Midwives Group

Midwives Group

Midwives in the Highlands

Midwives in the Highlands

Wednesday, July 14, 2010

A brief summary

Our schedule was filled with learning, sharing, experiencing the culture and lives of our sisters in Guatemala. We worked for 4 days in the rural Mayan villages of Chuicutama and Pacutama about an 1 1/2 hours outside of Quetzaltenango

The trip included
•Participating in midwifery and health promoter trainings – with a focus on prenatal care, fetal position, traditional birth, post-partum care. The health promoters learned about vital signs, blood pressure and thermometers
•Participating in a local health committee meeting to explore development of VCU collaboration to improve health access and services in the 5-7 area villages.
•Communal lunches with our Mayan women hosts
•lessons from midwives on medicinal herbs
•Sharing in laughter and fun via therapeutic clowning - bubbles and colorful outfits
•sweat baths in a ‘Temascal’ a sacred Mayan tradition
•Lecture from a ‘bone-setter’, similar to an orthopedic surgeon
•Lecture from a Mayan spiritual guide and participation in a sacred Mayan ceremony
•A Mayan Cosmovision lecture on history and culture with Daniel Matul: with a focus on Mayan conception of health and current Mayan health conditions and practices with trends and issues in Mayan Women’s Health Care
•Presentation on the Health situation in Guatemala from Yolanda Castile a government public health nurse and district manager.
•Meeting with ACAM – Maternity Center in Concepcion Chiquirichapa, Guatemala
•Stop at Iximché(“E-ch-em-shay”)the Pre-Colombian capitol of the Kakchiquel Maya kingdom from 1470 until its abandonment in 1524.
•Salsa lessons in Antiqua

Two of the VCU School of Social Work students utilized the trip to receive independent study credit as they studied issues related to women’s health, maternal mortality, family life and social justice in rural Guatemala under the faculty guidance of Karen Smith Rotabi, PhD, Assistant Professor Virginia Commonwealth University School of Social Work.

The group also used an article by Rotabi: “Ethical Guidelines for Study Abroad’ to critically analyze the teams approach to the service/exchange experience. Using the pillars for ethical study model the group considered issues of power and privilege, community capacity, competence, integrity, dependency, and self-determination to facilitate a safe yet challenging learning environment with a social justice and human rights framework.

Overall it was an amazing trip - transformative as the folks at Highland Support Project like to define things. The midwives were very happy to receive the kits we had prepared and were particularly thrilled with the scissors. So many of our family and friends contributed to this effort with donations of cash and supplies. The midwives shared that they often didn't have the right tools to assist in births and though amazingly creative and innovative using a machete for cutting the umbilical cord would not be something we wanted them to have to continue. We learned so much from the women we spent time with and we were incredibility inspired by their courage, tenacity and eagerness to lovingly support the health of their communities and the miracle of birth in their villages.

Monday, July 5, 2010

Reflection by Abby

Woke up at 2:45am on the Fourth of July to get ready to go home. I moved slowly as it was early and I was sad. My new-found family had left the day before and we did not have the best beginning of my last day (more on that later). However the ending was perfect with the five of us (Allison, Janett, Janet, Kristen and myself) sharing a great meal in an interesting restaurant with an even more interesting restaurateur.

On our last night together our team shared pizza on the rooftop of our hotel in Antigua Guatemala. We shared delights,highlights,what we have gained and what we were leaving behind. I was interpreting for my friend Gerardo (he was our driver on last years GHRC delegation). So I was not really able to process for myself. I was also very emotional and could not have gotten out two words with out breaking down.

I still have not completely processed of course but I was on the plane from Miami yesterday when the woman next to me started complaining about it taking too long and how she had just come from Turks & Caicos and she should have sat in first class. She then looked me in the eye and said, "but I don't want you to think I'm a snob".

Hmmm, those of you who know me well will be happy to know I just looked at her and said, "Maybe you should have (sat in first class that is)".

I did not know how to respond in a constructive way. I was at a LOSS for words. Imagine that.

Anyhow, I have thought about the highlights and delights. One of the highlights was by far being able to trudge up the mountain every day for three days in the rain, mud and cold weather to get to the trainings and upon reaching the training site and saying sakarik nan (hello!). They were excited to see us, and so grateful. During our sharing time when the woman felt so moved to speak every single one of them said how happy and grateful (emocionada's) they were that we made it safely up the mountain. Even though we had to translate from Spanish to K'iche to English there was perfect understanding that we were there in solidarity.

Another delight was being able to get to know the women we traveled with from Virginia and all that they had to offer to the group. I think we all learned something from the K'iche and M'am women, I learned that while we speak different languages we may have similar experiences. These women feel joy, pain and happiness just like we do. They are grateful to be alive and appreciate mother earth for the sustenance she provides us all. I think that upon some more reflection and processing I will come up with a far greater list of what I am taking away than what I left behind.

Abby Dini

Friday, July 2, 2010

Mayan Ceremony

As we climbed up the winding mountain path strewn with pine needles, shadows of the tall trees welcomed this new community into their ancient fold.
It was so surreal. Here we were in the town of Concepcion being led by a Mayan priest to the town's ancient alter, where we would all participate in a Mayan forgiveness ceremony. We shared the path with our new friends, the Mayan midwives, many of whom would be sharing in this experience for the first just like their American counterparts. Unfortunately this strange reality is not uncommon. Only in the past 15 years have the Mayan been able to express their ancient ways more openly in the town of Concepcion, as in many other villages across Guatemala. The path rose higher to meet a plateau where, encircled by the trees, was the sacred Maya alter. It became clear why today was the day of the bee and the buzzard in the Mayan calendar. The alter was covered in blackened ash surrounded by crucifixes, candles, flowers and...bees. The Maya priet began to unpack his cardboard box full of candles incense and pine wood, more like a holy medicine bag. Just before the ceremony began floating in the sky was a buzzard, he circled once as if to bless the two-leggeds beneath him and flew away. The wind blew giving rise to the sound of the trees, all the while being cradles by the surrounding mountains.

posted by Kristin Pacello

Health Care Promoters Training

monday morning we met 7 health care promoter students who were waiting at the clinic for us. Most had trudged in the rain over the mountain. they had learned a little about vital signs but had never seen a blood pressure cuff. Since we had brought some along we taught everyone how to take a blood pressure. everyone got it about as fast as I remember the med students getting it, even the older woman who couldn't read the numbers on the meter. we talked about high blood pressure in pregnancy, spent close to 3 hours together.

tuesday the teacher was there; she comes every 2 weeks. She taught about fever and then we used the thermometers we brought to show how to use them. second half she taught about child growth and development, including alternatives to corporal punishment and talking to your kids about changes that happen in puberty. very very good teacher, really engaged the class and had good information.

wednesday we were the teachers again. reinforced how to take vital signs, taught how woman can know the time of the month that they are fertile, and how to respond to emergencies like choking and injuries.

Hard to describe how good the connection was with these students even through double translation. Lots of smiles and nodding and all that other nonverbal stuff that goes with the best of being human!
posted by janet eddy

Thursday, July 1, 2010

Midwife Training

Mayan midwifery training from Alison's perspective...

Hola amigos y amigas! After three days in the midwifery training, I had about ten or eleven pages of notes. Much of it was either common knowledge or repetitive, so I took some highlights and have pasted them from my own blog to you all...

Here's some interesting facts I learned about Mayan midwifery (and more)
- Mayan midwives are called "Comadronas"
- The Mayan women of Guatemala are a largely oppressed population. This is so ingrained in their culture that you can see it in their faces. On our first day, they spoke quite softly with eyes toward the floor. By the end of the last training, they seemed much more empowered, looking us in the eyes and smiling.
- Most of the Mayan midwives operate with little or no equipment. Instead of a fetal stethoscope, they use a plastic tube (or a bamboo shaft) with two CD's attached on either end. They place one CD end upon the Mother's belly with the other end at their ear. Talk about innovation.
- Mayan midwives have a plant to treat just about any ailment that a woman could have: anemia, nausea, pain, UTI's, ANYTHING. Amazing. (p.s. corn silk is really good for treating UTI's. throw it in with some chamomile tea. wham bam no more UTI)
- Massage is a very important element in Mayan midwifery. Palpation of the mother's abdomen helps both in the treatment of contractions and other pains, and it also creates a significant level of trust between the midwife and her patient.
- Mayan midwives assist 85% of Guatemalan births
- If after the 5th month of pregnancy the baby is not in a vertex position, the Comadrona will massage the mother's abdomen with pomade to get the baby to re-position
- We met a little girl in the village that we've been training in (Pacutama) named Catarina Ofelia that was born during Hurricane Stan in 2005. Her father trekked 6 hours through the mountains in the middle of the storm with his wife in labor on his back. Talk about inspirational.
- Did you know: If the baby's heartbeat is heard on the mother's left side at the start of labor, that means that the baby will come quicker than if it's heard on the right side.
- During labor, the cervix should only be checked every 4 hours for dilation. Most women dilate around 1 cm per hour, but that's an average number. The reason why you wait 4 hours is because you don't want to put your patient through unnecessary pain. Imagine having your cervix stretched and a person trying to measure it every five seconds while you're having contractions. No bueno.
- Mayan midwives use onions to clear baby's sinuses directly after birth.
- Comadronas use sweat lodges called "tamazcals" to treat mothers and their babies after labor. It helps the healing process and is a calming, soothing way to end a slightly (or very) traumatic labor. The midwives blow hot air onto the mother's vagina to help it heal. They do not stitch up the perineum or vulva after birth, even if there is a tear (unless the mother has torn down to the rectum- this can be a serious situation that is usually referred to a hospital or birthing center in the city).
- In the past year, there have been over 50 births in Pacutama. Only 7 of them had complications, and all of those complications resulted in healthy mothers and babies.
- Mayans believe that the number of notches in the umbilical cord determine how many children that baby will eventually have.
- Usually, the placenta is either buried in the tamazcal or, if the family doesn't have a sweat lodge, they'll bury it under a tree or flower.
- Mayans believe that they need to teach their children respect both while they're in the uterus and throughout childhood.
- Women put money in their child's hand so that when they grow up they're not lacking and so they'll be hard workers. They rub chili around the baby's mouth for strength and spice in their life. They put salt on their tongue so their child will live a life of flavor and won't gossip. They swaddle their baby so they won't steal.

I hope I've shed at least a little light on the amazing experience we've had so far. These women are inspirational and I have every intention of returning.

- Alison Spillane

ACAM Maternity Center: Concepcion Chiquirichapa, Guatemala

Today we visit with the midwives of ACAM at their Mayan birth center. These are the same midives that have been providing the training at the village.

We also participate in a Mayan Ceremony.
and tonight salsa might be on the agenda.

We expect to have some down time tonight so we may have an opportunity to share more on the blog.

Road to Village

Wednesday, June 30, 2010

Chucatama village day 3

Every day has been unreal. Long days, hard travels to the village 1 1/2 hours each way on terrible roads and it has rained almost the whole time we are here. BUT the days with the villagers have been filled with learning and sharing. Today we had training with the midwives and the health promoters and we had a chance to meet with the area health village committee leaders. The hope is to develop a partnership to support developing sustainable health services that will be available for 6 to 7 area villages serving probably 5000 people.

The midwives training focused on traditional birth, postpartum care and postpartum depression. The trainers shared many skills and techniques they used, but also shared fascinating information on the ways they welcome a baby in to the world. Health promoters learned about taking vital signs, first aid and basic information on a women's ovulation cycles.

Team members under the guidance of Allison had a opportunity to interact in 'therapuetic clowning' which engaged the women in laughter and lighthearted fun and dancing.

Late this afternoon the team shared in the experience of a Temascal (sacred sweat)

Tonight a presentation on the mining situation in Guatemala.
Tomorrow we participate in a Mayan ceremony. Whew !! exhausting, but amazing

Chuicutama Part II

So I was on about the third paragraph of this blog last night when poof! I hit the wrong button on the computer and it was lost in the cosmos. So I will try to continue....

after returning from Chuicutama we had a little bit of down time. We walked a few blocks to try to resolve the cell phone issue. Also an unsuccessful endeavor I did not realize that the SIM cards expire. Oops.

Anyway we ate dinner Monday evening then headed out to a local bar El Cuartito to hear Cosmovision leader Daniel Matul speak.

The discussion included what contemporary Mayan leaders are saying about 2012, the year that the Mayan millennial calendar seems to mysteriously end, with many predicting great, global change. Sr. Matul is a Mayan Elder renowned throughout the world for his scholarly work, advocacy and activism, empowered by the Mayan council of Elders, Maya International League and other indigenous NGO's to speak for the Mayan people.

We listened to him speak for about an hour and a half (I was translating along with Lupe)about the relationship between humans and the universe. He talked about how important it is to balance ourselves, self-reflection and to practice LOVE! He was inspiring. We also asked him about what happened to the Ancient Mayans (the Great Empire) he responded that they had technology to see that something negative was going to happen so they dispersed so there would not be a concentrated center of all of their knowledge and resources (you can see a short video of a previous presentation on Highland Support Project's web page).

After his presentation we returned to the house it was late and raining and we had a lot to process.

Janett is going to tell you a little bit about Sunday...we skipped right over it! We had the opportunity to visit with Mayan Medicine people. A bone-setter (compone huesos), a Mayan Priest (Sacerdote Maya) and a midwife (comadrona). It was very enlightening.

-Abby Dini