In the summer of 2009, Cassandra Peitzman, a student at Harvard Medical School, travelled with PIH to Chiapas, Mexico. There she helped implement a photovoice project—an initiative that placed cameras in the hands of illiterate women from five communities, giving each the chance to document her world and life through pictures.

Over the course of six weeks, Cassandra and PIH and EAPSEC staff in Mexico spent roughly one week in each of the five communities: Rancho Bonito, Cerro Perote, Cinco de Mayo, Honduras, Nueva Libertad, and La Laguna.

Images taken by women living in the mountain village of Cinco de Mayo.

The women met in groups of 8-12 to discuss their rights, health care, farming techniques, and their children and families. More than just sharing stories and ideas, the women talked about the ways they could work together to improve life in the community. They also received a crash course in photography.


“This project sought to empower women in rural communities of the Sierra Madre mountains to analyze, document, and present the challenges that they faced as women and individuals,” recounts Cassandra. “It also attempted to facilitate organization between women by forming discussion groups, and to provide a supportive environment for the generation of specific, actionable goals for change.”

While the specific format of the workshops and home visits varied somewhat between each group, the overall structure of the project was consistent between communities.

“On the first day in each community, Lindsay [Palazuelos, PIH’s Mexico project coordinator] and I attended a meeting of local women,” says Cassandra. “We explained the intention and design of the photovoice project. We answered questions and invited the women to participate.”

During the second day of meetings, local women discussed the difficulties they faced in the community, the opportunities and resources available to them, and their ideas for positive change.

“We also taught the women how to operate digital cameras and distributed donated cameras,” remembers Cassandra.

Each woman had one full day to take pictures of whatever she wished, with an emphasis on things that she considered especially important, helpful, or difficult. At the end of the day Cassandra and Lindsay visited each woman’s home to discuss her pictures, her reasons for taking them, and her experience using the camera. 

Common themes emerged amongst the photographs. A surprising number of women took multiple pictures of wells, gardens, ovens, cleaned kitchens, and farm animals. There were far fewer pictures of family and friends than Lindsay and Cassandra had expected. And even fewer self-portraits.

Each woman documented her daily life, and for many of the women involved that meant capturing images of her daily labor—from baking bread to raising chickens.

“At this time, we also asked several directed questions about the challenges and resources that the women had in the communities and their opportunities for participation in decision-making,” says Cassandra.

“On the final day of the project, we held another workshop to show the participants’ pictures to the group, discuss the themes that had emerged in the pictures and conversations, and facilitate the generation of ideas for constructive change,” says Cassandra. “This final workshop often produced plans for small collaborations between the women, to cooperate in the planting of radish gardens, for example, or for broader-scale political action, organizing a group to inquire as to the whereabouts of government-promised resources.”

Cassandra worked closely with EAPSEC leadership, especially Leonel Gonzalez Ortiz, as she designed and implemented this project. PIH has accompanied the Chiapas-based nonprofit EAPSEC—El Equipo de Apoyo en Salud y Educación Comunitaria—since 1989.

As they moved between villages, Cassandra and Lindsay worked with and stayed in the homes of PIH/EAPSEC community health workers.

Before heading back to medical school in Boston, Cassandra printed all of the photos and made sure that each participant received copies of her pictures.

Learn more about PIH's work in Mexico.