Dr. Gustavo Parajón, known as Gus by his US friends, el Doctor by his Nicaraguan friends, and Papi by his family, died unexpectedly of a heart attack on the morning of March 13th, 2011 at the age of 75. He was a beloved physician, pastor, and leader, as well as a pioneer in the development of community-based health care in Nicaragua. Throughout his lifetime, he worked tirelessly to bring hope and peace to people in Nicaragua, he has inspired and mentored countless people to lives of service, and established many organizations to serve the poor. He was a humble and devoted servant of God, living out what he preached: Christian faith and social responsibility, bottom-up empowering approaches to development, and leading through service.

Early Years: A call to service

 

    After studying Chemistry at Denison University in Granville, Ohio, medical school at Case Western Reserve in Cleveland, Internal Medicine at Cleveland Metropolitan General Hospital, and Public Health at Harvard University, Dr. Gustavo Parajón returned in 1966 to his native Nicaragua for a short term trip to organize the first mass vaccination campaign for thousands of children against polio, and diphtheria. 

 

     As the chief resident of internal medicine at Case Western Reserve, Gustavo could have had a lucrative career in medicine in the U.S., but he was committed to returning to serve in Nicaragua. In 1967, backed by the First Baptist Church of Cleveland in Ohio, and the American Baptist Churches, Gustavo returned as a medical missionary with his wife Joan, a musician, along with their two children, David and Marta.

 

Initial work in primary health care

 That same year, he began a community based primary health care program (CBPHC) for the rural areas of Nicaragua called PROVADENIC (Project of Vaccinations and Community Development of Nicaragua) Gustavo recalls, “In the early days, I would visit a community, treat a child for diarrhea, and come back a month later and find that the same child had died in the time between my visits.  It was at that time that we began training leaders we called "health promoters" from the communities themselves in prevention and treatment of diarrhea and other deadly illnesses. Because the health leaders lived in the community and were there all the time sick children could be attended.  The communities were then empowered with the education and resources necessary to treat illness as it arose instead of depending on doctors and nurses who could only have been present once a month.” PROVADENIC served rural communities from 1967 until 2008.

Teaching for health: the role of health care professionals    

      Dr. Gustavo Parajón emphasized a bottom-up community approach to the prevention of disease and promotion of health rather than the more traditional top-down hospital-based approach. He believed that in every community there were capable leaders, regardless of their level of education, who had the skills, passion and commitment to make a difference to improve the health of their communities. He also believed that in a setting like Nicaragua, where health services did not reach the poorest people, that the role of health professionals should be to share knowledge, teach and encourage lay health workers. He worked with volunteers from Nicaragua and the U.S. to develop a values and skills-based model for training local community health promoters. They could then provide basic preventive and curative services in their own communities to prevent the deaths of women and children from illnesses such as diarrhea and pneumonia. About this approach, Gustavo said, ¨As people began to have success in one area like health, this led people to want to work together to address other needs such as education, sanitation, and income generation.¨

This integral vision of health led Gustavo to help start and support other organizations in Nicaragua such as CEPAD, a Christian community development organization, PRESTANIC, a micro-credit organization, and CONAR, a national coordinating committee for refugees. In addition, he was the senior pastor of the First Baptist Church of Managua, from April 1984 to June 2010.

Health for all: A Global mission

     During the 1970s and 80s, Gustavo was also actively involved with the Christian Medical Commission (CMC), part of the World Council of Churches (http://www.oikoumene.org/programmes/justice-diakonia-and-responsibility-for-creation/health-and-healing.html). The CMC promoted a reorientation of medical missionary work that focused on community empowerment and preventing disease as much as it did on treatment of disease, which was revolutionary at that time. (Read more about the CMC and Primary Health Care:  Contact 2001, CMC and WHO) With the CMC, Gustavo became part of a community of health advocates from around the world who participated in developing the Primary Health Care Model which culminated in the writing of the World Health Organization’s Primary Health Care document of Alma Ata in 1978. This model delineates the basic principles for the provision of equitable health care for all as an undeniable human right and an important element to bringing peace to the world by the year 2000. Unfortunately in Nicaragua and much of the world, the promise of Health for all is far from being reached, and inequalities in health care and access between the rich and the poor continues to grow -- which is why the work of Primary Health care remains highly relevant today.

 

     In the face of political and religious turmoil, natural disaster, dictatorship and war, Dr. Gustavo Parajón´s work in primary health care has been an unwavering presence in the struggle to bring quality health care services to the poor of rural Nicaragua. At the height of the war in the 1980s, two health promoters and four health committee members were targeted and killed, and yet the health promoters not only remained committed to their efforts, but reaffirmed their resolve to bring health to their communities.

    Says Juan de Dios Blandon, one of the health promoters from the community in Matagalpa where the health leaders were killed: “It is out of love for others that we continue on despite natural disaster, war and economic difficulties.”

Expanding Work In Primary Health Care: AMOS Health and Hope

    Dr. Gustavo Parajón’s most recent contribution to primary health care was through the work of AMOS Health and Hope. In 2006, Dr. Gustavo Parajón, along with other physicians and church leaders from both the U.S. and Nicaragua, formed AMOS Health and Hope -- a non-profit faith-based organization established in Nicaragua in 2007 to expand the community based primary health care work he started in 1967. With over 40 years of experience in primary health care, Gustavo helped to build and develop AMOS as an ecumenical organization to continue his original vision of health for all. AMOS currently serves 27 rural communities in the departments of Chinandega, Boaco, Matagalpa and the RAAS.

The mission of AMOS is to improve the health and well-being of poor and marginalized communities by working alongside them in health, education, and development. 

The values of AMOS are:  Loving our neighbor, respecting the rights and dignity of all people, service to vulnerable communities, empowerment for service, stewardship, peace and justice.   AMOS has sought to implement its mission through integrated primary health care systems that promote health, prevent disease, treat the most common causes of death and illness in a way that addresses not only physical health, but also spiritual, emotional, and social health.

Awards

      For his work in community development, reconciliation, peace and justice, Gustavo has received numerous awards including the Dahlberg Peace Award in 1980, the Baptist World Alliance Human Rights Award in 2006 in recognition of outstanding relief and development work, and Francisco Morazán medallion in honor of his courageous work for peace and reconciliation during the war between the revolutionary government and the Contras during the 1980s.

     Despite numerous awards, Gustavo was not one to bask in his honors. Instead, he loved to take the time to chat with people, to bring the bible to life and share the gospel of love and service, and to celebrate with local leaders as they worked to bring peace, justice and health care to their communities.

     Whether he was working in peace and justice or in health care, Gustavo led by his example. He had an unflagging Christian commitment to social justice and equality, and treated each and every person with respect, kindness, humility and love. He worked tirelessly at the individual, community, national and international level to foster participation and the empowerment of people to be able address the root causes of poor health. And he believed in each and every one of us -- that anyone can make a difference to make this world a better place if we serve out of love.

Grateful for the Past, Hopeful for the Future

    When we asked Dr. Parajón in a recent interview about his work in community-based primary health care and the relevance of AMOS Health and Hope, he smiled and repeated what he has often shared with us, "In Luke 4, Jesus begins his ministry with a call to heal, to release the prisoners, and to bring justice to the oppressed. He is doing whole things for the whole person. And he calls us to do the same."

     We will miss the gentle presence, teaching, and inspiration of Dr. Gustavo Parajón to work tirelessly towards health for all. We are comforted  that his vision continues to live on in all of us who were touched by his life.

Gustavo is survived by his wife, Joan, daughter Marta Parajón and husband, Denis Cuellar and children Cynthia, Debbi, Raquel and Annie; daughter Rebecca (Brian) Clark and daughter, Lauren; son David (Laura) and children Cristina, Scott and David. Dr David and Dr Laura Parajón are currently the co-directors of AMOS Health & Hope.