how we work.

HJC's mission

The mission of the Health Justice Collaborative (HJC) is to address the unmet health and human development needs of impoverished communities throughout the world. Because disregarding such needs compromises human dignity and autonomy, HJC will devote the resources and experience of its volunteers and partners to improve health toward the broader goal of decreasing social and economic disparity. In pursuit of this mission, HJC will be guided by the perspectives of the communities involved as well as principles of social justice. We dedicate ourselves to the pursuit of this mission until those conditions detrimental to a healthy and just human experience are overcome.

hjc programs.

Anya's Kids

Anya's Kids is our newest project, established to meet the nutritional, educational, and social support needs of pregnant mothers and their children during the first six months of life, as a means of improving maternal and neonatal health outcomes within Batey 1. The design of the Anya's Kids project reflects HJC's philosophy of community partnership -- working with community health workers to design the project -- while increasing the capacity of the health workers with each new programmatic activity and encouraging the community to be increasingly active in their own health needs.



During January 2006, a community health worker introduced us to a pregnant mother who needed assistance. A visit to her room at the end of the housing barracks confirmed real unmet health needs. Both of her children presented distended bellies and signs of malnutrition, and the pregnant woman herself was extremely thin given that she was in the third trimester of her pregnancy. Although her doctor had prescribed iron tablets for anemia and food supplementation to ensure appropriate weight gain during her pregnancy, she was not able to afford these items.

A review of data collected in 2005 (see: 2005 Survey Report) confirmed that many women in the community were in need of nutritional supplementation. A quarter of the children less than five years of age in the community exhibited mild to severe stunting, a sign of chronic malnutrition, and 15% of children less than five were mildly to moderately wasted. Furthermore, a majority of the community reported food shortages. Based on our mission to help reduce unmet needs as identified by the community, we developed the Anyas Kids project.

A woman's pregnancy and the first year of a child's life represent a unique opportunity to positively impact the life trajectory of that child. Conversely, a pregnancy in which a mother lacks access to basic nutrition and/or health care can adversely affect that child's life in a way that cannot be undone. HJC is committed to ensuring proper nutrition and health care for all women living in Batey 1. We believe that proper maternal nutrition, prenatal as well as postpartum care are fundamental human rights guaranteed for all.

As of June of 2007, HJC has enrolled 33 pregnant women into the Anya's Kids program. We have had six "graduates" of the program -- mothers with babies six months of age. In this program, mothers recieve nutrition supplementation, as well as education and social support from a community health worker during their pregnancy and through the first six months postpartum. Mothers are visited for one-on-one counseling by health workers and they attend monthly education and peer support group sessions. Sessions focus on topics such as nutrition, breastfeeding, access to healthcare and good hygiene practices. In addition, all babies born into the Anya's Kids program will receive birth certificate documentation so that they will have access to education and health care throughout the course of their lives.

The Anya's Kids program is named for Anya George-Svahn, born on June 6th, 2005 to former HJC board member Lisa George-Svahn and her husband Erland. Anya passed away on December 31st, 2005 in Stockholm, Sweden. Anya was a gift and blessing to us all and her spirit guides our work in the Batey communities of the Southwest Dominican Republic. For more information on specific project details, please contact us at healthjustice@thehjc.org.

Hygiene Promotion Program

Water and sanitation facilities were both identified by Batey 1 community members as inadequate, and subsequently, as important unmet needs. As a result, HJC has worked in collaboration with the community to develop a Water and Sanitation Initiative. Careful research revealed that a pipeline project is currently underway in the Southwest, which will deliver water to the community as early as spring of 2007. Despite these positive advances in clean water, the community still lacked adequate sanitation as well as safe hygiene practices. In January 2006, HJC worked with community health workers to develop and implement a Hygiene Promotion Program. The team completed a survey in Batey 1 to assess sanitation knowledge, attitudes and practices, as well as diarrheal prevalence of children under 5 years of age. Our data showed that 25% of children under 5 years of age had diarrhea in the past 2 weeks. In response, HJC worked with community health workers to implement a Hygiene Promotion Program. The Hygiene Promotion Program included 3 components: one-on-one visits where community health workers worked with mothers to improve hand-washing practices, community meetings to improve sanitary conditions, and primary school lessons designed to educate and involve the youth. The evaluation of this project is ongoing. For more information, contact us at healthjustice@thehjc.org.

past projects.

Community Health Assessment in Batey 1, 2005

The HJC conducted a community health assessment of "Batey 1," a community of approximately 1,000 people in the southwestern Dominican Republic. The survey was designed to measure health outcomes, access to health care, and other socioeconomic variables, among households with children under five years of age. The community health assessment was carried out with the help of local community health workers. For the full report, see: 2005 Survey Report.

You may be asking yourself: why did the HJC collect so much data?

Even though the poor health status in batey communities in the southwest region of the Dominican Republic was obvious to the eye and many community members and leaders expressed their health needs to the HJC in informal discussions and interviews, there was a need to document the health status of the people who live there. Many health problems are apparent among batey residents, and the HJC could potentially intervene on any number of issues, including nutrition, water quality, and lack of access to health care, but as a group we believe evidence based on assessments in the community is the most powerful tool to guide any efforts to improve health.

Would you dive in a pool without knowing the depth of the water? Of course not, and similarly, the HJC wanted to know the whole story of health in the community before attempting to partner with community members to improve health conditions. The existing data on the state of health in batey communities was incomplete. There have been small studies and interventions completed by local and international NGOs, but there was no existing comprehensive health status data exclusively focused on Batey 1.

Similarly, there has been documentation of human rights violations in batey communities by international organizations concerned with labor rights and citizenship, but these assessments have failed to tell the full story of the health impacts these violations have at the community level. It is widely acknowledged that social injustice and violations of human rights leads to poor health. In the words of the late Jonathan Mann and his co-authors, "...all rights violations, particularly when severe, widespread and sustained, engender important health effects, which must be recognized and assessed." (1)

The HJC has used the evidence we gathered to show the full impact that human rights violations have had and continue to have on the community’s health and well-being. Further, our ongoing goal is to empower the community to use the carefully collected data to advocate for change within the Dominican government and among the broader global donor community.

An unhealthy community is a community whose human rights and dignity are at stake. Data, as it reflects the realities and needs of a community, documents that which is inhumane and gives communities a voice so that they might achieve the wellbeing they deserve. The HJC, through gathering community health data, contributes to that voice.

(1) Mann JM, Gostin L, Gruskin S, Brennan T, Lazzarini Z, Fineberg HV. Health and Human Rights. Health and Human Rights 1994;1(1).