Illiteracy is a problem in our communities often related to the fact that some people speak only Quechua that is an oral, not written, language. An average diabetic takes a dozen or more pills every day divided throughout the day. We use symbols for medications and times of days and simplify the schedule so that patients take their medications at meal times and before bed.
We have patients suffering from dementia who have little family support. It is difficult for them to take their medications or for us to know what and how much they took when. Our promotoras (community health workers) are invaluable in this respect. We have a few patients who take all their all medications under direct supervision of promotoras. Promotoras live where they serve so patients are never more than a short walking distance away.
We are striving to provide high quality health care with few resources. Therefore we put all the money into care and none into buildings (except for a small permanent clinic we rent). It is better to not have a roof and give patients the medications they need than to have a roof and give them less.