June 4, 2024, was no ordinary day. At the Peruvian Medical Association, during the commemoration of Community Health Worker Day, a meeting took place that would mark a turning point. A delegation of Community Health Workers (CHWs) from the Mamás del Río and Mamás de la Frontera programs arrived from the Amazonian communities of the Marañón River and the Colombian border. That same day, we met Carmen Rosa Vilela Vargas, president of the Lima and Callao Health Promoters Network. What began as a conversation among colleagues transformed, a few weeks later, into a powerful alliance.
We recognized ourselves in the struggle, though from different realities. Carmen, from the urban promoters' organization, with years of community work and a tireless effort to connect with organizations that can provide support and with decision-makers. We, from the heart of the Amazon, where the Community Health Worker is often the only figure connected to health for miles around. Thus, a common front was born: diverse, decentralized, feminized, and profoundly human.
A couple of months later, Carmen met the Community Health Workers (CHWs) of Loreto. She listened to their stories and understood that while she and her colleagues were experiencing neglect, in rural communities they faced outright oblivion. Often there are no health centers, no transportation, and no professionals to provide support. The CHW is not just the link to the health system: often, they are the health system itself. Without them, there is no care, no oversight, no support.
That's how the women from the PROSA Network and Mamás del Río decided to join forces to achieve a greater impact. They brought experience in political advocacy. We brought scientific evidence generated in the field, grassroots community work, and the urgency of real change. That's how we began to build.
Between October 2024 and May 2025, three bills were introduced from different congressional blocs.
Despite their ideological differences, the three agreed on fundamental aspects: the need to formally recognize community health workers as part of the health system, their inclusion in primary care, access to incentives and training, and the creation of decent working conditions.
These three projects were fueled by evidence: data, experiences, and testimonies gathered by Mamás del Río over years in communities where public health services are otherwise unavailable. The medical history of this rural and forgotten country was finally being told in the language of public policy.
On April 8, 2025, we received news that filled us with hope: the Congressional Health Committee approved by majority vote the preliminary report on the bills recognizing the work of Community Health Workers (CHWs). This paved the way for debate in the plenary session. That day we celebrated, but we also reaffirmed our commitment: to persevere until the law was enacted. And we didn't stop. In June, we returned to Congress to reiterate to members of Congress, academics, and various organizations our position that Community Health Workers are the cornerstone of primary care and the voice of the community. It was a symbolic day in which we gained acceptance and support for this dream.
In recent months, efforts have focused on a new objective: the construction of the National Network of Community Health Workers of Peru. Because representation and unity are key to ensuring that achievements are not just empty promises. In the most recent bill presented, the creation of this Network is declared to be of national interest, as a necessary step to guarantee coordination, training, and the collective defense of their rights.
Throughout this journey, there have been obstacles, setbacks, and difficult negotiations. But there has also been an unwavering energy: that of those who know their work saves lives, even if it is not always recognized.
On November 20th, we took an important step forward with the workshop 'Agents of Transformation: Strengthening the Leadership of Community Health Workers in Peru'. We brought together nearly 30 women leaders from different areas of Lima to work on three key areas: organizing to defend their rights, effectively communicating their work, and analyzing draft legislation that seeks to protect them. This meeting was just the beginning; we will soon reach more of our fellow Community Health Workers!
©2024. Made with (❤︎) in Yachayninchik
