk of loss of belonging, loss of friendships and loss of identity (2001:51). Hoggett cautions about the danger of undermining the concept of agency by linking it with choice rather than change. Furthermore he mentions that even the concept of change has become infected by modernizing assumptions in which it is rapidly becoming synonymous with adaptability (2001:52). Community Health Workers and Promotoras 8 The U.S.-Mexico border contains some of the poorest counties in the United States (Health Resources and Services Administration 2000). The U.S. border population has a higher poverty level than the national rate, with more than 20 percent living below the poverty level as compared to 12 percent in the country as a whole (Environmental Protection Agency 1997). A number of factors in the area serve to aggravate health needs and conditions for this population, which includes an estimated 3 million people without health insurance (Snchez-Bane and Moya 1999; Department of Health and Human Services 1997). These include environmental problems arising from a general lack of infrastructure, air pollution, and agricultural and other hazards. Such conditions have been found to cause such health problems as high lead levels and high rates of respiratory 8 This section was also a part of the original research project report submitted to the Office of Rural Health Policy, Health Resources and Services Administration (May, et al. 2004). 49


illnesses in children among others. The dumping of raw sewage into local rivers and sewage runoff also poses a severe health threat in the area for households dependent on such water for drinking (Health Resources and Services Administration 2000). Health conditions caused by such threats are exacerbated when combined with factors such as poverty, limited literacy, educational levels and English skills, and a lack of transportation, which serve to limit access to healthcare (Snchez-Bane and Moya 1999). Further, there is a serious shortage of physicians, clinics and hospitals located in the area (HEALTH RESOURCES AND SERVICES ADMINISTRATION 2000; Snchez-Bane and Moya 1999; Ward 1999). According to some researchers, culture and language can represent barriers to medical care in the border region (Snchez-Bane and Moya 1999). The shortage of medical services is made worse by the lack of culturally competent care on the part of existing providers (Health Resources and Services Administration 2000; Snchez-Bane and Moya 1999). A lack of connection between patient and physician with regard to language and other cultural concerns increases the likelihood of health service underutilization (Snchez-Bane and Moya 1999; Loustaunau and Sobo 1997; Gmez-Murphy 1998). Such a health care environment serves to prompt many border residents to cross into Mexico to receive health care that is not only more affordable, but more responsive to patients expressed needs (Snchez-Bane and Moya 1999). In an effort to reach more border residents, a number of healthcare providers in border counties are using community health workers, known locally as promotoras de 50


salud, to increase utilization of services and help address barriers to service access (Williams 2001). Community Health Workers (CHWs) are community members with an understanding of neighborhood and individual health and social issues that use their knowledge of local resources to educate about disease and injury prevention, promote healthy living and help community residents access the health and social service systems (Koch, Thompson and Keegan 1998; Witmer et al. 1995). Their roles, responsibilities and activities may vary depending on client or community needs. Some specific examples of what they do include, individual and community needs assessment; coordination of care and case management; education of institutions about community culture, needs and strengths; education of families about prevention and access to care; and organization of community initiatives (Texas Department of Health 2001). The majority of CHWs in the United States are women of color with limited incomes and educational levels (Love, Gardener and Legion 1997). CHWs are used extensively throughout Latin America, Africa and Asia (Bell 2001; Kelly at al. 2001; Bender and Pitkin 1987; Hubbard 1985). They may be identified by a variety of job titles including community health representative, lay health educator, village health worker, camp health aide, and promotora (Snchez-Bane and Moya 1999; Koch, Thompson and Keegan 1998). The word promotora is the Spanish term for a lay community educator; such persons are used widely in health outreach programs in Mexico (Ramos, May and Ramos 2001; Leigh et al. 1998; Gomez-Murphy 1998). In the United States, promotoras 51


often work along the U.S.-Mexico border or in rural areas within which access to health care is severely limited or non-existent and where they have been shown to be effective health educators and service providers. CHWs may also be involved in community organizing and development projects (Williams 2001; Koch, Thompson and Keegan 1998). In the United States, the community health worker model was first introduced in the U.S. Federal Migrant Health Act of 1962 and the Economic Opportunity Act of 1964, which mandated outreach efforts in neighborhoods with high poverty levels and in migrant labor camps (Cauffman, et al. 1970). Since 1968 the Indian Health Service (IHS) has trained and deployed Community Health Representatives to serve the Native American population in Alaska, Montana, and other states (Rosenthal 1998; Witmer, et al. 1995). The IHS program is the only federally funded CHW program (Koch, Thompson and Keegan 1998). Along the U.S.-Mexico border, promotoras provide a number of outreach services including health education, case management and service referral (Ramos, May and Ramos 2001; Snchez-Bane and Moya 1999; Leigh et al. 1998). Across the country, the use of CHWs has been growing as health care organizations strive to increase service utilization while managing costs (Rosenthal 1998). However, a number of researchers have found that CHW contributions to the healthcare system are undervalued due to a lack of definition and standardization of their skills and roles (Rosenthal 1998; Love, Gardner and Legion 1996; Witmer, et al. 1995). According to Rosenthal (1998), development 52


of a working consensus about CHW roles and skills will facilitate their integration into the health care system, and thus enhance the systems ability to address the basic determinants of health, or the environmental, social and economic conditions that affect community health. In an effort to address this issue, Rosenthal (1998) identified seven core roles broad enough to be applied nationally in the huge variety of settings and communities in which CHWs work: Bridging cultural mediation between communities and the health and social service systems Providing culturally appropriate health education and information Assuring that people get the services they need Providing informal counseling and support Advocating for individual and community needs Providing direct services Building individual and community capacity (Rosenthal 1998) Perhaps the most important role that a CHW can play is as a bridge that connects health and human service networks with local communities (Rosenthal 1998). Ford, et al. (1998) identified boundary spanning as the unifying and defining principle of promotoras roles. Promotoras transcend a number of boundaries including culture, class, and education to bridge gaps between health service providers and border residents. Because of their local knowledge of the community most promotoras live in the communities within which they work they are able to establish trusting relationships with residents in the effort to decrease disease rates and increase service utilization (Walker 1994). Moreover, 53


their impact often reaches beyond direct health benefits to other areas of community social life (Hubbard 1985). Rosenthal (1998) outlined a set of core skills necessary for effective CHW outreach. In outlining these skills, Rosenthal and his team found that a number of community health advisors and other outreach workers often identified qualities or characteristics of CHWs in lieu of or in addition to specific skills. These qualities include shared values or experience of the people being served, membership in the community, dedication to community service, and respect in the community (Rosenthal 1998). The eight core set of skills identified are: Communication Interpersonal relations Knowledge base Service coordination Capacity-building Advocacy Teaching Organizational Communication emerged as the most important skill identified by CHW respondents in Rosenthals study. Within the colonias along the U.S.-Mexico border, lack of effective communication between residents and providers has been identified as a major factor in service underutilization (Earle 1999). Obstacles to communication between colonia residents and service providers or other bureaucracies are characterized as arising out of clashes of styles and 54


methods of communication between the social, economic and political world of colonias and the outside world (Earle 1999). Within the colonias, promotoras can help to minimize this clashing of styles through the establishment of personal communication and trust as opposed to relying on the use of form letters and phone calls (Earle 1999). Through the establishment of interpersonal communication, promotoras can work to overcome any fear or mistrust of authority upon receipt of a form letter and/or reach households with lacking telephone service. The communication and interpersonal skills identified by Rosenthal (1998) often begin as qualities which can be enhanced but not taught. Such qualities have often been developed in individuals who have been identified as natural helpers and often go on to work as CHWs, either through formal employment or as volunteers (McFarlane 1996; Milligan et al. 1987; Israel 1985; Pilisuk, et al. 1982; Patterson 1977). A natural helper is an indigenous community member to whom people turn naturally for help (Altpeter et al. 1999; Patterson 1977). Such individuals are not formally associated with an agency or organization they are not volunteers and they are not paid for helping (Blumenthal, Eng & Thomas, 1999; Ballew 1985; Patterson 1977). In addition, the ability to help often arises within the context of existing relationships or indigenous social networks (Ballew 1985; Pilisuk, et al. 1982). According to Patterson (1977), natural helper networks are mutual and based explicitly on the very nature of the interactional context of a personal relationship. Moreover, these helping activities are not replicated within the context of traditional healthcare service and should be 55


nurtured and extended so that they may complement existing services (Eng, Parker and Harlan 1997; Patterson 1977). Healthcare and other service agencies, therefore, can benefit by accessing existing natural helper networks in their outreach efforts (Eng and Hatch 1991; Eng, Parker and Harlan 1997). CHWs can serve as the link to natural helper networks especially if they have served in this capacity prior to formal affiliation with an agency (Eng, Parker and Harlan 1997). CHWs and the work they do have been shown to positively impact the health care system in a number of ways. They can increase access to care by building trust between residents and the healthcare system when they act as effective navigators and links for clients using traditional or managed care health systems (Koch, Thompson and Keegan 1998). This has especially been the case with low-income immigrant communities where access to resources is limited due to language or other cultural barriers. Because of their knowledge of the local community, CHWs are able to make personal connections with clients more often than are physicians and nurses. CHWs can also influence community definitions of health and illness through introduction of new health information and new approaches for addressing health problems (Hubbard 1985). They provide community residents with much needed health education on a variety of topics and guidance in navigating the health system. Moreover, they encourage preventive care and the use of local clinics as an alternative to emergency rooms. In many programs, they also contribute to patients continuity of care, appointment keeping, and 56


compliance with prescriptions and medical advice. They also educate service providers by sharing their knowledge of the community, especially with regard to community health needs, cultural understandings and outcomes of care. They encourage health care providers to understand and respond to clients and their communities in a culturally appropriate manner (Koch, Thompson, and Keegan 1998). The CHW model has been used to address a number of community issues including HIV/AIDS transmission (Blumenthal, Eng, and Thomas 1999), as well as community organization, and immediate community needs of a much broader scope (Barnes and Fairbanks 1997). Results cited in the Center for Policy Alternatives brief (1998), indicate that various programs have successfully lowered the rate of Emergency Room (ER) use among the poor and under/uninsured in Dorchester, MA and New York, NY; helped in detecting and preventing lead poisoning in Milwaukee children; improved child health status in Roanoke, VA; and helped in controlling hypertension in African-American community in Baltimore. In colonias along the Texas-Mexico border, promotoras worked with the Center for Housing and Urban Development and the South Texas Promotora Association in the development and implementation of an environmental health outreach program, addressing numerous hazardous conditions affecting area residents (Ramos, May, and Ramos 2001). Community outreach workers have been involved in mental health service referral and delivery in a number of instances. In Louisiana, Native Americans were trained as paraprofessionals to administer minimal mental health services 57


to their communities and to assist community members in navigating related state agencies (Runion and Hiram 1984). They have also been successful at promoting programs addressing larger community health issues or those less directly tied to the healthcare system (DiClemente, Crosby, and Kegler 2002). These programs include citizenship courses, drivers license courses, GED completion courses, leadership/advocacy programs and public housing advocacy (Sisters of Mercy of the Americas 2002; Wolff, Young and Maurana 2001; AVANCE 2000). Finally, the benefit of the community health worker model to CHWs themselves should not be overlooked. Research conducted with CHWs in Mexico suggests that promotoras receive a number of personal benefits through their participation in such outreach (Ramirez-Valles 2001). These benefits include getting out of the house into new environments, learning new skills and/acquiring knowledge about various topics, community service and betterment of their personal lives (Ramirez-Valles 2001). Such research suggests that identification of such benefits may be useful to service providers and other agencies in recruiting and retaining future outreach workers (Ramirez-Valles 2001). The work done by CHWs can help to strengthen families and communities (Poss 1999; Baker, et al. 1997). Research shows that improved health care can lead to other family and work benefits. Residents participating in community health outreach programs develop a sense of personal responsibility for family health (Koch, Thompson and Keegan 1998). CHWs share valuable information about the system to community and/or may advocate for individuals in 58


complicated bureaucratic health care systems thereby fostering confidence in addressing family health needs. For instance, communities may begin to take charge of their health by identifying their own needs and become involved in implementing their own solutions. Other benefits include increased employment rates and decreased child abuse rates in individuals served by a home-visiting program (Koch, Thompson, and Keegan 1998). Studies have also shown that promotora programs in the Southwest may help strengthen social support systems among community residents. The Downstream Program developed by the Midwest Migrant Health Information Office (MMHIO) provided additional training to Camp Health Aides (health outreach workers in migrant camps) thereby giving them the opportunity to continue work in their home communities in the colonias of Hidalgo and Cameron Counties of Texas. Health promoters received a great deal of training in a number of health-related areas including family planning and birth control, prenatal care and breastfeeding, parenting and child development, domestic violence and child abuse and neglect, substance abuse, HIV/AIDS, and breast self-examination among other topics. Colonia residents were encouraged to participate through direct home contact by health promoters, along with scheduled group brainstorming sessions facilitated by health promoters (Hernndez, Rodriguez, and Robinson 1995). They were therefore involved in helping to design the program and curriculum, along with identifying pertinent community needs. One main outcome of this program was that community women found a level of emotional support among friends, neighbors and health 59


promoters involved in the program. Local women also received a great deal of information regarding their personal health, helping to build confidence in themselves for dealing with health issues affecting them and their children Hernndez, Rodriguez, and Robinson 1995). The use of such workers can strengthen local economies by providing employment to local residents, which help to empower them by giving them opportunities to learn about new career opportunities, to serve as role models for underor unemployed individuals, and leadership training. The development of community outreach workers such as promotoras can contribute to the economic base of a community by linking such workers to new careers options through the confidence and skills developed from working as a team member with health care and other social service providers (Koch, Thompson, and Keegan 1998). The CHW model is most effective when promotoras and other outreach workers are able to develop relationships with community residents based on common cultural understandings (Sherer 1994). Ideally, CHWs work to integrate local beliefs within their outreach and education efforts thereby encouraging community participation in the education process (Aubel et al. 1991). Research indicates that this may be particularly beneficial in rural areas of this country with a predominantly Spanish-speaking or other populations with limited abilities in speaking English. Hispanics rarely turn to health care professionals for health-related information but instead seek out peers or authority figures within their own social networks. Illness may be perceived as mysterious and subject to otherworldly 60


intervention. As such, an effective delivery of health information requires the implementation of methods for establishing rapport with a client (Gmez-Murphy 1998). A number of outcomes can be used to measure the effectiveness of CHW programs at a variety of levels. These indices range from changes in the health behavior of a client or the clients family, changes in the overall health characteristics of the community, number of clients served, and even, programmatic impact on CHWs themselves (Ramirez-Valles 2001; Gmez-Murphy 1998; Witmer, et al. 1995). According to Bender and Pitkin (1987), the efficacy of the Latin American village health worker is tied to a national or official commitment to community participation in primary health care. Moreover, Matomora (1989) calls for extensive participation in all aspects of community health, particularly in the selection of village health workers if these are deemed necessary. Although such research findings may seem incongruent with U.S. healthcare models, they may be applicable to organizations working to increase service utilization in underserved communities. The importance of community engagement and participation in the procurement of community health benefits should not be underestimated (Baker, et al. 1997; Witmer et al. 1995). The Anthropology of the United States-Mexico Border The U.S.-Mexico border represents a complex history that integrates and at the same time divides two peoples and two countries. The border, which runs from Brownsville in Texas to San Diego in California, represents a political divide between two sovereign nations, but it represents much more than the political 61


line that divides the United States and Mexico; it represents a system of related identities, cultures, economic systems, political systems, systems of domination and of resistance. The U.S.-Mexico border is a small but complex world in which a multiplicity of identities co-exists and recreates itself continuously. Anthropology has contributed to the understanding of the U.S.-Mexico border. Perhaps a major theme that cuts through the anthropological literature is the call to observe life in the border as part of a historical process that predates the annexation of northern Mexico by the United States. As such, a main thesis of the literature is that policy-relevant phenomena such as migration, family relations, work, and health policy, need to be treated taking into consideration that the Mexican-American population of the border and the Mexican side border population in reality constitute a historical continuum of shared ethnicity and identity. Much has been written about the U.S.-Mexico border society and culture treating the issue of ethnicity and identity. This interest, which extends beyond anthropology, rests on the assumption that understanding who the border population is becomes an essential part of understanding the border. Anthropologists such as Alvarez (1995, 1987), Limn (1991, 1992, 1994, 1998), Paredes (1958), Velez-Ibaez (1994, 1996); Heyman (1990, 1991), and Vila (1994, 2000) are complemented by writers coming from literature and history, such as Anzalda (1987), Gonzales-Berry and Maciel (2000), and Martinez (1994, 1996). 62


A first important point to make in relation to U.S.-Mexico border identity is Staudts (1998: 2) interpretation of the border as counterhegemonic sites, by which the author means that beneath the veneer of formal rules, political machinery, immigration laws, and gender constructions, people move, work, shelter themselves, and otherwise engage in creative cultural production. But it is counterhegemonic with little political recourse. Following Staudt, the identity of the border residents needs to be examined from the point of view of resistance to historical forms of exploitation. Richardson (1999: 119), states that unequal economic relationships have led to complex cultural realities through which cultural bias is reified in social situations and institutions in the region. On the same point, Vila (2000: 1) states that, below the facade of a smooth relationship, there is an ongoing tension that surfaces here and there, involving many ethnic groups. Further, conventional ethnic labels used to describe border communities (e.g., Mexican, Anglo) homogenize groups of people who assign unique meanings to their own and others cultural identities (2000: 5). Velez-Ibaez (1996: 195) says in this regard that at the household the Mexican of the border struggles for control of their environments: At the household level, the main struggle (of Mexicans) is to defend themselves against the repeated attempts by the state and/or the market to exert complete control over their labor and productive capacities. Therefore, Staudts view of informality as a counterhegemonic practice makes sense. Informality is in Staudts view every economic activity that border residents carry out outside the formal 63


commercial and institutional channels, including building houses through self-help strategies. The concept of household as a counterhegemonic institution deserves further attention. It derives from the notion of extended families of Mexicans in the United States as described by Keefe and Padilla (1987). The household, and members of the kin network, are the ones with whom one exchanges labor assistance, has a fictive kinship relation of compadrazgo (co-godparenthood), shares in recreational activities and visitations, and participates in religious and calendric activities (Velez-Ibaez 1996: 201-202). Therefore even if in border communities people are not connected to formal organizations inside or outside their communities, the presence of extended kinship networks does create the social density safety net that protects the household from hegemonic forces and acts as a counterhegemonic force. Velez-Ibaez (1996: 205) adds that it is precisely the existence of strong extended family kin networks what prevents communities to be considered underclass, in spite of high levels of poverty and lack of infrastructure. Underclass formation is prevented by the presence of a household cluster family structure, the high level of home-ownership (in colonias), the low percentage of households headed by single females under 18 and no spouse present, and the ability of women to mobilize labor and resources in times of need within household clusters. Alvarez (1995) provides a thorough review of the anthropological literature about the U.S.-Mexico border and as such his article is the starting point for this discussion of identity at the border. Alvarez (1995: 449) asserts that the Mexican64


American border has become the icon and model for research into other borders as well as for the elaboration and refinement of the boundaries of several salient concepts and their referents. Alvarez identifies culture, community, and identity as the salient concepts whose elaboration and refinement are benefited through the study of the U.S.-Mexico border. Expanding on Alvarez suggestion that identity is one of the salient concepts associated to border, and that the U.S.-Mexico border is the icon of the border, I suggest in this paper that understanding the identity of the border population is the essential basis for understanding how anthropology has treated applied or policy-related issues. Still following Alvarez (1995: 451), the border people in general constantly shift and renegotiate identities and often they adopt multiple identities. This theme is common among the several anthropologists and other social scientists/humanists who have written about the Mexican-American border. Perhaps the most complete ethnographic study that makes the assertion of multiplicity of identities and constant negotiation of identities is Vila (2000). Vila conducted fieldwork in El Paso, Texas, between 1991 and 1997, interviewing 932 individuals on both sides of the border. The benefits of Vilas study derive not only from the large number of interviews, but also from the fact that research was conducted on both sides of the border, something not done very frequently. Conducting identity research on both side of the border is consistent with the view that the U.S. and the Mexican border regions constitute a cultural continuum, a view that is common among anthropologists and historians. In this book, as well as in the article previously published (Vila 1999), the author looks 65


at identity construction as the way members of the different ethnicities of El Paso and Juarez portray members of other multiplicity of ethnicities. As such, Vilas description of the construction of identities at the border is in reality a description of what he calls a multiple mirror. In this regard Vila (2000: 6) states that the border represents a multiple mirror situation where Juarenses construct not only Anglos as others, but in many circumstances they portray Southern Mexicans, Mexican Americans, Asian Americans, and African Americans as others as well. Vilas conception of identity construction at the border is different in some ways from that of Rosaldo (1993) and Anzalda (1987). While the latter both dismiss the notion of a hybrid border, or use the concept border crossing, Vila is in reality referring to a different notion, one in which inhabitants of the border do not necessarily cross the cultural borders or share a hybrid identity. Vila proposes instead the idea of reinforcing borders as an alternative to border crossing. Reinforcing borders refers to the notion that ethnicities that constitute the border region construct their particular identities in the process of differentiating themselves from the Other. This is seen by Vila (2000: 227) as essential in the process of identity construction. Here the author bases this assumption on Weedon, a postructuralist. According to Weedon (1989: 34), experience lacks essential meaning and language gives meaning to experience through a range of discursive systems of meaning, which are often contradictory and constitute conflicting versions of social reality. As such, there is no hybrid and no border crossing, at least not as a rule, but instead there is a clear group 66


of particular ethno-definitions based on how each ethnicity defines the other. Vila (2000: 6) sustains this thesis by saying that on the U.S.-Mexico frontier we have several borders, each of them the possible anchor of a particular process of identity construction. At least, there is the border of the Juarense (inhabitant of Juarez, Mexico) in its definition vis--vis the Mexican American; the border of the Juarense in its definition vis--vis the migrant into Juarez from other non-border Mexican states; the border of the Juarense in its definition vis--vis the Mexican American from El Paso, Texas; and the border of the Juarense vis--vis the Anglo American from El Paso. Life in the low-income U.S.-Mexico border, in particular in colonias, cannot be understood without an analysis of processes of identity formation and of construction of counterhegemonic strategies. The evident lack of resources in the poorest counties of the United States (located in the Texas LRGV), cannot necessarily mean the existence of an unstructured and unorganized underclass. Strong extended family networks assign the household a central role as a site for resistance to the forces of economic poverty. This is particularly important in colonias, where the lack of connectivity with formal organizations that characterizes the communities, does not necessarily mean lack of organized capacity for agency. On the contrary, capacity for agency is found in the hidden social relations and strategies of survival, such as the informal economy. This context is of primary importance for the analysis of promotoras interface encounters as they build their practice as community outreach and education workers. The richness of their counterhegemonic practices constitutes the ethos 67


of promotoras and the background of their discursive practices. At the same time, promotoras, supported by this ethos, engage in negotiations with social actors of different power configurations as they build their daily practices. In conclusion, culture brokerage provides the vehicle for the interpretation of the practice of promotoras as a form of community development. As is described in the review of the community health workers literature, promotoras (and community health workers in general) link systems as boundary spanners. In other words, they are culture brokers. By being so, they contribute to community development by being agents of change. Promotoras, as reflective agents of change (Hoggett 2001), are aiding their communities in their efforts of self-definition rather than being defined by others. 68


CHAPTER FOUR 9 THE SETTING The U.S.-Mexico border region comprises an area that stretches 2,000 miles from San Ysidro, California, to Brownsville, Texas, and extends 62 miles north of the border into the United States (Health Resources and Services Administration 2000). The Health Resources and Services Administration (HRSA) defines the border as consisting of 48 border counties in four U.S. states (HEALTH RESOURCES AND SERVICES ADMINISTRATION 2000). However, the U.S.-Mexico border represents much more than a geographic region. According to Martinez (1994:5), borders are places driven by bi-national trade, interdependence, and migrations where socio-political forces converge. Cross-border economic activities in the area have grown geometrically over the last decade, prompting some researchers to increase their scope to cities that are not geographically contiguous with the border, such as San Antonio, Texas and Monterrey and Nuevo Leon, Mexico (de Cosio and Boadella 1999:3). Life along both sides of the border has become intertwined in a variety of ways. The U.S. side of the border is home to about 6.2 million people (Environmental Protection Agency 1997) The area including the border region of California and Baja California contains roughly 44.5 percent of the total border population, while the El Paso-Ciudad Juarez region makes up approximately 15.4 9 An earlier draft of this chapter was included in the original project report submitted to the Office of Rural Health Policy, Health Resources and Services Administration (May, et al. 2004). 69


percent of the borders total population. Most other border areas are sparsely populated several counties and municipalities have fewer than ten persons per square mile In the border as a whole, approximately 80 percent of the population is of Mexican origin (Anzalda 1987). However, the communities along the border are not homogeneous, as they contain cultural, class and race-based differences that are powerful signifiers within these communities. Recent immigrants from Mexico and a second-generation Mexican American (Chicano/a) family most likely have different social class positions, as well as different attitudes towards Mexican and U.S. culture (Richardson 1999). Since the implementation of the North American Free Trade Agreement (NAFTA), the U.S.-Mexico border region has experienced rapid development and increased employment. Yet, new economic growth has rarely led to increased prosperity. The U.S. border population has a higher poverty level than the national rate, with more than 20 percent living below the poverty level as compared to 12 percent in the country as a whole (Environmental Protection Agency 1997). However, these conditions vary among border counties. Fifty-five percent of the population in Starr County, Texas lives below the poverty line as compared to about eight percent of the population in San Diego, California. According to a 1997 Environmental Protection Agency (EPA) report, three of the ten poorest counties in the United States are located in the border area and 21 U.S. border communities have been designated as economically distressed. 70


The existence of health problems in the border region is complicated by social, economic, and cultural factors occupational risks, limited ability to purchase nutritious food, barriers to affordable medical care, and, sometimes, cultural practices and beliefs about medical care (Texas Department of Health 2001) The agricultural boom of the 1950s brought with it occupational health concerns. Agricultural workers continue to be subjected to pesticides and other hazardous fertilizers. The current increase in industrial employment exacerbates exposure to dangerous chemicals, and physical and ergonomic hazards. Moreover, the U.S. Mexico border states contain nearly 3 million people who have no form of health insurance (Department of Health and Human Services 1997) The lack of health insurance and/or underinsurance has been associated with delayed healthcare, increased mortality, and adverse health consequences (Sanchez-Bane and Moya 1999) The lack of reliable forms of health care, including primary care physicians, clinics and hospitals in rural areas of the border can transform controllable medical conditions into dire predicaments Colonias along the U.S.-Mexico Border The EPA defines colonias as U.S. rural settlements with substandard housing and poor living conditions along the U.S.-Mexico border that may lack some or all of the following: paved roads, sewer systems, electricity, gas, clean water and/or health care services (Environmental Protection Agency 2001); see also Ward 1999; Browne, Jimenez, and Whitman 1994). Colonias are frequently located areas of low population density, a fact that helps explain why they are so often without infrastructure. Long distances make infrastructure improvements 71


more costly, particularly when it comes to accessing water. Moreover the social and economic isolation of colonias makes the development of roads cost-inefficient. According to Ward (1999), they exist in an administrative no mans land. Prior to the 1950, much of the land now occupied by colonias was a vast acreage of ranches and farms. In the 1950s, however, landowners began to sell off poor quality tracts of land, especially tracts prone to flooding or erosion, to their farm workers and to immigrants from Mexico (Vila 2000; Richardson 1999). It is essential here to note that the ranchers sold plots of land. One of the unusual characteristics of colonias is that a great majority of the residents own the land on which they live. The parcels of land, however, were sold via a Contract for Deed at approximately fourteen percent interest (Richardson, 1999). The contracts were not officially registered with the counties. Moreover, the agreement stipulated that the buyer must pay off the entire amount agreed upon for purchase of the property before receiving the deed. If the buyer missed one payment, the land could be repossessed (Ward 1999). The land was almost always sold with minimal services (e.g., drainage and access roads) with land developers promising, and nearly always failing, to provide such services (Richardson 1999; Rosenthal 1998; Vila 2000; Martinez 1994; Browne, Jimenez, and Whitman 1994). Despite the drawbacks of these types of contracts, there are benefits to buying ones own plot of land in a colonia. Most low-income border residents 72


cannot afford to buy land and a house in a suburban, or even a rural development. Moreover, prohibitive land costs in Northern Mexico have encouraged immigrants to purchase land in U.S. border counties (Browne, Jimenez, and Whitman 1994). To buy land in a colonia is to have the chance to build at ones own pace as finances allow. Unlike most economically distressed urban areas, a vast majority of colonia residents own their homes, many of them built with their own hands. As a result, it has been possible to develop deep social bonds among neighborhoods, facilitating the development of a strong underlying community ethos (Richardson 1999). For instance, sweat equity projects are currently under way in many of New Mexicos colonias, including the Las Palmeras colonia in Doa Ana County, where residents built collaborative water and sewage systems (Patterson 1998). Surveys of New Mexico colonias residents revealed that ninety-five percent of residents planned to be permanent residents; 68 percent owned or were buying their homes (Browne, Jimenez, and Whitman 1994). Thus, defining colonias solely by their dire conditions misrepresents them and the residents. They are not places ruled by desperation and fatalismthe difficult socio-economic conditions therein must be understood within the context of community life in colonias. The Lower Rio Grande Valley (LRGV) The LRGV of Texas consists of Cameron, Hidalgo, Starr and Willacy counties, and is the area in which the majority of Texas colonias are located. According to the U.S. Census Bureau (2000), Hidalgo and Cameron counties contain designated urban areas or clusters, while Starr and Willacy counties are designated rural. The total land area for these four counties measures 4,296 73


square miles with an average of 202.5 pers ons per square mile (U.S. Census Bureau 2000). Figure 3. Map of the Lower Rio Grande Valley Cameron, Hidalgo, Starr, and Willacy counties have a combined total population of more than 978,000, and account for nearly 5 percent of the total state population (U.S. Census Bureau 2000). Women outnum ber men in the LRGV counties by an average of 7.4 per cent (U.S. Census Bureau 2000). The highest overall percentage of the LRGV population is between 25 and 35 years of age (U.S. Census Bureau 2000). The racial and ethnic makeup of the LRGV counties testifies to the regions intimate relationship with Me xico. As of 1998, eight of every ten residents self-identified or were reported as being Hispanic or Latino in origin 74


(Texas-Mexico Border Health Coordination Office 1998). The remaining 19 percent are identified as White/Anglo, with less than one percent of Texas border county residents identified as either African American or Asian. Within the LRGV counties, Hispanics account for between 85 and 98 percent of the population. Overall, Spanish is spoken in 81 percent of LRGV homes compared to only 27 percent of the homes in the state as a whole. Population in the Texas border counties has grown 39.4 percent from 1990 to 2000. The highest growth has been experienced by Hidalgo County (48.5 percent). A few cities within these counties have experienced even more dramatic growth in the last decade. For example, Edinburg, located in Hidalgo County experienced 62.2 percent growth (U.S. Census Bureau 2000). As noted earlier, home ownership rates in colonias are high relative to other low-income neighborhoods. Homeowners occupy the majority of LRGV housing units as opposed to renters. The rate of owner-occupied units in LRGV counties is higher than that for the state overall. Although the LRGV has plenty of agriculture and is the vegetable, cotton, and sorghum basket of Texas, the manufacturing and service economies of the region provide more income and employment than does the agriculture industry (Texas Comptroller of Public Accounts 1998). Border county occupation rates in the service industries are higher than for the state as a whole, while occupation rates in the management, professional, and related industries are slightly lower. Migrant and seasonal workers represent 22 percent of the total LRGV working population, supplying the state of Texas with 74 percent of its farm 75


worker population (Texas-Mexico Border Health Coordination Office 1998). By definition, seasonal employment also means periods of seasonal unemployment, which may be linked to the eight percent higher unemployment rate in the border areas than in the rest of the state of Texas (Texas-Mexico Border Health Coordination Office 1998). Overall, border county income levels are substantially lower than those for Texas as a whole. This is particularly the case in Starr County, where thirty percent of the population has an income level of $10,000 or less per year. The median income for the border counties on average is lower than it is for Texas as a whole. More households are dependent on public assistance in border counties than in Texas overall. In addition, Social Security Income and Supplemental Security Income account for a higher proportion of the median income in border counties than they do for the state as a whole. These figures confirm reports that a higher number of families use social welfare services in the LRGV than in the state of Texas, or in the United States as a whole (Texas-Mexico Border Health Coordination Office 1998). The LRGV is poorer than the rest of the country more than 20 percent of the population living below the poverty level in 1990 compared to 12 percent for the country as a whole (Environmental Protection Agency 1997). The proportion of the population 25 years and over with less than a ninth grade education is higher in the LRGV counties than for the state as a whole. In Starr County, this percentage approaches 50 percent of the population 25 years and over. The number of persons with bachelors degrees in the state of Texas 76


exceeds the average LRGV level in this area. However, LRGV counties approximate state educational attainment levels at the high school graduate level and higher. The LRGV counties exhibit high rates of many health problems, including diabetes, Hepatitis A, and tuberculosis. In addition, Hispanic women living on the border are at greater risk of having cervical, stomach, and pancreatic cancers than are Anglo women. The LRGV area has the highest cervical cancer mortality rate in the United States (Oleszkowicz, Kresch, and Painter 1994). Women in Cameron, Hidalgo, Willacy, and Webb counties have three times the rate of death from cervical cancer as women in the United States as a whole. Many of these deaths occur as a result of the lack of educational outreach about cancer, and lack of access to screenings that would result in early detection. Oleszkowicz, Kresch, and Painter (1994) identified low income as the number one factor for women in the Rio Grande Valley not receiving a pap smear. Among Mexican-origin women, research shows that educational programs geared towards them (e.g., given in English and Spanish in a non-threatening atmosphere) are effective in encouraging these women to do self-examinations, and to seek out cancer screenings if they are affordable (Texas-Mexico Border Health Coordination Office 1998). 77


CHAPTER FIVE FINDINGS The findings of the study are divided into four of sections. First, I will present the promotoras who participated in the study, describing their demographics and their personal histories 10 Next, I will describe how promotoras experience their jobs and how work affects the achievement of a sense of autonomy and empowerment. Finally, I will describe the practice of promotoras and the ways it is represented in the communities. The Promotoras All of the twenty-six community health workers that participated in the study are women. Three of the women were born in border towns in the LRGV, and one of them was born in Fresno, California (not a border town). Of the women who originated in Mexico, 17 of them came from rural areas or towns in the border states of Tamaulipas and Nuevo Len, and the remaining five came from states in central Mexico, including Mexico City, San Luis Potos, and Zacatecas. The womens age ranged from 24 the youngest to 55 the oldest, with 14 of them in the 36-45 age range. Eleven of the women either had no schooling or had dropped out somewhere between first and sixth grade. Four of them had gone to high school but had not completed it, three of them had successfully obtained a GED, while four of them had graduated with an associate or technical degree, and three of them had dropped out of college before graduating. Next I 10 Appendix I includes the account of the life histories of promotoras. 78


will describe some of the common experiences of women regarding immigration and work. Immigration Experience of Promotoras The women described a diverse and complex immigration experience. There is not one single pattern that describes the reasons behind their decision to emigrate, or the mechanisms employed to cross the border and settle in the United States. Their accounts also reflect the intensity of the cross-border connections among relatives and families on both sides of the border, and how these connections play a role of either pulling people into the United States, or pushing people back to Mexico. Most commonly, these connections keep people in constant movement from one side into the other. There are cases of those who first settled in large cities such as Dallas or San Antonio, and then came to the LRGV, where they finally settled in the colonias where they lived at the time of the interview. Ms. Prez 11 represents a pattern of immigration described in the literature (Heyman 1991: 202; Bustamante 1987: 231) whereby immigrants from central or southern Mexican states first settle in border towns before crossing the Rio Grande into the United States. She was born in Zacatecas, later in life she and her parents migrated into the border city of Reynosa, from where she left to Texas. Ms. Prez came to the LRGV with her husband when she was 24 years old. Two years after her arrival she moved with her husband and two children into the colonia where they lived at the time of the study. Ms. Prez said: 11 This name is a pseudonym. All names of promotoras and program coordinators used henceforth are pseudonyms. 79


My name is Patricia Prez and I have been living in this colonia for six years already. I was born in Zacatecas, Mexico, but I was raised in Reynosa, Tamaulipas (border city, across McAllen, Texas). When I was twenty one years old I came into the United States and settled in Dallas. There I was approximately five years, perhaps more, I don't recall. Then we came here, to the Valley, I think it was in 1993, and soon after we came to live in this colonia, South Tower. I came to the Valley with my two children, now I have three children. I wasn't living with my husband, but I had my two children with me. First I rented a house, a small house. Then, soon after, our family reunited again, my husband and our other son who was living with him, and so we rented a larger house. Ms. Pereira constitutes another representation of this scaled type of migration pattern. She was born in a town in the interior of the state of Nuevo Len. From there she moved to the border city of Reynosa, not far from her birth town, where she married, became a widow, and then married again. The family migrated to the state of Washington, where they settled in Quincy, an agricultural town. There they worked as agricultural workers. After four years in the state of Washington, the family returned to Monterrey. Three more years passed until Ms. Pereira and her family decided to once again cross the river, this time to the LRGV, where they finally settled. Ms. Porras did not specify how she entered the United States with her children. She only said that she entered at night. She asked a friend to bring her furniture in her truck. Ms. Porras account is descriptive of the close interdependence that exists between both sides of the border, and of the strategies used by people who do not have papers in order to settle in the U.S. During years she was able to come to the U.S. side with her temporary card, to visit her mother who lived in the Pharr area, while she had her children stay in Reynosa. In Reynosa, Ms. Porras had a little house and was in the process of 80


making changes to it when she decided to leave more permanently. Since she did not have papers, she bought a house in a colonia, where papers are not required, although the mortgage was relatively high, $450 a month. Commonly the immigration experience of promotoras entails processes of family separation. On occasions women cross the Rio Grande into Texas after their husbands or relatives who had crossed earlier. As Hondagneu-Sotelo (1994: 12-15) states, mens migration into the United States since the years of the Bracero Program had left employment opportunities for women in Mexico, something that is even more patent in the border since maquilas heavily employ women. Fernndez-Kelly (1983: 65) describes that it is common to find women had had been deserted by their male partners as the latter migrate into the United States to find work. Ms. Rosalba represents the case of a woman who as a child was left behind as her mother migrated into the United States. Years later, Ms. Rosalba crossed the river to reunite with her mother. Ms. Rosalba said: My name is Angelica Rosalba. I was born in Reynosa in the year 1976. I was raised by my grandmother nd my grandfather in Reynosa, with whom I lived for 11 years. My mother lived in this side, and I lived in the other side. And grandmother tells me that that I used to say I want to go with my mother, I want to go with my mother. So, when I was 11 years old I came (into the United States). I crossed the river. All I remember is that crossed on the shoulders of a man. At that time my mother had a card and married my stepfather. He (stepfather) arranged for a passport for the two of us. We had to go to Monterrey to pick it up. On the way back, my mother could cross, but I couldn't, I was stopped at the border. I had to stay in Mexico. But since I was in school in Brownsville, I had to try again. So, I was crossed with the papers of someone else. Then I fixed my papers and here I am. I started school in third grade. It is not unusual for those who have family members in the U.S. side to obtain a 72 hour temporary card to visit their relatives. However, they are not 81


allowed to move out of the immediate border. This card does not permit work. In the border, this card is called la mica. Ms. Rosalbas mother was in the U.S. side of the border with la mica, and that is why she had to obtain a visa, leave the U.S., and come back in again. An important aspect of her experience is that she was separated from her mother at early age, staying in the border city of Reynosa while her mother had emigrated into the U.S., most probably to work and send money back to the daughter and the family. The separation remained for eleven years, until finally her mother had her cross the river. Women who left their families in Mexico and cannot go back to visit with them are one of the types of immigrants represented among the promotoras who participated in the study. Ms. Molina, born in Reynosa, state of Tamaulipas, told the story of how her undocummented status prevented her to return to Mexico after her migrating into Texas. She said: My name is Eulalia Molina, I have been living in the U.S. for 12 years. I came from Mexico in 1988, on the 9 th of May. I came to live here, in the Las Milpas colonias (Pharr, Texas). Now I have three children. A girl,12 years old, one 9 years old, and a boy 6 years old. I was born in Reynosa, Tamaulipas. My parents live there. I dont have family living here, except my children, my husband, and myself. Everyone in my husbands family lives here. For me it is very hard because I cannot cross the border back to Mexico. I havent seen my parents and my family since I arrived here (12 years ago). This is very hard for me. It was very difficult for me to leave my family and come here. My husband is now getting my documents. I left pregnant looking for a better future, I was two months pregnant of my oldest daughter when I left. Leaving my family behind was very hard but it was for a better future for my daughter. My husband came with me, without documents too, but his parents were living here already. So we came to live with them (husbands parents). My husband started to work in the fields, to support us. While in the fields he started to move papers, but only he could get his papers, because he didnt have money for me. There was no way to get papers for me at that time. I started the process 82


to get my papers in 1997, and I have a work permit since 1998. And I started to work with my work permit. I started at the Center, first as a volunteer. It is worth considering that this experience of being away from parents and relatives, from "mi familia," [my family] influences promotoras' identity as colonia women as well as their identity as promotoras. In other words, who they are and who they are as promotoras is mediated to some extent by their experience as 'expatriates.' This falls within the realm of why they choose to be promotoras, that is, "to help people not to suffer as much as they have suffered." Isolation at their homes because of fear to the outside environment, due to immigration status or not, and isolation from "la familia" is one aspect of the experience they want other women in colonias to learn how to deal with. Several of the women who work as promotoras have been undocumented at some point of their lives, or were undocumented at the time of the interview. Not having a legal residence status in the U.S., and therefore not having a social security number, had consequences on their ability to obtain a variety of services, as well as on some occasions limited their opportunities of education. Ms. Rodriguez states the connotations of not having a social security card: The problem is that a lot of people do not have documents or do not have a social security number, or have a permit to be here but dont have a social security number. Nowadays, social security is required everywhere. Doctors require it, and there have been occasions when not even hospitals want to see you if you dont have a social security number. A lot of people had that problem. Where would they go? They cannot go back to Mexico, because how would they cross back to the U.S.? We have learned of places where those people can be helped. But this problem is not exclusive of undocumented people, it also attains to low-income people in general. 83


Interestingly, Ms. Rodriguez concludes that the problems faced by people who do not have a social security number are also experienced by people in poverty in general. In relation to poverty and to the limitations set by not having a legal residence status, Ms. Porras described her own experience developing a strategy to solve the problems imposed upon her by not having a social security number. Ms. Porras described how she was able to obtain the Child Development Assistant Certificate (CDA) by showing the social security number of the son of a friend of hers. She said: And the secretary told me that I needed the Social Security number, and I responded that didnt have it. And on the following day, at the Edinburg class, I told them (my friends), They are asking me for my social security and to complete this letter. And then my friend told me, Take my sons social security. And I thought over and over again about my friends offer, because I knew those things are penalized by the law, but at the same time I would not get my certificate if I didnt do it. So I did it. And I told myself, If she is so sure about this, and if she is offering it to me with such care and regard for me, then it should be okay. All my friends wanted to help me in different ways, they were all good. So I mailed the letter with that information (friends son social security number). Ms. Porras account is an expression of womens agency, of a capacity to solve problems and to define themselves instead of being defined by others (Bhattacharyya 1995: 61). This is a common trait found in promotoras accounts of their life experience as immigrants and border women. Work Experience of Promotoras Women who participated in the study had had a variety of work experiences in Mexico and in the U.S. On some occasions, however, the promotora work was the first job they ever had. Still, a number of the women had had experience as volunteers before or during employment. Of the women who 84


had worked in Mexico, one of them had worked as a migrant worker in the United States and returned to Mexico every season; two of them said they had worked in maquiladoras by the Reynosa, Tamaulipas, border; two of them said they had worked as the equivalent to promotoras in the Sistema Nacional para el Desarrollo Integral de la Familia, DIF [National System for the Integral Family Development]. One said she had worked as a nurse assistant, another one as a teacher, and yet another one as an accounting assistant. Of the women who had had work experience in the United States, sixteen of them had worked in the fields either in the LRGV, or as migrant workers throught the country; one had worked as an informal provider of child care at the colonia where she lived; one had worked in a local cotton gin in a packing line, one in a health clinic, and six had been promotoras with other organizations. Fourteen of all of the women had volunteered in some fashion either in Mexico or in the United States. Although working in maquiladoras is an important component of the social and economic scene of the Mexican side of the border, only two women of the sample manifested having had that experience. Ms. Montemayor, from the Mexican border town of Rio Bravo, Tamaulipas, said that she had worked at the Zenith factory between 1983 and 1985, on a television assembly line. She had completed high school in Reynosa (preparatoria), and then migrated into the United States. Another woman, Ms. Porras, native of Ebano, in the Mexican state of San Luis Potosi, also worked in an assembly line in a factory in Reynosa. Ms. Porras started working in the factory in her last high school year. She knew some English because she had live in the McAllen area as a child, with friends of her 85


family. According to her, knowing English was essential at the moment of applying for the job. She started in Quality Control and throughout the next six years she changed positions several times until becoming a line supervisor. In the assembly line she met her husband, whom she married while still employed in the factory, and had three children also while employed in the factory. After six years working in the assembly line, Ms. Porras left the factory and worked as an accountant assistant, the title she had obtained in the technical school in Reynosa. Few years later, with her mother living in Pharr, she emigrated with her children. An important aspect of the experience of promotoras as immigrants has to do with the search for employment. On many occasions the promotora job was the first employment the women had in the United States. In some cases, promotoras had worked as maids for families or cooks in a colonia restaurant or in a tortilla factory. Regardless of their employment experience, promotoras face common challenges that are related to their condition of either single mothers, not speaking English, or of undocumented immigrants. In the following account Ms. Porras described her experience looking for a job as a recent undocumented immigrant: Every morning I used to go out looking for a job. And I also wanted to study. Since I am here, I have to study. Ive been told there is a school somewhere around here. Where is it that I cant find it? Las Milpas (colonia where Mrs. Porras settled and where she lived at the time of the interview) was not what it is now. I didnt want to talk to anybody. I always thought I wouldnt understand people. So I went to a store, where I saw an advertisement (offering a job). While I looked for a job I was already working cleaning houses. I looked for a job in the newspaper and also with people I knew and who referred me. And we used to clean houses on a day-to-day basis. In the colonia where we lived houses were vacated by 86


people who could not continue paying, and they left everything inside. So I cleaned those houses. And I left there everything I found, little or a lot (did not take anything of what was left in the house). And the owner of the house used to tell me, I want everything to be clean, floors washed, because we are going to paint the house. And if the windows are stained, I want everything clean, looking pretty. And everything else to the garbage can! Not to the garbage, I took everything with me. We made a garage sale with those things. I kept some of the things, but sold others. And I worked here in the LRGV store, with Mr. Rodolfo. I used to make flour tortillas. Even better, I used to do everything I could do. And I worked here and I worked there. And I tried to make sure that we didnt lack money to pay our bills. A common characteristic of promotoras is that they had been helpers in their communities before they were employed as promotoras. This is reflected in that several of them described their inclination and commitment to contribute to the well-being of their neighbors, which they did by volunteering in schools, churches, or other types of community organizations. Several of them did not participate in formal organizations but helped informally. As Ms. Gonzlez said, "I have always said: what would be better than being paid for something you have always done for free!" The account of how they were active helpers in their communities is varied. Some of them recalled during the interviews that they had been helpers since childhood in different manners. However, the helping attribute is complex since it is intrinsically connected to their role as women. Paraphrasing a description commonly made by women about their role is that being a promotora requires something special, something that allows the worker to acquire and sustain a close connection and commitment to the community. The natural helping attribute is assigned to non-compensated activities performed in formal organizations such as church, school, neighborhood organization, or outside the realm of formal organizations, just helping neighbors. 87


For example, Ms. Villa, who participated as an instructor at a pre-school program, mentioned that although she had never considered belonging to a community center or a community group, she enjoyed teaching children: I always liked helping people. But I never considered participating in a community center or having a job through which I could help the community. Never. Now I recall something that I had completely forgotten: when I was a child I used to enjoy teaching my friends. I always was the teacher. I recall that I used to tell my parents that I was going to be a teacher when I grow up. I was about thirteen years old. I went through elementary school then high school and I completely forgot I wanted to be a teacher. And now I am doing it! Ms. Hidalgo described her experience as a volunteer in Matamoros, a Mexican border city across from Brownsville. She volunteered in the local DIF, where she participated in a volunteer outreach vaccination program. Ms. Hidalgo added that she was a promotora without knowing it: I could have stayed at home, taking care of my family, cooking, waiting for my husband in the evening, waiting for my children to come from school. But I cannot do it. I want to let it be known what I have learned, so I will continue to volunteer, I will continue to participate in trainings, and telling people what I learn. Ms. Reinoso lived in Florida for a couple of years before settling in Progreso, a rural area bordering with the Mexican town of Nuevo Progreso or Las Flores. In Florida Ms. Reinoso did not volunteer in a formal organization, although she did get involved in different forms of helping others: I just offered help to the people who lived close to me and who did not know the place well enough. Ms. Reinoso added that she oriented parents regarding vaccination of their children, making sure that all neighbors knew about the need for vaccination. She added: How would I know that I would end up getting a job doing what I always did on my own? 88


Work and Autonomy The women who participated in the study described the changes they experienced as a result of their work as promotoras. Changes included a new division of labor with their husbands or partners, resulting in new roles played at home associated with a renewed way of defining themselves vis--vis their families and husbands, and the resulting adaptation of their families and husbands to the changes they experienced. Working as promotoras, and particularly their participation in decision-making activities within the programs that employed them, also helped to increase self-esteem and a sense of autonomy among the women. This was reflected in them in that for the first time they began to challenge the traditional ways of doing things in their personal lives, and in turn challenging those around them who had a particular view of their identities. In theoretical sense, it could be said that the process of increased autonomy served to strengthen womens agency and capacity to control their lives. This matter will be discussed in detail in the discussion section of this dissertation. The womens accounts suggest a correlation between working and participation in decision-making and self-esteem and autonomy, although the data are insufficient to establish a statistical correlation. Those women who were deeply involved in their programs and who played decision-making roles described themselves as having a high sense of self-esteem. They said that they were going through a process of increasing control over their lives, thus decreasing the traditional dependence they had on their husbands or partners. 89


This change in autonomy may represent a cultural change, in other words, a lasting change in womens roles and in how they define themselves and in how those around them define them. A long-term study, however, would be needed to verify those associations. In describing the relationship between work and autonomy I will describe three elements that are connected to womens identity. These elements could be placed in a continuum between tradition and cultural change, or between dependence and autonomy. First, I will depict womens accounts of the traditional roles they played at home and the traditional division of labor between husband and wife. Intertwined with this there is a traditional way of defining themselves and of others defining them. Second, I will describe the different activities and responsibilities they acquired within the promotora programs that served to trigger in them a change in self-esteem and a change in autonomy. The description of the triggering elements becomes crucial from a program planning perspective, since programs could either emphasize or de-emphasize such activities or orientations, which have an effect on the acquisition of differentiated levels of autonomy by women. In the discussion chapter of this dissertation the programmatic and applied implications of this will be discussed extensively. Finally, I will end this section describing the nature and manifestation of the changes in self-esteem and in autonomy experienced by women as a result of their work as promotoras. 90


Womens Accounts of Traditional Roles and Division of Labor Tradition is represented in how women seem themselves, in how people around them, and particularly their family members seem them, and in the roles they play at home and in the community. Promotoras represent an lite in terms of cultural innovation. That is, although they are members of their colonia communities, they are different from their neighbors because they have been exposed to new ideas and have developed new ideals as a result of work 12 The accounts of promotoras showed how they changed as a result of their work. Those women who had been promotoras longer can situate themselves at a distance regarding tradition, while those women who had recently started to work, and who had not had previous job experience generally situated themselves closer or even within the realm of traditional roles and traditional identity. But, what is tradition? When walking the streets of colonias, talking with neighbors, with promotoras and with program staff, it becomes evident that men are not in their homes during the day, while women are. Moreover, women predominate in community activities, except for evening school meetings, which are attended by both husbands and wives. Men are seasonally employed in local agriculture, in construction, and in the service sector. This is the reason why programs recruit among women and not among men. 12 This notion of promotoras being from the community but not being typical members of the community was first suggested to me by Michael Angrosino (personal communication). This is a very important point since the promotoras power to produce change in their communities derives precisely from their exposure to innovation. As will be seen in the discussion chapter of this dissertation, the culture brokerage role very well represents this notion of being from the community but not representing exactly the communitys values. 91


Such a basic labor differentiation in the colonia communities is directly reflected in promotora programs. For instance, out of the sample of 26 promotoras, there was only one man. Program coordinators explained this distribution in part by saying that women were at home during the day, while men were not. They added that women were the ones who took care of issues related to health and to children, coinciding with the programmatic objectives of all of the programs. This was well described by Ms. Rosaldo, one of the promotoras, who explained that: Most of the time the contact is with the mother. Sometimes I have told the men that they can also receive the books we take to the children, but they refuse to receive anything from us, it is always My wife has to do it. It is always the mother, the mother, men always step aside. It is the same when we are out registering children for the child program. If the wife is not at home, the husband does not make the decision to register their children. I insist: Look Sir, wouldn't you like to register your child? And they respond: 'The truth is that my wife has to be present.' It is always the wife 13 In colonias, husbands tend to exclude themselves from participation in activities that affect the family. Men are the breadwinners, while women are the childrearers. The same Ms. Rosaldo mentioned that it would be beautiful if men were involved a much as women, but I dont think it is natural, I think it has to do with the nature of men and women. Ms. Rosaldo thought it was natural for men to assist household and family activities; by extension, she defined as natural her own specialization in household-related roles. This conviction of the natural division of labor constitutes a key barrier to change. Promotoras described how their traditional roles had to change in order to adapt to the expectations of their 13 Unless otherwise noted, all quotations of promotoras accounts included in the dissertation are translations made by the author from the original Spanish. 92

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work. At home, they were used to listening to their husbands and to being submissive. At work, by contrast, they were they were encouraged to take initiative, to think critically, and to make decisions for themselves. Women experienced a sense of friction between the two views of their roles as women. This was particularly the case with the promotoras who worked in the community-based and community-controlled program, since the philosophy of the program included the empowerment of workers. This is how Ms. Fernndez described the change she had to go through as she started working in the program: At the beginning it was very difficult because I was used to do what my husband told me to do. You have to do this, do that. So, when I started working here, it was different. At the beginning, I wanted to do what they told me to do. So they told me: 'You cannot do it like that. You have to decide by yourself. You don't have to ask, you know how to do things. I don't know, it was difficult, because it is difficult when you are used to a certain way. I mean, when you are used to your husband doing everything: that he brings money home, this and the other. But it is beautiful to see change. Husbands resistance to wives playing an active role as breadwinners was commonly described by promotoras as one of the characteristic reactions to their employment. In some cases husbands did not reject their wives participation as volunteers in community groups, but did actively resist to their wives working for a salary and bringing money home. There are several accounts describing this reaction since many promotoras first worked as volunteers in their programs and only after a while accepted formal employment. Ms. Gonzlez said that her husband felt a sense of inferiority since her employment represented a change in the traditional household roles. Ms. Gonzlez husband was an irregularly employed construction worker. Her job, on the other hand, was stable which 93

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meant that on occasions he stayed at home while she went out to work. She said, It was something he could not explain himself, and he could not understand ithe has come to feel less than me, I think it is because my work is stable and his is not. He used to be a man who thought he was the one who should work, not me. Ms. Gonzlez was able to make her husband accept her new role as a breadwinner, and perhaps more telling, she finally convinced herself of the value of her contribution to the home. Mrs. Gonzlez felt proud of contributing to the household and of helping her husband provide for their children. Although her husband's job does not seem to be necessary in order to meet the basic needs of the household, she still feels that she is helping him. In other words, she keeps defining him as the main breadwinner while she is merely the secondary contributor, although she makes enough money to be the main breadwinner. This attitude could be interpreted as her way of not damaging his self-esteem, or as a reflection of how deeply internalized was her role as a secondary provider. Women questioned the traditional way of doing things as a result of their exposure to work. The women who had had work experience prior to their employment as promotoras had already gone through processes of challenging tradition. Women who had not had prior work experience were for the first time challenging their roles at home and at the community, and at the same time they were stimulating in their family members the need to change with them. Beyond the simple fact of their employment, change resulted from the women being assigned responsibilities in their jobs and being asked to make decisions that 94

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affected others than their families. Several women reflected upon how dismayed they were when they were asked to teach children, given that many of them had not completed their own formal education. For instance, when Ms. Prez was asked by her program coordinator to teach 3 and 4 year-old children, she was highly surprised and wondered, How will I teach 3 and 4 year-old, when I have not completed my education? You know I am not educated. The trust shown in them by the program coordinators did have an effect on her self-esteem since she realized that she could play a role in the community and benefit others despite the fact that she was a woman lacking a complete formal education (she had completed 6 th grade in Mexico). Thus the assignment of a teaching responsibility triggered in Ms. Prez a change in the way she perceived herself, in the way she defined herself and her perception of usefulness in society that expanded beyond the household to encompass the community as a whole. The Promotora Practice and Changes in Self-esteem and Autonomy Promotoras participate in several different activities as part of the implementation of their programs. Activities include home visits, organization and participation in health fairs, organization of folkloric activities, teaching children, teaching parenting classes to parents, teaching English to both children and adults, activities with the elderly, teaching arts and crafts, organizing and administering clothing closets and food banks, among others. Linking all of these activities is the service they provide community residents, sometimes formally and sometimes informally. In providing a service, promotoras help others and in doing that they obtain personal satisfaction, increase their self-esteem, and 95

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become active in their communities. Thus they transcend the traditional household orientation into a community orientation, not withstanding that promotoras continue fulfilling their household responsibilities. This process is also reflected in an increased autonomy. It is in home visits where the links among work, self-esteem, and autonomy are best reflected. The experience of visiting homes and of talking to residents had a sort of therapeutic effect on women because it enhances their self-esteem. During home visits promotoras do what they are asked to do by their programs such as providing information about health services, educational services, environment, and immigration, depending on the program. Additionally, they provide informal emotional support through dialogue with the women who are at home at the time of the visits. Ms. Molina said, We talk with them. How is the day? How is the family? The women who are visited and the promotoras obtain great satisfaction from the conversation. Ms. Molina expressed this dual satisfaction in the following words: The women are satisfied with the conversation we have with them. They are pleased to talk with us. We are also satisfied after talking with the ladies because we know they feel better after talking with us. After the home visits, we meet and exchange experiences. How did you do with the family you visited? The other promotora answers: Well, the lady received us and we talked about the family. Another lady talked about her children, and another one talked about an uncle. This one is very happy because she is waiting for her uncle to visit her. We have communication with the families, they trust us. Home visits are important for promotoras in the process of autonomy building. As Ms. Molina clearly states, families trust them. This trust makes them feel satisfied. In terms of the role change that promotoras experience, this trust 96

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entails recognition of their contribution. Trust in this case is public, as distinct from the private trust they enjoy from their families. Thus it could be claimed that public trust is an element essential in the understanding of the self-esteem and autonomy building processes women experience. Complementary to the trust residents entrust upon them is the realization that they are able to help. Promotoras know that they are useful because they can see changes in people as a result of their work. Of course, it goes without saying that the specific impact they exert is a function of the program which employs them, given the different emphases programs have. Nevertheless, promotoras perceive that their work produces change in people and this perception is crucial in understanding the impact that work has on their self-esteem and, ultimately, on their autonomy. I was able to observe the ways in which the promotoras were made to understand that they are, indeed, being helpful. When I accompanied them on home visits they provided information on services and on personal health care, during which, residents, mostly women and children, reacted positively. They also discovered that thanks to their advice residents received a particular service or were able to solve a problem related to issues such as housing or immigration. The walking sessions organized as part of a diabetes prevention program were another way for me to see how they made themselves useful. On several occasions I joined them as they walked around a field with dozens of ladies from the colonia who did not have the opportunity to exercise regularly. In this case, their outreach and education effort had a tangible effect, which promotoras valued highly not only in terms of the 97

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well-being of participants, but also in terms of their own capacity to contribute to that well-being. Thus their self-esteem was greatly affected by the realization that they were contributing to help the residents build healthy habits. Promotoras also found great satisfaction in the administration of blood pressure tests and diabetes examinations. Home visits impact the autonomy process in yet another way. Some of the promotoras described how their exposure to families during home visits made them aware that they needed to further their own education, since they realized that they were not prepared to respond satisfactorily to the needs of some families. Although the positive impact that dialogue and conversation had on families was universal in the experience of promotoras, as well as the accounts of residents who were served by promotoras, it is also common to find how requests for information and for knowledge motivated women to desire to further their education, which they did through training sessions within the program and sometimes through GED and associate degrees they pursued independently. Thus residents challenged and triggered change, which ultimately was reflected on higher degrees of autonomy, which they acquired through formal education. Ms. Porras described this process well: Some people I visited made me feel offended, sad. It is not that they wanted to offend me. I think that God used them to help me, to make me react. You have to improve. You have to educate yourself. This is going to happen again if you are not ready; it is not their fault. They are only seeing who you are. Well, I could not take my final exams and as a result I did not graduate with the CDA degree. This is a dream I have, I have to complete it. [Weeping]. It is not that I want to post a paper on the wall, but it is something I need, perhaps to pursue yet another degree at college, perhaps social worker, I dont know. And I am partially living this dream at the program, because I always learn through my work. 98

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Home visits provides the channel through which promotoras are in close contact with residents and in Ms. Porras case, the channel through which they become aware that they need to further their education. Ms. Porras was particularly explicit about how much she wanted to further her formal education by going to college and obtaining a degree. Not everyone wanted to go to college, but all of them greatly valued the informal and formal education they were receiving in their programs. Participation in decision-making is a key component of the self-esteem and autonomy-building processes that promotoras experience. However, participation in decision-making is a complex phenomenon. On the one hand it represents the achievement of a meaningful degree of autonomy as well as playing roles that are different from the traditional home-restricted roles. On the other hand, it represents the tension between tradition and innovation. Promotoras do not easily accept having to make decisions, and some programs limited their scope of decision-making, thus replicating at work the dependency on husbands they have at home. It was in programs that promoted womens autonomy and empowerment as guiding principles that women were encouraged to make decisions that impacted the community and the program itself. Programs that did not have womens autonomy and empowerment as guiding principles, however, had a decision-making structure in which women played a rather submissive role, and were not encouraged to make decisions that impacted significantly either the community with which they worked or their programs. Nevertheless, in those cases in which women were encouraged to make 99

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decisions, their self-esteem was positively affected. Women who worked with programs that motivated their decision-making abilities showed and expressed in interviews a higher degree of change and autonomy than those working for programs where such motivation was non-existent. There are two models that describe womens access to decision-making in the programs they work. The first model is one in which there is an organizational structure that establishes different levels for decision-making. Programmatic decisions are made by program directors at the local and state levels. Implementation decisions are made by program coordinators, who are close to promotoras but who are different from them in several ways. Program coordinators are social science or social service professionals. In this model, promotoras are restricted to localized decision-making. In other words, they can make decisions that are not programmatic and that do not affect implementation in a major way; they can make decisions that have to do with ways of doing things in the field. Within this first model, decision-making can be seen as an indicator of the degree to which reliance on local culture and knowledge has been co-opted by the formal organization with which workers are employed. In one of the agencies, the work that promotoras do is planned in coordination between promotoras themselves and program coordinators. However, final decisions are always made by coordinators. For instance, promotoras may have ideas about things they could do in their community, perhaps in collaboration with residents, or in collaboration with other agencies or community organizations; but the final 100

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decision as to whether or not they will do it is made by the coordinator. Promotoras can suggest activities and include them tentatively in their monthly schedules, but the schedule needs to be approved by the coordinator. Ms. Montemayor, a promotoras working for this agency, touched on this relative restriction that she and her colleagues have in regard to making programmatic decisions: We ask the coordinators for permission to do something. Sometimes they give us permission. Sometimes they dont. For instance, there is a new program in the community, but we have not yet told our supervisor about it. But I think she is going to approve our participation in it, since all that is good for the community is approved. The other day a group of promotoras from the clinic came to visit us and they letting us know about this new program for pregnant women. It is a program that provides transportation for women and a monetary help. It seems to be a good program. They wanted us to help them with a survey in the community, but we cannot do it until we ask permission to our supervisor. But I think she is going to give us permission, because it is good for the community. In this model the programmatic decisions are made by the program director, who in turn may receive indications from the external office. The dependence from an external office model, however, is only represented by one of the examined programs. The work schedules for the workers are made by the supervisors in collaboration with the promotoras. The supervisors are the ones who make contact with agencies and programs and are the ones who receive instructions from the program director. The promotoras may contribute to the design of the work schedules, but their contribution is limited to methodological rather than substantial issues. Of course, within this model, there is variation from program to program and from coordinator to coordinator regarding the degree to which promotoras can make implementation decisions. For instance, 101

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Mr. Carranza, a program coordinator, said the following regarding the differentiated decision-making roles of coordinators and of promotoras: When I say I supervise them, I provide them with a work schedule. You know. I'll tell them on this day, it's Make a Difference Day. I want you all to come up with an idea. Because they know better than I do what their community needs.They have a work plan that they need to follow. They have to visit isolated colonia residents in their homes to assess needs for health human services and internship programs. Ok? And then help residents become connected with those programs. So really, what they are in charge of doing is home visits. The second model of organization is one in which there is a fundamental principle of the empowerment of workers. In this model, the program encourages women to make programmatic decisions, not only decisions that have to do with implementation. In this model the traditional organizational structure has been replaced by a form of circular structure, one in which there are only two levels of decision-makers. First, all promotoras, called animadoras 14 in the program that best characterizes this model, based at colonia community centers, make decisions regarding the administration of their centers. They decide on the division of labor, which is not static but always subject to change as circumstances change. In some of them they are in charge of cleaning, in others of cooking, and in others of purchasing supplies. The contact with other organizations is in the hands of the promotoras whose role is to connect with agencies, while the contact with residents is done by all promotoras in their daily work. These promotoras are responsible for the management of the center. Then, there is a smaller group of women who call themselves mentors and whose role is to provide leadership and training to the rest of the promotoras. 14 The word animadoras translates as motivators. Thus, the promotoras from this program represent themselves as motivators of community residents. 102

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The mentors, however, are not permanent and do not form an lite in relation to the rest. Promotoras with more than five years of seniority can become mentors; however, this role change does not automatically translate into a salary increase for them. At the same time, mentors can go back to be promotoras. In this leadership model there is a higher degree of decision-making sharing, which is very well reflected in the accounts by these promotoras. Nature of Changes in Self-Esteem and Autonomy Ms. Prez spoke about the pride she feels in herself as a worker. She knows that her children are also proud of the fact that "...their mother wants to do more." She added that it is good for her children to know that women can do more than being in the kitchen and serving the family. "Of course I will serve my family, because I do it. Every morning I get up early to cook their breakfast. I do take care of the household chores." Ms. Prez shows how her work experience as a promotora is helping her to promote in her children a change in the way they view gender relations so that they move away from a strictly male-dominant view. When the job demands that women become more assertive, critical, and independent, these new attitudes eventually start creating a more permanent change in the womens perception of themselves and of the roles they should play at home and in the community. Ms. Fernndez also tells how the work experience helped her to change her attitude toward the role that her husband had defined for her. She explained how before she started working her husband used to tell her what to do: You have to do this, you have to do that. It all changed when I started working. The promotoras used to tell me that I could do things on my own, 103

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You just have to propose yourself and you can do it. But it took me sometime to understand. It is hard when you used to it another way. In other words, that the husband does everything. That he brings the money home, this and that. The women who work as promotoras experience a change in the way they view themselves in the context of the family, work, and community. This change seems to be a result of their experience as workers and more precisely of their insertion into the working world, sometimes for the first time. Their exposure to new activities, and new social relations, makes them question aspects of their lives they had not had the opportunity to question before, such as their traditional roles as housewives and their relationships with their husbands. As Ms. Prez said, We Mexican women have this tendency to ask our husbands for permission to do things. It is something we cannot change easily. This reasoning challenges their traditional roles as well as the way they think of themselves vis--vis their families and society in general. The renovated view of themselves experienced by women can be interpreted as an expression of self-empowerment. Also, it can be interpreted as a source of their agency, of their capacity to take control of their lives at a higher degree than before they started working. Added to their own questioning is the reaction to it by their family members, particularly their husbands. Although the study showed some variability in terms of how husbands reacted to their wives or partners insertion into the working world, it is common to find some degree of rejection of the new role played by their women. There is variability among husbands perceptions about the work their wives do. Some of them reject their work, restricting them 104

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and sometimes prohibiting them from working. In other cases, husbands show a high level of comprehension and understanding for their wives work. This attitude is sometimes guided by an understanding of how important the work is for the women themselves as well as for the communities, and sometimes guided by the interest of the family. For instance, Ms. Prez tells that her husband, who is about 30 years older than she, supports her in her job because in that way the couple's children would still have an income even when he is gone. Perhaps that is why he understands me, he motives me. He tells me: You have to work because the day I pass away, you will have to respond for my children. But I also like you to work because you are trying to improve yourself, because if you can do it by yourself, that means you can also look after my children. What I like the most is that I don't want my children to suffer because you cannot go out to buy food. I see that you can go out on your own. Ms. Prez adds that she has his authorization and his trust, both of which allow her to work. Several of the promotoras talked about how their husbands reacted to their employment. In some cases they accepted and in other cases they resisted to the idea of having their wives working. Regardless of the husbands' attitudes, a common trait is that promotoras ask permission from their husbands. For instance, Ms. Rosaldo explained the process she went through when she was invited to work in the program that employed her at the time of the interview. She said that although her husband approved her decision to work, he then changed his mind when Ms. Rosaldo could not find a baby-sitter for their 3 yearold child: I told them, 'Yes, I will start working.' I was one of the first ones to decide to join them in their program. I was very happy. So I asked my husband and he said, Yes, you can do it. But I had a child, he was 3 years old. And I had a person to help me care for my child, the same person who 105

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helped me while I was volunteering with the same program. So I told my friend from the program, Yes, I am ready! But the person who was going to help me, she could not do it anymore. And I felt very frustrated because then my husband said that I could not work if I didn't find a baby-sitter. And I responded, Okay, I won't work. But I was very sad. And I was sad for myself, since I was very enthusiastic about working...And I told myself, If my husband wants me to stay at home with the baby, I will do it. Ms. Rosaldo only began working three years after her first attempt, once her son entered school. Ms. Gonzlez told a similar story. She described how her then husband accepted her to volunteer in the agency, but did not approve of her working as a paid employee. In Ms. Gonzlez case, the husband did not accept the idea of her wife being a bread-winner, although he agreed to her working as a volunteer. As a result of her husband's refusal, Ms. Gonzlez decided to separate from him. Community Representation of Roles and Strategies 15 The practice of the promotoras includes a diversity of roles and strategies for implementation that have concrete representations in the community. Their work is multidimensional. Figure 4 summarizes the studys findings in a framework called Dimensions of Promotora Practice. Within the dimensions there are five domains of practice, i.e., areas of the community well-being that are affected by the promotoras. These are: Information and referral Education Community capacity building 15 An earlier draft of this section was included in the original project report submitted to the Office of Rural Health Policy, Health Resources and Services Administration (May, et al. 2004). 106

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Emotional support Advocacy Each domain is associated with implementation processes and representation of those processes in the community. By implementation processes I mean the processes through which promotoras connect with communities, the organizations with which they work, and service providers in general. The outcome of these processes is a specific type of impact. By representations in the community I mean the ways in which communities well-being is affected through promotoras work. This may occur at the level of individuals, families, and communities. There may also be representations at the level of the system, such as contributions to changing paradigms of service delivery. It is important to note that in reality the five domains of practice cannot be easily distinguished one from the other. Indeed, there is a high level of overlapping and intertwining among them. Figure 4 below shows the framework Dimensions of Promotora Practice. 107

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Figure 4. Dimensions and Community Representation of Practice Domains of Practice Process Community Representation What do Promotoras do? How do Promotoras do their work? How is Promotoras Practice represented in communitys well-being? Information and referral Home visits to identify needs, inform, and refer to services Organize health fairs and presentations at colonia homes Organize health fairs at schools and other places Inform community residents at community center/office Distribute information in public places Link residents with service providers Contribute to diminish isolation of colonia residents Contribute to change providers attitudes towards working in colonias Build individual capacity in community residents Education Teach parenting Teach early childhood care Teach disease prevention strategies Teach healthy life styles Teach environmental health Teach arts and crafts Educate community residents, particularly children and women. Empower community residents, particularly children and women Build healthy communities Community and Capacity Building Organize the community Recruit volunteers Organize health fairs at peoples homes Value peoples strengths Teaching money earning activities Organize (and outreach for) folklore activities Connect residents Build leadership Empower community residents Build economic capacity Recover and empower local and Mexican culture Emotional Support Counsel and advise women of community Give advice to children and youth Increase self-esteem of women, children, and youth Comfort and orient residents with emotional needs Advocacy Advise community residents on issues related to discrimination and access to services Talk with service providers about cultural competence and discrimination concerns Empower community residents Build self-reliance in communities Indirectly educate service providers on cultural competency The domains of practice described in Figure 4 are the means by which the predominant goals of the promotora organizations are accomplished. The emphasis placed on one domain over the other by a promotora, or a group of promotoras, responds in part to the organizations goals and objectives, and in part to personal interests and commitments established between the promotora(s) and a community. For instance, information and referral, education, 108

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and community capacity building are commonly emphasized by promotora organization as explicit domains of practice. However, emotional support and advocacy are domains of practice that promotoras often find essential in accomplishing their work, although not explicitly instructed to do so by the organizations. Emotional support and advocacy activities occur, not surprisingly, as a result of the promotoras being a part of the community and of felling a strong commitment to its well-being. I turn now to a detailed discussion of each of these domains. Information and Referral All promotora programs provide information and referral services. They provide information about where and how to access formal services, which might include information and solutions in areas such as immigration, housing, health, mental health, and education. Once community residents talk to promotoras about particular problems, then they are able to make specific referrals, and when possible, follow-up on them. In effect, promotoras become the bridge that connects residents to providers, and that provides a means of understanding between two different cultures. In this sense, promotoras become cultural brokers in their communities. All of the organizations that participated in the study have information and referral as a priority domain of practice. Information is provided on diverse topics, including health services, environmental, education, child care, immigration, and housing. Promotoras receive training on these and other topics from the employing organization as well as from health agencies, service 109

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providers, and non-governmental organizations. Promotoras are provided with fliers, booklets, and other forms of written information to disseminate in the community. During home visits, promotoras regularly ask residents about needs and, based on the responses, they provide them with relevant information. This information could be about services, or a general guidance about how to navigate the system. On some occasions, particularly if the person does not speak English, the promotora calls the service provider, asks pertinent questions, or makes an appointment. Regularly, promotoras follow-up through phone calls or home visits, to make sure that the referral was followed through. Home visits are central to the promotora experience. It is through home visits that promotoras skills and comparative advantage as insiders are made evident. 16 Through home visits promotoras demonstrate a high sense of cultural sensibility and respect for the people. They also demonstrate skills and knowledge acquired through training, about how to engage families. Ms. Ortega describes a home visit in the following terms: The first thing we find when we visit homes is that sometimes people dont want to talk with us because they think we represent a Church. They have said that to us on some occasions. We dress in a certain way so that we can be identified as promotoras. We first tell them that we are promotoras and that we work with the [community project]. Then, we tell them about what we do as promotoras and as a result they start trusting us. Trust, however, is developed slowly, visit after visit. We go back to a home as many times as it is necessary in order to develop trust. We tell people about services available to them. [] Simultaneously, we complete a needs assessment questionnaire; we always show them the questionnaire. They always ask us why we need to ask those questions. We tell them that it is for the well-being of the community, so that services are made availablethen we give them the information they need 16 A few promotoras do not do home visits, since some of them are trained to only teach, or to help people complete a variety of applications at the office, among other things. 110

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According to the data, promotoras provide both a general and detailed orientation about a diversity of issues or services. This is done through several strategies. For example, promotoras who participated in the study hold health fairs at colonia homes, schools, and churches; they also distribute material or give oral presentations in the waiting rooms of health clinics, in the waiting rooms of community centers, and even in public spaces such as malls and supermarkets. One promotora program coordinator from a health clinic program described his programs information and referral component in a way that is applicable, in general terms, to all the studys promotora processes. The program coordinator, Mr. Carranza, described it as follows: The information and referral is basically when the promotora will identify a need and we do not provide that service, we then make contact to our referring resource by calling and setting up an appointment. If there is a transportation problem, if they can't make it to the doctor's appointment, we will call and make arrangements so that they can get a voucher, or a cab service, or public transportation. The information and referral practices during home visits are highly regarded by community residents. A resident from a Hidalgo County community describes the type of information that she is given during home visits: They [promotoras] visit me at home and give me a lot of information about cancer, about tuberculosis examinations, and anything they want to educate us about. That is why they visit homes. They are also concerned about children, they visit homes and ask about the children, if they are vaccinated. They also tell us whenever the community closet has clothes for our children, or anything like that. Promotoras connect community residents to a variety of external provider systems, e.g. health, mental health, education, employment, training, housing, 111

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immigration, and so forth. In doing so, they contribute to filling an outreach gap. Several coordinators and directors who participated in this study stated that before having the promotora component in their agencies, they and service providers in general did not go into colonias to inform residents about available services because colonias lacked buildings where residents could be served. For instance, coordinators and directors said that there were no air conditioned rooms where they could give their presentations to groups of residents. In their view, this was particularly important in the hot south Texas summer. Another Director of an organization commented: We discovered that it was not only colonias residents who were isolated. Service providers were just as isolated. With the inclusion of the promotora component, organizations were able to bring providers to the community, adapting to the existing colonia conditions 17 Promotoras ability to hold community meetings in multiple settings, such as under the shade of a tree or in a small living room with no air conditioning, proved to providers that they did not require a complex infrastructure before they could reach out to colonia residents. Therefore, promotoras have not only bridged the divide between colonias and the system of providers, but also contributed to changing attitudes of service providers, and the paradigms through which they operated and in doing this they have diminished providers uneasiness with the other from colonias. 17 Program staff accounts of the infrastructural deficiencies in colonias, which made it difficult to provide locally-based services, could also be interpreted as an euphemism to represent their uneasiness encountering colonia residents, a virtually strange other. This assumption is supported by staff recognition that not only colonias were isolated, but that they were too. 112

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The concept of bridging the divide has a particular significance from the point of view of colonia residents. This is especially true for residents who are new to the colonia in particular or to the United States in general. A mother from a colonia said the following: We have the promotoras telephone number. A call is enough for them to help us answer whatever question we may have. Or they help telling us where to go in case of need. For instance, look at my case: I came here without knowing anyone in the United States and I did not know where to get medical care for my children. I didnt know for months, until I learned about WIC and the promotoras who work there. She, the promotora, took care of me just as if she were my advisor. Then she told me how to get my childs Medicaid, where to take my child to the doctor, and my daughter to the eye doctor. She even found a person who helped me get glasses for my daughter. I am tremendously grateful because we have promotoras here. Promotoras are key to recent immigrants adaptation to the colonia. This is particularly the case when the person does not know anyone except the promotora who knocks on her door. Thus, promotoras providing information acquires significance much beyond the act of making knowledge available. Many times the promotora becomes a friend and a resource throughout the complex process of adapting to the new life in the colonia and the country. For instance, a mother from another community said how the promotora had helped her by completing a variety of forms, including an application for an apartment. She was also in addition to the pregnancy education from the promotoras. She said: During my pregnancy some of my neighbors told me that I should come to the clinic. And here at the clinic they informed me about everything. They helped me to complete an application for a discount with the doctor, and they gave me information about how to go through my pregnancy and how I should care for my child. They took me to the hospital where I was going to give birth to my child. And then they helped me with the application for an apartment. They completed the application for me 113

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As bridges connecting residents with the service system, promotoras facilitate communication and understanding between them. This process can be understood as conducting cultural translation through which promotoras make understandable to the community residents the messages that service providers want to transmit. On the other hand, the promotoras also carry and interpret for the service provider information about the residents. As one director noted regarding the role of promotoras: They can open doors that we cannot. Because they know the people, they know what their needs are. They tell me what I need to do. Thus, promotoras not only take messages and information from one place to another, but they also translate that information into a language and a symbolic system that makes sense to residents and providers. They are cultural brokers, mediating between and among different cultures. Education Promotoras contribute to the general education of the community through outreach efforts to inform people about multiple issues and through activities that train and educate people on specific topics. Education is one of the common areas of intervention for promotoras. Although not all of the organizations have education as a predominant mission focus, all of them involve their promotoras in educational activities of some sort. In fact, every informational activity carried out by a promotora has an educational dimension, since as a result of delivering information promotoras are contributing to building a knowledge and awareness base in the community. The educational dimension of informational activities is a function of the depth with which topics are treated. Also, the provision of 114

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information becomes educational when it is systematic in its method. Ms. Obrador, one of the promotoras, explains the distinction between providing information and educating: Well, sometimes presentations are informative. For instance, CHIP presentations are informative. However, presentations on Shaken Baby Syndrome are also educational. As I am presenting information, I am teaching what I know. I say to myself: Since I know this, I am going to share it with you. In other words, it is sharing information and at the same time it is teaching something. Yes, the education I have received (through trainings) has helped me a lot. I think that as a promotora, the best prepared and educated one is, the better we can help peopleI try to be well prepared for my own well-being, but also for the well-being of the community, mostly of the community. There are those activities carried out by promotoras that are educational by definition. Some organizations have promotoras teach courses to community residents on a variety of topics, following structured curricula. In one of the organizations, promotoras conduct all educational activities. In another one, promotoras teach a parenting curriculum that is part of a nine-month intensive parent-child education program serving low-income families with children under 2 years of age. In this case, parents attend weekly parenting classes, where they learn toy making, child development and child discipline, nutrition, pre and post-natal care, and strategies about how to access services. In this same program, promotoras are trained to visit homes on a monthly basis to observe parent-child interactions. In order to conduct educational activities, promotoras receive training from specialized agencies. In the organization specializing in early childhood development and child and maternal health, some of the promotoras registered in a community college in order to obtain a Child 115

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Development Certificate. Another promotora organization hired promotoras who were already certified in an allied health specialization 18 Promotoras who participated in the study provide education in several areas, such as parenting, nutrition and healthy cooking techniques, environmental health, and driving lessons, among many others. The coordinator of an organization that emphasized on health outreach and education, described in very precise terms the basic educational components of the program: The educational part is when we do presentations on health disparities, we do presentations on various topics; we do them orally, we do them by VCR, video, and also by disseminating brochures. Health education is also strengthened by the promotoras doing on-site health fairs that provide diabetes screenings, that provide information on various topics, and this is all done in the colonias, where we take all the staff that is necessary. That is the educational portion of it. The representation of promotoras practice in community education is reflected in almost every domain of practice. This makes sense, because each domain involves activities that require community education of some form. Moreover, promotoras assign a very high value to education. A common incentive among promotoras is their desire to educate themselves so that they can educate the community. Even though the great majority of promotoras who participated in the study (85%) do not have a high school diploma, they value education for themselves, their family, and their communities. There are several examples of this notion of education as a motivating value. For instance, the fifty-five years old Ms. Gonzlez, who at the time of the interview had lived in the 18 It is important to note that promotoras think highly of the trainings their programs provide them. They see these trainings as opportunities to enhance their formal education, given that many times they lack complete schooling. 116

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United States for nine years, studied English at night at home after a whole day of work at the community center, with the ultimate goal of getting her GED. She said: This job is for me the greatest challenge of my life. I always tell my family that I am proud of my work. This has been something huge for me. And I always say: where are you going to get a job if you are not educated? But when you dont have education but you have the will to excel, you are going to be able to do it. Every night at home during half an hour I listen to English lessons cassettes, since I am trying to learn English. Now, I am grateful to God I understand some English. I cant speak English yet, but I can understand something. I used to go to school at night, but now that I moved to a new neighborhood I dont like to leave my children alone at home. Yes, I study at home at night. Because I tell you: even if it is the last thing I do in my life, I will get my GED. I am old, 55 years-old, learning English is not easy, but I dont lose hope. Promotoras aspire to reflect in their daily work their enthusiasm for learning and excelling. They are represented as role models. Ms. Quintana described how she and her husband took their young daughters with them to the fields so that they would know how hard the work was and, thus came to value education. She said: We went up North because we wanted our daughters to know how people suffer in the fields, so that they would know the value of education. My husband said: Lets go North so that they can see the people who dont go to school. That is true. And I think that worked because I remember that while we were in the fields, my daughters used to cry and I cried together with them. And as they cried, they asked me: Mom, why did you bring us here? And I responded: Your father wants you to know how it is when you dont go to school. And they added: But we are going to go to school! Well, it was a lesson and it worked because now my oldest daughter is going to graduate with a Ph.D. in Special Education. The fundamental notion is that education is something that cannot be taken away from a person; it is central to the experience of promotoras. Education is internalized by the promotora as a personal goal for her and her 117

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family and as a goal in terms of community transformation. But the impact of promotoras is deeper. The deep interest promotoras have in, and their motivation to get education represents a model to those with whom they work. The impact is at a level of a symbiotic relationship between the promotora, the promotoras work, and community resident. Community and Capacity Building Promotoras build community as they strengthen social networks by connecting residents to residents and residents to resources. Promotoras actively contribute to the development of horizontal connectivity among residents, to building leadership and economic capacity among residents, to promote local and Mexican culture, and to mobilize the community around issues of community improvement. Community capacity building constitutes a major component of promotoras practice because of its impact in terms of promoting and building community sustainability mechanisms. Although only two of the promotora organizations in the study have community capacity building as an explicit mission, it is clear that this domain of practice exists in the daily work of every promotora interviewed, and is also reflected in the views provided by residents in the focus groups. This is a surprising finding, because it goes well beyond the specific missions of most organizations. It seems that it can only be explained by the strong connection promotoras have to the communities where they work and to the residents they serve. Out of their strong ties to the communities arises a 118

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natural interest in strengthening those communities. The data suggest this conclusion as they reveal that promotoras emphasized these activities: Connecting community residents Building leadership Recognizing and developing strengths Building economic capacity Promoting local and Mexican culture Connecting residents is a supreme expression of community capacity building. Promotoras help to connect people who may live in small colonias but who do not know each other, or who do not know each other well enough to constitute a social network of support. Connecting residents has implications for breaking through isolation and building horizontal integration and social support networks within individual colonias, and even between colonias. Promotoras connect residents through the group activities they organize at community centers, schools, churches, or at the homes of community residents. These activities provide people opportunities to meet and establish relationships. A community resident served by an organization that has the explicit mission focus of building community highlighted the importance of the program in connecting her to other neighbors: Well, the program has allowed us to get to know each other here in this area of the colonia. Before, we were isolated in our homes, nobody knew each other. Now the program has taught us how to get to know each other, how to share with each other we met in a parenting class that we had once a week. We had seen each other before because our children were participating in the programs early childhood activities. But only in parenting classes we became friends. We started to know each other better during those classes; we started to convivir! [share with each other]. 119

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This community resident makes reference to the isolation in which some residents live in colonias. Many times this isolation results from fear of the environment, particularly when the resident is a newly-arrived immigrant. In this context, promotoras role as bridges among residents, as builders of social networks, acquires a critical significance for community building. A coordinator of one health-related promotora organization said the following: I think they [promotoras] have done some capacity building in colonias. The best thing I can describe about how they've done that is that the capacity building has been done through the health fairs where the coloniala comunidad en la colonia [the colonia community] has come together and said we need this, we need to bring this kind of service to our colonia, and then they have us go in. So the colonia has built that capacity to voice their opinions, their needs, where they are not really organized but there are certain homes that are seen as, "In that home we can have a health fair." La colonia sabe que en esa casa por que tiene una yarda grande [the community knows that in this house there is a large yard], tallest tree with the biggest shade, ah es donde tenemos los servicios [that is where we provide the services]. So they have identified certain people in the colonia that allow services to be rendered on site, because not every home opens their door for health services. Community celebrations, parties, and tardiadas" 19 are vehicles used by promotoras and their programs to help build and strengthen relationships among neighbors who sometimes live disconnected from each other. An example of this is a community festival to which the researchers were invited to participate by the staff of one of the participating promotora organizations. The organizations promotoras actively participated in the festival and used the opportunity to motivate people to relate to each other. Thus, from the point of view of that organizations promotoras, the celebration was an opportunity to strengthen community. A coordinator of this program said the following: 19 Tardiadas are community gatherings featuring food and music. 120

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Every year we have a fiesta. When we first started we came up with the idea to have this fiesta so that we could bring people out of their homes and just come and visit at least once a year, and just get out there and eat and just have fun [] A lot of people just stay home.. We need to get out. We need to communicate. We need to help each other. We need to do things for other people, not just for ourselves. Another example of the community capacity building role is given by a promotora from a colonia in Cameron County. Ms. Ortega works in the same colonia where she has lived for many years. She told the story of how her knowledge of the colonia makes her aware of houses for sale as well as of people who are looking for houses, for either renting or buying. Ms. Ortega told the following story: A few days ago, while we were doing home visits, we met an old friend, who told me, I need a house because I cant live with my in-laws any longer. And I asked her, Do you want to buy? And she responded that yes, she wanted to buy. So I told her that as soon as I knew of someone who wanted to sell, I would let her know. And right after that we went on to Rancho Viejo and immediately we find a house that is being sold. And the lady from the house told me, I am selling the house, I am leaving and I am selling it cheap. So I responded to her, I have a buyer for you! I go back to my friend and I tell her that I found her a house. She bought it already. The other day she came to the Center to tell me that she was getting ready to move. For me it is a great satisfaction that those people have a house of their own! Building leadership in the community is another expression of community development. The study found that one key way of building leadership is through recruitment of volunteers to assist promotoras in several capacities, e.g. helping them organize and carry out health fairs at residents homes. Volunteers are recruited by promotoras to help in general activities at the office or community center where they are based, including providing training on a variety of topics. For example, a promotora from a program that focuses on education said that 121

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youth are recruited as volunteers to help in a summer program, through which children from the community are involved in educational and recreational activities. These volunteers are given a small donation at the end of their participation in the program. We now have youth who are helping in our work with children. We invite them to come during the summer and we provide them with an orientation. They come and they help us with the different activities we do with the colonia children. They also help us with cleaning and other Center activities Volunteers have an impact in terms of the sustainability of programs. A coordinator of a program, part of a coalition of promotora organizations working on the promotion of diabetes prevention and awareness, discussed how volunteers allowed her to make certain activities sustainable in time, not dependent on the direct intervention of the promotora. One of the activities of the coalition is to recruit community residents to participate in walking groups in the streets of the colonia, or in a park, or in the back yard of the community center. This activity is made sustainable by asking each participant in the walking group to recruit a number of community residents with whom she/he could start her own walking group. Thus, from the original walking group recruited by the promotoras, a number of additional walking groups emerge. The program coordinator explained this in the following terms: In order to sustain some of our programs we'll recruit volunteers to kind of train them to carry on. The example I can share with you on that is under the diabetes coalition. One of the goals is to start walking groups. Right now the promotora is coordinating that, we just started that last week. So she has recruited 8-10 residents and the goal is at the end of the sixth week, because is only a six week target, is to identify a volunteer in that walking group that will continue the walking group. So then the walking groups are sustained in time. 122

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In nine of the twelve participating organizations, women volunteer for several months before they are hired as promotoras. While volunteering, others in the community and the promotora organization recognize them as resourceful and potential leaders, and facilitate their transition to a formal leadership role. Also, programming held at residents homes constitute an opportunity for the identification of people (women most of the time) who become known as people who have access to resources and are themselves resourceful. The coordinator from a health-related promotora organization said the following in this regard: They (people who lend their homes for health fairs) become a resource. The other homes see that home, that female, as a person who has resources so they can utilize that through them. And we would love to have twenty homes in a colonia that we have access to Community health workers also contribute to building community and capacity by recognizing strengths of residents. In one of the organizations, promotoras incorporate mothers from the colonia in an arts and crafts participatory learning process. Women are invited to the community center and asked to teach other women the skills they have and the crafts they know. In that way, promotoras are helping women value themselves and their capacities. Ms. Garca made the point: Look, many people have a lot of skills to do arts and crafts from recyclable material, such as using the newspaper to make fans and other things. Something that is very inexpensive and that makes their homes look nice. Women do things like that in their homes. We motivate them to come to the Center so that they can learn more and they can teach other people. It is like learning from another person and at the same time that person is going to learn from you. It involves giving and receivingEvery week they bring with themselves an idea that they teach to the other people. That is how they express their skills. 123

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Building economic capacity is another important dimension of community capacity building. Promotoras have an impact by serving as resources to residents who are seeking job opportunities. As repositories of information on diverse topics and community needs, promotoras know of people or businesses that offer jobs, as well as about people who seek jobs. A promotora from a program in which promotoras are based in a community center, reflected about this in the following exchange of questions and answers with the interviewer: Q: Do you have a list of people offering jobs? A: Yes. People come to the Center and leave with us announcements of job opportunities. Q: Do you take the list with you when you do home visits? A: Yes. We take the information with us. Indeed we take a lot of different information with usAnd we also have information about jobs for people who want to work up North. We have all of that. Finally, the promotoras included in the study recognize on several levels the value of the local and Mexican culture for empowering both individuals and the community. One program with an explicit education and community capacity building mission focus emphasizes with its promotoras the promotion of culture. This program implements several activities with the purpose of recovering Mexican culture, first among the promotoras themselves, and then among other community residents. For example, one program celebrates promotoras birthdays and Mothers Day through the Mexican tradition of maanitas, in which the group of promotoras welcomes the celebrant(s) early in the morning with songs and hot chocolate, accompanied with bread. Two promotora programs, in collaboration with a Mexico-based program called Prctica Vacacional [Summer 124

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Training], bring teachers from Mexico during the summer to teach Mexican artistic expressions and sports to colonia children. Ms. Villa described this as: A program in which an instructor comes from Mexico to teach Mexican culture. Last year we had a lot of children participating; there were about 60 children. The Mexican instructor taught dance, painting, and all that is related to Mexican culture. We had him here for three weeks. A final example of promotoras role in promoting Mexican culture is found in the group of promotoras working in collaboration with a school system. As part of a specific project of family involvement in school activities, the promotoras actively work in the organization of folklore activities at the school, some of them working with performers brought by the program from Mexico. Other promotoras participate in the organization of folkloric ballet lessons for the children of the colonia, through the recruitment of instructors among the colonia youth. Emotional Support Promotoras, through their presence and work, exert an impact on the mental and emotional well-being of the community. Emotional support results from the interplay of a culturally-based practice called confianza [trust], something residents come to feel toward promotoras, and of the promotoras deep identification with residents rooted in their common history and culture. Many times promotoras are the only people residents know and trust, and as a result they become confidants, providers of comfort and advice. This is particularly the case when personal issues such as marriage crises and recent immigrants adaptation to life in the colonia are concerned. Emotional support is an important domain of practice for promotoras. Although emotional support is not an explicit mission, goal, or objective of any of 125

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the participating promotora organizations, the majority of promotoras who were interviewed mentioned that they provided some form of emotional support to the people of the community they served. This practice appears to arise out of what promotoras come to see as a deeply rooted need in the communities they serve. This seems to be confirmed by community residents themselves who consistently mentioned emotional support as a main area of impact of the promotora. Promotoras as providers of emotional support to community residents, in particular women, is a reflection of three related elements: confianza, respeto [respect], and confidentiality. Confianza and respeto are central values in which the practice of promotoras is rooted. People open themselves to promotoras because of the confianza that promotoras instill in them, and because residents see them as part of the community. Belonging to the same cultural community, with many common life experiences as a border woman or as an immigrant, makes the community person (usually women) trust her with her own issues and problems. Ms. Mendoza reflected on confianza and on why people feel it towards them: During home visits, we talk with the women; we explain that we are here to help them, that we have this program and what the program is about. We invite them to participate and to get involved in our activities. I believe they trust us because of our home visits, because of our invitation to participate. Since we are from the colonia (I live right here) I know some people from here. Because people trust us, they invite us into their homes, offering us something to drink, or even something to eat. We live with the people from this community! Generating confianza is a priority for promotoras. They know that confianza is essential in order to be effective in the help they have to offer. A 126

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promotora, living in the same colonia where she works, comments on the significance of confianza for her work, which in part consists of asking people information about their families and their needs: I knock on the door and step back a few feet, because you never know who you are going to find. Since a requirement of the program is that the promotora should live in the colonia, we know a lot of the people, and if we dont know them personally, at least we know who lives where; we know that lady from the Church, or that other lady from the school and we know that she is got a bad temper, but anyhow we knock at the door. Then we introduce ourselves and try to be gentle even if they are not. Even if the sun is burning hot and the dogs have us frightened, or whatever, we try to be gentle and to instill confianza so that they can feel confianza towards us. We try to understand that we are strangers, that they dont know us, and that we are asking for personal information. We try to inspire confianza so that they accept to answer our questions. Respeto is another element that motivates people to share personal issues and problems with promotoras. Ms. Mendoza reflects on the fact that respeto towards others and towards oneself is a fundamental of their community work. She said: You have to say things respectfully. In this job you have to smile even if you are not in a good mood. And I say that respeto towards people and towards yourself is a basic principle. If you respect yourself, you are going to respect other people. That is something that my parents taught me, although they could not put me through school. And this is something I teach my children too. Confidentiality, something that all promotoras offer and keep, is the third element that motivates women to share their issues and problems and accept emotional support. Confidentiality as a value generates confianza and invites respeto. In other words, confianza exists in part because promotoras are able to keep private conversations confidential. At the same time, safeguarding confidentiality is a sign of respeto. This commitment to confidentiality speaks to 127

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the professional quality of promotoras. Even though promotoras are closely tied to their communities and know many, perhaps most, residents with whom they work, they promise and keep confidentiality. In part, this is a reflection of the training promotoras have received from their organizations. It is also a reflection of the seriousness with which promotoras take their work 20 Generally, promotoras provide emotional support on issues related to personal crises and to cultural shock derived from the process of acculturation among recently arrived immigrants. Emotional support may be provided in the form of advice about how to deal with discrimination at health services, school, or in other settings. Many times people are alone in colonias, disconnected from neighbors and institutions. In these cases, the promotora who visits may be the only contact with the outside world people may have, and the person who can help them navigate the new environment. As a mother in a colonia served by promotoras said, since we are not in our country, it is motivating to find people who give us a hand A community resident from another community summarizes the experience of many women from the community regarding the emotional support provided by promotoras. This person referred to the promotora as a psychologist, since she helped her go through her marriage crisis: she is like a psychologist. She listens to us, she pays attention. I had problems with my husband and she oriented me. My family did not accept my pregnancy because I was too young. She [the promotora] was always 20 Promotoras capacity to keep confidentiality sets them aside from the traditional gossiping that is commonly found in small communities such as colonias. This capacity for confidentiality reaffirms the assumption that although promotoras are from colonias, they are not entirely typical of its residents. Trainings received and their commitment to community well-being may help to understand this point. 128

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beside me. Without her I wouldnt have been able to overcome my problems and succeed. I recall that she used to call me at home and ask me: How are you this morning? Yes, she motivated me to overcome [my problems]. A woman from a colonia recounted her experience before and after she established contact with one of the promotora organizations. Before, she had a low self-esteem and was not capable of making herself respected. As she became in contact with the organization through its promotoras, her self-esteem increased: Yes, my self-esteem was very low. I cried all of the time. Instead of saying no, I cried. I couldnt defend myself. Until the day I started to participate with the promotoras. I noticed that step by step they were helping me. They made me feel that I was worth somethingThey started to value me as an individual, they visited me every day. At the beginning I didnt like it, but then as I realized that I was feeling better, I welcomed their visit. Now, my family values what I say. That was not the way it was before Finally, some of the promotoras interviewed in the study described situations of domestic violence in which they intervened by talking to the abused woman and trying to show her ways to resist aggression and to change the status quo. Ms. Lozano, who had worked in Michigan as a promotora with a migrant workers health outreach organization, described a situation in which she was able to advise a woman who was hit constantly by her husband. According to Ms. Lozano, her advice contributed to the wifes decision to leave her husband once the level of violence became intolerable. The promotoras account is long, but depicts so well this type of situation: There was a couple recently married. They were very young, 17 years old. We used to live in small trailers, one next to the other. I remember that girl. I had noticed that every time she wanted to hug her husband, he moved away. And he was drunk all of the time. I had been told that he used to hit his wife every day. So I spoke to her and I told her that if she 129

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needed help, to trust me, to speak to me. But I had already talked with my supervisor who told me I should not help her if she did not want to be helped. She asked me to wait for her to ask for help. Until one day I was called to go to her trailer because she was undergoing pain. Her husbands family, who lived in the trailer next to theirs, said to me that she was always inventing pain, that she was always inventing pain whenever she had a quarrel with her husband; they said she was crazy. I talked with the girl but she didnt want to be helped. One day she came to me asking me to help her because my husband just hit me and he told me he would hit me as soon as he came back home. So, she finally told me that her husband hit her everyday, every time he would get drunk, and then he would apologize to her. She said she couldnt take it anymore. She was so young, she was like 16 years old. I am still affected every time I remember this. Well, I called 911 and the police came and she finally said everything, how she was hit, that she was hit up to three times a day. Then I took her to the shelter, and the police looked for the husband, but they never found him. Then, later, she returned to him. But this time, I told him If you touch her again, I am going to call the police. And he never touched her again. I told her: if you go back to him, it is okay, but you must know that he will continue to hit you, that is how it will always be. He will not change. There are many women who think men are going to change, and they end up dead. Well, she is now in Mexico with her parents, without her husband. Many times the capacity shown by promotoras to intervene in situations of domestic violence is a reflection of their own experience dealing with similar situations, and overcoming them. The study found cases of promotoras who were able to break with physically or psychologically abusive relationships once they went through an illuminating experience, sometimes after they had been approached and counseled by other promotoras. In this sense, promotoras capacity to successfully intervene responds to their deep cultural competence. Promotoras capacity to provide emotional support in delicate cases such as domestic violence is beautifully summed up by Ms. Rodriguez, who said that being a promotora means being a mujer [woman] and having a corazn 130

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[heart]. She added: Corazn because you have to feel and deeply understand what the women from the community go through, and mujer, because only women have the sensibility to do that. Advocacy Advocating for the rights of colonia residents is a common way in which promotoras impact their communities. This impact is present even though organizations may not have it as an explicit goal or objective. It seems to flow from the comprehensive and holistic approach to the community that characterizes promotoras practice. In turn, comprehensiveness and holism in practice seems to be a reflection of the high level of identification with and commitment to colonia residents felt by promotoras. Among other things, promotoras facilitate communication between the culture of the provider and that of the colonia resident by educating residents about how best to protect and defend their rights as clients. As a result, promotoras empower individual residents, contribute to building a self-reliant community, and educate service providers about serving residents in culturally sensitive and respectful ways. Interviewees commonly expressed the conviction that their work was motivated, in part, by the need to educate community residents to prevent them from having to experience some of the situations experienced by promotoras and teach them self-advocacy. Ms. Molina summarizes this motivation for advocacy in these words: It is very important to me to be able to help my people who come from Mexico, or from wherever they may come. The same way as I was 131

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helped, I want to help other people. I want others to learn what I have learned (about the system). That is a huge motivation for me. Personal experiences of discrimination are critical in triggering advocacy efforts. Ms. Molina described the way she was treated in the hospital at the time when she was about to give birth to her child. Not speaking English, she was unable to communicate to the physician the description of the birth-associated pains she was feeling, and as a result, the physician referred to her using an epithet and telling her go home since, according to him, she was not ready to give birth to the baby. The physician was wrong and she gave birth in the car on the way home. This experience motivated this woman to help other women showing them how to avoid being treated badly by service providers. Ms. Molina said the following in this regard: Many people have not had to go through the same experiences I went through because of the knowledge I now have. To many people going through the system has been easier given my help. Advocacy is represented in the following variations: Promotoras express concern for the way their client-residents are treated at clinics. Promotoras accompany undocumented client-residents to clinics. Promotoras explain to community residents how the system (e.g., Medicare and school systems) works. Advocacy is commonly practiced in health clinics, where promotoras ensure that patients are treated respectfully. Ms. Manzanares, promotora from the health clinic said the following: 132

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Once a client needed to see a dentist but she was told at the clinic that the next available appointment was not any time soon. I learned that someone who had asked for an appointment after my client did, was able to schedule hers a month earlier than my client. Most probably this person knew the clinic staff. I went down stairs to the scheduling office and requested to have my clients appointment changed. Not mentioning names, we always tell [supervisors] that those things are happening. On that occasion, I called my client and told her that her appointment was changed from September to August. Ms. Manzanares mentioned how she tells the clinic staff that they have to treat her client-residents well, that they have to respect them. This is a form of direct intervention legitimated by promotoras recognition and status in clinics, by the fact that they are insiders and know the system well. As mentioned earlier, promotoras has a dual competency, as an insider of the community and as an insider of the system. Ms. Manzanares told the following in this regard: We know the people at the front desk. We tell them: I want an appointment for this person for such and such date. They usually respond: No, it is not possible. Then we insist and ask for the soonest available date. We are able to get a sooner date, but an outsider to the clinic would not be able to get it. We know how the system works. Because the staff and I have a good relationship, there is trust among us, and that is why they give me the appointments I need. And I tell the staff: Treat patients well because they are going to tell us how they were treated. I think that health clinics benefit from us on that way. An important component of the advocacy intervention of promotoras is the role they can play in facilitating services to undocumented residents. Ms. Montoya, a colleague of Ms. Manzanares, told her experience with a pregnant lady who feared the system due to her undocumented status. At the same time, her neighbors did not want to accompany the lady to the hospital fearing the migra (Immigration and Naturalization Service, INS). Ms. Montoya, who is a 133

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United States citizen, did not share her fears; she accompanied the lady to the hospital and oriented her on how to manage the situation: Nobody wanted to give her a ride to the hospital because she was undocumented. Since I am born here, nobody is going to kick me out to Mexico. She was pregnant, close to giving birth to her baby. I was the one who always took her to the hospital. The day of her giving birth, she was scared because of being undocumented. Nobody from the colonia wanted to go with her, also because of fear. I took her to the hospital. I told the hospital staff that the lady was not from here. I never denied her status. I told the lady not to carry her passport with her because sometimes at hospitals they take your passport away and destroy it. Finally, advocating for residents rights seems to be at the center of promotoras sense of responsibility and care for the community. Several of them described how they did not want their fellow colonia residents to go through the same experiences of discrimination and abuse they went through as recent immigrants. Thus, they educate residents on how to function in the system, on what their rights are, and on how to defend those rights. Very importantly, they also educate the service providers on how they should treat colonia residents. As such, promotoras add another dimension to their role as cultural brokers, a dimension that clearly reflects their deep identification with and commitment to the well-being of the community. 134

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CHAPTER SIX DISCUSSION In this dissertation I am proposing a framework for the examination of the practice of promotoras. This framework derives from the contributions made by Wolf (1956), Geertz (1960), Silverman (1965), Fallers (1955), Loeffler (1971), and Paine (1971). While these references are dated, they provide the theoretical basis that has guided applications and publications since the 1970s.The applied work includes Weidmans (1978) fundamental work in the field of mental health services, and the work in health and education by Weiss (1994), Singh, McKay, and Singh (1999), Schwab, Drake, and Burghardt (1988), Moldy (1981), Gentemann and Whitehead (1983), Jezewski and Sotnik (2001), Al-Krenawi and Graham (2001), Stage and Manning (1992), and Landy (1974). In this chapter I will analyze the practice of promotoras as a configuration of six descriptive parameters identified by Silverman (1965). Following Wolf (1956), I will suggest that this configuration permits promotoras to function as guardians of crucial junctures in the relationship between the communities or colonias and the larger system represented by service providers and the state. Resulting from the encounter of several conditions, all of which are depicted in the configuration, promotoras as guardians of junctures are capable of facilitating colonia residents transition through the synapeses that prevent the integration of the local communities to the larger system. This conclusion is shown in Figure 5 below: 135

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Figure 5. Promotoras Configuration and Crucial Junctures Type of relationship-MechanismsFrequency and Intensity-Nature of Mediator-Functions-Type of Integration Infrastructure Services System and State Language Colonias Cultural competency Immigration status Discrimination Figure 5 shows the connection between the promotoras configuration and the crucial junctures through which promotoras facilitate transition. The promotoras configuration, represented by the rectangle on top, serves as the conditions that make it possible for promotoras to link the colonias communities-the local-and the service system and the state-the global. The linking between these two systems, represented by the side rectangles, takes place as promotoras facilitate residents transition through the crucial junctures of the local-global relationship, which are represented by the rectangles in the middle. 136

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Promotoras configuration The literature describes some degree of variation among mediators or brokers. There is not a single characterization of what culture brokerage is and, consequently, of how culture brokers behave. There is, however, agreement in that culture brokerage relates to the process through which individuals play roles that permit or facilitate the relationship between local communities and the larger system. Thus culture brokers are the individuals who bridge systems that otherwise would not be connected. Indeed, Wolf (1956: 1075) calls brokers guards of crucial junctures; that is, they play a critical function in allowing the linkage between systems. The linkage would not be, or would be different, without the interference of these brokers. Silverman (1965: 183) claims that the specific characteristics of mediators, or brokers, vary around seven different parameters. In other words, the author accepts variations around a universal form. Universality is given by the linkage role and the criticality of that role for social integration, while variation is given by local manifestations of that role. I will describe promotoras brokerage role based on Silvermans parameters, leaving out one of them (the size of the mediating group), since I find it lacking significance in this study. The six parameters are as follows: Type of relationships between mediator and community Mechanisms to establish relationships Frequency and intensity of relationships The nature of the mediators, including their history and identity 137

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Functions Kind of integration into the local system Each parameter is discussed below. Type of relationship with community Promotoras establish an egalitarian relationship with the communities they serve and to which they belong, despite the fact that they have undergone special training, and some of them have even pursued higher education. Moreover, they are employed, unlike many of the residents they serve. Promotoras do not, however, hold a hierchichal distinction in relation to the rest of the community. Indeed, a main point made by promotoras, community residents, as well as service providers is that the strength of promotoras resides precisely on their being from the community and sharing a sense of belonging to it. In this sense, promotoras as a category are closer to the representative-type of broker (Loeffler 1971) than to the patron-kijaji-type (Geertz, Wolf, Silverman). The representative-type of broker is one where the broker is not differentiated hierarchically from the rest of the community, while in the patron-kijaji-type the broker establishes a patronage relationship with the community based on power differentials. Such might be the case when a politician acquires power and then goes on to establish a hierarchical differentiation from the community she/he represents. Mechanisms to establish relationships local community-larger system Silverman (1965) states that the relationship between the local community and the broader system can be established through different mechanisms, 138

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including kinship, ritual kinship, employment, or political appointment. Women who become promotoras establish these relationships through their work, either paid or unpaid rather than through kinship or political appointment, as described in the literature. Promotoras work in programs implemented by service providers such as health clinics, child and maternal health programs, immigration advocacy groups, community development organizations, and grassroots organizations. The promotora label or category is a creation of the organizations, based on the general category of community health worker or community health aide, and on Mexican examples of promotoras de la salud [health promoters]. Thus, the capacity of promotoras to link the local community and the larger system is tightly connected to the organizations structure, mission, and role definitions they provide to the promotora function. Weiss (1994: 343) makes an interesting point when stating that school-aides play some roles that are publicized and some roles that are less-publicized. The less-publicized roles are those not explicitly defined in the job descriptions of school-aides since they emerge spontaneously. The more-publicized roles are those explicitly described in the job description, and that reflect a more rigid job performance. The less-publicized roles are reflected in innovative performances that allow school-aides to navigate through the school bureaucracy. Following Weiss, it may be said that promotoras capacity to be innovative in their roles as guards over the crucial junctures of the relationship between the colonia communities and the larger system, is related to the degree of flexibility 139

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built into the roles defined by the organization. An early finding of the study was that the openness of the job definition was directly proportional to degree of innovation in performance. Those organizations that define jobs more rigidly limited promotoras capacity to innovate and solve problems outside of what is explicitly established. Therefore, an important mechanism to link the local with the larger system is precisely the innovation that derives from flexible roles. Frequency and intensity of relationships Brokers can interact with the community and with the larger system either sporadically or continuously. Similarly, brokers can be more or less emotionally involved in these relationships. Silverman described an individual who is emotionally intense in his role as a broker. Promotoras continuously relate with the community through their involvement in activities such as outreach, visits, health fairs and teaching. Although interactions may vary in intensity, promotoras are emotionally invested in these relationships because of the high level of identification they feel with the people they serve. On the other hand, interaction with the service system is less frequent and less intense; it occurs during training sessions, meetings, research activities, and health fairs. However, interaction with providers does not occur on a daily basis, which is the case with community residents. Nature of mediators Another early finding of the study is that the promotora job is not like any other regular nine-to-five job. Field observations of promotoras, their accounts of how and why they do their job, and the accounts of clients and colonia residents 140

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regarding their work, showed this job required specific skills and individual qualities not commonly found in anyone. Something special characterized the best promotoras. The following are some of the characteristics found in promotoras performance: They consider clients within a community context. Promotoras do not work with individual clients, instead they work with the community as a whole, even if they provide services to individuals. They feel part of the communities where they work, even if they do not reside there. They use their own life experience as a constant reference when doing their job. As Ms. Molina said, I dont want them [residents] to go through the same things I went through when I arrived into this country. They have an outstanding work ethic, which is demonstrated by their capacity to give themselves to the job during and after hours. They show capacity to innovate in the quest to find solutions to peoples problems. The personal background of the women seems to be a critical factor in explaining these characteristics. The life history accounts show that the women often had a life of struggle and that they had a history of overcoming difficult circumstances. Several of the women who emigrated from Mexico came into the United States illegally and as a result had to live in conditions of fear and insecurity. Many had to labor in jobs that required much physical effort, such as 141

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agricultural field work. Discrimination in access to services was also a common feature of their experience. I suggest that the combination of these difficult experiences facilitated a process of agency development in them, which is reflected in their capacity to be innovative promotoras, to serve communities as if they were their own, and to give themselves to the job beyond what is established in the job description. Thus a major proposition of this study is that the circumstances that have impacted the life histories of women of the U.S.-Mexico border colonias constitute a critical factor in shaping the particular form acquired by their job performance. Thus, the centrality to their practice is not that they are community residents, rather, it is a matter of who those community residents are. A by-product of their experiences is the agency promotoras developed in the process of struggling and overcoming hard circumstances. Following Hoggetts agency model (2001: 47), what distinguishes promotoras from other community residents is that they are reflexive agents; that is, they are not passive victims of circumstances but are conscious shapers of their history. Their capacity to innovate to act outside of their job prescriptions (the unpublicized roles that Weiss describes) is precisely a reflection of the process of becoming conscious agents, a process that is built as they struggle and overcome structural restrictions and limitations associated to their life histories. However, I stress that the proposition that promotoras are reflexive agents does not mean that only reflexive agents are promotoras. In other words, some variation can be found in a continuum that goes from self as non-reflexive object 142

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to self as reflexive agent, passing through self as reflexive object and self as non-reflexive agent. What I suggest is that the innovative promotoras, the ones who best personalize the performance attributes listed above are precisely the ones who do not see themselves as objects of circumstances beyond their choosing. Variation in functions As it is widely described in the findings chapter of this dissertation, promotoras play a number of roles and functions, depending on the organization with which they work. Broadly speaking, they serve the following functions: Inform community residents about services and about the social service system in general. Educate community residents, particularly children and women. Deliver services such as health exams. Provide emotional support to community residents. Build community capacity in colonias through education and empowerment. Advocate for the rights of community residents. These six functions are positioned around one major objective: to link residents to the larger system and to facilitate social integration. In broad terms, that is what promotoras do. Kind of integration into the local community According to Silverman (1965), mediators or brokers may be part of the local system yet not reside in the community, they may reside locally but remain detached from the local system, or they may be outsiders with only tangential 143

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relationships to the local system. This distinction is highly pertinent in the case of promotoras. The several programs that were studied presented a number of variations in this regard. In general, promotoras are local to colonias, although they may not necessarily reside in the specific colonias where they work. In some of the studied programs, promotoras serve several colonias in an area and they may or may not reside in one of them. In other programs, promotoras work in the colonia where they reside. Regardless of the specific model, a common aspect shared by promotoras is that they are from colonias, and they identify with colonias and their communities. I postulate that not residing in the colonia they serve does not limit their capacity to serve and to feel identified with the community. In this sense, the local is not the specific colonia they reside, but colonias as a category of community. Guardians of crucial junctures of the relationship local community-larger system Following Wolf (1958: 1075), whose work on culture brokerage in Mexico constitutes the starting point for the theoretical formulation of the concept, promotoras can be understood as those individuals who stand guard on the crucial junctures of service-related and community development relationships which connect the local system to the larger system. These elements constitute points where circumstances converge in making the relationship between the local and the larger system difficult for representatives at both ends. Following this logic, promotoras facilitate the transition through critical junctures by making use of their knowledge of both systems. One of the promotoras, Ms. Obrador, 144

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defined the promotora concept in a way that suggests the facilitation role through crucial junctures that I postulate here: As the name indicates, promotoras promote. We promote health, but we also promote access to social services. We also make sure people are receiving the help they need. Many times there are obstacles and procedures that make it difficult for people to access services and those cases we try to find a way to simplify things for them. For instance, one may say: Look, if you are applying to Medicaid and dont understand the procedure, call me. Ill find a way to help you. Or if we know that the clinic staff is helping people to fill in applications, we tell them to go to the clinic. We make an effort to simplify the processes for them. Because a lady may say: No, no, no, it is too much paperwork. I dont understand anything, I dont want to get in trouble. And we tell her to go to this and that place where she can be helped. In colonias the crucial junctures of the relationship between the local and the larger society represented by service providers and the state bureaucracy, are most notably the following four: deficient colonia infrastructure, language and cultural incompetence, immigration status, and discrimination. These junctures, and the role that promotoras play in facilitating residents transition through them, are described below. Deficient infrastructure Colonias are characterized by insufficient and deficient public infrastructure, some of which have a direct impact on the residents capacity to relate with larger society, particularly with services. Scarce public transportation is undoubtly a major obstacle for colonia residents, who see themselves in the obligation of either owning a car or car pooling with neighbors when they see the need to venture into the city. The possibility of driving a car is many times restricted by immigration status in the cases of those who do not have immigration papers. Besides scarce public transportation, the absence of 145

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buildings from which services can be provided in colonias is a major obstacle that limits peoples access to social services and that ends up limiting peoples social integration. This latter condition has been significantly ameliorated in several colonias through the building of community resource centers by a state university, from which service providers serve colonia residents. Although these two elements are not the only deficient infrastructural conditions in colonias, they are the ones that significantly restrict residents capacity to relate to the larger system, and to integrate into that system. Promotoras show an acute sense of creativity when looking for ways to evade the restrictions imposed by the lack of local infrastructure. In the words of a service provider, promotoras showed us that we dont need to have an air-conditioned building in order to meet with people in a colonia. Promotoras arrange for a health fair in the living room of a colonia resident, or for parenting classes in the yard of a neighbor, of for an informative presentation in a crowded room. Although it cannot be denied that promotoras are asked by the program coordinators to look for places where services can be housed for a session or two, it is the promotoras capacity, creativity and resourcefulness that make it possible for them to find ways around this critical juncture. Language According to the U.S. Census (2000), Spanish is spoken at home in 81% of the LRGV. In some counties such as Starr, the rate of homes where Spanish is the primary language is higher than 90%. It is reasonable to assume that in colonias, the rate is even higher. Thus, language constitutes a major critical 146

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juncture in the relationship between local colonia communities and the larger system. Even though service providers are likely to be bilingual in the Texas border area, language remains an obstacle when people are faced with the need to navigate the system because rules, regulations, and administrative paper work are not always available in Spanish. The level of English language competency among the residents is not sophisticated enough to understand the language of bureaucracy. Promotoras are able to overcome these barriers because of the training they receive, in which they are taught how to translate terms and concepts. Not all of them, however, are fully bilingual. Nevertheless, those who are bilingual do play a significant role in providing linguistic translation not only for the local residents but also to the service providers. Translating to residents involves, among other things, making people aware of the content of letters from diverse government agencies, many times related to immigration, welfare, and housing. Cultural competency Cultural misunderstanding aggregates language as a barrier for understanding. Most service providers are from Mexican background and speak Spanish. However, as several promotoras mentioned, speaking Spanish does not make them wholly competent to understand colonia residents 21 Indeed, during fieldwork I noticed a sort of incongruence between professional and colonia cultures. Professionals did not always know and understood the nuances 21 My own status as a native Spanish speaking foreigner from a culture different to that of professionals and to that of colonias, meant that I did not easily understand the language and the cultural nuances of communication. Following Agar (1987), in fieldwork I had to be a student of the culture. 147

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of colonia life, even if they were Mexicans or of Mexican background. Thus the participation of women from colonias as mediators acquires significance from the point of view of what is known, in the social and human services field, as cultural competence. Promotoras allow understanding between cultures by being able to transmit to service providers knowledge about needs and about expectations of colonia residents. Furthermore, promotoras build cultural competence through their direct contact with residents in outreach and education activities. In outreach, the strategies are commonly planned by the coordinator and her/his group of promotoras. As such, promotoras contribute their knowledge of colonias, their communities and their ways of life by developing outreach strategies that are accepted by residents. These strategies can be as simple as doing a home visit at the most appropriate time. This is why cultural competence between services and colonia communities is built by promotoras themselves. They are the bridge that connects the systems. Beyond linguistic translation, promoters are capable of effectively dealing with cultural understanding, showing service providers how to communicate and how to implement services in a culturally competent way. Cultural translation goes both ways, since promotoras are also effective translators to the local residents of the idiosyncrasy of bureaucracy and of what they should expect from services. Indeed, participants in program activities emphasized how promotoras helped them in understanding the culture and the system not only in formal activities, such as classes of several sorts, but also in the informal encounters in the church on Sundays, at the corner store, in the park, or at the market. 148

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Immigration status Immigration status is a cornerstone of this model of crucial junctures. Colonia residents who have not legalized their immigration status live in fear of being arrested and sent back across the border. This condition limits their capacity to connect with the world outside the colonia in significant ways. Colonia residents who are undocumented live encapsulated in their homes, fearing going out and relating to neighbors, thus restricting their capacity for social integration into the neighborhood and into larger society. Promotoras facilitate this integration by providing a safe environment where these residents can interact with other neighbors, and by bringing services to the colonias. Residents who were undocumented at the time of field research described how their lives changed once they were contacted by promotoras 22 They received significant emotional support that empowered them to go out and integrate. Discrimination Finally, discrimination is another crucial juncture in the relationship between colonias and larger society. Residents and promotoras alike described situations in the context of provision of services in which they felt discriminated against or on which they were treated with disrespect because of their lack of system knowledge, their origin, or their lack of competency in the English language. Promotoras who had gone through similar situations early in their 22 One of the challenges of fieldwork in colonias has to do with research with undocumented residents. Their fear of strangers makes them taka a rather defensive stance when communicating with outsiders. The close relationship that I was able to establish with several of the promotoras helped to facilitate communication with residents who may have been illegally in the United States. Seldom did the people tell me that they were undocumented residents; this is something I was told (not always) by the promotoras who accompanied me during visits to colonias. 149

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immigration history empower residents by teaching them ways to overcome the negative psychological impact of discrimination and to relate with services in order to avoid being discriminated. For instance, Ms. Molina made the point, with great emotion, that she was a promotora precisely to teach residents how to deal with discrimination because of the disrespectful treatment she received at various hospitals as a recent immigrant. The model of promotoras as guardians of the crucial junctures of the relationship between the local and the larger system would be incomplete without an attempt to explain how they have come be develop competency as facilitators of transition between systems. Is it the training they receive in their programs? Is it the knowledge they acquire as they practice? Or is it the knowledge and life experience they bring to the job that makes the difference? I argue that although training and competencies acquired in the job are undoubtly important in shaping their capacity as promotoras, it is their life experiences that provide the keys to understanding their reasons for becoming promotoras and the capacity for innovation they show in their practice. 150

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CHAPTER SEVEN CONCLUSIONS AND RECOMMENDATIONS In this dissertation I have attempted to make a contribution to the understanding of a practice that facilitates access to services by community residents in situations of cultural diversity, exacerbated by a lack of mechanisms for accessing localized minority populations. I have done so by making use of the concept of culture brokerage, as developed by anthropologists concerned with the phenomenon of development. The inaugural studies of culture brokerage provided a tool to understand the how the connections between local and indigenous communities and the administrative lites of the newly created states in Africa and in the Middle East. Other studies did the same in Mexico, still contributing to the understanding of this relationship between the local and national administrations. Therefore, it is safe to state that culture brokerage, even in the studies that contributed mostly to its theoretical development, constitutes a contribution to applied anthropology. Studies that followed had a direct and explicit applied orientation, in multiple areas including health, education, and politics. For instance, the seminal work by Weidman (1976, 1978) represents an example of the application of culture brokerage for the implementation of community outreach programs. The study of promotoras practice as a form of culture brokerage represents an effort to explain the work of these types of community workers from the perspective of their capacity as linkages, as connectors between the 151

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local and the supra-local, and facilitators of cultural communication. In this sense, it follows the line established by Silverman (1965), Loeffler (1971), Wolf (1956), and others. At the same time, it provides a conceptual instrument through which the work of community health workers in general and of promotoras in particular, can be designed and implemented. In this way, this study is following the line of applied anthropological work on culture brokerage represented by Weidman (1976, 1978), Gentemann and Whitehead (1983), and Weiss (1994), among others. It is expected that the model of promotoras as facilitators of the transition of community residents through crucial junctures, would provide insights for program design and implementation, so that programs would be planned and implemented taking into consideration knowledge about the junctures that characterize the relationship between the local and the supra-local in their particular communities. Also, based on what is suggested in this study, programs could take into consideration in planning and implementation the cultural and life history characteristics of their workers, so that trainings, the degree of flexibility allowed to workers, the job descriptions could be designed in such as way as to enhance not diminish workers capacity for innovation. Conclusions In this dissertation I examined the practice of promotoras, a local form of community health outreach found in the U.S.-Mexico border but which is now common in other areas of the country (Ford, et al. 1998). Based on the review of the anthropological literature, I found it pertinent to interpret practice as a form of culture brokerage, since promotoras share with brokers and mediators a role of 152

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connecting cultures and systems through cultural translation and interpretation that allows for understanding between local communities and the larger system. Thus this dissertation is an exercise in what Landy (1974) calls the anthropology of role. I have explored through ethnographic methods the roles played by border promotoras, examining these roles not only as their effect on communities, but also as a dialectic process of agency construction and empowerment. I suggest that promotoras are reflective agents (Hoggett 2001) because of their history of struggle as border women, and also that practice within an organizational context serves as a mean to empower and strengthen womens agency. A central point of this dissertation is the proposition that promotoras should be interpreted as guardians of the crucial junctures of the relationship between the local colonias and the system of services and the state. I take this concept from Wolf (1956) and apply it to the practice of promotoras. Following Silverman (1965: 173), I suggest that being guarians of crucial junctures implies that their work is essential, that it cannot be replaced by others. In other words, others could establish connections between local communities and systems of services, however, only local residents with the characteristics of promotoras could do it on such a holistic and comprehensive manner, touching individual residents, families and communities in diverse dimensions of their lives. I state that the crucial junctures in colonias are six: infrastructure deficiencies, language, cultural competency, immigration status, and discrimination. These are nodes that constitute obstacles for the horizontal as well as vertical integration of 153

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community residents. Promotoras facilitate the transition of community residents through these nodes. I further suggest that promotoras capacity to facilitate transition through obstacles results from the intertwining of several elements, all of which are represented in the promotoras configuration. Following Silverman (1965), who applies the concept to brokers, the configuration represents the key characteristics of promotoras, and they include: type of relationships between mediators and community, mechanisms to establish relationships, frequency and intensity of relationships, the nature of mediators, functions of mediators, and the kind of integration of mediators into the local community. All of these elements are equivalently important in configuring who are the promotoras. However, nature of mediators deserves a special mention since this how I contextualize promotoras agency. Following Hoggett (2001), I postulate that promotoras move on the continuum of agency proposed by the author, from non-reflexive object to reflective agent. The best promotora is a reflective agent, someone who is a conscious shaper of her history although in circumstances not of her choosing. I postulate that this agency is developed as a result of their history of struggle as border women, and is represented in their capacity to change as women and to change traditional culture of submission in gender relationships. Furthermore, I suggest that development of agency is a dialectical process because it is also developed and strengthened in work within an organizational context. Womens agency results from a dialog between personal history and work. Therefore, the 154

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history of promotoras and their agency, is critical to understand why they are able to brokers and, following Press (1969), to understand why they are innovators. Recommendations A number of recommendations emerge from the study, some of which are programmatic in nature and some of which are oriented to applied anthropologists. Recommendations follow. Programmatic Recommendations 1. The training provided to promotoras by their programs has an effect on womens empowerment and capacity to build agency. Women become empowered and capable of changing culture and traditions of gender relations at home as they work and learn in work. Therefore, I suggest that the design of the training curricula should include promotoras so that the curricula reflect womens experience and knowledge. 2. Programs need to acknowledge and even celebrate womens culture and history. Promotoras are capable of doing what they do because of what they are and have been. Thus programs need to integrate this piece of knowledge into their programmatic activities, celebrating culture and remembering the struggles of border women-or Latino low-income women if that is the case. 3. Programs should better train women on how the system of services works. They have a potential to strengthen their capacity as culture brokers even more if they are more knowledgeable of the system. Programs train promotoras on how to deliver information and services, but there is some 155

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space for improving on providing knowledge of the characteristics of services and systems. In other words, this is a call not to underestimate promotoras capacity to learn and to be even better bridges between systems. 4. Programs need to plan their job descriptions integrating the notion proposed by Weiss (1994) and used in this dissertation, that community health workers play publicized and unpublicized roles, and that the unpublicized roles are the ones that reflect workers capacity of innovation. Thus programs need to leave space in job descriptions for creativity and innovation by not defining roles rigidly. Flexibility in roles and functions is critical. 5. The best promotoras are the ones capable of innovating. Innovation allows promotoras to go around the system, of finding solutions outside of the box, beyond structure. Thus programs need to motivate innovation through a combination of procedures, including flexible job descriptions and trainings that not only give information and knowledge but also promote women creativity. Recommendations to Applied Anthropologists 1. Making research useful is the key issue that defines applied anthropology. Based on this basic assumption I make three recommendations that will address this point. These are: 156

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a. The definition of the research questions needs to result from a dialogue with the participant community. I recommend dialogue not only with funding sources but also with participants. b. Feedback to participants is essential and this should not be left to the end of the study in the form of the final report. Feedback to participants should be assigned the same importance as the reporting that funding agencies usually require. In this study, feedback happened constantly, in informal conversations with participants as well as in formal presentations to the association of promotoras and to individual groups of promotoras and of program staff. c. Useful to whom? It is important to clarify from the beginning who needs the findings of the study. In this dissertation I addressed recommendations to program planners and managers, not to policy designers or decision-makers. The early definition of the interested audience will shape the type of research and methods used. For instance, findings geared toward policy makers would benefit from mixed methods, and their presentation in the final report should include graphic and numeric representations. This dissertation did not mix methods and clearly, findings are oriented to program level decision-maker and not to policy makers. 2. From an anthropological point of view, in-depth inquiry requires fieldwork. The permission I obtained from my job supervisor to settle in the field for a 157

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year is not something that can be expected in all cases. In a way, my research methodology resembled more the classic anthropological extended fieldwork, than the rapid-ethnographic approaches common in contemporary applied anthropology. How can in-depth anthropological inquiry be achieved given the time limitations that characterize the contract type of research in which applied anthropologists commonly participate? Should fieldwork (the trademark of anthropological research) be replaced by methods that do not rest on being in the field for an extended period of time? I came to the conclusion that without having been in the field for approximately a year I would not have been able to achieve the in-depth understanding I was seeking; semi-structured interviews and focus groups would not have provided the sense of a whole needed for a satisfactory understanding. Therefore I recommend that applied anthropologists need to devise methods that make it possible to do in-depth, holistic research within the restrictions common in the context of contract research. 3. I recommend research that examines promotoras capacity to innovate by being able to transcend the structure imposed on them by the employing organizations. How does innovation happen given job descriptions that provide a structure for daily practice? How does innovation relate with the duality informalityformality? Can innovation occur within a rigid job structure? Certainly, in this research I suggest that informality and innovation are tightly related, and that flexibility on the part of employing 158

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organizations is essential in order to let informality and innovation emerge. Still, further research is needed. Theoretically, such research would examine the nature of the interaction between agency and structure. 4. I suggest that it is necessary to conduct research aiming at the examination of how the practice of promotoras influences the development of the community as a whole. Bhattacharyyas (1995) definition of community development as a process of building solidarity and agency could constitute the conceptual framwork for such a study. The study should examine how the practice of promotoras (characterized as it has been in this dissertation as a practice that finds its richness in its informality, in womens capacity to innovate, and in womens agency) contributes to the development of networks of solidarity and social support among residents, and to the development of residents capacity to be reflective agents. 159

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REFERENCES CITED Adler, P. A. and P. Adler 1987 Observational Techniques. In Handbook of Qualitative Research. Norman K. Denzin and Yvonna S. Lincoln, eds. Pp. 377-392. Newbury Park, CA: Sage Publications. Agar, Michael 1980 The Professional Stranger. An Informal Introduction to Ethnography. San Diego, CA: Academic Press. Al-Krenawi, Alean and John R. Graham 2001 The Cultural Mediator: Bridging the Gap Between a Non-Western Community and Professional Social Work Practice. British Journal of Social Work 31: 665-685. Altpeter, M., J. L. Earp, C. Bishop, and E. Eng 1999 Lay Health Advisor Activity Levels: Definitions From the Field. Health Education & Behavior 26(4):495-512. Alvarez, Robert R. 1987 Familia: Migration and Adaptation in Baja and Alta California, 1800-1975. Berkeley: University of California Press. 160

PAGE 168

1995 The Mexican-US Border: The Making of an Anthropology of Borderlands. Annual Review of Anthropology 24:447-470. Angrosino, Michael V. 1994 On the Bus With Vonnie Lee: Explorations in Life History and Metaphor. Journal of Contemporary Ethnography 23(1):14-28. Angrosino, Michael V. and Kimberly Mays de Prez 2000 Rethinking Observation: From Method to Context. In Handbook of Qualitative Research. Norman K. Denzin and Yvonna S. Lincoln, eds. Pp. 673-702. Thousand Oaks, CA: Sage Publications, Inc. Anzalda, Gloria 1987 Borderlands: La Frontera. Berkeley, CA: Aunt Lute. Aubel, Judi, Bill Hanson, Napoleon Cevallos, and Homero Morales 1991 Ecuadorian Promotores Learn to 'Facilitate' Rather Than to 'Direct'. Community Development Journal 26(1):35-42. AVANCE 2000 AVANCE Website. Electronic document,, accessed March 13, 2002. 161

PAGE 169

Baker, E. A., N. Bouldin, M. Durham, M. E. Lowell, M. Gonzlez, N. Jodaitis, L. N. Cruz, I. Torres, M. Torres, and S. T. Adams 1997 Latino Lay Health Advocacy: A Collaborative Lay Health Advisor Approach. Health Education and Behavior 24(4):495-509. Ballew, Julius R. 1985 Role of Natural Helpers in Preventing Child Abuse and Neglect. Social Work 30(1):37-41. Barnes, M. D. and J. Fairbanks 1997 Problem-Based Strategies Promoting Community Transformation: Implications for the Community Health Worker Model. Family Health Journal 20(1):54-65. Bell, David 2001 Diagnosis of Malaria in a Remote Area of the Philippines: Comparison of Techniques and Their Acceptance by Health Workers and the Community. Bulletin of the World Health Organization 79(10):933-942. Bender, D. E. and K. Pitkin 1987 Bridging the Gap: The Village Health Worker As the Cornerstone of the Primary Health Care Model. Social Science and Medicine 24(6):515-528. 162

PAGE 170

Bernard, Russell 1994 Research Methods in Cultural Anthropology: Qualitative and Quantitative Approaches. Thousand Oaks, CA: Sage Publications. Bhattacharyya, Jnanabrata 1995 Solidarity and Agency: Rethinking Community Development. Human Organization 54(1):60-69. Blumenthal, Connie, Eugenia Eng, and James C. Thomas 1999 STEP Sisters, Sex, and STDs: A Process Evaluation of the Recruitment of Lay Health Advisors. American Journal of Health Promotion 14(1):4-6. Bourdieu, Pierre 1990 The Logic of Practice. Cambridge: Polity Press. Browne, Jimenez, and Whitman 1994 Borderlines. New Mexico's colonias: Growing shame on the border. Electronic document, accessed March 27, 2005. Bustamante, Jorge A. 1983 Maquiladora: A New Face of International Capitalism on Mexico's 163

PAGE 171

Northern Frontier. In Women, Men and the International Division of Labor. J. Nash and P. Fernndez-Kelly, eds. Pp. 224-256. Albany: State University of New York. Cauffman, Jay G., Willis Wingert, David B. Friedman, Edward A. Warburton, Bernard Hanes 1970 Community Health Aides: How Effective Are They? American Journal of Public Health 60(10):1904-1909. Center for Policy Alternatives 1998 Community Health Workers: A Leadership Brief on Preventive Health Programs. Washington, D.C.: Center for Policy Alternatives. de Cosio, Federico G. and Andrs Boadella 1999 Demographic Factors Affecting the U.S.-Mexico Border Health Status. In Life, Death and in-Between on the U.S.-Mexico Border: Asi Es La Vida. Martha O. Loustaunau and Mary Sanchez-Bane, eds. Pp. 1-22. Westport, CT: Bergin & Garvey. Department of Health and Human Services 1997 United States-Mexico Border Priority Program. Washington, D.C.: Department of Health and Human Services. 164

PAGE 172

DiClemente, Ralph. J., Richard A. Crosby, and Michelle C. Kegler, eds. 2002 Emerging Theories in Health Promotion Practice and Research: Strategies for Improving Public Health.San Francisco: Jossey-Bass. Earle, Duncan 1999 The Border Colonias and the Problem of Communication: Applying Anthropology for Outreach. In Life, Death and in-Between on the U.S.-Mexico Border: Asi Es La Vida. Martha O. Loustaunau and Mary Sanchez-Bane, eds. Pp. 23-38. Westport, CT: Bergin & Garvey. Eng, E., E. Parker, and C. Harlan 1997 Lay Health Advisor Intervention Strategies: A Continuum from Natural Helping to Paraprofessional Helping. Health Education and Behavior 24(4):413-417. Eng, Eugenia and John W. Hatch 1991 Networking Between Agencies and Black Churches: The Lay Health Advisor Model. Prevention and Human Services 10(1):123-146. Environmental Protection Agency (EPA) 1997 The 1997 United States-Mexico Border Environmental Indicators Report. Washington, D.C.: Environmental Protection Agency. 165

PAGE 173

1997 United States-Mexico Border: Environmental Indicators-1997, 4-6. Washington, D.C.: United States Environmental Protection Agency. 2001 Appendix 8: Social and economic overview of the U.S.-Mexico border. U.S.-Mexico border XXI Frontera XXI Website. Electronic document,, accessed 2001, May 14. Fernndez-Kelly, Maria P. 1983 For We Are Sold, I and My People: Women and Industry in Mexico's Frontier. Albany, NY: State University of New York Press. Ford, Leigh A., Michael D. Barnes, Robbin D. Crabtree, and Jo Fairbanks 1998 Boundary Spanners: Las Promotoras in the Borderlands. In U.S.-Mexico Border Health: Issues for Regional and Migrant Populations. J. G. Power and Theresa Byrd, eds. Pp. 141-164. Thousand Oaks, CA: Sage Publications. Frable, Deborah 1993 Dimensions of Marginality Distinctions Among Those Who Are Different. Personality and Social Psychology Bulletin 19(4):370-381. 166

PAGE 174

Geertz, Clifford 1960 The Javanese Kijaji: The Changing Role of a Cultural Broker. Comparative Studies in Society and History 2(2):228-249. Gentemann, Karen M. and Tony L. Whitehead 1983 The Cultural Broker Concept in Bicultural Education. Journal of Negro Education 52(2):118-129. Glaser, Barney G. and Anselm L. Strauss 1999[1967] The Discovery of Grounded Theory: Strategies for Qualitative Research. New York: Aldine de Gruyter. Gomez-Murphy, Maria 1998 Innovative Strategies in Delivering Health Care: the Promotora Model. Salud Sin Fronteras-Health Without Borders: Proceedings of the U.S.-Mexico Border Conference on Women's Health, September 26-28, Edinburg, Texas. Washington, D.C., National Cancer Institute Gonzales-Berry, Erlinda and David R. Maciel 2000 Introduction. In The Contested Homeland: A Chicano History of New Mexico. Pp. 1-11. Albuquerque: The University of New Mexico Press. 167

PAGE 175

Greener, Ian 2002 Agency, Social Theory and Social Policy. Critical Social Policy 22(4):688-705. Health Resources and Services Administration (HRSA) 2000 HRSA's U.S.-Mexico Border Health Home Page. Electronic document,, accessed June 24, 2002. Hernndez, Elida, Josefa Rodriguez, and June G. Robinson 1995. Creating support systems for colonia women through lay health promotion outreach programs. U.S.-Mexico Border Conference on Women's Health. Austin, TX: The University of Texas System. Heyman, Josiah Mc. C. 1990 The Emergence of the Waged Life Course on the United States-Mexico Border. American Ethnologist 17(2):348-359. 1991 Life and Labor on the Border: Working People of Northeastern Sonora, Mexico, 1886-1986. Tucson: University of Arizona Press. 168

PAGE 176

Hoggett, Paul 2001 Agency, Rationality and Social Policy. Journal of Social Policy 30(1):37-56. Hondagneu-Sotelo, Pierrette 1994 Gendered Transitions: The Mexican Experiences of Immigration. Berkeley, CA: University of California Press. Hubbard, Joyce K. 1985 Emergence of the Role of the Village Health Worker -A New Status in Tarahumara Society. Border Health Imamura, Anne 1990 Strangers in a Strange Land. Coping With Marginality in International Marriage. Journal of Comparative Family Studies 21(2):171-192. Israel, Barbara A. 1985 Social Networks and Social Support: Implications for Natural Helper and Community Level Interventions. Health Education Quarterly 12(1):65-80. Jezewski, Mary A. and Paula Sotnik 2001 Culture Brokering: Providing Culturally Competent Rehabilitation 169

PAGE 177

Services to Foreign Born Persons. Buffalo, NY: The University of New York at Buffalo. Keefe, Susan and Amado Padilla 1987 Chicano Ethnicity. Albuquerque, NM: University of New Mexico Press. Kelly, Jane M., Benta Osamba, Renu M. Garg, Mary J. Hamel, Jennifer Lewis, Samantha Rowe, Alexander K. Rowe, and Michael S. Deming 2001 Community Health Worker Performance in the Management of Multiple Childhood Illness: Siaya District, Kenya, 1997-2001. The American Journal of Public Health 91(10):1617. Koch, Erna, Aimee Thompson, and Patrice Keegan 1998 Community Health Workers: A Leadership Brief on Preventative Health Programs. Washington, D.C.: Center for Policy Alternatives. Landy, David 1974 Role Adaptation: Traditional Curers Under the Impact of Western Medicine. American Ethnologist 1(1):12-138. Leigh, Arden F., Michael D. Barnes, Robbin D. Crabtree, and Jo Fairbanks 1998 Boundary Spanners: Las Promotoras in the Borderlands. In U.S.-Mexico Border Health: Issues for Regional and Migrant Populations. J. G. 170

PAGE 178

Power and Theresa Byrd, eds. Pp. 141-164. Thousand Oaks, CA: SAGE Publications. Limn, Jose 1991 Representation, Ethnicity, and the Precursory Ethnography: Notes of a Native Anthropologist. In Recapturing Anthropology: Working in the Present. R. G. Fox, ed. Pp. 115-135. Santa Fe: School of American Research Press. 1992 Mexican Ballads, Chicano Poems: History and Influence in Mexican-American Social Poetry. Berkeley: University of California Press. 1994 Dancing With the Devil. Madison: University of Wisconsin Press. 1998 American Encounters: Greater Mexico, the United States, and the Erotics of Culture. Boston: Beacon Press. Loeffler, Reinhold 1971 The Representative Mediator and the New Peasant. American Anthropologist 73(5):1077-1091. Loustaunau, M. and E. Sobo 1997 Community Health Workers: The Cultural Context of Health, Illness, and Medicine Wesport, CT: Bergin & Garvey. 171

PAGE 179

Love, M. B., K. Gardner, and V. Legion 1997 Community Health Workers: Who They Are and What They Do. Health education and behavior 24(4):510-522. Martinez, Oscar J. 1994 Border People: Life and Society in the U.S.-Mexico Borderlands. Tucson, AZ: University of Arizona Press. Martinez, Oscar J. 1996 U.S.-Mexico Borderlands: Historical and Contemporary Perspectives. Wilimington, Del.: Scholarly Resources. Matamora, M. K. S. 1989 Mass Produced Village Health Workers and the Promise of Primary Health Care. Social Science and Medicine 28(10):1081-1084. May, Marlynn L., Ricardo B. Contreras, Linda Callejas, and Elvia Ledezma 2004 Mujer y Corazn: Community Health Workers and Their Organizations in Colonias on the U.S.-Mexico Border. An Exploratory Study. College Station, TX: Southwest Rural Health Research Center, Texas A&M University Health Science Centers School of Rural Public Health. 172

PAGE 180

McFarlane, J. 1996 De Madres a Madres: An Access Model for Primary Care. American Journal of Public Health 86(6):879-880. Milligan, Sharon, Patricia Maryland, Henry Ziegler, and Anna Ward 1987 Natural Helpers As Street Health Workers Among Black Urban Elderly. The Gerentologist 27(6):712-715. Moldy, Doris M. 1981 The Community Health Aid As Cultural Broker. Practicing Anthropology 4(1):16-18. Oleszkowicz, K. L., G. M. Kresch, and J. T. Painter 1994 Pap Smear Screening in Family Physicians' Offices in a Rural Area With High Cervical Cancer Rate. Family Medicine 26(10):648-650. Paine, Robert 1971 A Theory of Patronage and Brokerage. In Patrons and Brokers in the East Arctic. Pp. 8-21. St. John's, NL: Memorial University of Newfoundland. Paredes, Americo 1958 With His Pistol in His Hand: A Border Ballad and Its Hero. Austin: University of Texas Press. 173

PAGE 181

Patterson, Kent 1998 Taking Action. Sojourners Magazine 27(5):55. Patterson, Shirley L. 1977 Toward a Conceptualization of Natural Helping. ARETE 4(3):161-173. Pilisuk, Marc, Susan Parks Hillier, Jacqueline Kelly, and Elizabeth Turner 1982 The Helping Network Approach: Community Promotion of Mental Health. Journal of Primary Prevention 3(2):126-132. Poss, J. E. 1999 Providing Culturally Competent Care: Is There a Role for Health Promotores. Nursing Outlookd 47(1):30-36. Press, Irwin 1969 Ambiguity and Innovation: Implications for the Genesis of the Culture Broker American Anthropologist(71):205-217. Ramirez-Valles, Jesus 1999 Changing Women: The Narrative Construction of Personal Changes Through Community Health Work Among Women in Mexico. Health Education & Behavior 26(1):25-42. 174

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2001 "I Was Not Invited to Be a [CHW]...I Asked to Be One": Motives for Community Mobilization Among Women Community Health Workers in Mexico. Health Education & Behavior 28(2):150-165. Ramos, Irma N., Marlynn L. May, and Kenneth S. Ramos 2001 Environmental Health Training of Promotoras in Colonias Along the Texas-Mexico Border. American Journal of Public Health 91(4):568-570. Richardson, Chad 1999 Batos, Bolillos, Pochos, and Pelados: Class and Culture on the South Texas Border. Austin: University of Texas Press. Rosaldo, Renato 1993 Culture and Truth: The Remaking of Social Analysis. Boston: Beacon Press. Rosenthal, E. L., 1998 The Final Report of the National Community Health Advisor Study. A Policy Project of the Annie E. Casey Foundation.Tucson, AZ: University of Arizona. 175

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Runion, Keith and Gregory Jr. Hiram 1984 Training Native Americans to Deliver Mental Health Services to Their Own People. Counselor Education and Supervision 23(3):225-233. Sanchez-Bane, May and Eva M. Moya Guzman 1999 Community-Based Health Promotion and Community Health Advisors: Prevention Works When They Do It. In Life, Death and in-Between on the U.S.-Mexico Border: Asi Es La Vida. Martha O. Loustaunau and Mary Sanchez-Bane, eds. Pp. 131-153. Westport, CT and London: Bergin & Garvey. Schwab, Brenda, Robert E. Drake, and Elisabeth M. Burghardt 1988 Health Care of the Chronically Mentally Ill: The Culture Broker Model. Community Mental Health Journal 24(3):174-184. Scientific Software 2004 Atlas.Ti. Knowledge Workbench. Berlin: Scientific Software. Sherer, Jill L. 1994 Neighbor to Neighbor: Community Health Workers Educate Their Own. Hospital and Health Networks 68(20):52-56. 176

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Sibley, David 1981 Outsiders in Urban Societies. New York: St. Martins Press. Silverman, Sydel F. 1965 Patronage and Community-Nation Relationships in Central Italy. Ethnology 4(2):172-189. Singh, Nirbhay N., Jennifer D. McKay, and Ashvind N. Singh 1999 The Need for Cultural Brokers in Mental Health Services. Journal of Child & Family Studies 8(1):1-10. Sisters of Mercy of the Americas 2002 Stories from the Texas-Mexico border. Electronic document,, accessed April 26, 2002. Stage, Frances K. and Kathleen Manning, 1992 Enhancing the Multicultural Campus Environment: A Cultural Brokering Approach.New Directions for Student Services,San Francisco: Jossey-Bass Publishers. Staudt, Kathleen 177

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1998 Free Trade? Informal Economies at the U.S.-Mexico Border. Philadephia: Temple University Press. Steward, Julian 1950 Area Research: Theory and Practice. New York: Social Science Research Council Bulletin. Texas Comptroller of Public Accounts 1998 Bordering the Future: Challange and Opportunity in the Texas Border Region. Austin, TX: Texas Comptroller of Public Accounts. Texas Department of Health 2001 TDH Medical & Research Library: Community Health Worer bibligraphy. Electronic document,, accessed March 3, 2001. Texas-Mexico Border Health Coordination Office 1998 Texas-Mexico Border Counties, 1998: Demographics and Health Statistics. Edinburg, TX: The University of Texas System. U.S. Census Bureau 2000 American FactFinder. Electronic document,, accessed 2001, March 14. 178

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Van Maanen, John 1988 Tales of the Field: On Writing Ethnography. Chicago: The University of Chicago Press. Velez-Ibaez, Carlos 1996 Border Visions: Mexican Cultures of the Southwest United States. Tucson: The University of Aizona Press. 1994 Plural Strategies of Survival and Cultural Formation in U.S. Mexican Households in a Region of Dynamic Transformation. In Diagnosing America: Anthropology and Public Engagement. Shepherd Foremen, ed. Pp. 193-234. Ann Arbor: University of Michigan Press. Vila, Pablo 1999 Constructing Social Identities in Transnational Contexts: The Case of the Mexico-US Border. International Social Science Journal 51(1):75-87. 2000 Social Categories, Metaphors, and Narrative Identities on the U.S.-Mexico Frontier: Reinforcing Borders. Austin, Texas: University of Texas. Walker, M. H. 1994 Building Bridges: Community Health Outreach Workers Programs: A Practical Guide. New York: United Hospital Fund of New York. 179

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Ward, Peter M. 1999 Colonias and Public Policy in Texas and Mexico: Urbanization by Stealth. Austin, TX: University of Texas Press. Weedon, Chris 1989 Femenist Practice and Postructuralist Theory. Oxford: Basil Blackwell. Weidman, Hazel H. 1978 Miami Health Ecology Project Report: A Statement on Ethnicity and Health. Miami, FL: Department of Psychiatry and Department of Pediatrics, University of Miami School of Medicine. 1976 Praise of the Double Bind Inherent in Anthropological Application. In Do Applied Anthropologists Apply Anthropology? Michael Angrosino, ed. Pp. 105-117. Southern Anthropological Society, Proceedings No 10, Athens, GA: University of Georgia Press. Werner, O. and G. M. Schoepfle 1987 Systematic Fieldwork: Vol. 1. Foundations of Ethnography and Interviewing. Newbury Park, CA: Sage Publications. 180

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Weiss, Melford S. 1994 Marginality, Cultural Brokerage, and School Aides: A Success Story in Education. Anthropology and Education Quarterly 25(3):336-346. Williams, Darryl M. 2001 La Promotora: Linking Disenfranchised Residents Along the Border to the U.S. Health Care System. Health Affairs 20(3):212-218. Witmer, Anne, Sarena D. Seifer, Leonard Finocchio, Jodi Leslie, and Edward H. ONeil 1995 Community Health Workers: Integral Members of the Health Care Work Force. American Journal of Public Health 85(8):1055-1058. Wolf, Eric R. 1956 Aspects of Group Relations in Complex Society: Mexico. American Anthropologist 58:1065-1078. Wolff, Marie, Stacey Young, and Cheryl A. Maurana 2001 Community Advocates in Public Housing. American Journal of Public Health 91(2):12-13. 181

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APPENDIX A: AUTHORIZATION FOR DATA UTILIZATION 23 School of Rural Public Health Southwest Rural Health Research Center U.S. Mail _____________________________ Express Mail 1266 TAMU 3000 Briarcrest Drive, Suite 310 College Station, Texas 77843-1266 Bryan, Texas 77802 979 458-0653 fax 979 458-0656 To Whom It May Concern: Mr. Ricardo Contreras has permission to use data from the Promatoras Organization study, funded by the Southwest Rural Health Research Center through a grant from the federal Office of Rural Health Policy. Mr. Contreras played a key role in that project, as project director, and we are delighted that he is also using the data for his dissertation. If you have any questions, please do not hesitate to contact me. Yours truly, Catherine Hawes, Ph.D. Professor of Health Policy and Management Director, Southwest Rural Health Research Center School of Rural Public Health Texas A&M University System Health Science Center Cc: Dr. Marlynn May, CHUD Dr. Joan Van Nostrand, Office of Rural Health Policy 23 The signature above Catheriine Hawes could not be reproduced by the scanning system. The original letter is available upon request. 183

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APPENDIX B: DEMOGRAPHIC PROFILE OF PARTICIPATING PROMOTORAS seudonym Age Place of Birth Married? Number of Children Schooling Years in Colonia Years in U.S. Time as Promotora Prior Jobs Patricia Prez 38 Zacatecas, Mexico Yes 3 6 th Grade Mexico 6 21 2 years Yes Josefina Pereira 40 Dr. Arroyo, Nuevo Len, Mexico Yes 2 Elementary school 4 4 4 years Yes Guadalupe Reinoso 40 Rural Tamaulipas Mexico Yes 5 6 th Grade Mexico 2 18 3 years No Lucia Gonzlez 55 Valle Hermoso, Tamaulipas Mexico No (Divorced) 8 6 th Grade Mexico 9 9 3 years Yes Maria Escobedo 42 Rio Bravo, Tamaulipas Mexico Yes 2 Technical college, Mexico (accounting) 11 11 3 years Yes Norma Montemayor 41 Rio Bravo, Tamaulipas Mexico Yes 2 Incomplete high school, Harlingen, Texas 4 4 3 years No Magdalena Robles 52 Sebastian, Texas Yes 3 9 th Grade, Sebastian, Texas 52 52 4 years No Ularia Manzanares 29 Brownsville, Texas Yes 3 GED 3 29 2 years Yes Juana Montoya 43 Pharr, Texas Yes 3 GED Community College Degree 43 43 3 years Yes Dolores Ortega 35 Matamoros, Tamaulipas, Mexico Yes 5 th Grade Mexico 23 23 4 years Yes Migra-nt Mercedes Obrador 44 Monterrey, Nuevo Leon, Mexico Yes 2 School teacher, Mexico 1 10 4 years Yes Emiteria Lozano 31 Matamoros, Tamaulipas, Mexico Yes 3 Incomplete college in Mexico 8 16 2 years Yes 184

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APPENDIX B (Continued) Pseudonym Age Place of Birth Married? Number of Children Schooling Years in Colonia Years in U.S. Time as Promotora Prior Jobs Paola Duran 44 Matamoros, Tamaulipas, Mexico Yes 6 Incomplete high school Mexico 28 28 3 years Yes Luisa Jaramillo 30 Rio Bravo, Tamaulipas, Mexico Yes 3 Technical college, Mexico (accounting) 10 10 4 years Yes Maria Garca 51 Matamoros, Tamaulipas, Mexico Yes 4 6 th Grade Mexico 20 30 3 years Yes Migra-nt Maria Undenciana Ramirez 54 Valle Hermoso, Tamaulilpas, Mexico Yes 7 Nurse Assistant MX, GED and Associate degree 21 21 1 year Yes Migra-nt Cruz Quintana 43 San Luis Potosi, Mexico Yes No schooling 18 18 1 year Yes Amalia Rodriguez 47 Pharr, Texas Yes 3 GED 17 47 3 years Yes Juana Rosaldo 44 Reynosa, Tamaulipas, Mexico Yes 3 No schooling 10 13 1 year Yes Migrant Crecencia Fernndez 39 Mexico, D.F., Mexico Yes 5 2 nd Grade, Mexico 5 5 2 years Yes Migrant Eulalia Molina 29 Reynosa, Tamaulipas, Mexico Yes 3 No schooling 2 2 3 years No Alma Cavazos 24 Morelos, Mexico Yes 1 High School Diploma 13 19 1 year Yes Migrant Angelica Rosalba 25 Reynosa, Tamaulipas, Mexico Yes 1 Incomplete college 14 14 4 years Yes Socorro Mendoza 37 Monterrey, Nuevo Leon, Mexico Yes 7 8 th Grade, Mexico 10 10 3 years Guadalupe Villa 34 Fresno, California No 0 High School diploma 13 13 2 years Yes Baby sitting Enedelia Porras 41 Ebano, San Luis Potosi Mexico Yes 3 College Associate degreee 2 years Yes 185

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APPENDICE C: INTERVIEW AND FOCUS GROUP PROTOCOLS Re: IRB File Number 100044 -A Comparative Study of Outreach Workers (Promotoras) and Their Organization in Health Promotion on the U.S.-Mexico Border Interview and Focus Group Protocols Promotoras (English and Spanish) Community residents (English and Spanish) A) Community Health Workers (English and Spanish) English Version 1. Personal and Historical Background (Please, tell us something about you and your family) Name Age Place of birth If born outside the U.S., date of arrival Family Residence (years in residence) Residential history 2. Educational and Employment History (Please, tell us something about your schooling and employment history) Last completed school year? Any supplementary schooling? Previous employment? 3. Background as a Community Health Worker (Please, tell us something about how you became a community health worker?) How did you become a promotora? What made you become a promotora? What was the work about in the beginning? How is it now? What motivates you to be a promotora? 4.Current Employment as a Community Health Worker (Please, tell us about your current work as a promotora) How did you get this job? What motivated you to get this job? What do you expect from your work in this program? How are your activities planned? 186

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APPENDIX C (Continued) Please tell us how is a typical working day for you? What training do you get? What do you think about it? What do you learn through it? 5. Experience as a Community Health Worker (Please, tell us something about what it means to you and your family, to be a promotora?) What motivates you as a promotora? What does your family react to your work as a promotora? What does your husband think about your work as a promotora? Spanish Version 1. Antecedentes Personales e Historicos (Por favor, diganos algo sobre Ud. y su familia) Nombre Edad Lugar de nacimiento Si nacida en Mxico o en otro pais, fecha de llegada a los EUA Familia Lugar de residencia (aos en residencia) Historia residencial 2. Antecedentes Educacionales y Laborales (Por favor, diganos algo sobre la escuela, cursos que ha tomado, y empleos que ha tenido) Ultimo ao cursado en la escuela Cursos suplementarios? Trabajos anteriores? 3. Antecedentes como promotora (Por favor, diganos algo sobre como Ud. empezo a ser promotora) Donde fue promotora por primera vez? Que la llevo a ser promotora? En que consistia su trabajo de promotora? Que la motiva a ser promotora? 4. Trabajo actual de promotora (Por favor, cuentenos algo sobre su trabajo actual de promotora) Como consigui este trabajo? Que la motivo a tomar este trabajo? Que hace Ud. en este trabajo? Que es lo que Ud. pretende lograr como promotora en este trabajo? 187

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APPENDIX C (Continued) Como se planifican las actividades de las promotoras? Por favor, diganos como es un dia tipico de Ud. aqu en el trabajo? Que tipo de entrenamientos recibe? Que le parecen esos entrenamientos? Aprende algo nuevo? 5. Experiencia del trabajo (Por favor, diganos que significa para Ud. ser promotora?) Que la motiva ser promotora, a venir al trabajo todos los dias? Que piensa la familia de su trabajo? Que piensa su esposo de su trabajo? Que la motiva a trabajar? B) Focus Groups with Residents (English and Spanish) English Version 1. Community Characteristics History of community Leadership in community Resources in community Services in community 2. Involvement with Promotoras First contact with promotoras Development of relationship 3. Work of Promotoras Activities of promotoras with them Areas of residents lives in which promotoras help Way in which promotoras help 4. Effect of work on residents lives Things residents are able to do better with help from promotoras Things that did not change with help from promotoras. Spanish Version 1. Antecedentes Personal y Familiares (Por favor diganos algo sobre Ud. y su familia) Nombre Edad 188

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APPENDIX C (Continued) Lugar de Nacimiento Si nacida en otro pais, fecha de llegada a los EUA Familia Residencia Historia residencial 2. Caracteristicas de la Comunidad Historia Lideres Recursos/Problemas Servicios 1. Establecimiento de Vinculos con Promotoras b. Forma en que se estableci el vnculo con promotoras c. Forma en que se desarroll el vnculo con promotoras 3. Trabajo de las Promotoras Actividades en que las promotoras se invlucran con los residentes reas de la vida de los residentes en que las promotoras ayudan La manera en que las promotoras ayudan 4. Efecto del trabajo de las Promotoras en las vidas de los residentes Cosas que los residentes pueden hacer mejor gracias a trabajo de promotoras Cosas que no han cambiado aun con el trabajo de las promotoras 189

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APPENDIX D: INFORMED CONSENTS IRB File Number 100044 -A Comparative Study of Outreach Workers [This Consent to Participate form will be read and explained to any person not reading English or Spanish] CENTER FOR HOUSING AND URBAN DEVELOPMENT TEXAS A & M UNIVERSITY Title: A Comparative Study of Outreach Workers (Promotoras) and Their Organization in Health Promotion on the U.S.-Mexico Border I, _________________________________________ (PRINT name), voluntarily agree to participate in this study. I understand that I am one of approximately 120 persons who will be interviewed. The purpose of the study is to identify the characteristics of promotora programs in terms of a) how they are organized, b) how they work with parents and colonia residents, and with service providers, and c) how they impact colonia residents health. I am being asked to participate in one interview. I give my permission to have the interview tape-recorded. There are no anticipated risks to me if I participate. The interview will take about one hour. I can stop participating at any time. I understand that I will not be affected in any way if I decide to interrupt my participation, or if I decide not to participate. I understand that I am free not to answer specific questions and that I will not be affected in any way if I decide to do so. This research has been reviewed and approved by the Institutional Review Board-Human Subjects in Research, Texas A&M University. For research-related questions or problems regarding my rights as research participant, I may contact the Institutional Review Board through the IRB Coordinator, Office of the Vice President for Research and Associate Provost for Graduate Studies at (979) 845-1811. I have read and understand the explanation provided to me. I have all my questions answered to my satisfaction, and I voluntarily agree to participate in this study. I have received a copy of this consent form. ___________________________ ___________ Signature of Participant Date ___________________________ ___________ Signature of Interviewer Date ___________________________ ___________ Signature of Researcher Date Ricardo B. Contreras, M.A. 190

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APPENDIX D (Continued) IRB File Number 100044 -A Comparative Study of Outreach Workers [Esta Forma de Permiso a Participar ser leda y explicada a todas las personas que no lean Ingls o Espaol] CENTRO PARA LA VIVIENDA Y EL DESARROLLO URBANO UNIVERSIDAD DE TEXAS A&M Titulo: Estudio Comparativo de Programas de Promotoras de Salud en la Frontera Estados Unidos-Mexico Yo, __________________________________________________ (NOMBRE), acepto voluntariamente participar en este estudio. Entiendo que soy una de 120 personas que participar en este estudio. El propsito de este estudio es identificar las caractersticas de programas de promotoras in trminos de a) cmo ellos se organizan y estructuran, b) cmo ellos se colaboran con proveedores de servicios y cmo trabajan con vecinos y, c) cmo afectan el acceso a servicios de salud. Se me ha pedido participar en una entrevista. Doy mi autorizacin para que la entrevista sea grabada en medio audio-magentico. Adicionalmente, estoy conciente de que mi participacin en este estudio no implica riesgos para mi persona. La entrevista tendr la duracin aproximada de 1 hora. Tengo el derecho de interrumpir mi participacin en esta entrevista en cualquier momento. Estoy conciente de que no habrn consecuencias para mi si decido no participar o interrumpir mi participacin. Estoy conciente de que estoy en libertad de no responder a determinadas preguntas y que esta decisin no me afectar de ninguna manera. Esta investigacin ha sido revisada y aprobada por el Institutional Review Board-Human Subjects in Research, de la Universidad de Texas A&M. Para las preguntas relacionadas con investigacin o problemas asociados con mis derechos como participante, puedo ponerme en contacto con el Institutional Review Board por medio del Coordinador IRB, en la oficina del Vice Presidente Para la Investigacin y Provost Asociado Para los Estudios Graduados, al nmero telefnico (979) 845-1811. He ledo y comprendido la explicacin que se me ha dado. Todas mis preguntas han sido contestadas a mi satisfaccin y acuerdo voluntariamente a participar en este estudio. Tambin, he recibido una copia de esta forma. ___________________________________ _______________ Firma del Participante Fecha ___________________________________ _______________ Firma del Entrevistador Fecha ___________________________________ _______________ Firma del Investigador Fecha Ricardo B. Contreras, M.A. 191

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APPENDIX E: LIST OF CODES USED IN ANALYSIS WITH ATLAS.TI Unbrella Codes (Defined Before Exploration of Data) Emerging Code Community: Approached by Promotoras Community: Attitude Towards Help Community: Capacity Building Community: Community Initiatives/Projects Community: Community Relationships/Networks Community: Definition Community: Governance Community: Governance bodies Community: Isolation_Providers Community: Isolation_Residents Community: Legal Status_Impact Community: Needs Community: Needs_Domestic Violence Community: Needs_Health Community: Needs_Housing Community: Needs_Immigration Community: Poverty Community: Poverty and Insurance Community: Reasons to Request Help Community Communty: Undocummented Community: Culture_Confianza Community: Culture_Gender Community: Culture_Language Community: Culture_Religiosity Community: Culture Community: Culture_Respeto Program: Activities: Border Witness Program: Activities_Ballet Folk Program: Activities_Ballet Folk._Instructor Program: Activities_Border Witness Program: Activities_CHIP Program: Activities_Contribuido Program: Activities_Convivencias Program: Activities_Driving Program: Activities_Environm. Program: Activities_Immunization Program: Activities_Manualidades Program: Activities_Prog. Infantil Program: Activities Program: Activities_Transportation 192

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APPENDIX E (Continued) Unbrella Codes (Defined Before Exploration of Data) Emerging Code Program: Case Managment Program: CHUD_Americorp Program: CHUD_CRC Program: Coalitions Program: Collaboration Among Programs Program: Community Participation Program: Coordinator Background Program: Costs and Fees Program: Decision-Making Program: Evaluation Program: Funding Program: Goals/Objectives Program: Governance Program: History Program: Identification of Needs Program: Impact_Fathers Program: Information Management Program: Leadership Program: Location Activities/Services Program: Mission Program: NCDV_VISTAS Program: NCDV_VISTAS_Roles Program: Number of Participants Program: Number of Workers Program: Philosophy and Vision Program: Philosophy_As Seen by Coordinator Program: Philosphy as Perceived by Workers Program: Planning Program: Requirements Program: Salary and Insurance Program: Strategy Program: Structrure_Comite Disciplina Program: Structure Program: Survey Program: Target Populaton Program: Work Schedule Program_History Program_Parent Educator Programs: Child and Maternal Health Programs: CHUD_VISTAS Programs: MHP_Camp-Health Aid_1 Programs: Services Program: Structure Programs: Special Projects 193

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APPENDIX E (Continued) Unbrella Codes (Defined Before Exploration of Data) Emerging Code Workers: Activities_After School Workers: Activities_Ballet Folk. Workers: Activities_Books Workers: Activities_Border Witness Workers: Activities_CHIPS Workers: Activities_Classes_1 Workers: Activities_Clean Up Workers: Activities_Clothing Workers: Activities_Communication Workers: Activities_Community Activities Workers: Activities_Construyendo Comunid. Workers: Activities_Contribuido Workers: Activities_Convivencias Workers: Activities_Crafts Workers: Activities_Daily Rutine Workers: Activities_Driving Workers: Activities_Elderly Workers: Activities_Environm. Workers: Activities_Food Bank Workers: Activities_Gifts to Residents Workers: Activities_Gifts to Residents_Distribution Workers: Activities_Hair Cut Residents Workers: Activities_Health Fairs_1 Workers: Activities_Health_1 Workers: Activities_Holidays Workers: Activities_Home Visits Workers: Activities_Home Visits_Barriers Workers: Activities_Home Visits_Process_1 Workers: Activities_Immigration Workers: Activities_Immunization Workers: Activities_Intermediarios Workers: Activities_Job Fairs Workers: Activities_Job Training Workers: Activities_Jueves Juveniles Workers: Activities_Male Family Roles Workers: Activities_Manualidades Workers: Activities_Microenterprise Workers: Activities_Multiphacetic Workers: Activities_Nutrition Workers: Activities_Parades Workers: Activities_Parenting_1 Workers: Activities_Planning_1 Workers: Activities_Planning_Schedule_1 Workers: Activities_Pregnancy_1 Workers: Activities_Presentations Workers: Activities_Presentations_Health_AIDS Workers: Activities Workers: Activities_Presentations_Homes 194

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APPENDIX E (Continued) Unbrella Codes (Defined Before Exploration of Data) Emerging Code Workers: Activities_Presentations_Response Workers: Activities_Prog. Infantil Workers: Activities_Recycling Workers: Activities_Service Referral Workers: Activities_Sewing Workers: Activities_Transportation Workers: Activities_Tutoring Workers: Activities Workers: Activities_Youth Workers: Culture_Confianza Workers: Culture_Family Workers: Culture_Gender Workers: Culture_Parenting Workers: Culture_Religiosity Workers: Culture_Respeto Workers: Value_Education Workers: Value_Education_Learn English Workers: Value_Family Workers: Value_Work Workers: Culture Workers: Values_Confidentiality Workers: Demog_Age Workers: Demog_English Workers: Demog_Husband Employment Workers: Demog_Last School Grade Workers: Demog_Place of Birth Workers: Demog_Place of Birth_Mexico Workers: Demog_Place of Residence Workers: Demographics Workers: Demographics Workers: Education of Self Workers: Family Relationships_Children Workers: Family Relationships_Mexico Workers: Family Support Workers: Family_Constitution Workers: Family_Education Workers: Families Workers: Family_Income Workers: H_Work_MX_Accountant Workers: H_Work_MX_DIF Workers: H_Work_MX_Maquilas Workers: H_Work_MX_Nurse Assistant Workers: H_Work_MX_Teacher Workers: H_Work_No Experience Workers: H_Work_US_Child Care Workers: H_Work_US_Factory Workers: H_Work_US_Fields Workers: H_Work_US_Health Workers: H_Work_US_Misc Workers: H_Work_US_Progression Workers: H_Work_US_Promotora Workers: H_Work_US_School Workers:Work History Workers: H_Work_US_Volunteer 195

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APPENDIX E (Continued) Unbrella Codes (Defined Before Exploration of Data) Emerging Code Workers: Volunteering Workers: What Makes a Promotora? Workers: Workers' Perceptions of Staff Perceptions Workers: Working extra hours Work Workers: Self-definition Workers: History_Colonia Life Workers: History_Education Workers: History_Family Workers: History_Family_Husband's Work Workers: History_Housing Workers: History_Legal Status Workers: History_Migration Workers: History_Migration_Monterrey Workers: History_Migration_Scaled Migr. Workers: History_Work Workers: Personal History Workers: History_Work, Beginnings Workers: Husb_Perc_Adapting Workers: Husb_Perc_Negative Workers: Husb_Perc_Positive Workers: Husbands Workers: Husbands' Perceptions of Work Workers: Husbands/Parters Attitude toward Womens Work Workers: Husbands_Attitudes Toward Them Workers: Impact on Community_Thanksgiving Meal Workers: Impact on Family Workers: Impact on Family_Less Time Workers: Impact on Health Care System Workers: Impact on Health Workers: Impact_Comm._Elderly Workers: Impact_Comm._Emot. Support Workers: Impact_Comm._Empow. Workers: Impact_Comm._Help Workers: Impact_Comm._Satisf. helping Workers: Impact_Comm_Holism Workers: Impact_Community Workers: Impact_Community_Connect Neighbrs. Workers: Impact_Community_Driving Workers: Impact_Community_Link Resds.-Services Workers: Impact_Door Keys Workers: Impact_lmmigration Workers: Impact_political mobilization Workers: Impact_Self Workers: Impact_Self_Empowerm. Workers: Impact_Self_Greateful program Workers: Impact_Self_Learn from Comm. Workers: Impact_Self_Learning Workers: Impact_Self_Pride Workers: Impact_Self_Shyness Workers: Impact of Work Workers: Impact_Self_They value us 196

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APPENDIX E (Continued) Unbrella Codes (Defined Before Exploration of Data) Emerging Code Workers: Knowledge Workers: Knowledge Contribution to Community Workers: Knowledge Contribution to Programs Workers: Knowledge Workers: Knowledge of Community Workers: Roles_Advocacy Workers: Roles_Animadoras Workers: Roles_Case Managers Workers: Roles_Comm./Capacity Building Workers: Roles_Connect Residents to Services Workers: Roles_Defined by Coordinator Workers: Roles_Defined by Director Workers: Roles_Defined by Providers Workers: Roles_Defined by Self Workers: Roles_Distribute Clothing Workers: Roles_Education_1 Workers: Roles_Elderly Workers: Roles_Emotional Support Workers: Roles_Employment Workers: Roles_Environment Workers: Roles_Facilitation_1 Workers: Roles_Fill in applications Workers: Roles_Follow-Up Workers: Roles_Health Education Workers: Roles_Health Services Workers: Roles_Housing Workers: Roles_Identification Needs Workers: Roles_Immigration Workers: Roles_Information and Referral Workers: Roles_Information Program Activities Workers: Roles_Involve Churches Workers: Roles_Involve Colonia Organizations Workers: Roles_Medicaid Enrollment Workers: Roles_Meds to Neighbors Workers: Roles_Organizadora Workers: Roles_Organization Activities Workers: Roles_Recruitment Workers: Roles_Support/Feedback to Providers Workers: Roles_Transportation Workers: Roles Workers: Roles_Walking Dictionaries Workers: Training Workers: Training, Initial Workers: Training_As Perceived by Providers Workers: Training_As Perceived by Workers_1 Workers: Training_As Provided by Org_1 Workers: Training_Cultural Appropriateness Workers: Training_Mejor._Comm. Workers: Training Workers: Training_Teaching 197

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APPENDIX E (Continued) Unbrella Codes (Defined Before Exploration of Data) Emerging Code W_1_Adv_Advice parents about school system W_1_Adv_Be with clients during doctor's appointment W_1_Adv_Concern for how patients are treated W_1_Adv_discrimination W_1_Adv_Explain health insurance system W_1_Adv_Organize residents for colonia improvement W_1_Adv_Orient parents on school system W_1_Adv_Serve not understood clients W_1_Adv_Take undocumented patient to Clinic W_1_Adv_Advice parents about school system Workers: Community Representation as Advocacy W_1_Adv_Be with clients during doctor's appointment W_1_CB_Connect People W_1_CB_Connect residents in collaboration with Church W_1_CB_Connect residents to services W_1_CB_CRC as space for building community W_1_CB_Create political mobilization W_1_CB_Creating comm. groups helps to unite W_1_CB_Distributing gifts to children W_1_CB_Educate women to work at home W_1_CB_Facilitate payment of services W_1_CB_Follow up after referral W_1_CB_Help children develop self-esteem W_1_CB_Help Parents help children W_1_CB_Job training W_1_CB_Learn about services in health fairs W_1_CB_Liasons between residents and health centers W_1_CB_Motivate residents to share their needs W_1_CB_Promote and utilize residents' creativity W_1_CB_Promote information and awareness in community W_1_CB_Promote leadership through health fairs W_1_CB_Promote Mexican Culture (Ballet) W_1_CB_Promote voluntarism in community W_1_CB_Publicly recognize value of volunteers W_1_CB_Put into practice residents' strengths W_1_CB_Refer to emergency services W_1_CB_Soccer as family celebration W_1_CB_Tardiadas to unite people W_1_CB_Teach children discipline W_1_CB_Train residents' as trainers/teachers W_1_CB_Visit residents to announce services Workers: Community Representation as Community Building W_1_CB_Connect People 198

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APPENDIX E (Continued) Unbrella Codes (Defined Before Exploration of Data) Emerging Code W_1_Ed_Become better parents W_1_Ed_Empower parents W_1_Ed_Improve communication at home W_1_Ed_Learn nutrition for children W_1_Ed_Learn to dialogue with doctors W_1_Ed_Presentations health disparities W_1_Ed_Promote parent participation in school W_1_Ed_Provide information and educate W_1_Ed_Support parents in child's education W_1_Ed_Become better parents W_1_Ed_Empower parents W_1_Ed_Improve communication at home W_1_Ed_Learn nutrition for children W_1_Ed_Learn to dialogue with doctors W_1_Ed_Presentations health disparities W_1_Ed_Promote parent participation in school W_1_Ed_Provide information and educate Workers: Community Representation as Education W_1_Ed_Support parents in child's education W_1_ES_Advice children/youth on substances W_1_ES_Advice women on marriage issues W_1_ES_Be better parents W_1_ES_Explain mental illness to residents W_1_ES_Improve mother's character W_1_ES_Increase self-esteem W_1_ES_Keep children's secrets (piojos) W_1_ES_Listen to women with emotional needs W_1_ES_Need to learn about medications W_1_ES_Provide advice to women W_1_ES_Provide informal minicouseling W_1_ES_Refer clients for MH services W_1_ES_Refer women to domestic violence services W_1_ES_Support depressed women W_1_ES_Teach children discipline W_1_ES_Teach Problem Children W_1_ES_Value Children W_1_ES_Advice children/youth on substances W_1_ES_Advice women on marriage issues W_1_ES_Be better parents W_1_ES_Explain mental illness to residents W_1_ES_Improve mother's character W_1_ES_Increase self-esteem W_1_ES_Keep children's secrets (piojos) W_1_ES_Listen to women with emotional needs W_1_ES_Need to learn about medications Workers: Community Representation as Emotional Support W_1_ES_Provide advice to women 199

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APPENDIX E (Continued) Unbrella Codes (Defined Before Exploration of Data) Emerging Code W_1_ES_Provide informal minicouseling W_1_ES_Refer clients for MH services W_1_ES_Refer women to domestic violence services W_1_ES_Support depressed women W_1_ES_Teach children discipline W_1_ES_Teach Problem Children Workers: Community Representation as Emotional Support W_1_ES_Value Children W_1_IR_All activities W_1_IR_Complete applications W_1_IR_General orientation W_1_IR_Inform about welfare W_1_IR_Link residents to medical services W_1_IR_Pregnancy care W_1_IR_All activities W_1_IR_Complete applications W_1_IR_General orientation W_1_IR_Inform about welfare W_1_IR_Link residents to medical services Workers: Community Representation as Information and Referral W_1_IR_Pregnancy care 200

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APPENDIX F: ATLAS.TI NETWORKS OF CODES24 is part of is part of is part of is part of is part of is part of part of is part of is part of is part of is part of is part of Community: Reasons to Request Help {1-1}~ Community: Poverty and Insurance {2-1} Community: Poverty {2-1} Community: Needs_Immigration {1-1}~ Community: Needs_Housing {1-1}~ Community: Needs_Health {6-1}~ Community: Needs_Domestic Violence {4-1}~ Community: Needs {25-1}~ Community: Legal Status_Impact {2-1}~ Community: Isolation {6-1}~ Community: Governance bodies {13-2}~ Community: Governance {2-1} Community {0-12} is part of is part of is part of is part of Community: Culture {50-4}~ Community: Culture_Confianza {16-1}~ Community: Culture_Gender {9-1}~ Community: Culture_Language {2-1}~ Community: Culture_Religiosity_1 {2-2}~ 24 Following grounded theory, the code on top represents a category which includes a number of concepts. Concepts are defined inductively. Categories are defined deductively, i.e., they represent the focus of the study. 201

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APPENDIX F (Continued) is part of rt of i is part of is part of is part of is part of is part of is part of is part of part of Program: Activities {26-13}~ Program: Activities_Ballet Folk {2-1}~ Program: Activities_CHIP {3-1}~ Program: Activities_Contribuido {5-1}~ Program: Activities_Convivencias {2-1}~ Program: Activities_Driving {5-1}~ Program: Activities_Education {8-1}~ Program: Activities_Environm. {1-1}~ Program: Activities_Immunization {5-1}~ Program: Activities_Manualidades {2-1}~ Program: Activities_Prog. Infantil {12-1}~ Program: Activities_Transportation {4-1}~ Program: Activity_Pregnancy {3-1}~ is part of is part of is part of is part of is part of is part of Workers: Demog_Age_1 {27-1} Workers: Demog_English {1-1} Workers: Demog_Husband Employment_1 {15-1} Workers: Demog_Last School Grade_1 {22-1} Workers: Demog_Place of Birth {22-1} Workers: Demog_Place of Birth_Mexico_1 {20-1} Workers: Demog_Place of Residence {29-1} Workers: Demographics {34-7} 202

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APPENDIX F (Continued) is part of is part of is part of Workers: Culture {14-5} Workers: Culture_Confianza_1 {6-1} Workers: Culture_Gender {10-1} Workers: Culture_Parenting {1-1} Workers: Culture_Religiosity {2-1} Workers: Culture_Respect {2-1} is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of Workers: H_Work_MX_Accountant {1-1} Workers: H_Work_MX_DIF {1-1} Workers: H_Work_MX_Maquilas {2-1} Workers: H_Work_MX_Nurse Assistant {1-1} Workers: H_Work_No Experience {3-1} Workers: H_Work_MX_Teacher {1-1} Workers: H_Work_US_Child Care {1-1} Workers: H_Work_US_Factory {4-1} Workers: H_Work_US_Fields {31-2}~ Workers: H_Work_US_Health {1-1} Workers: H_Work_US_Misc {1-1} Workers: H_Work_US_Progression {1-1} Workers: H_Work_US_Promotora {6-1} Workers: H_Work_US_School {1-1} Workers: H_Work_US_Volunteer {20-1} Workers Work History {0-15} 203

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APPENDIX F (Continued) is part of is part of is part of s part of is part of is part of is part of is part of is part of is part of is part of Workers: History {54-1}~ Workers: History_Colonia Life {1-1} Workers: History_Education {11-1} Workers: History_Family {39-1}~ Workers: History_Family_Husband's Work {1-1} Workers: History_Housing {18-1}~ Workers: History_Legal Status {7-1}~ Workers: History_Migration {17-12} Workers: History_Migration_Monterrey {1-1} Workers: History_Migration_Scaled Migr. {1-1} Workers: History_Work {56-1}~ Workers: History_Work, Beginnings {83-1}~ is part of is part of is part of is part of is is part of is part of is part of is part of is part of is part of is part of is part is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of Workers: Activities {20-37}~ Workers: Activities_After School {1-1}~ Workers: Activities_Border Witness {3-1}~ Workers: Activities_Clean Up {3-1}~ Workers: Activities_Community capacity building {19-1}~ W { Workers: Activities_Food Bank {3-1} Workers: Activities_Hair Residents {9-1} Workers: Activities_Health Fairs_1 {8-1} Workers: Activities_Home Visits {37-1} Workers: Activities_Home Visits_Barriers {12-1} Workers: Activities_Home Visits_Process_1 {29-1} Workers: ActivitiesImmigration {3-1} Workers: Activities_Intermediarios {8-1}~ Workers: Activities_Job Fairs {2-1} Workers: Activities_Jueves Juveniles {2-1} Workers: ActivitiesMicroenterprise {2-1} Workers: Activities_Nutrition {2-1} Workers: Activities_Parenting_1 {5-1} Workers: Activities_Planning_1 {25-1} Workers: Activities_Pregnancy_1 {3-1} Wo Workers: Activities_Presentations_Health _AIDS {2-1} Workers: Activities_Presentations_Homes {1-1} Workers: Activities_Presentations_Respon {} Workers: Activities_Service Referral {3-1} Workers: Activities_Sewing {1-1} vities_Teaching Workers: Activities_Youth {11-1} 204

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APPENDIX F (Continued) is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is par is part of is part of is part of is part of Workers: Roles_Distribute Clothing {2-2} Workers: Roles_Defined by Providers {1-3} Workers: Roles_Defined by Self_1 {4-2} Workers: Roles_Facilitation_1 {5-2} Workers: Roles_Education_1 {7-2} Workers: Roles_Elderly {4-2} Workers: Roles_Emotional Support {19-3}~ Workers: Roles_Employment {1-4}~ Workers: Roles_Environment {1-2} Workers: Roles_Fill in applications {1-2} Workers: Roles_Health Education {11-2} Workers: Roles_Health Services_1 {7-2} Workers: Roles_Identification Needs {19-2} Workers: Roles_Immigration {4-2} Workers: Roles_Information and Referral_1 {50-2}~ Workers: Roles_Information Program Activities_1 {5-2} Workers: Roles_Meds to Neighbors {7-2} Workers: Roles_Organization Activities {1-2} Workers: Roles_Transportation_1 {6-2} Workers: Roles_Support/Feedback to Providers {7-2} Workers: Roles_Walking Dictionaries {2-2}~ Workers: Roles {13-23}~ is part of is part of is part of is part of is part of s part of is part of is part of is part of is part of is part of is part of s part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of is part of Workers: Impact on Community_Thanksgiving Meal {2-1} Workers: Impact on Family {24-1} Workers: Impact on Family_Less Time {1-1} Workers: Impact on Health Care System {3-1} Workers: Impact on Health_1 {9-1} Workers: Impact_Comm.Elderly {1-1} Workers: Impact_Comm._Emot. Support {8-1} Workers: Impact_Comm._Empow. {2-1} Workers: Impact_Comm._Help {1-1} Workers: Impact_Comm._Satisf. helping {1-1} Workers: Impact_Comm_Holism {3-1} Workers: Impact_Community {58-1}~ Workers: Impact_Community_Connect Neighbrs. {16-3}~ Workers: Impact_Community_Driving {2-1} Workers: Impact_Community_Link Resds.-Services {21-1}~ Workers: Impact_Door Keys {1-1} Workers: Impact_lmmigration {1-1}~ Workers: Impact_political mobilization {4-1} Workers: Impact_Self {68-1}~ Workers: Impact_Self_Empowerm. {5-1} Workers: Impact_Self_Greateful program {1-1} Workers: Impact_Self_Learn from Comm. {2-1} Workers: Impact_Self_Learning {4-1} Workers: Impact_Self_Pride {5-1} Workers: Impact_Self_Shyness {3-1} Workers: Impact_Self_They value us {1-1} Impact {0-26} 205

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APPENDIX G: MEMOS WRITTEN IN ATLAS.TI 25 THEME CATEGORY: WORK MEMO: Promotoras are natural helpers (1 Quotation) (Super, 07/27/03 06:48:38 PM) P14 No codes No memos Type: Commentary 07/27/03 06:48:46 PM A common characteristic of promotoras is that they have been helpers in their communities from before they were employed as promotoras. As Mrs. Gonzalez, "I have always said: what would be better than being paid for something you have always done for free!" The account of how they were active helpers in their communities is varied. Some of them remebered during the interviews how they were helpers since their childhood. For instance, Mrs. Rosaldo, who participates as an instructor of pre-school children at program, mentioned that although she had never considered belonging to a community center or a community group, she did like enjoy teaching as she was a child: "I always liked helping people. But I never considered participating in a community center or having a job through which I could help the community. Never. Now I recall something that I had completely forgotten: when I was a child I used to enjoy teaching my friends. I always was the teacher. I recall that I used to tell my parents that I was going to be a teacher when I grow up. I was about thirteen years old. I went through elementary school then high school and I completely forgot I wanted to be a teacher. And now I am doing it! (89:42) MEMO: Program's impact on practice (1 Quotation) (Super, 04/26/03 12:12:41 PM) P 2 No codes No memos Type: Commentary 04/26/03 12:12:49 PM There are several examples of how programs, with their different goals, philosophies, sets of duties and responabilities given to workers, define the practice of promotoras. However, there are also examples of how programs' influence is not determining or as deep as to define everything promotoras do. Indeed, one of the central thesis of this dissertation is exactly that practice has two levels, one the program prescribed set of activities, roles and duties, and a deeper level where promotoras do a number of things that do not respond to programs' prescriptions but instead they respond to promotoras agency and identity as colonia residents. Going back to examples of how programs 25 All original names have been replaced by codes or pseudonyms. This is a selection from the 55 memos created during the analysis. I memos I registered reflections and interpretations, as well as theoretical considerations emerging from data. 206

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APPENDIX G (Continued) impact practice, even if it is at the level of visible activities, Ms. Ramirez (P41) says the following: "Well, we used to walk the streets too. However, we only distributed flyers, brochures and we told people the medical tests they had to do, such as diabetes testing or papanicolao. We only left the information. In other words, home visits were not as frequent. Now I am with people, and I know how to be with people." [P41: 773-777]. MEMO: Decision-Making (4 Quotations) (Admin, 11/29/01 11:03:40 AM) P44 No codes No memos Type: Commentary Decision-making is an important aspect of the work that promotoras and CHWS do. The basic assumption is that promotoras and CHWs are different from professional or para-professional employees in that they lack institutionalization, that is, their work is characterized by a strong reliance on their own knowledge and on the culturally-based strategies of communication. Based on this assumption, it is exactly this reliance on the local culture and local knowledge that makes them extremely valuable since they can communicate what professionals, with their reliance on externally-based models of communication, cannot communicate. This strength showed by promotoras and CHWs in general may be restricted if workers are institutionalized and their local culture and local knowledge is co-opted by the formal organization. Decision-making is precisely an indicator of the degree to which reliance on local culture and knowledge has been co-opted by the formal organization with which workers are employed. In the case of this program, the work that promotoras do is planned in coordination between promotoras themselves and program coordinators. However, final decisions are always made by coordinators. For instance, promotoras may have ideas of things they could do in their community, perhaps in collaboration with residents, or in collaboration with other agencies or community organization, but the final decision about whether or not they will do it, is of the coordinator. This is reflected in that promotoras can suggest activities and include them, tentatively, in their monthly schedules, but the schedule needs to be approved by the coordinator. The following quotation reflects this relative restriction that promotoras have in regard to making programmatic decisons: "Q. Y eso por ejemplo de decidir a llevar a los nios al saln es algo como grupo deciden hacer? A: Es idea de nosotros. Y ya les preguntamos a las mamas si le daban permiso a estos nios de llevarlos al corte de pelo porque aqu cuando es tiempo de que salen de vacaciones hay un programa que le digo que les dan el almuerzo y la comida. El ISD viene aqu y les da el almuerzo y la comida y les hacen algo recreativo para los nios. La seora Moreno tambin se involucro en eso el ano pasado. Que traer a una persona a ensear a los nios en tiempo de vacaciones a colorear, a escribir y nosotros tambin les ayudbamos a servir porque no haba quien ayudar a servir a los nios. Entonces la supervisora nos pona un schedule cuando podamos ayudar y ayudbamos y eso fue algo que el ano pasado se hizo y este ano prximo se va a volver hacer. No se si nos 207

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APPENDIX G (Continued) van a dar permiso de que vuelvamos ayudar a Dona Moreno a organizar este. A servir la comida o a limpiar y todo eso." Another illustrative quotation is: "Entonces ustedes tienen muchas cosas que ustedes hacen que surgen ustedes mismas no? A: Si, noms pedimos permiso. A veces nos dan permiso. Pero si. Como horita hay otro programa nuevo que no le hemos dicho a la supervisora pero yo pienso que todo cuando es para el bien de la comunidad se va aprobar. Ase poquito, la semana pasada vinieron unas personas de la Clnica 22 con otras promotoras de Mano A Mano. Quieren que les ayudemos a buscar personas que estn embarazadas, mujeres embarazadas de tres meses para...creo que hay una beca de dinero para esas personas que quieren que las personas desde los tres meses de embarazo hasta los dos anos de edad les van a estar dando (inaudible) para ver como se desarrollo este nio desde los tres meses hasta los dos aos de edad. Les van a buscar transporte, les van a dar, si la persona necesita comida, las van a llevar a que le estn chequando el bebe y le van a buscar una clase de seguro mdico. Mucho beneficio para esas personas que hay aqu que no tienen nmeros sociales. Que no tienen papeles. Y all es lo que me gusto, que aqu hay mucha gente que no tienen papeles.Y hay veces dicen que se les hace muy difcil que por el transporte y pues dicen que van a dar todas estas clases de servicios. Y nos dieron una encuesta de las preguntas que les van hacer a las personas pero necesitamos pedir permiso a la supervisora. Pero yo pienso que si nos lo va a dar porque es algo para la comunidad. Es algo que es bueno." This decision-making specialization shown in this program is a characteristic of the organization culture. However, it may also be a reflection of the culture of dependency and subjugation that traditionally subjugated people have in regard to the powerful. [SEE MEMO 'WORKERS' DEPENDENCY IN DECISION MAKING EVENTUALLY JOIN THESE TWO MEMOS]. This characteristic of decision-making has to do with autonomy and empowerment. How autonomous are promotoras and CHWs? To what extent have they been co-opted by the formal organization? To what extent have they been institutionalized by the formal organization? Following the latter, to what extent do they keep (or have they lost) their reliance on local culture and knowledge, which is their strength? In this quotation by a promotora from CHUD is expressed one of the fundamamental differences between styles of administration and organizational cultures that are found in the programs included in the study. The promotoras working with CHUD express relatively high levels of dependency from coordinators in making decisions that have to do with their daily work. In this case, the promotora tells that although the group (of promotoras) would like to participate in the excercising classes, they do not do it because in order for them to participate they would have to request permission from their coordinator. This is a clear manifestation of the apparent contradiction between styles of work, and cultures. On the one side, there is the culture and the style of community residents who are working as outreach workers, but who at the same time bring to the work the richness of their condition of community residents. This richness is expressed in a their reliance on local knowledge and on their natural non-dependence from 208

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APPENDIX G (Continued) professional models of work. At the same time, they are employed by an organization that has a specific style of work that is a reflection from the university organizational culture. This culture is hierarchical, and thus it imposses on workers respect for hierarchies. This impossition of hierarchies is in reality an impossition of a particular organizational culture on a group of community workers whose main richness is precisely their natural nondependence from organizational cultures. The following quotation reflects to a certain extent an important level of internalization of the hierarchical culture of the organization, and the resulting adaptation of their behavior and style of work to that culture: "Y ustedes participan en eso, clase de aerobics? A: Pues nosotros no hemos podido porque nosotros ya tenemos el schedule de nosotros, no hemos podido. Como lo han hecho de 11:00 a 12:00 de medio da, nosotros todava estamos con lo del trabajo. No podemos. Nada mas lo que nosotros hacemos es involucrar a las personas que vallan. Pero, me gustara tambin estar en eso, pero no podemos por el trabajo de nosotros no podemos. No podemos hacer eso o a no ser de que le digamos a la supervisora, nos das chanca de ir un ratito hacer aerobics, pero eso esta muy bueno para uno. La salud y todo eso." An indicator of the power of the organizational culture, and of hierarchies, is 'pedir permiso' (ask for permission). Promotoras make decisions on their own, but usually they ask for permission before making the decision. That is, they an idea, which may come from their close involvement with the community and their understanding of their needs, or from their close relationships with other programs in the colonia, but they seldom put that idea into practice without asking for permission from the coordinator. I am under the impression, as stated above, that this dependency regarding deciosion-making has to do with the organizational culture. However, it cannot be ignored that there is a culture of dependency that Latin American people in general have when relating with people that occupy more powerful poistions in society. That is, there is a culture of subjugation and dependecy of the traditionTheally powerless from the traditionally powerful. The powerful are the professionals, the ones of higher socio-economic status. This is the perpetuation of the culture of the 'patron,' that is, the class differentiation that existed between the land owner and the peasant. In Mexico, this is expressed in the 'relaciones ejidales.' [VERIFY THIS POINT. I AM NOT SURE IF THE EJIDO PERPETUATES THE INTERNAL COLONIALISM TYPICAL OF THE HACIENDA MODEL] MEMO: Motivation_Sources of (4 Quotations) (Super, 07/27/03 03:27:09 PM) P 8 P14 P15 Code(s): [Workers: Motivations for Work_1] [Workers: Motivations_Work with Companeras] No memos Type: Commentary 209

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APPENDIX G (Continued) Promotoras reported several sources of motivation for work. One of those sources is thesatisfaction obtained from seeing that their work with the community produces concrete results, another source is the perception that they go through changes and that their families value them more, as a result of work. Another source of motivation is the working with their 'compaeras,' their partners. This latter source of motivation is like a process of feedback that they obtain as they do the work and they achieve things. Mrs. Rosaldo described this a a process through which "we motivate ourselves from each other." She expanded on this: "It is something very nice to see the strength and desire that people have. For instance, our funder, Sister Mary, who the desire she puts on her work, for the improvement of the community. That motivates me. To see someone who is always after the well-being of people. She and all of my compaeras, mostly those that have been working here for 10 or 11 years. It is a motivation to see how much they want to make this program successful." (89:36). Another source of motivation is the satisfaction for giving in work the best they can give.This satisfaction results from doing a job even when they are aware that they do not know everthing. Economic need is not reported as a major source of motivation for work. In most of the cases husbands did have an employment. In some cases the promotora job was a replacement of other jobs, including the working in the fields with the husband, either travelling north or in the same Lower Rio Grande Valley. It was common to see that women contributed to the household economy complementing their husbands's jobs, and sometimes, as Mrs. Rosaldo described, becoming the main income of the houshold. However, the pride derived from their new roles of breadwinner, or at least as contributors to the household economy, complementing ther husbands' incomes, did consitute an important source of motivation. Mrs. Rosaldo clearly stated that when she said how proud she was in helping his husband at home, although in reality she had already become the main breadwinner of the family, displacing the historic role of his husband as a breadwinner. (89:41). MEMO: Skills acquired in work (1 Quotation) (Super, 07/06/03 04:23:33 PM) P 6 No codes No memos Type: Commentary 07/06/03 04:23:40 PM Mrs. Rodriguez tells that before starting working with the agency she did some independent administrative work at home, such as completing income tax returns and book keeping. She said working at the agency allowed her to expand her existing skills: "Pero es un programa que ha crecido, y yo he crecido con l. Nos desarrollamos desde el casi el principio. Y he aprendido mucho. Yo ya tenia destrezas cuando entre a trabajar con XX, pero las he extended. Yo trabajaba en mi casa tambin, hacia income 210

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APPENDIX G (Continued) tax returns, book keeping, todo eso yo hacia en mi casa ese trabajo. Pero este, cuando vine a trabajar con XX, como que lo extend ms. Y he aprendido mucho ms." This is not a unique case in terms of the women expaning their skills as they work for the program. However, it may be a somewhat unusual case in the sense that Ms. Rodriguez had a 'business'-type of occupation prior to working as a promotora. As a hypothesis, this occupation may ease the transition to the promotora job, not only for herself, but also for the husband in relation to her money earning status that comes with a job. As several promotoras said, one of the sources of resistance from husbands is precisely the fact that promotoras' become wage earners since that seems to threaten husbands' power and control. MEMO: Work history (1 Quotation) (Super, 04/26/03 12:03:15 PM) P 2 441 -443 No codes No memos Type: Commentary 04/26/03 12:03:22 PM The work history of promotoras can be divided into at least three categories. First, their work history in the colonia, perhaps working as promotoras with another agency. A second category is that work history as part of the migration process, most of the times as agricultural workers. The third category is that work history related to employment in Mexico in the case of immigrants. MEMO: Connecting Neighbors (2 Quotations) (Super, 05/19/03 11:21:17 AM) P 3 P64 Code(s): [Workers: Impact_Community_Connect Neighbrs.] Memo(s): [Social Capital] Type: Commentary 05/19/03 11:21:26 AM CHWs' impact in communities in terms of connecting neighborhs with neighbors, is a consequence of: a) specific activities implemented by the program that employs them that have as a explicit goal promoting the establishment of connections among residents where before they live in isolation from each other; b) of programs' activities that, although not having connecting residents among themselves as an explicit goal, accomplish that as a result of the process itself. This is a synergetic outcome; and c) of CHWs capacity to connect neighbors in virtue of their belonging to the community and of their understanding that social networks are necessary. This is an example of how it is not the program, or organization, by itself which defines activities, roles and impacts, but instead it is a combination (or synthesis) of program and agency (their agency as community workers). Finally, the concept of connecting neighbors also relates to the notion of social capital. CHWs create social capital in two ways: connecting neighbors among neighbors, and connecting residents to servcies. 2 quotation(s) for memo: CONNECTING NEIGHBORS Quotation-Filter: All -------------------211

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APPENDIX G (Continued) P 3 3:10 [Vinimos aqu a estar en este c..] (21:21) (Super) Codes: [Workers: Impact_Community] [Workers: Impact_Community_Connect Neighbrs.] [Workers: Roles_Comm./Capacity Building] Memos: [Connecting Neighbors] [Social Capital] "Vinimos aqu a estar en este centro. Empezamos nosotros, yo empec con clases de manualidades con seoras haciendo cosas manuales para la casa. Criando cosas que no sean tan caras. Cosas que tenemos en la casa diaria. Aparte de que se enseen, hagan amistad, unin con uno o otra de las que se apuntan, las mismas que apuntamos, verdad, las seoras. Unas aunque viven serquitas, tienen aos de que viven all y no se conocen. Aparte de eso, las invitamos y se hace un grupo, y durante de esos tres meses que conviven, se empiezan a decir una a otra oye tantos aos de vivir aqu y nunca nos hablamos. Como nos vinimos a reunir, se hacen amigas, invitan a comer una a otra. Y aparte nosotros tambin vamos y las visitamos y hacemos una comunicacin bien bonita con ellas. Y dicen, oye tantos aos que viva esta seora aya mira, aqu nos vinimos a juntar y ya nos conocemos. Pero yo que como la gente teniendo tantos aos viviendo como no-se comunicacin. Bajo de este programa como hace unin en la comunidad." P64: 64:1 [: I think the important thing ..] (7:20) (Super) Codes: [Workers: Impact_Community_Connect Neighbrs.] [Workers: Impact_Community_Link Resds.-Services] Memos: [Connecting Neighbors] [Social Capital] "I think the important thing around the Colonias Program at CHUD has been a theme that has focused on connecting isolated communities to programs and services. The opposite of isolation is not more programs. The opposite of isolation is connectivity, so the first phase of what the Colonia Program established around the border was certainly, I believed the physical infrastructure capacity for those program providers to connect to people. And that physical infrastructure is what we called now Community Resource Centers and those Community Resource Centers act as a platform, the platform for the myriad for the programs and services to be closer to the community. For them to access the community through that particular infrastructure. I think that particular initiative has been quite successful, but just like any initiative, on the onset you begin to establish and implement something that is very good, you begin to see the opportunity like any entrepreneur would to add layers of support. To make it better; to enhance what's there because certainly any system in connecting people to the outside system is very, very difficult." In this case, Ms. P41 talks about her past experience as a promotora with another agency in the LRGV. She tells about the differences in the roles she played in the other agency vis a vis her current employer. This is a good exemple of how the agency helps to determine what promotoras do, at least officially. Ms. Ramirez says the following: "Well, we used to walk the streets too. However, we only distributed flyers, brochures and we told people the medical tests they had to do, such as diabetes testing or papanicolao. We only left the information. In other words, home visits were not as frequent. Now I am with people, and I know how to be with people." [P41: 773-777]. 212

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APPENDIX G (Continued) MEMO: Work helps to sacar el don (2 Quotations) (Super, 07/25/03 12:33:14 PM) P15: 3 -3 3 -3 No codes No memos Type: Commentary 07/25/03 12:33:20 PM Participation in promotora programs has several types of impacts on women. Promotoras described how participation increased their self-esteem, the image they had of themselves and the image their families had of them, and their level of education, among other things. One of the types of impact is personal empowerment, understanding empowerment as the condition of being able to perform at the maximmum of one's capacity, and of discovering skills and orientations that one did not know to posses. Ms. Crecencia Fernandez, who works in a child program as promotora, described how participation in the program allowed her to discover skills she did no know she had, since most of her adult life she had spent at home, as a housewife. Thus, employment and employment as a promotora in particular, give promotoras the opportunity to identify and explore aspects of their lives and of their capacity that they had not explored before given their roles as housewives and of not having a salaried work experience. Ms.Fernandez said the following in this regard: "I like talking with people and being with people. I like it very much. I like very much. The program helped me to get these skills out of me, because I didn't know I had them. Becasuse when you are at home, you are like a housewife: go cleaning, take care of the children, make the beds, and all of that. And now I am doing similar things (working with children), but I am doing it for people who have a need. Perhaps they have more needs than I have. You know, I like working with people!" (90:4). The sense of empowerment is further described by Ms. Fernandez: "When my children were young, I looked at the teacher as someone larger than me. If there was a problem at school, I just told myself: 'he must be wright, he is the teacher.' Then, as I started to get work in this program, going to trainings, I started to think: 'No, a teacher is a teacher, but we are all the same.' I could not see that before. So, working here brings a lot out of me. So many skills and qualities we have that we didn't know we had....Now I think: 'The teacher is more educated than me, but we are the same.' As a result, I can now talk with the teacher, tell him about my feelings. I can tell him what I think when something happens with my son at school. Before, I just said 'yes., yes, yes.'" (90:7). However, it is important to note that the degree to which the job of a promotora helps women to discover skills and orientations they had not known before, is in part a function of the experience women had as salaried workers. In those cases when women did not work out of home before, then the impact of the promotora work is greater than in the cases when the promotora did have a salaried work before. 213

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APPENDIX G (Continued) MEMO: Work Experience as Volunteers (1 Quotation) (Super, 11/10/03 07:53:45 PM) P 4 4 -4 No codes No memos Type: Commentary Some promotoras have an experience as volunteers both in the U.S. and in Mexico. One of the types of volunteer jobs is the work in the church (15:63), the work at schools, and as volunteer promotoras. Mrs. Dolores Ortega describes her volunteering at the catholic church in her colonia: Q: Cuando usted empez a trabajar el 98 usted haba tenido experiencia antes de trabajar como de voluntaria o algo parecido? A: Nada mas cuando estbamos con la comunidad con el padre. Era lo nico que l nos involucraba aqu en la colonia. O sea nosotros los Jueves tenemos comunidad de basics, que se llama, que vamos a una casa y luego vamos a otra y nos juntamos como un grupo de 10 a 15 personas. Entonces ya de all el padre habla y dice de lo que esta pasando y nos platica y nosotros platicamos a la otra gente que no esta llendo a la comunidad. Hablamos con las dems personas que va a ver una actividad y mira que en la iglesia estn haciendo esto de salud. Entonces all fue en donde yo empec. Pero muy poco. Aya de ves en cuando. En realidad yo casi no sala en ese tiempo. No mucho. MEMO: Work brakes isolation of promotoras (1 Quotation) (Super, 07/23/03 09:31:23 AM) P14 8 -8 No codes No memos Type: Commentary 07/23/03 09:31:33 AM Ms. Rosaldo (89:3) mentioned how she lived in isolation in her colonia, in her own house. She did not know people from the colonia, except her closest neighbor. She added that working in the program as an animadora allowed her to know people, to know the colonia: "I am greateful to God that the job I have has allowed me to get to know a lot of people. I am greateful for that." MEMO: Working with children (1 Quotation) (Super, 03/31/02 10:15:38 PM) P10 No codes No memos Type: Commentary The situation described here by this animadora --that she had her hair pulled by one of the children in one of her classes gives an indication of the conditions which some of these workers must face. This animadora appears to have learned something about 214

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APPENDIX G (Continued) working with children, understanding them, disciplining them -she says that she chose to joke about the situation rather than to throw the offending child off as suggested. However, how many of these workers how many coordinators -realize some of the difficulties that they must face while in the field? MEMO: Workers: Solidarity among workers->89:39 (1 Quotation) (Super, 07/27/03 03:46:01 PM) P14 No codes No memos Type: Commentary 07/27/03 03:46:09 PM Solidarity among workers is a common trait of promotoras and it is found across agencies.However, there are those programs that provide the conditions to strengthen solidarity links among workers. XX is one of those agencies. The program, which is managed by workers themselves, encourage promotoras to take the children to the centers whenever that is necessary, thus allowing women to solve a problem that would potentially limit their capacity to work. Mrs. Rosaldo described this in the following words: "A veces pienso yo que no es que descuide a mis hijos no, tampoco es como le digiera. Mire ahora con el verano, no ocupamos mucho porque andamos con los visitantes y todo eso. Y el dia, nosotros los pap, muy pronto porque andamos haciendo varias cosas, pero toca que tambin los nios estn de vacaciones y estn en la casa. Pero yo dije que voy hacer. Pues el verano pasado no fue para m de mucha actividad porque acaba de llegar. Andaba como perdida. Pero ya este verano ya sabia que era lo que me tocaba hacer. Y estaba yo con ese pendiente, pero gracias a Dios que tuve el apoyo tambin de las muchachas. Vino Vicky y me dijo Carmen, este puede traerte tus hijos. Mientras no interfieren en tu trabajo, puedes trartelos. Y los nios pueden comer aqu en la hora de la comida y puedes tenerlos aqu atrs, en el patio. O sea eso ya es algo que yo estaba pensando que voy hacer con mis hijos y me dan esa oportunidad. Estas trabajando y al mismo tiempo estas al pendiente de tus hijos. Gracias a Dios me dieron esta oportunidad. Era algo que yo tenia un poquito as de encontra en estos das." (89:39). MEMO: Workers: Social Relationships (1 Quotation) (Super, 03/31/02 10:28:29 PM) P10 No codes No memos Type: Commentary The development of social relationships with other women in the community here seems to serve two purposes. The first, is to establish a sense of trust and caring-Ma del Carmen says that the women are like her, "they ask a lot of questions like her." Afterestablishing these relationships, they can begin to inform them about various programs available to them. Although Ma del Carmen says that she thinks that the programs will only work if there is a show of true concern and a true relating to the community first. 215

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APPENDIX G (Continued) MEMO: Workers: lessons from past (0 Quotations) (Super, 07/02/02 02:28:03 PM) No codes No memos Type: Commentary This promotora recounts her painful experiences in high school where she was made fun of for being a "wetback" and not speaking English. She talks of how some of the same students who laughed at her are now her clients. One in particular, she reminded of how mean she was to her. She says that she told the woman that she wanted her to realize "that we are all automatically equal" and that she should take note so as not to commit the same mistake with someone else. MEMO: Workers: Impact_Self_Pride->88:12 (1 Quotation) (Super, 07/06/03 04:55:11 PM) P 6 No codes No memos Type: Commentary 07/06/03 04:55:36 PM The pride that promotoras feel from their work is largely due to the changes they see happening on people with whom they work. This is very much related to the role that the community plays as a motivation for their work as promotoras. Based on the 'mirror principle', on the identification that links promotoras to their communities, they are deeply motivated whenever they are able to produce change in people and in the community as a whole An example of this is provided by Mrs. Rodriguez who taught English as a Second Language to women from the colonia. She described how much pride she felt when seeing that the women who took her class were able to communicate in English for the first time. For instance, she: "Cuando terminamos el training, la primera clase fue la, yo creo que la mas, donde me senta mas tensa. Y la ms nerviosa. Pero como quiere yo trate de llevar la clase a segn lo que yo me haba enseado. A las tres, cuatro semanas, que ya empec a ver fruto en las personas, fue cuando vide que yo estaba haciendo lo que realmente me haban pedido hacer. Y me gusto mucho y me emociono mucho porque las mujeres empezaron a compartir conmigo que cuando iban a las tiendas por ejemplo cuando iban a comprar, por ejemplo la mujer compra medias, verdad. No saban a veces las tallas, el size. No saban que quera decir la "L", la "M", o la "S." Entonces cuando ya supieron esas palabras, que es lo que decan, ellas ya saben que talla usan y van y buscan en otra parte. Cuando iban a la supermarket, tambin, me dicen que ahora ya podan identificar, por ejemplo, las latas a cual era el corn, a cual eran el green beans, a cual eran los peas. Muchas veces ellas trataban de identificar con el foto. Pero hay generic products que para orarse dinero comparaban y no saban leer y no traiba picture el label, y ya conociendo las palabras, corn, green beans, y todo eso, ellos podan ya comprar lo que iban, lo que queran comprar. A veces traibamos el helote en crema o molido, y a mucha gente no le gusta. Y eso a m me empez, bueno me empec a sentir muy bien. Porque ahora ellas ya, era algo chiquito, pero para ellas era algo muy grande. Y luego tambin empezaron a ensearse a como llenar money orders para los pagos. Que antes iban a correo y compraban el money order y all mismo pescaban a 216

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APPENDIX G (Continued) cual quiera que supiera escribir a ayudarles a llenar el money order y el sobre y todo. Y ahora ellas ya podan hacer eso. Y pues para muchos de nosotros es algo que tomamos, no le ponemos pensamiento porque lo sabemos hacer y con facilidad lo hacemos, pero para ellas era algo nuevo, y era algo grande verdad. Y pues eso a m me tocaron, y me sigue tocando porque todava ay gente asina que todava necesita aprender mas ingles o como llenar un papel. Es bonito. A m me daba mucho orgullo y gusto con ellas, compartiendo. MEMO: Workers: Impact_Learn from Community (2 Quotations) (Super, 07/27/03 03:01:50 PM) P14 No codes No memos Type: Commentary 07/27/03 03:01:58 PM Promotoras reported that they learn from their work with the community. Thus, learning is not a unidimensial phenomenon, but instead it is multidimensional, with promotoras learning from trainings provided as part of their formal training process, as well as from the community with whom they work. Learning from trainings processes seems to be a logical consequence of being exposed to constant training sessions, sometimes more than twice a week. However, learning from the community is more of a sublte characteristic of the promotora practice, since it reflects the workers' willingness and capacity of understanding of and indentification with the the people with whom they work in daily routine. Mrs. Rosaldo, the same promotora who described how she listens to the mothers of the children who participate in her child program class, also described how she learns through the process of listening to mothers' problems, concerns, and ways of rasining their children. Mrs. Rosaldo described how after visiting families all promotoras get together and debrief about what was learned during visits: "It is beautiful that we visit families once a week. We visit them to know how they are doing, and many times the ladies are waiting for us, to tell us about their personal things. Then, we get back to the center and we all sit in a circle and we all share how our visits went. What we learned from people. And what we talk never leaves us (keep confidentiality). It is something that remains with us, the team, and the ladies from the community." Mrs. Rosaldo goes on to specify what she means with 'learning' during home visits: "We learn when we visit homes, when we see how people struggle in their children. I have learned a lot from seeing a lot of things, I have learned about the good and the bad too. However, I always try to capture the good (instead of the bad). You talk with them, but at the same time you observe, and that is how you learn about people's way of life. We learn a lot." (89:34) MEMO: Workers: Impact_Comm_Holism->89:31 (4 Quotations) (Super, 07/27/03 08:40:14 AM) P14 P15 No codes 217

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APPENDIX G (Continued) No memos Type: Commentary 07/27/03 08:40:22 AM A key characteristic of the promotora model is that promotoras are comprehensive and holistic in their work. This means that promotoras are able to deal with issues that cross thematic boundaries, responding to individual, family or community needs as a whole. The extent to which the practice of promotoras is holistic, however, varies with the type of agency where they work. There are those agencies that incorporate in their mission and strategies a comprehensive approach to community needs, such as the case of the agency XX and the YY Program. In those cases, the holism of practice is facilitated by the program. At the same time, there are those programs that have a specialized focus, concentrating on health outreach or child and maternal health, such as the Nuestra Clinica del Valle and AVANCE, and when this is the case, the holism of the promotora practice is restricted by the program. Regardless of the type of agency, however, an interesting finding of this study is that promotoras maintain the holistic character of their practice. What changes is the intensity of the holistic practice and the organizational support to it. From another point of view, what changes is the degree to which promotoras have to cross the boundaries set by the program in order to practice: the greater the degree of specificity of the program focus, the greater the promotoras have to cross organizational boundaries in their practice; the higher the degree of holism of the program focus, the less the promotoras have to cross organizational boundaries in their practice. This notion of crossing organizational boundaries will be further discussed in the Discussion chapter of this dissertation. Mrs. Rosaldo explained very clearly what holism in practice means. She described the times when she met with mothers of the children who participate in her child program class. She visits them at home to let her know how their children are doing, but most of the time the conversation expands into other areas of interest and concern for the mother, sometimes beyond the performance of the child in the program. Frequently, the informal meeting becomes an emotional support session, the promotora listening to a diversity of problems about which the mother wants to talk, including marriage issues. Mrs. Rosaldo described this in the following words: "We visit mothers to talk about their children and how they are doing in class. Well, we go with the intention of talking about the children but we end up talking about things they need to take out of themselves, and since they trust us, they do it with us. They know that whatever is said there will stay there. How can I tell you? It is something beautiful feeling that they trust you and that you cannot let that person down. That they are trusting you any little problem they may have. Many times the husband doesn't listen to them, they do not have enough patience with them. It is not that they want to complain about their husbands, it is just that they want to talk, and you listen. And that is good." (89:31). Mrs. Fernandez, who works in the same child program as Mrs. Rosaldo, confirmed the account: 218

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APPENDIX G (Continued) "We talked with them about the child's progress with us. They ask us 'How did my child behave? How is he doing in class?' Sometimes, if they have a personal problem, they talk with us about it. This is possible because they know us. They are seeing us continuously, so they trust us. Sometimes we don't have the answer to their problems, but listening to them is enough for them and for us, because we fell useful; just listening to them." THEME CATEGORY: AGENCY AND IDENTITY MEMO: Workers_Agency (1 Quotation) (Super, 05/19/03 02:48:52 PM) P 3 Code(s): [Workers: Agency] [Workers: Working extra hours] No memos Type: Commentary 05/19/03 02:49:03 PM The central postulate of this dissertation is that although CHWs perform within an organizational structure, that is a program, which defines roles, activities, functions, etc., they are to a large degree moved by their own agency. In other words, their particular motivation as part of the community triggers their committment to the community and the same time it is reflected in them doing for the community beyond 'the call of duty. An example of agency triggering perfomance is given by quotation 131:21, when the CHW tells that she provides transportation to colonia residents even after work hours. In this case, the program provides trasnportation services to the community. This CHW adds that she also stays after hours during commuity celebrations or parties organized by the program. The dichotomy organization-agency really reflects or responds to the fact that CHWs are part of the community. Thus, work and community life overlap to some degree, to the point that it is not always simple for CHWs to separate what is required from them by their job from what is required from them by the community as community residents themselves. However, it is important to note that this overlapping organization-community does not require that CHWs actually live in the colonia; the sense of belonging through social class, common history, and ethnicity is as strong as territorial belonging. MEMO: Women's Identity is shaped by history (1 Quotation) (Super, 04/26/03 01:47:33 PM) P 3 9 -9 Code(s): [Workers: History] [Workers: History_Family] [Workers: History_Housing] [Workers: History_Legal Status] [Workers: History_Migration] [Workers: History_Work] Memo(s): [Social history of promotoras] Type: Commentary 04/26/03 01:48:19 PM This refers to the notion that the identity of the promotoras, as a woman and a worker, is shaped and even defined by her experiences throughout her life. Her experience as an 219

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APPENDIX G (Continued) immigrant, or as an agricultural worker, or as a colonia resident born in the U.S. or even in the same colonia, all are associated, and even more, may help to shape, women's identities. Here we can find the relationship between work (identity as a worker) and her migratory experience. Also, the relationship between gender (her identity as a woman) and her migratory experience, or her experience as a poor colonia dweller. MEMO: What Makes a Promotora? (1 Quotation) (Super, 07/01/02 04:08:08 PM) P 81 3 -3 No codes No memos Type: Commentary According to this promotora, the qualities of a promotora "se llevan en la sangre." They are innate, literally translated "in the blood." However, she does say that the trainings are useful because they teach workers how to relate/treat their clients during home visits. MEMO: Things That Make a Promotora (3 Quotations) (Admin, 11/11/01 12:30:35 AM) P 84 No codes No memos 11/11/01 12:31:42 AM Things that Make a Promotora. This is a very important aspect related to promotoras and community health workers in general. What is particular to the ladies that make them good promotoras? Is there any thing in particular in terms of their knowledge, their way of life, their life experience, that makes them valuable as community health workers, and that makes them different from professional workers? This is perhaps a key question that this study needs to answer. The coordinator of one of the case study programs (NCDV) responds to this question saying that their personal history and the fact that elements of this history is shared with the history and life of colonia residents, the residents with whom they work, in particular the elements of deprivation in material terms, makes them particularly suited for the work. In his words: "I think, the one thing I can surely say is that promotoras lived being uninsured, needing health care services, were immigrants, have been sick, have been turned down for health care and other services, so they have lived that. They know first hand what it is like. Because of that experience, they have the ability to emapthize, to communicate, and to have the compassion to go out in the colonias and try to inform these colonia residents of health care, etc., etc.," 220

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APPENDIX G (Continued) Promotoras and other community health workers who were interviewed in the study sustained the same intimate relationship between their experience with poverty and discrimination as poor, and particularly as poor Mexicans, and their desire to work for the colonia residents. As one of the workers said, explaining what motivated her to work for her organization. THEME CATEGORY: WORKERS ACTIVITIES MEMO: Residents fears in home visits (1 Quotation) (Super, 06/07/03 12:36:32 PM) P 6 Code(s): [Workers: Activities_Home Visits] [Workers: Activities_Home Visits_Barriers] [Workers: Activities_Home Visits_Process_1] No memos Type: Commentary 06/07/03 12:36:41 PM Promotoras reported that they encounter various barriers when they do home visits. Sometimes barriers relate to dogs in the street or men who are alone at home and because of that the promotoras choose to make it brief. One of the promotoras, Ms. Rodriguez (88: 5) talked about people not opening doors because thinking they Jehova Witnesse or the immigration police ("la migra"). As Ms. Rodriguez remembered her beginnings as a promotora she described her first experiences visiting home, about which she said the following: "The majority of people did not let us step into their homes. Or else they instructed their children to let us know they weren't home. People feared opening the door to anyone. And I think they saw my partner who was Anglo and myself Mexican, and they wondered about who we were. Some of them tought we were Jehova Witnesses, other thought we were social workers, and still others thought we were from the immigration police ("la migra"). Now that they are participating in our program, they have told me that they feared us, and that is why they were reluctant to open the door. Then, this fear waned away as they began to know us, to know what we were doing; inviting them to our program, inviting them to English classes." [88:5]. MEMO: Residents' isolation (1 Quotation) (Super, 07/24/03 03:47:50 PM) P14 No codes No memos Type: Commentary 07/24/03 03:47:58 PM An important element of the work of promotoras that comes from the community and its characteristics is the degree to which residents are isolated. The literature describes isolation in colonias (see Ward and Richardson) and this is confirmed by the accounts from promotoras, who tell how they are able to connect neighbors who either did not know themselves beyond the minimmal level of interaction or who did not have a good relationship when they had it at all. Ms. Rosaldo described what happens when she and her promotora colleagues visit colonia homes selling tickets from the bingos the program 221

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APPENDIX G (Continued) organizes. She described how they are able to bring neighbors together both at the time of selling the tickets as they visit homes, and during the bingos: "We do bingos. And we sell the bingo tickets. And all of us are out in the colonia selling bingo tickets. And we sell ticket to the whole community, all the ladies are there, even if they don't know each other. This lady lives here, this other lady lives there, and they don't know each other. Perhaps they have seen each other as they walk the streets, but they don't know each other. And when we are at the bingo, they are all there together. They are all talking. It is beautiful to see how the ladies are all out. 'Where do you live? I live over there in San Vicente.' 'And I live there but I have never seen you.' You hear those types of comments, that they are neighbors but they have never talked to each other. It is beautiful, even if it is for a little while down there at the park, because we do our activities at the park. The whole community is there. All the women are there, the whole community is there." (89:25). Ms. Rosaldo goes on to describe how mothers from the community get to know each other in the driving lessons the program gives to the community. She described how "...the ladies exchange telephone numbers, since they are studying the same, but for some of them it is more difficult than for others. So the exchange phone numbers to talk about what they didn't understand. It is a way of connecting one person with the other. And we see how they are coming together. And it is with something that you would not think it would produce that effect, just driving lessons. But I find there is a way to connect residents. They call each other and they become friends. People who had not seen themselves before, or people from a different colonia, now they are connected." (89:26). Ms. Rosaldo goes on to describe how not only women are connected but how as they connect to each other, the obtain resources they need. This is a manifestation of the notion of social capital which tells that through social networks people obtain resources. Ms. Rosaldo said the following: "They talk while in our meetings. They are talking and then one tells the other about how she was helped by promotoras, or how the promotoras put her in contact with the clinic. So after the meeting or class finishes, the lady stays and inquires about how to obtain services at the clinic. MEMO: Presentations at People's Homes (1 Quotation) (Super, 07/23/03 03:34:05 PM) P14 No codes No memos Type: Commentary 07/23/03 03:34:11 PM It is common that promotoras organize presentations from agencies at residents' homes. First, they ask to the people they know in the colonia who would be willing to lend their house for a morning or an afternoon, so that someone from an agency could give a presentation to a group of neighbors. The presentations usually are in the living room, or under a tree at the yard. It is important to note that this is a major contribution of promotoras 'to service delivery in colonias (and in poor and isolated rural areas in 222

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APPENDIX G (Continued) general). That is, they have shown that it is possible for service providers to provide some of their services, at least to make informative presentations, under infrastructural conditions that may not seem adequate from the point of view of the agency. For instance, a coordinator of a promotora program explained how service providers did not go to colonias before their program was established, because they were looking for comfortable environments, "they were looking for air-conditioned rooms, and they did not find that In colonias." Thus, promotoras showed that presentations and even health fairs can be as effective under the shade of a tree in a hot Texas summer, as in an air-conditioned room. Mrs. Rosaldo describes in the following way how she looks for and finds houses where service providers can make their informative presentations: "We go out to the colonia, we think of house with a big tree that can give a big enough shade, or a house with a long roof at the yard. Then we think of the person who owns or (rents) the ideal house, and we talk with her. We ask her if she would be willing to let us use her house, and we tell her about the agency and what they would be talking about. Always people are willing to lend their houses. I have not come across anybody who has denied our request. All the colonia ladies are willing to collaborate." (89:18). MEMO: Workers: Health Classes (0 Quotations) (Super, 05/13/02 11:03:33 AM) No codes No memos Type: Commentary This is an interesting passage dealing with the fact that promotoras are providing medical information to clients and providers/program mgrs. want to be sure that they are not providing erroneous information. This seems to be a concern raised in the literature-how much accurate information can be entrusted to paraprofessionals. However, it seems that in this case, training is used to prepare the promotoras to provide accurate and accepted information. MEMO: Workers: Classes_Driving (3 Quotations) (Super, 04/18/02 05:20:59 PM) P 2 P10 Code(s): [Community: Legal Status_Impact] [Community: Needs_Immigration] [Workers: Impact_Community_Driving] [Workers: Impact_lmmigration] No memos Type: Commentary 04/26/03 12:45:44 PM A very descriptive example of how promotoras affect undocummented residents self-esteem and capacity to do things by themselves, is the driving classes that animadoras from the agency XX teach. Ms. P41 tells the following: "We started teaching a class about what is needed in order to obtain a driving license. I have worked a lot on this area because there is a lot of need in the community due to the fact that many people don't have a license because of fear related to the fact that 223

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APPENDIX G (Continued) they are undocummented. And we have been very successful. Many people have been helped by this program." MEMO: Workers: Activities_Communication->88:25 (1 Quotation) (Super, 07/10/03 11:28:20 AM) P 6 No codes No memos Type: Commentary 07/10/03 11:28:28 AM Mrs. P 6 talked about how she obtains information from the residents she visits at home. She said that she does not ask dircect questions, but instead she lets people express their problems freely. "Okay, principalmente en las visitas que hacemos se sabe lo que se necesita en la comunidad. Porque no hacemos preguntas directas para las familias. Muchas veces sale en la conversacin que es lo que se necesita. Si es una tema que todava falta mucho para llevar acabo la comunidad. Entonces ya teniendo buen contacto y comunicacin con las familias, podemos hablar con ellas y les diremos estamos viendo esta necesidad grande en su comunidad, este queremos traer esta agencias que vengan a dar sus presentaciones, como ve si usted nos presta su lugar para reunirnos. Y la mayora siempre nos ha dicho que si y siempre estn dispuestas." (88: 25). MEMO: Workers: Activities_Auto Maintenance (1 Quotation) (Super, 04/24/02 10:24:14 AM) P 1 No codes No memos Type: Commentary This is an interesting activity in that is very practical and as this quote shows, can be beneficial to the staff as well as residents. The learning of something so seemingly daunting as auto maintenance to someone who does not know how to drive can foster the development of a great deal of confidence in oneself. This animadora also talks of the trust and social relationships involved at the agency that have helped her to overcome her fears in this area. THEME CATEGORY: IMMIGRATION AND CROSSBORDER RELATIONS MEMO: Relationship migration-work (1 Quotation) (Super, 04/25/03 08:51:03 AM) P 1 Code(s): [Workers: History_Legal Status] [Workers: History_Migration] [Workers: History_Work] [Workers: Recruitment] No memos Type: Commentary 04/25/03 08:51:20 AM 224

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APPENDIX G (Continued) Ms. Prez tells of how she came in contact with the organization and how she was offered the job. In her account it is explicit the perception of herself that she had associated with her condition of herself as an undocummented immigrant. Thus, Ms. Prez tells that the women from Agencia XX visited her at home and told her aboutworking with them, about helping the community but she was not sure, that she would like to but that she did not have papers. In her account, Ms. Prez also claims that she did not have education and because of that she was not ready to work. They used to visit me and to talk with me about working with them. They asked me if I would like to work with a group of people from the community. And I used to tell them: 'Yes, I would like to do it, but I don't have papers, I lack education, I am not ready to work.' They insisted: 'No le hace, si tu quieres, puedes.' (Come'on, if you want to do it, you can do it.' After listening to them, I felt at ease, optimistic, and I used to say: 'I would I work in the United States? I have not education, I don't know what that work is about.'" In her account, Ms. Prez reflects on the sense of insecurity she used to feel, associated to two things: first, her undocummented status and second her lack of formal education. It is apparent how the promotoras who contacted her made her revise her approach to her capacity and, convincing her to work. This approach is characteristics of promotoras recruiting strategy and it has to do with the fact that they understand the colonia women's realities. The life-changing experience that women go through as they work as promotoras is a reflection of this... MEMO: Workers can't go back to Mexico (1 Quotation) (Super, 04/26/03 01:04:48 PM) P 3 9 -9 Code(s): [Workers: History_Family] [Workers: History_Legal Status] [Workers: History_Migration] No memos Type: Commentary 04/26/03 01:04:54 PM There are cases when promotoras have left Mexico after their husbands, who were in the U.S. already. In these cases, whenever the women are undocummented, they cannot return to Mexico. One promotora in particular, Ms. Molina [P131] described how hard it is for her to not be able to see her parents and relatives who stayed in Mexico. She says the following: "I was born in Reynosa, Tamaulipas. My parents live there. Now I don't have any relatives living with me, only my children and my husband. All of my husband's relatives, however, are here .It is very hard for me not to be able to cross the border to visit with my parents. I haven't seen my parents and my relatives since I came to the U.S. (four years). It is very hard for me. Now I am fixing my papers through my husband, he is requesting my papers. It was very hard to leave my family behind." [P131: 014-019]. 225

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APPENDIX G (Continued) Promotoras who have left their families in Mexico and who cannot go back to visit with them are not unique cases. They represent one of the types of immigrants represented among the promotoras who participated in the study. It is worth considering that this experience of being away from parents and relatives ("mi familia," "my family") influences promotoras' identity as colonia women as well as their identity as promotoras. In other words, who they are and who they are as promotoras is mediated to some extent by their experience as 'expatriates.' This can fall within what some promotoras refer as one of the reasons for which they are promotoras, that is, "to help people not to suffer as much as they have suffered." Isolation at their homes because of fear to the outside environment, due to immigration status or not, and isolation from "la familia" is one aspect of the experience they want to help other women in colonias to learn how to deal with. MEMO: Migration into the Mexico border (2 Quotations) (Super, 05/21/03 05:22:46 PM) P 4 P10 Code(s): [Workers: History] [Workers: History_Family] [Workers: History_Migration] No memos Type: Commentary 05/21/03 05:22:57 PM Most frequently, the promotoras who imigrated from Mexico were born in a Central or Southern state of Mexico, such as Zacatecas or San Luis Potosi, and then their families migrated into cities closer to the border, such as Reynosa bordering with McAllen, Texas, or Matamoros, bordering Brownsville, Texas. Families usually settled in the border towns for several years, where women may find jobs in the maquiladoras or other service employments and men may migrate into the United States. The most common pattern is, precisely, that of husbands coming into the United States first, many times without papers, and leaving wives behind. Wives then migrate into the United States once husbands have an employment. There are too the cases of women who migrate into the United States following relatives, not husbands. The women who were interviewed presented a diversity of settlement patters in the United States. There are cases of those who first settle in a large city such as Dallas or San Antonio, and then come to the Valley, where they finally settle in the colonias where they lived at the time of the interview. Ms. Porras tells her story since she was born in San Luis de Potosi. She tells how she, as a child, was taken from San Luis to the Valle Hermoso, and from there to Reynosa. From Reynosa, she migrated to the U.S. years after being married, having children and separating from her husband. Ms. Porras is representing a common pattern of migration from Mexico into the United States, i.e., that people come from the south of Mexico and stay for a while in Mexican border towns or cities, from where men leave to the U.S. and men work in maquiladoras, until they also leave into the U.S. [See bibliography]. Ms. Juarez shows a similar pattern of scaled migration. She was born in Zacatecas, then her family migrated into the border city of Reynosa, until she left into Texas. She came 226

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APPENDIX G (Continued) into Texas with her husband at age twenty one. Two years after her arrival she, her husband and two children moved into the colonia where they currently live: "My name is Patricia Juarez and I have been living in this colonia for six years already. I was born in Zacatecas, Mexico, but I was raised in Reynosa, Tamaulipas (border city, across McAllen, Texas). When I was twenty one years old I came into the United States and settled in Dallas. There I was approximately five years, perhaps more, I don't recall. Then we came here, to the Valley, I think it was in 1993, and soon after we came to live in this colonia. In 1995 we came to this colonia in South Tower. I came to the Valley with my two children, now I have three children. I wasn't living with my husband, but I had my two children with me. First I rented a house, a small house. Then, soon after, our family came together again, my husband and our other son who was living with him, and so we rented a larger house. Then, one day, the program coordinator Ms. Zapata visited us. She came with Ms. Gomez, who also works in the program. They were getting to know families to learn about their needs as immigrants in the United States, how we managed to live with a small income, if the husband worked or didn't work. They came as friends." (1:32). MEMO: Migration History (6 Quotations) (Super, 04/25/03 08:25:15 AM) P 1 P 3 P 4 P11 Code(s): [Workers: History] [Workers: History_Family] [Workers: History_Housing] [Workers: History_Legal Status] [Workers: History_Migration] [Workers: History_Work] No memos Type: Commentary 04/25/03 08:25:45 AM Ms. Prez (Agency XX P2) came to the Valley from Monterrey, Nuevo Leon, together with his husband. They came "to try to improve the future of our children." Their decision to emigrate was motivated by a "new law" that was passed in 1997. Since they time the family came to the Valley, they have lived in the same colonia, renting houses. Now, Ms. Prez, "we renting a small house while my husband finishes building our own house." Ms. Prez presents a migration history that is not uncommon to the patterns of Mexico-U.S. Immigration. She was born in a town in the border state of Tamaulipas although not close to the border. From there she moved to the border city of Reynosa, where she married, became a widow, and then married again. Her husband was from the city of Monterrey, in the border state of Nuevo Leon. From there, she emmigrated with her husband to Washington state, a town called Quincy, where they worked as agricultural workers. The family lived in Quincy for four years, until they returned to Monterrey. Three more passed until the family decided to once again cross the river, this time to the Lower Rio Grande Valley. Ms. Prez describes her migratory process in the following way: "I was born in Arroyo in 1960. At 14 I came to Reynosa, where I married and then, because of God's will, I became a widow. I married for the second time, my husband was from Monterrey but he had lived most of his life in the U.S. So, when we married he 227

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APPENDIX G (Continued) took me to Monterrey, where we lived about four months. His house was there, his children were living there. Then we left to the state of Washington, where my children were born. There I was between 1991 and 1994, in a small town called Quincy. Then, we returned to Monterrey, where we lived until 1997. That is when we came to the Valley. I have been here about three to four years, and I have been working only one year. 06/02/03 10:04:23 AM Ms. Jimenez (145) from Agency XX tells her story since she was born in San Luis de Potosi. She tells how she, as a child, was taken from San Luis to the Valle Hermoso, and from there to Reynosa. From Reynosa, she migrated to the U.S. years after being married, having children and separating from her husband. Another lady, Ms Jimenez (145:16) describes a similiar migration experience. She was born in San Luis Potosi and as a child left with her family to Valle Hermoso, in Tamaulipas, and from that rather small town to the border city of Reynosa. From Reynosa she migrated into the United States to the border city of Pharr, across the border from Reynosa. Ms. Ramirez crossed the border alone with her children, while her husband (from whom she was separated at the time), stayed behind. Ms. Jimenez had her mother living in Pharr for sometime before she decided to emigrate and because of this Ms. Jimenez had visited frequently the Lower Rio Grande Valley, always going back to Reynosa, until one day she decided to emigrate for good. During her frequent visits to the LRGV, she had the opportunity of looking for a place where she and her children would live. This is how Ms. Jimenez describes her experience: "Y pues conmigo tambin tenia sueos. Yo quera que mi hijo tambin participara en algn deporte. Y que hiciera lo que se pudiera. Ya no lo pudimos hacer aya porque nos tuvimos que venir para ac. Y un dia decid que iba venirme, pero iba venirme en el tiempo de vacaciones. Ese tiempo me iba decir a m si mis hijos iban entrar a la escuela o no. Entonces ya divorciada definitivamente en ese tiempo en el 90. una tarde cargue mis cosas verdad, ped una familia que tenia una troca grande. Y les dije que si se queran traer mis cosas porque me iba a venir a vivir en Pharr. Ya para ese tiempo yo ya haba venido a recorrer todo. Venia cada fin de semana. Pues antes del tiempo del embarazo, yo venia a visitar a mi mama en Amigos del Valle. Me bajaba del bos en la calle diez y caminando recorra todo eso hasta llegar. Y miraba y pensaba que hacer como venirme, ser bueno, estar aqu en Brownsville. Y bueno lo decid un dia. Dije me voy a ir, ya me alivie, ya mi bebe ya tiene casi ocho meses. Y ya habamos recorrido varios lugares y en ni un lugar nos haban aceptado porque pedan numero social y crditos. No tenamos crditos. Entonces le dije a mi mama vamos a compra aqu en la quinta. Es la nica opcin que tenemos y no nos piden crdito. Yo deje mi casita alla, la rente, me ayude con la renta y vend el material que tenia para construir otro cuarto porque ya ramos tres de familia. Y pues yo quera que cada uno tuviera su cuarto porque nosotros vivamos, en un cuarto dormamos todos. Y haba sido muy difcil, yo no quera que mis hijos pasaran lo mismo. Todo se hizo al nombre de mi mama. Compramos, y mucha gente nos deca, 'estas loca pues te van a quitar todo eso. No es tuyo y es de tu mama, o es mucho dinero.' Eran $450.00 por mes que pagaba aparte biles. Yo no tenia trabajo aqu, no tenia documentos, no sabia s mis hijos iban a ir a la 228

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APPENDIX G (Continued) escuela aqu o no. Pero nos vinimos una noche. Dos veces cruzamos para traer los muebles ms necesarios, los que no los deje, los regale. Y pues nos quedamos aqu para vivir." (145:10). An important aspect of the experience of promotoras' as immigrants has to do with the search for employement. On many occasions the promotora job was the first employment the women had in the United States. Other times, they had had previous jobs. In the latter cases, promotoras had worked as maids in an established famiily or cooks in a colonia restaurant or in a tortilla factory. Regardless of the type of employement, promotoras face common challenges that are related to their condition of either single mothers, not speaking English, or their condition of undocummented immigrants. Ms. Jimenez (145:18) gives the following account describing her experience looking for a job as a recent undocommented immigrant: "Entonces todas las maanas sala yo a recorrer lo que era aqu las calles y a buscar trabajo. Y a conocer gente. Y yo quera estudiar. Pues ya estoy aqu tengo que estudiar. Pues aqu no se me han dicho que hay una escuela no s dnde estar no la veo. Y estaba muy diferente. La rea de Las Milpas no es lo que es ahora. Yo no quera hablar con casi nada. Cada persona que yo miraba, yo deca pues no le voy entender. Y pues ya llegue a la tienda y mire un anuncio y mientras buscaba este, yo trabajaba en casa. Buscaba en el peridico con personas que conoca y que me recomendaban. Y nos bamos a limpiar casas por dia. Aparte all en la colonia donde vivimos se desocupaban las casas de las personas que ya no podan seguir pagando, y ellas dejaban todo. Y entonces yo me encargaba de limpiarlas. Y todo lo que dejaban poco o mucho que dejaban las familias, yo lo dejaba. 'Quiero que me limpien todo', me deca el dueo de all. 'Que quede limpio, piso lavado porque vamos a pintar y todo.' Y si las ventanas estn manchadas, 'bien limpiadito todo, que este bien bonito.' Y todo eso a la basura. Nombre cual basura, si esto va ser mo! Y me lo llevaba. Y ponamos venta de garage. Muchas cosas nos servan para nosotros la familia y muchas cosas para venderlas. Y trabaje aqu en la tienda RGV, don Rodolfo. Hacia tortillas de harina.Hacia todo lo que poda hacer. Y trabajaba aqu y trabajaba alla. Y procuraba que no nos faltara para los biles. Como quiera al estar ac yo siempre le abr las puertas a mi esposo, nunca lo sent que dejamos de ser esposos porque aunque por medio de un papel, legalmente nos separamos, ms que todo porque yo estaba buscando que mis hijos tuvieran una seguridad. Si nosotros ya no vamos a continuar como pareja, ya no nos entendimos, mis hijos tienen el derecho de tener la proteccin econmica de los dos y el cario." THEME CATEGORY: HOME MEMO: Women need husbands' authorization (0 Quotations) (Super, 04/25/03 10:59:51 AM) No codes No memos Type: Commentary 04/25/03 10:59:59 AM Some women mentioned that they need their husbands authorization to work. For instance, Ms.Prez said the following: 229

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APPENDIX G (Continued) "I have his permission, his authorization. And the best of all, the trust he has deposited on me. I have to go on, continue working." [2: 649-651] MEMO: Women feel pride of helping at home (1 Quotation) (Super, 07/27/03 06:40:08 PM) P14 192 -192 No codes No memos Type: Commentary 07/27/03 06:40:20 PM Promotoras reported that they feel pride of their work. This pride feels from being able to help the community overcome their problems, many times some of the same problems that they have had to overcome as colonia residents. Pride, however, also comes from knowing that they are contributing to the economy of the household, sometimes for the first time in their adult lives. Mrs. Rosaldo described that very clearly when she explained how her husbadn was uneasy with the fact that her job was better, more stable than his. Although his husband attitude was not something easy for her to deal with, she still felt proud of being able to help her husband. [SEE 89:41]. THEME CATEGORY: CULTURE MEMO: Confianza (1 Quotation) (Super, 04/24/02 10:28:44 AM) P 1 No codes No memos Type: Commentary The process of developing trust/confianza is one that requires a lot of follow-up on the part of the animadora. Although she mentions knowing some of the community residents before she started, she says that now "she can say she knows everyone." She is well-trusted by residents, so much so that if someone is not home, her family or friends will tell her where she can find that person. She said: Quiero decir que por las visitas uno va y platica con ellas, les explica que estamos aqu para ayudarles, que tenemos este programa, les explicamos en que consiste nuestro programa, y las invitamos, tratamos de envolverlas. Por medio de las visitas, de las invitaciones que les hacemos, entonces creo que ellas nos tienen confianza. Como somos personas de aqu mismo de la colonia, como en mi caso, aqu mismo vivo, yo conoca a ciertas personas aqu. Ahora que estoy aqu en este programa, pues con ms ganas, vamos y las visitamos. Y hoy puedo decir que conozco a todas las personas. Incluso me pueden a veces preguntar, la persona de aqu no esta, se fue para los trabajos, o como se llama la persona que vive a tu lado, o por la tercera calle, yo puedo decirle el nombre de esa persona, cuantos hijos tiene, porque hay mucha comunicacin. Como soy de aqu mismo las conozco. Y tambin vamos a otras colonias, como en la colonia El Capote ya nos conocen: "Ah vienen las de". Y muy bien que nos recibe. Nos dan muy bonita atencin cuando vamos. Y los nios tambin ya nos conocen: nos miran con cario: "Ah viene mi Miss, ah viene mi maestra". Y, 230

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APPENDIX G (Continued) pues para m, digo "Ay, su maestra?" Yo me quedo pensando, no tengo titulo. Pero para ellos yo soy su Miss, su maestra, porque viene haciendo una ternura, un cario sobre esos nios que a m me gusta mucho. Y me gusta tratar con la gente. Talvez le inspiro confianza, porque tienen esa confianza, nos pasan a sus hogares, nos ofrecen un refresco, a veces hasta de comer. Vivimos con la gente de esta comunidad. MEMO: Valuing Children (2 Quotations) (Admin, 06/25/02 04:50:57 PM) P10 21 -21 21 -21 Code(s): [Workers: Roles_Emotional Support] No memos Type: Commentary One of the roles that promotoras play in the communities where they work is that of emotional and social support. Promotoras provide emotional support to women and to children. Regarding children, one expression of that support is promotoras' involvement in caring for the children of the community, particularly when children have presented behavioral problems. An example of this is provided by animadoras, the community based organization that works in the Las Milpas area, Hidalgo County. Behind animadoras' concern for children's well-being is the notion of valuing children and recognizing their strengths in spite of environmental difficulties. For instance, a promotora from the agency XX told the interviewer about the occasion when she and her team of animadoras decided to invite the communities' children to sell soda and 'chetos con queso' together with the team of animadoras. The animadoras' justification for inviting the children to participate in the activity was that "...perhaps he needs someone to trust in him...this makes them feel important, they know that other people care for them, besides their parents." The same promotora added that the children and youth who need the most help are the ones who have behavioral problems. She describes an occasion when her group of animadoras talked with the children who were painting grafitti on the park's walls. They invited them to come to the community center every Thursday and get a soda in exchange of taking care of the park. The strategy worked. That animadora added that they preferred to follow the strategy of talking directly with the kids instead reporting them to their mothers; they preferred to take a direct approcah: "Someone suggested that we should talk with their mothers, that we should yell at them. I say that is not the way, that there are other better ways for the children not to become more rebelious. Their rebellion is a way to call our attention. And it did work. If we try something and it doesn't work, we need to look for another strategy. It is not easy." MEMO: The Value of Education (5 Quotations) (Admin, 12/04/01 12:33:00 AM) P 2 P44 P45 Code(s): [Workers: Value_Education] No memos Type: Commentary 12/04/01 12:33:09 AM 231

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APPENDIX G (Continued) Many of the promotoras, animadoras, and master volunteers we have interviewed have expressed in several different forms how important education is for them and their families. In a few cases, ladies have mentioned how the desire to educate her children have has been the reason that has lead the family to travel as migrant workers. The underlying assumption is that by workin in the fields children would value education, since they would see how hard it is to work in the fields. For example, a promotora from agency 1 described the experience of taking her daughters to the fields because her husband "wanted the children to learn how people in the field suffer so that they know about the value of going to school." This promotora describes her experience as follows: "Pero fuimos por una razn de que estaban las nias ms chicas y quera mi esposo que aprendieran como sufre la gente del campo para que ellas sepan el valor que tiene el estudiar. Dijo, vamos para que miren a los que no estudian. Y eso es cierto. Y yo creo que si funciona porque cuando estbamos trabajando all, me acuerdo que las nias se sentaban a llorar y yo lloraba junto con ellas porque yo no sabia hacer ese trabajo y nos sentbamos a llorar y los pepinos all creciendo. Y ellas lloraban y nos decan, Mami porque nos trajiste? Y les deca, Es que tu pap dice para que sepan lo que pasa cuando no estudian. Y ellas decan, No pero si nosotros si vamos a estudiar. Pero bueno, es una leccin y si funciono porque a horita mi hija la mayor a horita va a sacar su doctorado en educacin especial." Ms. Ramirez also reflrects on the value of education and how she and her husband instilled that value on their children by making them understand that if they did not educate themselves they would end up as agricultural workers. In her account, Ms. Ramirez tells how they did it: "Since the beginning, our goal was education. I did not work, I was totally dedicated to raising my family. We worked in the fields during our children's school vacations. We were migrants, we used to travel to New Mexico, we did that for two years. By doing that, by taking our children to the fields, they valued studying. They were able to understand the difference between studyig and working in the fields." MEMO: Social Capital (3 Quotations) (Super, 05/19/03 11:41:05 AM) P 3 P64 Code(s): [Program: Activities_Transportation] [Workers: Impact_Community_Connect Neighbrs.] [Workers: Impact_Community_Link Resds.-Services] Memo(s): [Connecting Neighbors] Type: Commentary 05/19/03 11:41:14 AM The concept of social capital should be a central construct of this dissertation. Social capital is found in two manifestations: a) as CHWs connect residents to residents and b) as CHWs connect residents to services. In both manifestations, residents are connected to social networks out of which they can get a resource. Social capital precisely refers to obtaining resources out of social relations; it is a functional and instrumental view of social relations and social networks. 232

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APPENDIX G (Continued) An example of building social capital is when Promotoras from agency XX provide transportation to neighbors. They carry residents from the colonias where they work to doctors appointments, to the store, etc. By doing that, they are making it possible for residents to be linked to outside of the colonia resources. Thus, this is an example of an outcome in terms of facilitating people's access to resources. It could be that the concept of social capital should be a central and structuring concept of this dissertation, particularly in the community impact section. MEMO: Effects of promotoras being from the community (3 Quotations) (Admin, 11/26/01 10:31:02 AM) P43 No codes Memo(s): [Living in Community Allows Confianza] Type: Commentary Effects of Promotoras Being from the Community. [CONFIANZA AS A VALUE OF THE COMMUNITY] One of the assumptions of promotoras as community health workers, in particular in colonias in the LRGV, is that by living in the community, by being members of the same community as the residents with whom they work, they are capable of establishing a connection that could not be established otherwise. This point is illustrated by one promotoras (Agency CHUD), who, while commenting about how people react to their home visits, said the following: "Ya era casi toda la gente de la colonia nos conocia. Eramos mas poquitos. Creo que cuando pusieron el trabajo de promotoras pusieron buena seleccion al poner promotoras de aqui mismo porque hemos visto que vienen otras promotoras, como las de Planned Parenthood, las de Mano a Mano, (ellas) tambien batallan; no les abren las puertas." This point is essential to understand the efficacy of the work promotoras do. Furthermore, it also helps to understand how agencies vary from each other in terms of the type of promotion work they do, as well as in terms of how the community reacts to them. for instance, in our study we have included agencies whose promotoras do not necessarily work in the colonias they live, and other agencies whose promotoras do live in the colonias where they work. As a hypothesis, which needs to be verified by data, the type of interaction that takes place in both situations is different. I could not suggest if one type of interaction is better than the other, but there are elements that make them different. [I NEED TO ILLUSTRATE THIS DIFFERENCE]. However, and this seems to be important, belonging to the specific community visited, is not critical in determing the quality of the interaction. Rather, based on observing promotoras work, just the fact that promotoras share culture and history with residents, create a bond that facilitate interaction. In other words, it is better to have a promotora, who is from the same culture and social class, even thou she does not reside in the colonia that is being visited, than not having a promotora. 233

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APPENDIX H: QUOTATIONS ASSOCIATED WITH MEMOS 26 Migration History [1:69][127] Yo nac en Dr.Arroyo en el 60..--------------------Yo nac en Dr. Arroyo en el 60,luego a la edad de 14 aos mevine para Reynosa. En Reynosame case y luego despus porvoluntad de Dios yo quedeviuda, estuve sola dos aos. Me volv a casar, mi esposo erade Monterrey pero l mas viviaqu en Estados Unidos. Entonces cuando me case con lme llevo a Monterrey yestuvimos viviendo como porcuatro meses; el ah tiene sucasa, sus hijos ah. Me fui paraWashington (estado), allnacieron mis hijos. Estuve ahdesde el primero del 91 hastaoctubre del 94. En un pueblitoque se llama Quincy. Allnacieron mis hijos, luego nosregresamos a Monterrey yestuve ah desde el 96 hasta el97, fines del 97, y fue cuandode ah me vine para ac. Entonces ahorita tengo comotres, cuatro aos de vivir aqu, yde trabajar aqu en ARISEtengo un ano. [3:5][9] soy nacida en ReynosaTamaulip..-------------------soy nacida en ReynosaTamaulipas. All viven mispadres. Horita no tengo familiares viviendo aqu. Nomas mis hijos, mi esposo, y yo. Por parte de mi esposo, toda lafamilia de el esta aqu. Para mes bien duro por que yo nopuedo pasar para all. Tengocasi lo que tengo aqu de no vera mis papas y mi familia. Y param es bien duro. Este, comoestoy arreglando documentos,por mi esposo verdad, me losesta pidiendo, este, es muydifcil a m despegarme de mifamilia para venirme para ac.Por un mejor futuro para, yosal embarazada, ya tenia dosmeses de embarazo de la msgrande cuando me vine. Y fuemuy duro venirme y despegarmede mi familia. Y pues para un futuro mejor para mi hija. Miesposo fue, el tambin vino aqua los estados unidos junto conmigo sin documentos, este,pero sus papas vivan aqu. Ynos vinimos a vivir con ellos. lempez a trabajar en laagricultura. En la labor parasostenernos, verdad. As sindocumentos. En la agriculturaempez a mover papeles, pero elnada mas arreglo por falta dedinero. No haba comoarreglarme a m en ese tiempodinero, verdad. Y horita tengodesde el '97 que met mispapeles. Y horita en esta fechatengo permiso de trabajo desde el '98. Y tengo mipermiso de trabajo y empec atrabajar. Me invitaron el programa de Arise a trabajar conellos. Porque me vieron enempeo, que empec a estar como voluntaria en Arise. [4:10][4] Y un dia le dije a mimama ant..--------------------engaamos a mi mama en esamanera y le dijimos que bamosa ir con mi abuelita. Y cuandoestbamos aya mi abuelita nosdijo como ir, dijo mira los voy allevar all, se toma la lancha, seviaja todo el dia, se llega a tallugar, all ay familiares que loconocen. Y les van a decircomo. Y as fue. Llegamos conocimos a mi pap, con unagran alegra verle fsicamente. Yle deca me parezco o no meparezco a mi pap, es as,porque me gustan las plantas,es porque l es campesino ysiembra la tierra y todo eso. Yempec hallar cosas similaresverdad. Y por eso a m tambinme gusta estudiar, porque mipap aunque no tuveeducacin, pero el se educosolo. l aprendi y all casi llego hacer doctor. Era el querecetaba y cuanta cosa. Ycuraba y cuanto. El lea libros de medicina y todo. Leia laBiblia. El solo se instrua. Y fueuna alegra saber y como queestabilizo un poco ms mi vida. No me siento volando ac en elaire, no soy nadie realmente,no, tengo pap tambin yestoy orgullosa de mi mama que nos he sacado adelante. Ytodo eso. A partir de all,bamos cada ao, cada dosaos a verlo y visitarlo. Y ya alterminar la secundaria, l ultimoao de secundaria que yoregrese a terminar y que puesvoy a trabajar y voy a estudiar. Ya me gradu y ala mejor mevoy a Tampico para estudiarpara eso. Porque mi pap nosofreca eso. Vente para ac,tienen algunas [...] que sonmaestras y en Tampico tienenfamiliares. El tenia una moto,voy te dejo en la moto en fin de semana el domingo y en fin desemana voy y te recojo para tevengas para ac para el rancho. Entonces pues no fue as. Regrese, me fui a estudiar eltercer ao de secundaria y memet a trabajar en una fabrica. Como acababa de ir recin de aqu para aya llevaba una [...]as como que estabaaprendiendo ingles y como que sabia mucho ingles. Pues lleguea la entrevista y les dije que yosabia ingles y que haba estadoen Estados Unidos. Y que teniaun poquito de abilidad en eso ypues que quera trab [11:1][655] Bueno lo quepuedo agregar es ..--------------------Bueno lo que puedo agregar esque batalle bastante para estaraqu. Antes de yo estar aqu hebatallado bastante como paravenirme para ac. Como mevine. Por l ri. Cruce dosveces l ri. La primera vesfueron, hace 21 aos. Cuandotuve mis primeros hijos. Antesde tenerlos me fui paraColorado. Y all tuve los cuatrograndes. Pero al cruzarme l ricon un coyote. A dejarmeabandonada el coyote all enmedio del desierto. O sea sufrbastante para yo estar aqu. Ytener lo que ahora tengo.Despus la segunda ves mevine con mis cuatro nios. Y yono tenia quien me los pasara,entonces yo arriesgue y me lostraje a ellos tambin por l ri. Nos venimos por l ri los seis. Mi esposo yo y los nios. Y fuecuando ya llegue aqu. Y comopasaste los nios por l ri siellos son ciudadanos? Pues yono tenia quien me los traer yno los poda dejar aya tampoco y quien me los traa. Yo tenia que trarmelos. Puesestaba bien.. Sufre uno bastante pero gracias a Dios nohe ayudado salir adelante a m ya mis hijos.I1..Cuanto tiempo paso paraque usted regularizara lospapeles.R1..Mis papeles apenas tienencomo tres aos que losarreglamos.I1..Los dos, los de su maridotambin?R1..Y eso paso porquetenamos tanto tiempo de ir sinver a, mi mama venia, contarjetas se vino. Pero la mamadel no. Y l quera ir, un 10 demayo fue l para aya y lopescaron al cruzar para atrs. Entonces dijeron que lo iban aventar para atrs. Y l dijo, nosi toda mi familia es de aqu,no mas mi esposa y yo notenemos papeles. Entonces a elle dieron la chanza de quepoda arreglar si conseguaabogados. Que haba abogadosque no cobraban. Y que podaarreglar los papeles por que yatenamos tanto tiempo aqu, yya tenamos todos los niosaqu. Pero conseguimos unabogado que no, que el que no cobraba no nos pudieronayudar. Entonces conseguimosun abogado que pagamos y ese si nos ayudo.I1..Y [...]proceso un par deaos?R1.. Pues no a mi esposo ledieron el permiso luego luego,casi. Ya el otro ao arreglamosjuntos. Los pasaportes los dos. 26 Memos are identified by the booknote-style symbol. Quotations are identified by an internal nomenclature, thus real names are not identified. 234

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APPENDIX H (Continued) What Makes a Promotora? [81:17][3] A: Pues yo piensoque la actit..--------------------A:Pues yo pienso que laactitud que uno debe de tenercomo promotora ya uno la llevaen la sangre. O sea de supensamiento de uno, ya sabeuno como se debe decomportar con las personaspero el entrenamiento tambinte sirve en mas a fondo decmo debes de tratar a laspersonas. O sea, all en losentrenamientos te explicancomo debe uno de llegar a lascolonias, pero yo pienso que yaeso tu ya lo sabes de adentro.O sea, solamente debera de seruna persona que de plano noentiende como para que tevayas y te ras con una seora ocomo lo estaba explicando unacompaera en el entrenamientoque vayas y luego, luego lesdigas, oiga a usted le gustanlos tacos? A mi tambin megustan. O sea, no vas a llegar as, pero yo pienso que eso yaes de ti; de tu forma de ser. Yaes como tu sabes como llegar alas personas. Yo pienso que elentrenamiento si te sirve decmo llegar y todo eso cuandono tienes experiencia, pero yopienso que eso ya lo tienes tuadentro de ti. No vas a llegarcon mucha confianza con unapersona que no conoces y as. Women's Identity is shaped byhistory [3:5][9] soy nacida en ReynosaTamaulip..-------------------soy nacida en ReynosaTamaulipas. All viven mispadres. Horita no tengo familiares viviendo aqu. Nomas mis hijos, mi esposo, y yo. Por parte de mi esposo, toda lafamilia de el esta aqu. Para mes bien duro por que yo nopuedo pasar para all. Tengocasi lo que tengo aqu de no vera mis papas y mi familia. Y param es bien duro. Este, comoestoy arreglando documentos,por mi esposo verdad, me losesta pidiendo, este, es muydifcil a m despegarme de mifamilia para venirme para ac.Por un mejor futuro para, yosal embarazada, ya tenia dosmeses de embarazo de la msgrande cuando me vine. Y fuemuy duro venirme y despegarmede mi familia. Y pues para un futuro mejor para mi hija. Miesposo fue, el tambin vino aqua los estados unidos junto conmigo sin documentos, este,pero sus papas vivan aqu. Ynos vinimos a vivir con ellos. lempez a trabajar en laagricultura. En la labor parasostenernos, verdad. As sindocumentos. En la agriculturaempez a mover papeles, pero elnada mas arreglo por falta dedinero. No haba comoarreglarme a m en ese tiempodinero, verdad. Y horita tengodesde el '97 que met mispapeles. Y horita en esta fechatengo permiso de trabajo desde el '98. Y tengo mipermiso de trabajo y empec atrabajar. Me invitaron el programa de Arise a trabajar conellos. Porque me vieron enempeo, que empec a estar como voluntaria en Arise. 235

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APPENDIX H (Continued) [84:37][6] I think, the one thing I can s.. -------------------I think, the one thing I can surely say is that promotoras have lived being uninsured, needing health care services, were migrants, have been sick, have been turned down for health care and other services, so they've lived that. They know first hand what it is like. Because of that experience, they have the ability to empathize, to communicate, and to have the compassion to go out in the colonias and try to inform these colonia residents of what those needs are, or what those issues may be, and where they can have access to health care etc, etc. I mean I can tell you that they have the communication ability, they can communicate, they have compassion, they have empathy, they are resourceful, they put in more than forty hours a week, they are underpaid but they do the job anyway. And they are Superwomen, because they do all these, and what do they ask in return is very little, nothing. [84:38][6] Do you think that that persona.. -------------------Do you think that that personal commitment to the well being of the community is really a key aspect to this? R1: I think it is a key and it is essential. Because if they don't have that usually we wont see promotoras last because they have other plans, other ideas. They are so unique that I could not do promotora work. Why? Because I think that my commitment is better utilized in administrating, developing programs so that we can have those kind of promotora projects. These women have the ability to access these homes where I would not be allowed in certain homes because I am a male and sometimes the homes don't allow strangers to go in their homes. But these women open so many doors. [84:40][6] What I have seen with mine but.. -------------------What I have seen with mine but I don't know if this is appropriate, but in their homes, they dictate what happens. Mandan. En sus hogares ellas mandan. The husband is there, yes, and he will have equality. But they put things into action. And I think that is a quality that they bring to the job. They have that assertiveness. They are aggressive when they need to be. But one of the qualities that I have seen in all the women is that they tell their husband, "This is the better way to do it." And that is the way that it is done. It is not the husband machismo, no, they have a good head on their shoulders and they do that even in their personal living. Things That Make a Promotora 236

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APPENDIX H (Continued) [45:3][3] Pero fuimos por unarazn de q..--------------------ero fuimos por una razn deque estaban las nias mschicas y quera mi esposo queaprendieran como sufre la gentedel campo para que ellas sepanel valor que tiene el estudiar.Dijo, vamos para que miren alos que no estudian. Y eso escierto. Y yo creo que sifunciona porque cuandoestbamos trabajando all, meacuerdo que las nias se sentaban a llorar y yo llorabajunto con ellas porque yo nosabia hacer ese trabajo y nos sentbamos a llorar y lospepinos all creciendo. Y ellaslloraban y nos decan, Mami porque nos trajiste. Y les deca,es que tu papa dice para quesepan lo que pasa cuando no estudian. Y ellas decan, no perosi nosotros si vamos a estudiar.Pero bueno, es una leccin y sifunciono porque a horita mi hijala mayor a horita va a sacar sudoctorado en educacinespecial. [45:4][3] Y ellos se acuerdan deves en ..-------------------ellos se acuerdan de ves encuando de la experiencia? A:Todava se acuerdan porque lachiquita que esta casada quetiene baby, tiene 18 anos peroesta casada y tiene baby. Y leestaba diciendo yo, tu le vas adar la leccin que te dio tupapa a la nia. Y dice,probablemente. Depende comose mire la situacin. Si se acuerda porque ella estabachiquita porque tenia que ir acargarnos los botes para que nosotros echramos lospepinos. Y era trabajo y si secansaba porque si estaballoviendo andas entre el lodo ytodo. Y yo pienso que a veces st afecta eso. sea, te ayuda a reflexionar que es bienimportante a estudiar. Siporque yo tambin las lleve alazadn. Andbamos desaijandola calabaza, me parece que erala pumpkin y el betabeltambin. Y como el betabelestaba sembrado casi la arenaesta bien arenosa, se pone biencaliente. Ellas lloraban que lesarda los pies y las manos delazadn. Las ms grandecitas. Lamas grandecita, Claudia tendra12 y Elizabeth ya tenia 14,andaba en 15. Era la que msnos ayudaba. Pero s. [44:36][4] Que se a significadopara mi? ..--------------------ue se a significado para mi?Pues yo creo lo del principio quese a significado para mi, puesbastante. Por decir, pues eaprendido bastante de esto pormedio de los entrenamientos. Yque mas se a significado parami? Es que e aprendido y lo queeh aprendido, yo lo e enseadoy algo muy beneficioso. [44:37][4] Por decir cuando ami me han d..--------------------or decir cuando a mi me handado entrenamiento de salud ode cualquier entrenamiento quese trate y que es para lacomunidad y para mi, yo lo doymas adelante; la informacinComo eso de salud, que casi lamayora son entrenamientos desalud, pues nosotros loaprendemos y a hora asepoquito nos dieronentrenamiento aqu del seno dela mujer y ya cuando vamoshacer las home visits, ya lesplaticamos mas sobre esto de la mujer. Lo en donde prefierehacer el chequeo y pues haymuchas cosas que hemos aprendido y lo enseamos. The Value of Education 237

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APPENDIX H (Continued) [44:27][4] Y esa idea dellevarlos al cor..-------------------esa idea de llevarlos al corte depelo, como surge esa idea? A:Esa idea, hubo un tiempo, queya tiene para atrs, que aqumismo se empez en el CentroCultural. No recuerdo de dondevino esta idea, simplementebamos a cortar el pelo porquetambin miramos que la gente siquera es de corte de pelo. Perode un principio aqu se podancortar el pelo y venia bastantegente porque aqu estaba todo.Y luego hubo un tiempo que yano pudimos porque el condadodijo que no se permita eso aqu de corte de pelo. Entoncesahora lo que hicimos despus deall que nos dijeron, los llevamos nosotros directo conuna persona asta el saln deellos. [44:28][4] Y eso por ejemplo dedecidir a..-------------------eso por ejemplo de decidir allevar a los nios al saln es algocomo grupo deciden hacer? A:Es idea de nosotros. Y ya lespreguntamos a las mamas si ledaban permiso a estos nios dellevarlos al corte de peloporque aqu cuando es tiempode que salen de vacaciones hayun programa que le digo que lesdan el almuerzo y la comida. ElISD viene aqu y les da elalmuerzo y la comida y les hacenalgo recreativo para los nios.La seora Moreno tambin seinvolucro en eso el ano pasado.Que traer a una persona a ensear a los nios en tiempode vacaciones a colorear, aescribir y nosotros tambin les ayudbamos a servir porque nohaba quien ayudar a servir a losnios. Entonces la supervisoranos pona un schedule cuandopodamos ayudar y ayudbamosy eso fue algo que el anopasado se hizo y este anoprximo se va a volver hacer. Nose si nos van a dar permiso deque vuelvamos ayudar a DonaMoreno a organizar este. Aservir la comida o a limpiar ytodo eso. [44:29][4] Entonces ustedestienen muchas..--------------------ntonces ustedes tienen muchascosas que ustedes hacen quesurgen ustedes mismas no? A:Si, noms pedimos permiso. Aveces nos dan permiso. Pero si.Como horita hay otro programanuevo que no le hemos dicho ala supervisora pero yo piensoque todo cuando es para elbien de la comunidad se vaaprobar. Ase poquito, la semanapasada vinieron unas personasde la Clnica 22 con otraspromotoras de Mano A Mano.Quieren que les ayudemos abuscar personas que estnembarazadas, mujeresembarazadas de tres mesespara...creo que hay una beca dedinero para esas personas quequieren que las personas desdelos tres meses de embarazohasta los dos anos de edad lesvan a estar dando (inaudible)para ver como se desarrolloeste nio desde los tres meseshasta los dos anos de edad. Lesvan a buscar transporte, les vana dar, si la persona necesitacomida, las van a llevar a que leestn chequando el bebe y levan a buscar una clase deseguro medico. Muchobeneficio para esas personasque hay aqu que no tienennmeros sociales. Que notienen papeles. Y all es lo queme gusto, que aqu hay muchagente que no tienen papeles. Yhay veces dicen que se les hacemuy difcil que por el transportey pues dicen que van a dartodas estas clases de servicios.Y nos dieron una encuesta delas preguntas que les van hacera las personas pero necesitamospedir permiso a la supervisora.Pero yo pienso que si nos lo vaa dar porque es algo para lacomunidad. Es algo que esbueno. [44:20][4] Y ustedes participanen eso, c..-------------------ustedes participan en eso,clase de aerobics? A:Puesnosotros no hemos podidoporque nosotros ya tenemos elschedule de nosotros, nohemos podido. Como lo hanhecho de 11:00 a 12:00 demedio da, nosotros todavaestamos con lo del trabajo. Nopodemos. Nada mas lo quenosotros hacemos es involucrara las personas que vallan. Pero,me gustara tambin estar eneso, pero no podemos por eltrabajo de nosotros nopodemos. No podemos hacereso o a no ser de que ledigamos a la supervisora, nosdas chanca de ir un ratito haceraerobics, pero eso esta muybueno para uno. La salud ytodo eso. Decision-Making 238

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APPENDIX H (Continued) [1:33][37] Laura Losoya, es deaqu de la..--------------------Laura Losoya, es de aqu de lacomunidad, vecina, y DanielNegrete, hijo de LupitaNegrete, estuvo viniendo aayudarnos. l si participoanteriormente en Sor Juana,era participante, y ahora vino aayudarnos como maestro de losnios. Lupita Negrete es unamentora, ahorita tiene como 10aos trabajando en ARISE, yella es mama de Daniel Negrete. Cuando Daniel era chicoparticipaba en ballet comoalumno. Ahora el ya estagrande, esta estudiando, yacepto darnos su tiempovoluntario a ayudarnos con losnios y l les ense el JarabeTapatillo. Entonces los niosya se lo aprendieron y paranosotros es una satisfaccin ver que los nios pueden hacerlo,y bailan. Esperamos estar maspreparados para luego salir adonde se nos solicita. [1:37][33] Y si, contamos con 5o 7 nios..-------------------Y si, contamos con 5 o 7 niosque estn participando. Ahorita en el verano losuspendimos porque como aques un rea muy chica,solamente son tres calles y aques donde estamos masenfocados con esta comunidady con El Capote. En El Capotelos nios que encontramos estn muy chiquitos y noparticiparon. Pero aqu mismoen esta colonia si, encontramosnios que si quieren participar. [10:27][21] Nosotrosempezamos a vender ch..--------------------Nosotros empezamos a venderchetos con queso y soda,verdad, entonces lo que haciaes que un miembro del staff lohacia, se arrimaba a los niospor si ellos queran hacerlo, sabes que, Sabes que, platique con Eva,ellos quieren vender, vamos adarles la oportunidad porque alo mejor l necesita que alguienconfe en l. Tu crees? Si,vamos a tratar, vamos a ver quepasa. No pues, el nio empez avender los chetos all, y sodas,y se senta l como si era eldueo de la tienda, "Ya parezcoRafa, Miss," el de la tienda deenseguida, del parquecito. Esoa ellos los hacen sentirimportantes, ya saben que hayalguien a quienes les importa, aparte de su mama y de su pap. Yo creo que las personitas,nios o jovencitos, que msnecesitan ayuda son esos niosque andan haciendo destrozoso cositas as. [32:5][45] Alicia: Si muchoscontinan. D..--------------------Alicia: Si muchos continan. Delas mamas continan con yasea Ingles o el GED por que eslo que uno les hace muchonfasis. La necesidad que ellosestn tambin preparandopara cuando sus nios crezcanque les puedan ayudar en laescuela. Por que hay veces quedice uno, pues noms llegueasta aqu, y ya no puedo ms. Entonces, nosotros les decimos.Les tratamos de hacer nfasisen eso, de que es muy buenopara ellos, en si, en su persona,que se sigan preparando yaparte tambin de que van apoder ayudar a sus hijos yacuando estn en niveles masavanzados de la escuela. Ypues, que ellas tengan unamanera tambin de... masadelante si quieren trabajar oalgo que tengan ellos losmedios por que a veces es muydifcil, y ms aqu, hay muchacompetencia. Si la persona noesta preparada, es problema.Entonces si, tratamos de que...darles a ellas los medios paraque vayan ellas saliendotambin adelante por el bien deellas y por la familia. Capacity Building 239

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APPENDIX H (Continued) [44:37][4] Por decir cuando ami me han d..--------------------or decir cuando a mi me handado entrenamiento de salud ode cualquier entrenamiento quese trate y que es para lacomunidad y para mi, yo lo doymas adelante; la informacinComo eso de salud, que casi lamayora son entrenamientos desalud, pues nosotros loaprendemos y a hora asepoquito nos dieronentrenamiento aqu del seno dela mujer y ya cuando vamoshacer las home visits, ya lesplaticamos mas sobre esto de la mujer. Lo en donde prefierehacer el chequeo y pues haymuchas cosas que hemos aprendido y lo enseamos. [44:40][4] No se elmedicamento. Eso fue,..--------------------o se el medicamento. Eso fue, ahorita que esta usted diciendode eso, la ultima ves quetuvimos ceremonia de MHMR,bueno ese fue uno de los temasque yo dije...tuvimos el grupopara platicar lo que habamosaprendido y lo que queramos aprender. Y eso fue unas de lascosas que yo los dije en lapresentacin a Lizette. Le dije, sabes que es lo que me gustaraque dieran mas delante depresentaciones? Que me ensearan las diferentespastillas o medicamentos que seles dan a las personas. Y dijo, nos han dado muchoentrenamientos, boletines. Sehabla de enfermedades, pero nose nos a enseado losmedicamentos que toma lapersona. Es una cosa que megustara saber, porque yo voya la casa y hablo con lapersonas que aqu esta unapersona que viene de la agencia, pero digo, si lapersona ya esta con la agencia,nos va ensear las pastillas que esta tomando su hijo, no vamosa saber que son esas pastillasporque nunca nos dieron unapresentacin de las pastillasque se les esta dando a laspersonas para cada persona. Y le gusta la idea esa de MHMR. Ydice, si tienes razn. Estamoshablando de puras enfermedades, pero no estamoshablando de los medicamentosque se les da a la persona. Fuelo que le gusto. Dijo que eraalgo bueno que se a dicho enese entrenamiento. [44:41][4] Saber quemedicamento le estn..--------------------aber que medicamento le estndando a los nios o la persona,que medicamento estatomando. Es algo que yo quierosaber. Si nos hacen algunapregunta sabrselas responderen ese momento. Promotoras Like to Teach theCommunity 240

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APPENDIX H (Continued) [44:27][4] Y esa idea dellevarlos al cor..-------------------esa idea de llevarlos al corte depelo, como surge esa idea? A:Esa idea, hubo un tiempo, queya tiene para atrs, que aqumismo se empez en el CentroCultural. No recuerdo de dondevino esta idea, simplementebamos a cortar el pelo porquetambin miramos que la gente siquera es de corte de pelo. Perode un principio aqu se podancortar el pelo y venia bastantegente porque aqu estaba todo.Y luego hubo un tiempo que yano pudimos porque el condadodijo que no se permita eso aqu de corte de pelo. Entoncesahora lo que hicimos despus deall que nos dijeron, los llevamos nosotros directo conuna persona asta el saln deellos. [44:28][4] Y eso por ejemplo dedecidir a..-------------------eso por ejemplo de decidir allevar a los nios al saln es algocomo grupo deciden hacer? A:Es idea de nosotros. Y ya lespreguntamos a las mamas si ledaban permiso a estos nios dellevarlos al corte de peloporque aqu cuando es tiempode que salen de vacaciones hayun programa que le digo que lesdan el almuerzo y la comida. ElISD viene aqu y les da elalmuerzo y la comida y les hacenalgo recreativo para los nios.La seora Moreno tambin seinvolucro en eso el ano pasado.Que traer a una persona a ensear a los nios en tiempode vacaciones a colorear, aescribir y nosotros tambin les ayudbamos a servir porque nohaba quien ayudar a servir a losnios. Entonces la supervisoranos pona un schedule cuandopodamos ayudar y ayudbamosy eso fue algo que el anopasado se hizo y este anoprximo se va a volver hacer. Nose si nos van a dar permiso deque vuelvamos ayudar a DonaMoreno a organizar este. Aservir la comida o a limpiar ytodo eso. [44:29][4] Entonces ustedestienen muchas..--------------------ntonces ustedes tienen muchascosas que ustedes hacen quesurgen ustedes mismas no? A:Si, noms pedimos permiso. Aveces nos dan permiso. Pero si.Como horita hay otro programanuevo que no le hemos dicho ala supervisora pero yo piensoque todo cuando es para elbien de la comunidad se vaaprobar. Ase poquito, la semanapasada vinieron unas personasde la Clnica 22 con otraspromotoras de Mano A Mano.Quieren que les ayudemos abuscar personas que estnembarazadas, mujeresembarazadas de tres mesespara...creo que hay una beca dedinero para esas personas quequieren que las personas desdelos tres meses de embarazohasta los dos anos de edad lesvan a estar dando (inaudible)para ver como se desarrolloeste nio desde los tres meseshasta los dos anos de edad. Lesvan a buscar transporte, les vana dar, si la persona necesitacomida, las van a llevar a que leestn chequando el bebe y levan a buscar una clase deseguro medico. Muchobeneficio para esas personasque hay aqu que no tienennmeros sociales. Que notienen papeles. Y all es lo queme gusto, que aqu hay muchagente que no tienen papeles. Yhay veces dicen que se les hacemuy difcil que por el transportey pues dicen que van a dartodas estas clases de servicios.Y nos dieron una encuesta delas preguntas que les van hacera las personas pero necesitamospedir permiso a la supervisora.Pero yo pienso que si nos lo vaa dar porque es algo para lacomunidad. Es algo que esbueno. [44:20][4] Y ustedes participanen eso, c..-------------------ustedes participan en eso,clase de aerobics? A:Puesnosotros no hemos podidoporque nosotros ya tenemos elschedule de nosotros, nohemos podido. Como lo hanhecho de 11:00 a 12:00 demedio da, nosotros todavaestamos con lo del trabajo. Nopodemos. Nada mas lo quenosotros hacemos es involucrara las personas que vallan. Pero,me gustara tambin estar eneso, pero no podemos por eltrabajo de nosotros nopodemos. No podemos hacereso o a no ser de que ledigamos a la supervisora, nosdas chanca de ir un ratito haceraerobics, pero eso esta muybueno para uno. La salud ytodo eso. Decision-Making 241

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APPENDIX H (Continued) [43:12][4] Entonces, muchas yalas conoce..--------------------ntonces, muchas ya lasconocen? A:Si. Deporsi, yaeran casi toda la gente de lacolonia nos conoca. ramos mas poquitos. Creo que cuandopusieron el trabajo depromotoras pusieron bienbuena seleccin al ponerpromotoras de aqu mismoporque hemos visto que vienenotras promotoras como las dePlanned Parenthood, las deMano a Mano, tambin batallan.No les abren las puertas. [43:13][4] Porque ellas no sonde aqu de..--------------------orque ellas no son de aqu de lacomunidad. Y en cambiotenemos que ir con ellas y si lesabren y las atienden porque alfinal son los mismos programaspero la gente no entiende quese trata de lo mismo. Son lasmismas organizaciones. Q:Yporque han tenido que ir conellas? A:Porque no quierenabrir las puertas cuando llevanalguna informacin. Por ejemplo, del PlannedParenthood, que traen muybuenos servicios, no les quierenabrir las puertas a veces. Q:Yellas les piden a ustedes que lasacompaen? A:Pues nos hanpedido que las acompaemos oque les llamemos por telfonopara decirles, va ir esta personade la clnica y les lleva buenainformacin o les llevan ellos tambin ante-conseptivos. Lesllamamos y es de las maneras enque a veces si las dejan entrar.Les abren la puerta. [43:29][4] Cuando tocamos lapuerta? Hori..--------------------uando tocamos la puerta?Horita ya la gente tieneconfianza. Nos abre luego luegola puerta y nos preguntan,hora que nos traen? Hora queservicios hay? Como era antes,hora ya es muy diferente. Ahorita nos abren la puerta luegoluego. Nos ofrecen caf, nosofrecen agua, pasar. Nos dan elpase. Es muy diferente a antes.Q:Entonces, muchas ya lasconocen? A:Si. Deporsi, yaeran casi toda la gente de lacolonia nos conoca. ramos mas poquitos. Creo que cuandopusieron el trabajo depromotoras pusieron bienbuena seleccin al ponerpromotoras de aqu mismoporque hemos visto que vienenotras promotoras como las dePlanned Parenthood, las deMano a Mano, tambin batallan.No les abren las puertas. Effects of promotoras beingfrom the community 242

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APPENDIX H (Continued) [10:24][140] Ese es un motivogrande para m..--------------------Ese es un motivo grande param. Y tambin que mis hijosmiren, como este muchacho,que su mama no quiere estarnada mas all. Que sepan que lamujer no mas se hizo para estaren la cocina y atendiendo a la familia. Claro que si la voy aatender, claro que la atiendo,porque todas las maanas me levanto bien temprano a hacersus almuerzos, cumplo con lastareas de mi casa. Y trato quecuando hay oportunidad,juntarnos y preguntarnos, lespregunto como estn en la escuela, que piensan hacer estasemana, que planes tienen paraotro da, cositas as que no quite ese lazo que tenemosporque as pues va a ser luz dela calle oscuridad de la casa. [10:37][3] Como mujer deMxico siempre t..--------------------Como mujer de Mxico siempretenemos esa tendencia, de pedir permiso al marido. Es unade las cosas que no podemoscomo quitar mucho, verdad. Ahora ya estoy mas cambiada,ya pienso diferente, perosiempre con el permiso delmarido, aunque sea cosasbuenas. Porque las cosas malasno las preguntamos. [14:22][136] R1.. Casi siemprees mas con l..--------------------R1.. Casi siempre es mas conlas mamas, casi siempre elcontacto es mas con la mama. Y pues no s, yo a veces comocuando vamos a entregar loslibros de los nios, he tratado de, que yo, no s si est bien,pero yo le digo no esta laseora, no no esta, yo bueno, usted no puede recibir el librodel nio. No, es que necesitoque este ella. O sea ellos, la mama, la mama, casi ellos sehacen a un lado. Y yo miretraigo el libro del nio, se lo puedo dejar o como ve? Nomejor que este ella. O cuandoandamos haciendo aplicacionestambin, mire seor, andamosregistrando nios para elprograma infantil pues no estala seora. Ellos tambin pap,ellos tambin pueden hacerlo,por eso yo me atrevo me heatrevido, mire seor es queandamos registrando nios, nole gustara registrarlo. Puesmire, la mera verdad, necesitaque esta mi seora. Siempre laseora. [14:23][140] R1.. Pues, es algoque pues la..--------------------R1.. Pues, es algo que pues lamama es muy importante paralos hijos. Es que uno es la queesta con los hijos. O a vecesque no estn trabajando, perosiempre es uno. Siempre es lamadre, la madre, la madre, la queesta al tanto de los nios, quehay una junta en la escuela,siempre ellos llegan mami hayjunta en la escuela. Nunca, esraro el nio que llega con supap. Papi hay junta en laescuela, papi me pidieron estoen la escuela. Siempre es lamama. No s, y seria bonitotambin que al pap lo tomaranen cuenta como toman encuenta a uno de madre. Perono se es algo natural, pornaturaleza pienso yo. [14:24][148] Y siempre pasaas. Y cuando a..--------------------Y siempre pasa as. Y cuandoandamos registrando siempreandamos de dos y les dicho amis compaeras no esta laseora, vamos a decirle al seor. No, mire regrese cuando estemi seora, ella es la que sabe. Ellos solitos se hacen a un lado.Y no es que uno los haga, noes eso. Simplemente es quesabemos que es la mama. Quiere uno tener un contactoas, solo con ellas. [15:9][3] Q: Y cuando comenza trabajar..--------------------Q:Y cuando comenz atrabajar, como fue suexperiencia? Como se senta?A:Pues al principio pues biendifcil para mi porque yo estabaimpuesta que mi esposo siempreme deca todo lo que tenia quehacer. Tienes que hacer esto,tienes que hacer el otro.Entonces ya cuando empez eltrabajo fue diferente. Pues casiquera hacer casi lo similar queme dijeran que tenia que hacer.Entonces me decan, no, tupuedes hacerlo. noms es deque tu te propongas pero dureun tiempo para yo entender.Que yo lo poda hacer pero yosiempre quera que meestuvieran diciendo. Vas a seresto o tienes que hacer esto oles iba a preguntar, puedo aser esto. Me decan, no tu lopuedes hacer. No necesitaspreguntar, tu lo sabes a ser.Pero, no se, si fue bien difcilpara porque es difcil cuandouno esta impuesta. O sea que elesposo haga todo. Como quiendice, que el traiga el dinero,que esto y el otro. Y unoestaba esperanzado, pero yadespus, pero es bien bonito. Gender roles 243

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APPENDIX H (Continued) [1:9][31] I1. En estas clases deBallet ..--------------------I1. En estas clases de BalletFolklrico, qu es lo que Ud.hace especficamente?R. Cuidar a los nios y a veceslos animamos a que mantenganla disciplina, a que obedezcan alas personas que nos estnayudando, a los maestros deBallet, que nos tienen queobedecer. La disciplina de losnios. Y a arrimarles el material necesario para que acten. (Elmaterial es) el vestuario deballet, su radio, tenerles elmaterial necesario. Ese materialestaba en Sor Juana porque ahantes haba ballet, era bienfuerte. Pero de un tiempo aclos muchachos ya crecieron y no participaron porque estnestudiando, preparndose. Entonos no encontraron talvezmas participantes, o como haymucho trabajo, porque ahoraSor Juana ya es parte de (), osea como que los programasestn en las comunidades. Entonces trajimos el materialpara ac y aqu lo tenemos,entonces si tenemos el material vamos a buscar nios quequieran participar. Y si,contamos con 5 o 7 nios que estn participando. Ahorita enel verano lo suspendimosporque como aqu es un reamuy chica, solamente son trescalles y aqu es donde estamosmas enfocados con estacomunidad y con El Capote. EnEl Capote los nios queencontramos estn muychiquitos y no participaron. Pero aqu mismo en esta coloniasi, encontramos nios que siquieren participar. [15:32][3] Pues lo quenosotros les decim..--------------------ues lo que nosotros lesdecimos, el progreso del nio.Muchas veces tienen la, buenoMs., como se porto el nio? Seporto bien o como va en lasclases? Como lo ha visto? Seporto mal, no se porto mal. Y aveces, como te digo, si tienenalgn problema personal, yaque nos conocen con el tiempoporque no luego, luego porqueestamos tres meses trabajandocon los nios. O sea casi nosestn viendo continuamente yya despus nos agarranbastante confianza. Y ya pues,como te digo, no tiene uno larespuesta, pero muchas vecesnada mas con escucharla ya esbastante para ellas y paranosotros tambin porque nossentimos tiles, escucharlasnada mas. Impact_Emotional Support 244

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APPENDIX H (Continued) [4:29][16] Tuvimos unacertificacin en l..--------------------Tuvimos una certificacin enliderazgo comunitario. Fuimoscertificadas por el CentroCultural Mxico Americano deSan Antonio. Tuvimos unacelebracin bien bonita. Fueun gran privilegio que yoestuve entre grupo siendocelebrada. Tuvimos mariachis,tuvimos comida, tuvimos unlugar grande. Nuestra familia comparti con nosotros en esemomento. Yo ped, exig a mifamilia que ese dia estuvieranall conmigo. Porque haba sidouna lucha de muchos aos. Decrecer y de tratar de hacer lomejor como mujer para mifamilia, de tratar de hacer lo mejor como hija, y como esposatambin. [4:32][20] Pero mientras estascon la gen..--------------------I1.. Eso es lo que usted hacecomo mentora?R1.. como mentora...I1.. En actualidad usted esmentora?R1.. S. Este, no sabre a mentecomo es lo que me hace comomentora, pero ensear a otrasmujeres a tener la misin deArise, a enamorase de Arisepara que puedan crecer ymejorar como yo. Este, yo creoque soy alguien importante para m como mentora. Pero hepensado que enseando a otraspersonas, entrenando a otraspersonas, no estoy alcanzandocinco nios, estoy alcanzando20, 30, o no s cuantos. Porque horita ya hay mas depues dos animadoras se puededecir por centro, qu Integration of education, workand family 245

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APPENDIX H (Continued) [45:10][3] Q: Y a logradoproducir cambio..--------------------Q:Y a logrado producircambios en sucomportamiento? A:Pues meimagino que no se que pienseeste nio, pero a horita meestaba diciendo su mama queya se esta portando mejorporque ya andaba bien mal el.De la escuela lo corrierondefinitivamente y me estabadiciendo que pues a horita ya esPapa. Y es chico el muchacho.Tiene 16 anos pero ya estahiendo a la escuela. Quiere sacarsu GED. [45:11][3] Q: Y usted a el porejemplo pu..--------------------Q:Y usted a el por ejemplopudo referirlo a agencias o apersonas que lo pudieran ayudar? A:Pues yo lo mande aque fuera a sacar su GED y ledije que si quera el programa del abuso de drogas pero aveces le digo no acepta. Comoel me dijo, no si yo quiero lo dejo. Y ese es decisin de el.Pero a horita me esta diciendoque ya no usa la droga, que laesta dejando. Ala mejor escierto. Y as. Muchosmuchachitos que yo conozcome siento con la confianza quea veces pienso, los regao, perono es un regao, es por su bienque le digo, prtate bien mihijo, ve a la escuela. O si me losencuentro por all en la calleque yo se que deben estar en laescuela, les pito y que paso?Para en donde vas? No, pues esque voy a un mandado. Living in Community AllowsConfianza 246

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APPENDIX H (Continued) [4:2][4] Y as empez la vida denosotr..--------------------corriendo de agua, en lasmontanas, el tren, viajbamosen tren. Muy bonito verdad. Una experiencia muy bonita. Por una parte pienso que fuebueno que paso eso porquetengo esos recuerdos. A lamejor si mi vida hubiera sidouna vida de matrimonio,estable que nunca sale unonoms de escuela a casa. No hubiera tenido todo esto quetuve oportunidad de tener. Llegamos a Reynosa despusde haber andado en mucoslugares. Antes de venir aReynosa, me quede un ao conuna madrina, en Valle Hermoso. En ese tiempo tuve laexperiencia de saber lo que esextraar a nuestros padres. Loque es llorar a nuestros padres. Porque no es lo mismo de queandes aqu y aya, aunquetengas difciles, aunque notengas comida, pero tienes a tumadre. Tienes algo que te hacesentir segura. Entonces mepidieron si me quera quedar yyo dije que s. Me quede unao. Todas las noches lloraba. Me meta debajo de la casaporque era una casa grande demadera, mi madrina tenia lamanera. Ella quera que mequedara como parte de sufamilia como una hija pero eseao fue un tiempo tanto param como para ellos, en darnoscuenta si realmente era lo quequeramos. Pues al ao quevino mi mama yo me le peguecomo chinche. Comohormiguita, y ya no me le [10:31][3] Mi nombre es Mariadel Carmen ..--------------------Mi nombre es Maria del CarmenGarza y ya tengo seis aosviviendo aqu en la colonia deSouth Tower. Nac en (....)Zacatecas, Mxico, pero soycriada en Reynosa, Tamaulipas. A los 21 anos me vine a losEstados Unidos a Dallas Texas. Ah estuve como por cinco anoso quiz mas, ahorita norecuerdo. De ah nos venimospara ac, para El Valle, el 93creo, y luego nos vinimos a aqu,a esta colonia. En el 95llegamos a esta colonia deSouth Tower. En ese tiempollegue con mis dos hijos, tengotres hijos. Yo no estabaviviendo con mi esposo, perotenia los dos hijos mas chicosconmigo y ya empec a viviraqu rentaba, verdad, rentabaun casa chiquita que a dondeestaba viviendo all. Nosvolvimos a encontrar toda lafamilia, mi otro hijo que estabacon mi esposo y mi esposo ypues, nos rentamos una casams grandecita. Entonces unda llego Ramona y Lupita,personas que trabajan en Arise. Para entonces aqu todava noestaba el programa de Arise. Ellas llegaron conociendo afamilias para saber que eran sus necesidades, como llegamosaqu a Estados Unidos, como lehacamos para sobrevivir con unsolo sueldo, que el esposotrabajaba, no trabajaba. Llegaron mas bien como en un plan de 'amigas' podra decirse,verdad. Migration into the Mexicoborder 247

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APPENDIX H (Continued) [8:16][3] Pues yo pienso que ami lo que..--------------------ues yo pienso que a mi lo queme motiva es, como dije, ayudara la gente, ver, no muchadiferencia, pero ver un cambio.Poco a poco pero se esta viendoun cambio en la gente y el queyo pongo mi granito de arenapara ese cambio que estasucediendo es lo que motiva yel que las personas cuandovienen de otras partes, ello,gracias a Dios conozco un pocode Reynosa, pude ser yo la guapara llevarlos a ensearles. Medio una satisfaccin. Me gustami trabajo. [14:36][172] Me motiva puesnos motivamos u..--------------------Me motiva pues nos motivamosunas con otras. Es algo muy bonito de ver las ganas quetienen las personas. Laspersonas que principalmente yodigo como Jerry que es lafundadora, y las ganas que ellapone que todo sea para el biende una comunidad. Eso memotiva. Una persona que estabuscando siempre el bien para todas las personas. Ella y todaslas muchachas que tienen susaos trabajando y todo eso. Ya personas con 10 o 11 aosde trabajar. Es una motivacinde ver las ganas que tienen desacar adelante este programa. [14:41][192] Para mi esposo enun principio..--------------------Para mi esposo en un principioestaba como, era como, es quenunca yo haba trabajado. Nunca. Entonces yo empiezo atrabajar, y a pesar yo estoybien a gusto. Yo estoyencantada de la vida trabajandoy l su trabajo no es. Aqu sillueve, hago fri o hiela, yoaqu tengo mi trabajo, es untrabajo estable. Y el del no. Sillueve, o hace mal tiempo ellosya no trabajan y estn en lacasa. Entonces tenia esaproblemita verdad, de que sesenta mal de que yo estaba, lsi el tiempo mal dura unasemana l esta en la casa porque no se puede hacer nada. Y haba eso como porque yopienso ahora estoy aqu en lacasa, y ella esta trabajando. Eraalgo que el no lo poda explicar y no lo poda entender. Puesya tengo un ao aqu perono-pasa nada. De repente si sepone serio. Y yo siempre hetenido eso de cuando el no estatrabajando mira que el se sientecomo menos. Pero no pasanada, la vida sigue igual, yo soyla misma y l es el mismo perose he llegado a sentirse menos. Por eso que el trabajo esestable y yo pienso que eso es. Pero problema pues no, comoyo pensaba. Porque l era unode los que no tu trabajar no, cuando y porque, si yo puedotrabajar y yo puedo trabajar. Yaparte de que yo estoy haciendo lo que me gusta, estoycontribuyendo a la casa. Sacara delante a mis hijos. Si con eltrabajo de los estbamosviviendo mas o menos bien, yacon este es bastante. Yo mesiento bien orgullosa de poderayudar. Tal vez el no loentienda as. Esto colaborando con l en sacaradelante en sacar adelante anuestros hijos. [15:35][3] Bueno, lo que a mime motiva e..--------------------ueno, lo que a mi me motiva esla satisfaccin cuando nosotrosdamos lo mejor de nosotros.Porque muchas de las vecesnosotros no sabemos todo,pero si ya estamos enseandolo mas que podamos nosotros,lo mas que nosotros pudanosdar, la satisfaccin es cuandonosotros terminamos la clasedel programa que son tresmeses. Porque cuandoempezamos la clase, es como,bueno estoy haciendo bien eltrabajo aunque yo se que estoyhaciendo bien mi trabajo con lasnias, pero ya cuando terminas el ciclo que viene siendo tresmeses, ya vemos all: hicimosbuen trabajo o no hicimos buentrabajo y ay las seoras no lofirman que estn bienagradecidas con nosotros. Yo creo que esa es la satisfaccinmas grande que tiene uno queesta haciendo mejor su trabajo. Pues dando de si lomejor que pude uno. Motivation_Sources of 248

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APPENDIX H (Continued) [32:21][45] Alicia: Pues a horitaque, por..--------------------Alicia: Pues a horita que, porejemplo, va resultar esacuestin(???) de que entrenar a todas las promotoras y quecontrolar el archivo, papelera,temos que hacer reportes. Entonces todava mas trabajode oficina con mucho papeleo ytodo eso. Entonces yo me estoy encargando de controlartodo eso. Entonces pues ya veque me esta absorbiendo tiempo que tenia para ac. Ahorita me va hacer unpoquito... presionada derepente en que tengo quehacer esto pero aparte lo queestaba haciendo. Entoncesdigo yo, bueno haber comocombinamos eso. Pero como lesdigo, yo no quiero que mevayan ir quitando de ac para(???) obligaciones, por que am me gusta mas ac con lagente y todo. Pero al menosque ya las cosas cambien, posno, dice uno no pos, pos buscola educacin. Por que comoquiera ya en una escuela estauno siempre con los alumnos o me gusta educacin paraadultos. Entonces ya haymanera o no de seguir en eso. A la mejor ya no va a ser saludpero el caso es que a m megusta estar en contacto con la gente. [49:11][3] R1: It varies, theagencies, f..--------------------R1: It varies, the agencies, forinstance, one week could be TheDepartment of Human Services,this past week was Texas RoleLegal Aid. It can happen twoways, as program coordinatorswe will call the agency and say:can you come do training forthe ladies? Sometimes we willdetermine on that because theladies will tell us we need some information on this agency or asituation will occur and we willaccess were they need someinformation about. Sometimesagencies call us and say: can wedo training for your promotoras? So there is twoways of coordinating those. I1:So what happens is there acontract? R1: No, there is nocontract. There might be just aletter of commitment. I1: Thattraining is about a specificissues? R1: Yes. I1: But thoseare not services are notprovided by provider services?R1: There could be, because, letme give you an example, TheDHS may give a training to thepromotores and they will givethem a training, and by trainingI mean They will give themmore information about whatthey do. They can later in thefuture and provide that serviceto the residents. That hashappen because DHS has cometo Progresso, I will use them asan example, they come twice amonth to provide services toresidents they will sentresidents. I1: Is there a type oftraining related to specificprojects that they have to do aspecific numbers of visits? R1:Sure, but those are fundedones like Reach. Reach theyare going through a training that started in February, theywent through three-weekintensive training, and in March every Thursday they are goingto training from 9-1, but wehave set objectives under the Reach grant. So they have todo certain numbers of homevisits everyday, walk in groups, and cooking classes. I1: Arethere other training that in thesame category in would youjust put Reach? R1: 21stCentury has one and I wouldnot call them training eitherbecause there may be weeklyor monthly meetings and weare been updated. Is a littlecomplicated. I1: What I amthinking is that there are twocategories and training forspecific projects. Promotoras' autonomy 249

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APPENDIX H (Continued) [3:10][21] Vinimos aqu a estaren este c..--------------------Vinimos aqu a estar en estecentro. Empezamos nosotros,yo empec con clases de manualidades con seorashaciendo cosas manuales para lacasa. Criando cosas que no sean tan caras. Cosas quetenemos en la casa diaria. Aparte de que se enseen,hagan amistad, unin con unoo otra de las que se apuntan,las mismas que apuntamos,verdad, las seoras. Unasaunque viven serquitas, tienenaos de que viven all y no seconocen. Aparte de eso, lasinvitamos y se hace un grupo, ydurante de esos tres meses que conviven, se empiezan a deciruna a otra oye tantos aos devivir aqu y nunca nos hablamos. Como nos vinimos areunir, se hacen amigas, invitana comer una a otra. Y apartenosotros tambin vamos y lasvisitamos y hacemos unacomunicacin bien bonita conellas. Y dicen, oye tantos aosque viva esta seora aya mira,aqu nos vinimos a juntar y yanos conocemos. Pero yo quecomo la gente teniendo tantosaos viviendo como no-secomunicacin. Bajo de esteprograma como hace unin enla comunidad. [64:1][7] : I think theimportant thing ..--------------------:I think the important thingaround the Colonias Program atCHUD has been atheme that has focused onconnecting isolatedcommunities to programs andservices.The opposite of isolation is notmore programs. The opposite ofisolation is connectivity,so the first phase of what theColonia Program establishedaround the border wascertainly, I believed the physicalinfrastructure capacity forthose program providers toconnect to people. And thatphysical infrastructure is whatwe called now CommunityResource Centers and thoseCommunity Resource Centersact as a platform, the platformfor the myriad for theprograms and services to becloser to the community. Forthem toaccess the community throughthat particular infrastructure. Ithink that particularinitiative has been quitesuccessful, but just like anyinitiative, on the onset youbegin toestablish and implementsomething that is very good,you begin to see theopportunitylike any entrepreneur would toadd layers of support. To makeit better; to enhancewhat's there because certainlyany system in connectingpeople to the outside system isvery, very difficult. Connecting Neighbors 250

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APPENDIX I: BIOGRAPHIES 27 OF PROMOTORAS Angelica Rosalba, Age 25 Mi nombre es Anglica Rosala. Nac en Reynosa hace muchos aos, en 1976. Yo me vinebueno me cri en Reynosa por 11 aos con mi abuelita y mi abuelito. Por 11 aos viv con ellos. Mi mam estaba de este lado en los Estados Unidos y yo viva all. Y dice mi abuelita que yo siempre deca, As que cuando tena yo 11 aos, me vine. Me cruzaron como quien dice por el ro. Yo no ms recuerdo que yo iba en la espalda de un seor, en el agua. Luego vivimos en Brownsville. Y en ese tiempo mi mam era de tarjeta, y se cas con mi padrastro y el nos arregl pasaporte a las dos. Tuvimos que ir a Monterrey (a arreglar el pasaporte). Mi mam pas la primer vez, yo no. Me tuve que quedar all en Mxico, no me aceptaron a m. Y luego ah vengo para atrs, porque ya estaba en la escuela (en Brownsville), as que yo tena que cruzarme y me cruzaron con papeles de otra persona. Y ya despus arregl y ya he estado aqu. [My name is Anglica Rosalba. I was born in Reynosa, years ago, in 1976. I came (to the United States).well, I was raised up in Reynosa, where I lived for 11 years with my grandmother and my grandfather. I lived with them for 11 years. And my mother was in the U.S. side, y and I lived there. And my grandmother tells my that I used to say all the time: That was how I came when I was 11. I was crossed, you could say, I was crossed the river. All I remember is that I came on the back of a man, by the river. Then we lived in Brownsville. At that time my mother had a card and she married my step-father, and he got passports for the both of us. We had to go to Monterrey (to get the passports). My mother crossed back into the U.S., but I couldnt. I had to stay in Mexico, since I was not allowed back in. Then I tried again, because I was at school already in Brownsville, so I had to come back. So I was crossed with the papers of someone else. Then I got my papers and now I am here.] Eulalia Molina, Age 29 Mi nombre es Eulalia Molina, tengo viviendo aqu en los Estados Unidos doce aos. Me vine de Mxico el ao 88, el 9 de mayo. Vine a vivir aqu en la colonia Las Milpas. Horita tengo tres nios. Una nia de doce aos, una de nueve y un nio de seis. Soy nacida en Reynosa Tamaulipas. All viven mis padres. Horita no tengo familiares viviendo aqu. No ms mis hijos, mi esposo, y yo. Por parte de mi esposo, toda la familia de l est aqu. Para m es bien duro porque yo no puedo pasar para all. Tengo casi lo que tengo aqu de no ver a mis paps y mi familia. Y para m es bien duro. Como estoy arreglando documentos, por mi esposo, verdad, me los est pidiendo. Yo sal embarazada, ya tena dos meses de embarazo de la ms grande cuando me vine. Y fue muy 27 Names are pseudonyms. 251

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APPENDIX I (Continued) duro venirme y despegarme de mi familia. Y pues para un futuro mejor para mi hija. Mi esposo fue, el tambin vino aqu a los Estados Unidos junto conmigo sin documentos, pero sus paps vivan aqu. Y nos vinimos a vivir con ellos. l empez a trabajar en la agricultura. En la labor para sostenernos, verdad. As, sin documentos. En la agricultura empez a mover papeles, pero el nada ms arregl; por falta de dinero, no haba como arreglarme a m en ese tiempo, verdad. Y horita tengo (papels), desde el '97 que met mis papeles. Y horita en esta fecha tengo permiso de trabajo, desde el '98. Y tengo mi permiso de trabajo y empec a trabajar. [My name is Eulalia Molina. I have lived in the United States for twelve years. I came from Mexico in 1988, 9 th of May. I came to live here in Las Milpas. Now I have three children, a girl twelve years old, another 9 years old, and a 6 year-old son. I was born in Reynosa, Tamaulipas. That is where my parents live. Now I do not have family with me, only my children, my husband, and myself. It is very hard for me because I cannot cross back to Mexico. I havent seen my parents and my family since I came here. That is very hard for me. I left when I was pregnant of my oldest child. It was very hard to leave my family behind. It was for a better future for my daughter. My husband left with me, undocumented too, but his parents lived here. We came to live with them. He started to work in the fields, to support us, undocumented. I started the process to get papers, but because of lack of money, he could only get papers for himself. Now I have papers; I started the application in 1997, and since 1998 I have a work permit. So I started to work.] Amalia Rodrguez, Age 47 [Bueno, yo nac en la ciudad de Pharr (LRGV). No s si quiere saber cmo fue que yo vine naciendo ac? Pero mis padres los dos son de Mxico. Y ellos se vinieron para ac muy chiquillos, porque quedaron hurfanos. Y se conocieron de este lado y se casaron. Pero estaban ellos aqu ilegalmente. Y entonces nacieron dos hermanos. Un hermano y una hermana antes que yo. Y cuando yo iba nacer, mis padres les cay la migracin en su casa. Y pues ellos los echaron para Mxico. En esos tiempos no ms los llevaban directo al otro lado y all los dejaban. No llevaban un proceso como ahora. So, mi mam ya estaba en das, como quien dice. Y esto fue en un mes de febrero, que es tiempo de aires, de fros, y a veces de lluvias. Y entonces como quiera ellos no queran quedarse all porque queran que yo naciera ac tambin. So, se regresaron para atrs (para los Estados Unidos). Y as les pas como dos o tres veces. Y cada vez la inmigracin llegaba y los llevaba para atrs. La tercera vez que se los llevaron, mi mam ya andaba mala. Y el tiempo se vino ms fuerte, los aires y la lluvia y las aguas del ri se levantaron demasiado. Y un viejito que les ayudaba a cruzar no estaba ese da. So, ellos como quiera tomaron el riesgo, se pusieron de riesgo ellos, sus vidas, y tambin yo, porque mam estaba embarazada. Pero ellos como quiera cruzaron. Y casi se ahogaban, mi mam dice. Y eso me gusta 252

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APPENDIX I (Continued) ahora compartirlo porque antes yo no saba eso pero ahora si, como ya lo s, para m tiene un efecto muy grande porque las luchas que mis padres han llevado no las puedo comparar con el riesgo que ellos tomaron ese da para que yo naciera ac. Y al llegar ac, pues claro, llev mi pap el doctor, porque el doctor llegaba a la casa. Y llegando ellos, ya estaba la migracin en la puerta y el doctor les dijo que no, que se fueran. Que vinieran para atrs en cuarenta das, pero que no se la podan llevar. So, yo nac en este lado. Pues me siento privilegiada, verdad, pero ms que nada, valoro mucho el esfuerzo que mis padres hicieron. [I was born in Pharr (LRGV). Do you want to know how it happened that I was born here? Both my parents are from Mexico, and they came here when they were little, because they became orphans. They met on this side and they got married here. But they were here illegally. So two siblings of mine were born before I was born, a brother and a sister of mine. And when I was about to be born, Immigration came to my parents house. As a result, they were sent back to Mexico, and in those times people were sent back to Mexico just like that and people had to stay there, there was no process like it is now. So my mother was about to give birth to me, any day. It was in the month of February, month of air, cold and sometimes rainy. And since they did not want to stay there, they came back to the U.S. again. They did that two or three times. And everytime they came, Immigration caught them and sent them back. The third time they caught them, my mother was not feeling well; on that day, the weather was bad, the air, and the rain and the waters of the river rised up too much. And the old man who used to help them cross was not there on that day. So they took the risk, they risked their lives and also mine, because my mother was pregnant. But regardless, they crossed the river. And they almost drowned as they were crossing, my mother tells me. And I like to share this story, because I didnt know about it before, but now I know it and it has a big effect on me because the struggles of my parents cannot compare with the risk the took on that day so that I could be born here. And as they arrived here, my father took the physician to the house, because doctors used to go home at the time. And as they arrived at the house, Immigration was already at the door and they doctor told them that they should leave, that they could comeback in 40 days, but that they could not take my mother on that day. So I was born on this side. Thus I feel privileged, but more than that, I value a lot my parents efforts.] Guadalupe Juarez, Age 52 Well, I've been a housewife for 29 years without working out of the home and I decided that I needed to find a job and work because when my youngest was in high school, he had a hard time. Needing help with homework and I thought to myself, I don't know anything. How can I help my youngster to learn if I didn't have that much education? But I was willing to learn. I was told about this job, I didn't know what it would be about. I just came in and applied and fortunately I 253

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APPENDIX I (Continued) got it. And I didn't know what Vista was and volunteering services in the community until after the training. When I went to trainingactually, I thought I would not work because my husband was the type that housewives should stay home, and that's it. But I had a hard time the first year to get out of the house to come to work, especially when you have to go to trainings for three days. So, I thought But then, I thought to myself, If something were to happen to him, where would I turn to? So I told him that I needed to stay at this job. And we got back from training. We started doing home visits. It was hard for me also at first, but after a couple of weeks, we got used to it. We got used to going to home visits. Feeling more comfortable with the families and we had a lot of trainings with different agencies where I learned a lot cause this information I had never heard of before and at the same time, by learning all these trainings with these different agencies it helped us to come do our home visits. And during our home visits we come up with families that also need a lot of help like, for instance, Tropical Texas, Family Crisis Center, all those agencies that we knew we could refer the residents. So every time we do a home visit, we find the need of those programs and we refer them. And luckily we've come up and helped plenty of families around here that didn't know that the help was there, but us learning about it and referring it to them, we feel that we help them. Josefina Pereira age 40 Buenas tardes, bienvenidos sean aqu a nuestro centro. Mi nombre es Josefina Pereira, tengo 40 aos, yo vengo de Mxico, vengo de un lugar que es Monterrey, Nuevo Len. Soy casada, tengo dos hijos, Jos y Enrique, de 9 y 10 aos. Tengo 4 aos que me vine para el Valle. Me vine en diciembre del 1997, aprovechando una nueva ley que surgi entonces. Mi esposo crey conveniente venirnos para ac para tratar de mejorar el futuro de nuestros hijos. Entonces yo estoy viviendo aqu en la colonia South Fork. Estamos rentando una vivienda pequea mientras mi esposo termina de construir nuestro propio hogar. Yo nac en Dr. Arroyo en el 60, luego a la edad de 14 aos me vine para Reynosa. En Reynosa me cas y luego despus por voluntad de Dios yo qued viuda, estuve sola dos aos. Me volv a casar, mi esposo era de Monterrey pero l ms vivi aqu en Estados Unidos. Entonces cuando me cas con l me llevo a Monterrey y estuvimos viviendo all como por cuatro meses. l ah tiene su casa, sus hijos ah. Me fui para Washington (estado), all nacieron mis hijos. Estuve ah desde el primero del 91 hasta octubre del 94. En un pueblito que se llama Quincy. All nacieron mis hijos, luego nos regresamos a Monterrey y estuve ah desde el 96 hasta el 97, fines del 97, y fue cuando de ah me vine para ac. Entonces ahorita tengo como tres, cuatro aos de vivir aqu, y de trabajar aqu en el programa tengo un ao. 254

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APPENDIX I (Continued) [Good afternoon, welcome to our Center. My name is Josefina Pereira, I am 40 years old, I come from Mexico, from a place called Monterrey, in the state of Nueva Len. I am married, I have two children, Jos and Enrique, ages 9 and 10. I came to the Valley four years ago. I came in December of 1997, taking advantage of a new law that was enacted at the time. My husband thought convenient that we come here to try to improve the future of our children. So, now I am living here at the South Fork colonia. We are now renting a small house while my husband is building our own house. I was born in Dr. Arroyo (inner-state town in the border state of Nuevo Len), in 1960 and at age 14 I came to Reynosa (border city in the state of Tamaulipas, across from McAllen, Texas). In married in Reynosa, and soon after, by Gods will, I widowed. I stayed alone for two years. I married again, my husband was from Monterrey but he had lived in the U.S. more than in his city. We lived there for about four months. His house is there (in Monterrey), also his children. Then we moved to Quincy, a town in the state of Washington. My children were born there. Then we moved back to Monterrey where I stayed from 1996 to the end of 1997. That is when I came here. So, Ive lived here for about four years, and Ive been working at the program for about a year.] Undencina Ramirez, age 54 Yo soy nacida en Mxico, en Valle Hermoso Tamaulipas. Tuvimos diez aos viviendo en Reynosa. E ingresamos a los Estados Unidos en el '75. Primero eduqu mi familia, claro verdad. Mis hijos en la escuela. Esta era una de las metas que mi esposo llev, educar a nuestros hijos. Aqu terminaran su escuela y su high school, y su educacin. Una de las razones que no vinimos para Estados Unidosmi esposo ya haba arreglado. l trabajaba aqu en los Estados unidos. Yo tena dos nios en la escuela en Mxico. Y una era nacida aqu. Entonces, iba a cursar el segundo grado en Mxico y me dijeron que la nia tena que hacerse ciudadana mexicana para poder ingresar a la escuela. Ella era ciudadana de aqu so fue uno de los motivos que tuvimos de all y venir para ac. Para ponerlos en la escuela. So este, y tenemos aqu mas de veinte aos viviendo aqu en los Estados UnidosTuvimos siete hijos. Cinco mujeres y dos hombres. Gracias a Dios estamos muy bien bendecidos. Porque la mayora estudi. Tenemos dos que estuvieron en la universidad. Una hija que est en Jacksonville, ella estudi para enfermera y est trabajando all en Jacksonville. [I was born in Valle Hermoso (inner-state town), state of Tamaulipas, Mexico. We lived ten years in Reynosa (border city). We entered the U.S. in 1975. First, I educated my family. This was one of the goals of my husband, to educate our children. Here they ended their schooling, their high school. 255

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APPENDIX I (Continued) One of the reasons for which we came to the husband had already gotten his papers. He worked here in the U.S. I had two children attending school in Mexico, and one of them had been born here. I was told that my child had to become Mexican citizen in order to enter school. Since she was an American citizen, she couldnt enter school. That was one of the reasons for which we decided to come to the U.SWe had seven children, five daughters and two sons. Thanks God we were blessed, because the majority of them went to school. Two of them go to college. One of my daughters lives in Jacksonville, she is a nurse and works there]. Eudelia Porras, age 41 Bueno pues mi nombre es Eudelia Porras, todava uso mi apellido de soltera. Este, voy a platicar sobre cmo fue que llegu yo a este mundo verdad porque creo que seria incompleto lo que yo diga. Yo nac de padres separados. Mi pap Luis Porras, y mi mam Margarita Moreno. Fui la tercera de tres. Y como en todo matrimonio que no se pueden continuar a llevar adelante su vida matrimonial de pareja, pues surgi eso de que se separaron. Entonces seria en el octavo mes de embarazo de mi mam yo nac en bano, San Luis Potos, y fue un privilegio porque nac, crec mis primeros tres aos en casa de mi abuela materna. Hoy ya fallecida. No conoc a mi padre hasta los catorce aos. Y era un inters muy profundo de saber de donde vengo, quienes son mis, pues mi pasado paternal. Quera saber y conocer. Y conoc de mi familia por parte de mi mama de mis tos y eso verdad. Y haba mucha influencio sobre ese lado pero tambin quera conocer a mi pap. Como quiera estuvimos con mi abuelita viviendo all yo creo que hasta los tres aos. Despus estuvimos como aqu se mira en los Estados Unidos que la gente migra de un estado a otro para trabajar. Y as empez la vida de nosotros. [Well, my name is Eulalia Porras. I still use my family last name. I am going to tell you how I came into this world, because I think what I tell you would be incomplete if I didnt tell you about it. I was born of divorced parents. My father, Luis Porras and my mother, Margarita Moreno. I was the third child out of three. And as in every married couple that cannot live together, they separated. It was about in the eight month of my mothers pregnancy that I was born in bano, state of San Luis Potos. And it was a privilege to have been born and grown up in my grandmothers house, who is now gone. I did not meet my father until I was fourteen. And I wanted to know who my father was, where I had come from. I knew my mothers family, my uncles, but I wanted to know about my father. Anyhow, we lived with my grandmother until I was three years old. Then we traveled from state to state, just like in the U.S., where people migrate from state to state to work. And that is how our life began.] 256

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APPENDIX I (Continued) Socorro Mendoza age 37 Bueno lo que puedo agregar es que batall bastante para estar aqu. Antes de yo estar aqu he batallado bastante como para venirme para ac. Cmo me vine? Por l ro. Cruc dos veces l ro. La primera vez fueron, hace 21 aos. Cuando tuve mis primeros hijos. Antes de tenerlos me fui para Colorado. Y all tuve los cuatro grandes. Pero al cruzarme l ri con un coyote. A dejarme abandonada el coyote all en medio del desierto. O sea sufr bastante para yo estar aqu. Y tener lo que ahora tengo. Despus la segunda vez me vine con mis cuatro nios. Y yo no tenia quien me los pasara, entonces yo arriesgu y me los traje a ellos tambin por l ro. Nos venimos por el ro los seis. Mi esposo yo y los nios. Y fue cuando ya llegu aqu. [Well, I can tell you that I struggled a lot to be be here. Before being here, I struggled a lot in order to come here. How did I come here? I came crossing the river. I crossed the river twice. The first time it was 21 years ago, when I had my first two children. Before having my children I went to Colorado, where I had the four older ones. I crossed the river with a Coyote (individual who helps people crossing the river in exchange for payment). The coyote abandoned me in the desert. In other words, I suffered a lot in order to be here, and to have what I now have. The second time I came with my four children, and I didnt have anyone to bring them so I took the risk and brought them with me across the river. The six of us came across the river, my husband, myself and the children. And that is when I arrived here. Guadalupe Villa age 34 Primero vivimos all en San Juan. Pero despus compramos aqu un solar. Y tuvimos que venirnos para ac. So era un poquito duro. Primero que nos vinimos para ac, la colonia esta no tenia agua, no tenia luz. Y tenamos el bao afuera, que es el bao del poso. Y era un poquito duro porque all estbamos todos, pues no viviendo bien, pero viviendo diferente que aqu. Y pues si me acostumbr a esto. Tenamos que. Una vecina del frente nos pasaba agua. Nos pasaba la luz. Pero pues hora estoy, dir podra vivir yo otra vez, si vivira as, porque es ms sencillo que tener agua corriendo. Y la luz y todo eso. Y era diferente. Y despus, pues no trabajaba yo. Pero si tenia, trabajaba cuidando nios. Porqu no tenamos un carro. Luego yo iba a buscar un trabajo en el pueblo. Y los vecinos me decan que si no podra cuidar los nios. Les cuidaba los nios o as. Y si no estaba cuidando nios de vecinos iba a otra parte a cuidar los nios. Pues a familias que conocan. Y despus bueno ya despus pasaron aos as, y yo cuidaba a mi pap. Mi papa estaba malo. Despus el se muri, y pues nadie sabia manejar all en la casa. Entonces yo aprend a manejar. Tuve que ir a la escuela a aprender a manejar, porque no saba manejar. Y pues ya aprend a manejar y despus ya pude yo salir, buscar un carro y buscar trabajo. 257

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APPENDIX I (Continued) [We first lived there in San Juan (colonia in the LRGV). Then we bought a little piece of land here, in this colonia. And we moved here. When we first came, the colonia did not have running water, did not have electricity. The bathroom was outside, it was a well. It was a little hard, but we were all together; we did not live well, we lived differently than we do now. A neighbor from across the street gave us water, and electric light. I worked taking care of children, because we did not have a carYears passed like that and I also took care of my father, he was ill and then he died. And noone knew how to drive at home, so I learned how to drive and then I could go out, get a car and look for a job]. Juana Rosaldo age 44 Bueno mi nombre es Juana Rosaldo. Yo soy casada, tengo tres hijos, y vivo en la colonia South Tower. Mi direccin es 500 Rancho Blanco aqu y all esta su casa. Y pues familia, tengo mucha familia. Yo vengo de Mxico. Nac en Reynosa Tamaulipas. Y llegue aqu en el ao 88. En el ao 88 llegue aqu ya casada. Me cas y me vine para acNo, empezamos viviendo en McAllen. All estuvimos como tres aos, y luego ya compramos el solar ese y nos cambiamos para ac. Y desde entonces estamos aqu. Como diez aos ya viviendo en esta colonia. Y a pesar a que viva en esta colonia, no conoca mucha gente de aqu en la colonia. Nada ms mi vecina. Y este pues hora gracias a Dios, por el trabajo que yo tengo, verdad, mucha gente que conozco ya. Gracias a Dios. Y este vengo de una familia grande. Mis hermanos son 10 de familia. Solamente tengo 3 hermanos nacidos aqu en Estados Unidos. Y todos los de ms en Reynosa. Ya nada ms tengo a mi mam. Mi pap ya no lo tengo. Y ahora mi vida es mi familia, mis hijos, mi esposo, y mi trabajo. Este de mi familia que les puedo contar. De mis hijos, pues estn chiquitos, tienen 11, 10, y 6 aos. [Well, my name is Juana Rosaldo. I am married, have three children, and live in the South Tower colonia. My address is 500 Rancho Blanco 28 ; that is where your (sic) house is 29 And I have a big family. I come from Mexico, I was born in Reynosa (border city), Tamaulipas. I arrived here in 1988. In that year I arrived already married. We got married and came here. We started living in McAllen, there we lived for about three years, and soon after we bought this piece of land and moved to this colonia. Its been ten years since we moved here. And even though I lived here, I didnt know anybody, except my next door neighbor. But now, thanks God I know a lot of people through my job. I have a large family, ten brothers, only three of whom were born in the U.S., and the rest in Reynosa. My mother is still alive, but my father is not. And now my life is my family, my 28 Not real address. 29 As a way of being welcoming to the outside, local people say my house is your house, or that is my house, your house. 258

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259 APPENDIX I (Continued) children, my husband, and my job. This is what I can tell you about my family. My children are little, they are 11, 10, and 6 yeas of age.] Patricia Prez age 38 Mi nombre es Patricia Prez y ya tengo seis aos viviendo aqu en la colonia de South Tower. Nac en (....) Zacatecas, Mxico, pero soy criada en Reynosa, Tamaulipas. A los 21 aos me vine a los Estados Unidos a Dallas Texas. Ah estuve como por cinco aos o quiz ma s, ahorita no recuer do. De ah nos venimos para ac, para El Valle, el 93 creo, y luego nos vinimos a aqu, a esta colonia. En el 95 llegamos a esta colonia de South Tower. En ese tiempo llegu con mis dos hijos, tengo tres hijos. Yo no estaba viviendo con mi esposo, pero tenia los dos hijos mas chicos conmigo y ya empec a vivir aqu rentaba, verdad, rentaba un casa chiquita que a donde estaba viviendo all. Nos volvimos a encontrar toda la familia, mi otro hijo que estaba con mi esposo y mi esposo y pues, nos rentamos una casa ms grandecita. [My name is Patricia Prez, and I have been living in the South Tower colonia for six years. I was born in (...) Zacatecas, but I was raised in Reynosa, Tamaulpas. At age 21 I came to the U.S., to Dallas, where I worked in factories, packing food, making tools for cars, in a tortilleria cleaning houses. There I was for about five years or so, I dont remember well. Then we moved to the Valley in 1993 I think, and soon after we moved into this colonia In 1995 we arrived at South Tower. At that time I came with my two children, I have three children now. I was not living with my husband at the time. I rented a house, a very small house. Later the family reunited and we rented a larger house.]

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ABOUT THE AUTHOR Ricardo Contreras received a Licenciatura degree in Sociocultural Anthropology from the Universidad de Chile in 1989. In 1992 he came to the United States as a Fulbright Scholar to complete a Masters degree in Applied Anth ropology from the Univers ity of South Florida. From 1995 to 2003, he was a researcher at the Louis de la Parte Florida Mental Health Institute, where he participated in a large number of applied re search and evaluation projects in the area of social and human services. Currently, Mr. Contreras is Associate Researcher with the Institute of Social Studies, Universidad Diego Portales Santiago, Chile, where he teaches anthropology and methodology courses a nd conducts research on issues of local participation and citizenship.