Safe Motherhood Project Guatemala

This is an interview with one of our students, Victoria Isabel Lopéz Lopéz, from La Agradía de la Esperanza. 

When I began I didn’t know anything. I wanted to serve but I was scared. I had dreams and everyone told me I should become a comadrona but I was afraid. I got sick and I suffered a lot as the years passed. I suffered and suffered with a lot of bleeding. I went to doctors and to comadronas but they couldn’t find any reason for it. They said everything was fine. I visited another person and they told me that I was suffering because I was supposed to become a comadrona. I was still afraid. I didn’t want to. My husband was jealous and didn’t want me to work either but in the end he accepted it.

When my sister became pregnant with her sixth child, my brother-in-law suggested that I should start with my sister. I had looked after her other babies after they were born and he had always told me I should become a comadrona.

The first time I touched her stomach, it seemed really big, not normal. I didn‘t know much but I knew it wasn’t normal so I sent her for a check-up with a doctor. The doctor told her she had lots of liquid but that everything was normal and it was fine for her to give birth at home.

I felt more assured. But then she began her labour early. It was only seven months.

In the beginning, for a short time, everything was fine, normal. She had pains and then came time for the birth. My sister was guiding me as she had had other children and knew what to do. The baby was born without problems and we waited for the placenta. I touched her stomach and felt something move!

“There’s another child!” I told her.

I don’t know if it was the shock of it or for some other kind of weakness but she fainted.

My brother-in-law went to find a doctor. When the doctor entered she looked at me and asked, “Why haven’t you cut the cord?”

I didn’t say anything. I had thought of it, but my brother-in-law had told me to wait for the placenta. Since I didn’t know much I listened.

The doctor told me I should have, that the baby doesn‘t need the placenta after it is born. Now I know and if the placenta doesn’t come quickly, I cut the cord. I learned this that day. I cut it while the doctor examined my poor sister and confirmed that there was another baby and that it was still alive.

The doctor gave my sister an injection and began to stimulate her so the pains began again. My sister woke up and gave birth to another baby. The doctor gave her some pills for an infection she had and then left us.

Word got out that I had delivered my sister’s twins and since that day, 25 years ago when I started to work, to serve as a comadrona, it hasn’t stopped. I’ve delivered more babies then I can recall. There are months when it’s only two but four or five is more common. As I gained experience, more and more people asked me to assist. All because my sister and her husband gave me the opportunity.

March 8th, 2013 | Category: General | Leave a comment

Stepping off the airplane in Guatemala City, we were welcomed by a warm breeze, heavy with the perfume of tropical flowers. Over the next days, we made our way first to San Lucas Tolimán to meet up with our Guatemalan team-mates and then on to El Rodeo, the town we are teaching in this year. We had the opportunity to see a small portion of the incrediblebeauty and diversity of the country. Our route took us up through the highlands of cool pine forests, patchwork fields of vegetables and corn, and small towns clustered on ridges. Then we began to descend along a tortuous highway, through forests and across rivers. The air warmed and the vegetation became tropical. We passed through fields of food-bearing trees – bananas, coffee, cashew, and citrus – and clusters of houses almost hidden by crotons, bougainvillea, hibiscus, and datura trees.

El Rodeo, in the department of San Marcos, is in the foothills, halfway between the mountains and ocean. Tomorrow is the final day of training for the 28 participants in this week’s course. Our students are comadronas, the traditional birth attendants of the Maya people, and bomberos, the volunteer firefighters who also provide the local ambulance service. These students are bright and highly motivated. They learned surgical hand-washing as a way of preventing infection; prenatal care; how to identify the pregnant woman with risks who should not deliver at home; and the care of women during labor and delivery. We discussed, and practiced in great detail, the management of various complications during labor, including hemorrhage, convulsions, and shoulder dystocia (where the baby becomes stuck in the birth canal after its head is delivered). This is “hands-on” learning at its best.

Tomorrow we discuss emergency planning; we have already had great discussions between the comadronas and bomberos about improving communications and timing around emergency transport (there are two hospitals that people use here; one is one hour away, and the other is 1.5 hours away).  Our final themes relate to contraception and breastfeeding.

We expect to have a similar number of students next week from other nearby villages. Stay tuned.

We’ve added some photos of our time in El Rodeo to Flickr–check them out!

February 23rd, 2013 | Category: General | Leave a comment

Once again, we are in the midst of getting ready to head off to the highlands of Guatemala. We are so excited to be planning our 11^th ”Safe Motherhood” program in the training of Traditional Birth Attendants, or “Comadronas”, as they are called in Guatemala, the needed skills of safe birthing and neonatal care.

This year from Feb. 16 – March 8, Ruth Brighouse (MD), Annette Borkent, and Kristine Zylstra-Moore will be in Guatemala, joining with Cenaida Juarez, our project coordinator, (whom you may remember, we employed in October) as well as Gloria Cutuj, and Gloria Mejia, both of whom have been part of our team for the past number of years. It is particularly exciting this year as we will be implementing the next step of our program to expand its reaches into other remote areas of Guatemala. Cenaida has sought out leaders in a variety of communities in rural Guatemala and has invited them to come to a “Train the Trainers” course. We will have a week of training and then facilitate these new instructors to teach the course to comadronas, who have not had previous training, the following week. Once the new instructors have returned to their villages, Cenaida will go to their towns at some point in the coming year, along with either one or both Glorias, to assist them in teaching the course to other comadronas in their own area. It is very evident that this is a very important step in promoting the independence and self sufficiency of this project.

Our third week will be spent in meeting with various officials from the government of Guatemala. Cenaida told us of the very real possibility of seeking an audience with important members of government and the Ministry of Health (she already has some strong connections). She sees this as a golden opportunity as there are members at varying levels of government who are interested in women’s health. She is in the midst of setting up these meetings. We also plan to meet with members of other NGOs involved in women’s health issues to see if we can work to enhance expansion of our training and coordinate some activities. We also hope to start some local fundraising efforts with a Guatemalan Rotary club.

Hiring Cenaida and encouraging the growth of the project with further leaders feels like a natural and progressive step in our continuing work with Guatemalan midwives. We envision over the next few years a strong expansion of our project, using our teaching model and format to expand to many more communities with independent and local leaders. This has always been our goal. Although this will, for a time, make the project more costly to maintain, it will pave the way for much greater Guatemalan involvement and support.

Would be willing to make a donation towards this year’s effort? Our expenses will now be about $15,000, as we not only need to cover the costs of implementing the program (materials and medicines, instructional booklets, etc.) throughout the year, including Cenaida’s wages and travel costs of the team but also need to acquire more equipment. We are part of Rose Charities which is a registered charitable organization and provides tax receipts. Please make out your cheque to “Rose Charities”, indicate on the memo line that it is to support ‘Safe Motherhood Project’, add your email address (to make tax receipts easy to send back to you) and send to:

Rose Charities Canada

1870 Ogden Ave, Vancouver, BC

V6J 1A1, Canada

It is also possible to donate online.  To do so click on “Donate Now through Canadahelps.org” on the left sidebar.  Within the Canada Helps site, the donation details under “Fund designation” please select “Safe Motherhood” from the dropdown menu.  Other details should be clear.

Of course, if you can’t contribute financially, please do not feel any obligation! And, in all of this, We appreciate your prayers and good wishes!  It is a real blessing to be looking forward to working in Guatemala again and to continue with our vision of bringing our Safe Motherhood Project to a variety of communities!

The very best to you in the New Year!

February 3rd, 2013 | Category: General | Leave a comment

Annette Borkent and Ruth Brighouse, directors of the Safe Motherhood Project in Guatemala, have recently returned from a week in Guatemala from Oct. 13-18th. It was very exciting to be in Guatemala, and officially employ a trained Guatemalan midwife, Cenaida Juarez, as the Coordinator of the Safe Motherhood Project. We have been training Traditional Birth Attendants in Guatemala annually since 2003 and Cenaida has been with the project since its inception. Cenaida is ready to take on a much larger role in the implementation of the training of the Traditional Birth Attendants in remote areas of Guatemala. It is very evident that this is a very important step in promoting the independence and self sufficiency of this project.

Although this will, for a time, make the project more costly to maintain, it will pave the way for much greater Guatemalan involvement and support. Cenaida’s primary task will be to train others who can teach the birthing course and who, in turn, provide support for local traditional birth attendants.

She will seek out leaders in a variety of communities in rural Guatemala and invite them to come to a “Train the Trainers” course next February. We will have a week of training and then facilitate these new instructors to teach the course the following week. Once they have returned to their villages, Cenaida will go to their towns at some point in the coming year, along with another one or two of our Guatemalan instructors, to assist them in teaching the course to traditional birth attendants in their own area. In short, she will develop a new and growing network of groups who will be teaching traditional midwives the needed skills of safe birthing and neonatal care. It will be great to have Cenaida use her great communication skills to help the project blossom in other areas of Guatemala.

Cenaida told us of the very real possibility of seeking an audience with important members of government and the Ministry of Health (she already has some strong connections). As this will be Cenaida’s employment, she will now be able to use her skills full time to seek support and obtain official recognition of this important course. She sees this as a golden opportunity as there are members at varying levels of government who have an interest in women’s health. These people were voted in last November and have a 4 year term. Cenaida will also link with other small NGOs involved in women’s health issues to see if we can work to enhance expansion of our training and coordinate some activities.

Our trip to Guatemala was an exciting watershed for us. Hiring Cenaida and encouraging the growth of the project with further leaders feels like a natural and progressive step in our continuing work with Guatemalan midwives. We are very fortunate indeed to have such a skilled and dedicated person like Cenaida in this official role and we look forward to exciting further developments.

Update prepared by Annette Borkent and Ruth Brighouse

Annette Borkent (Canada), Cenaida Juarez (Guatemala) and Ruth Brighouse (Canada) of the Safe Motherhood Project.

Cenaida Juarez, the Guatemalan Project Coordinator, from San Lucas Tolimán.

Working out the details of the future of the project and a contract for Cenaida.

Gloria Cutuj and her granddaughter Melanie. Gloria will be assisting Cenaida on all teaching workshops.

View of Lago Atitlán in the highlands of Guatemala.

November 10th, 2012 | Category: Uncategorized | Leave a comment

Safe Motherhood just finished a course in Guatemala for the tenth year, teaching safe birthing practices in rural Guatemala. Our Canadian team this year was made up of Ruth Brighouse (MD), Kristine Zylstra Moore and Annette Borkent. We were joined by our Guatemalan teammates, Cenaida Juarez, Gloria Cutuj, Gloria Mejía and Aura Xatá.

We spent both of our weeks in Panajachel, a town on Lago Atitlán. We taught a total of 46 students including 16 traditional midwives, 14 first aid attendants, and 16 nursing students mostly from the surrounding areas. Six were from towns as far away as 3-7 hours by bus. All were very eager to learn the essentials in becoming more knowledgeable in safe birthing.

All of our students could speak Spanish, which made the teaching go much more quickly. This left more time for our discussions of family planning, emergency planning, as well as human rights, women’s rights and how to promote good self esteem in pregnant women. We also discussed the importance of good nutrition. This topic is of immense importance as statistically, Guatemala is 4th place worldwide for levels of malnutrition and is the worst in this regard in all of Latin America! They also recognized that racism and discrimination were continuing problems and human rights were regularly violated in the present health care system. We hope to see more cooperation at the ground level over the coming years.

Each student had the opportunity to bring in a pregnant woman to have a prenatal assessment done in conjunction with their traditional midwife and Ruth. These patients then also received a packet of clothing for their baby as well as prenatal vitamins, folic acid and iron.

Each week during our closing circle, we heard many people express their gratitude for the course. Many of them eloquently shared that this was the first time they had received any hands- on training and how useful this was for them. After doing many demonstrations and role playing situations, they felt quite confident that they had learned the information.

We are in the midst of trying to have our course recognized officially by the federal govt. of Guatemala to make it possible to spread the course further afield and increase the ease of getting supplies into the country. Thank you so much for your continuing and gracious support for this project. Our project is making a real difference in the lives of many people in Guatemala! We are always grateful for donations so that we can continue our work.

May 8th, 2012 | Category: General | Leave a comment

The Safe Motherhood Project is thrilled to announce we are now officially a member-project of Rose Charities, a wonderful international charitable organization that oversees many amazing volunteer projects. We have updated our donations information to reflect this new and exciting change.

Rose Charities Mission Statement:
“Through innovative, self-sustaining projects and partnerships, Rose Charities supports communities to improve quality of life. We do this within a framework of volunteerism that places emphasis on results. The Rose Charities international network of independent organizations are not-for-profit, secular and non-political. By linking people and working together we all benefit.

We support community-based projects that have strong local leadership and dedicated volunteers. We work with them as they find their own solutions to the problems of poverty. Our role is to find the resources and skills to help them. These communities are able to stretch a small donation to achieve miracles. We support projects in Cambodia, Vietnam, Sri Lanka, Nepal, Pakistan, Kenya and Madagascar on a variety of poverty reducing issues.

Rose Charities Canada is run by volunteers. This keeps our costs to a minimum and enables us to spend your donation on projects and not on salaries or overheads. We are always looking for more people to join us! We believe donors should be able to see where their money is spent.”

Rose Charities Canada is a registered Canadian charity. Registration number: 85944 2303 RR0001.

For more information on Rose Charities, please visit http://www.rosecanada.info/about/.

November 29th, 2011 | Category: Uncategorized | Leave a comment

Once again, our time with the Mayan traditional midwives was extremely rewarding! We spent our first week in San Lucas Tolimán, the town on Lago Atitlán where we began our project 9 years ago. We taught 24 women from a variety of walks of life but all were very eager to learn the essentials in becoming more knowledgeable traditional midwives. Our youngest student was the granddaughter of a woman we taught during our first course in 2003! She now wants to accompany her grandmother and also become a midwife. We have, through the years, emphasized the benefits of working in pairs and it was wonderful to see this taking place. All but 2 of our students could speak Spanish, which made the teaching go much more quickly. Those who spoke Spanish and their Mayan dialect translated for those who spoke only Kaqchikel. This left more time for our discussions of family planning, emergency planning, as well as human rights, women’s rights and how to promote good self esteem in pregnant women (a common problem in many instances).

Our second week was spent in San Antonio Palopó. Our team of 7 travelled back and forth to this town daily by boat. We taught another 24 women there, a group made up of 4 nurses from the public health unit, 6 traditional midwives from the town itself and 14 traditional midwives from outlying areas. The municipality provided transportation by pickup, those farthest away being picked up at 6:30 to be at class at 8 AM. The teaching during this week also went very well and there was important dialogue between the traditional midwives and the professional nurses (to increase cooperation at the local clinic). All of the teaching was done in Spanish and Kaqchikel. This kept our 2 Mayan team members very busy indeed.

Each week during our closing circle, we heard many women express their thanks to us. Many of them eloquently shared that this was the first time they had received any hands-on training and how useful this was for them. After doing many demonstrations and role playing situations, they felt quite confident that they had learned the information. This was obvious to us as well.

An important meeting took place in July, 2010 in which the indigenous people of Guatemala were asked by the Guatemalan government to share their experiences as well as their ideas regarding improvement of health care of the indigenous. This came out of recognition that 75% of indigenous people live in extreme poverty and have been exploited. The government recognized that racism and discrimination were continuing problems and human rights were regularly violated. The government has implemented “el Tiempo de Solidaridad” (the Time of Solidarity) to rectify this situation. We hope to see more cooperation at the ground level over the coming years as we continue with our vision of improving the maternity care of women and babies, decreasing their mortality and improving the lives of our Guatemalan neighbours.

October 27th, 2011 | Category: General | Leave a comment

We had another very rewarding time teaching 61 traditional midwives this past Feb/Mar! We spent our first week in Santa Catarina Ixtahuacan and had the help of a young doctor from the public health center who was very effective in making the women realize the validity and the importance of the work they do. He also encouraged them to come to the health centre if they were concerned about the pregnant woman that they were helping. He would assess the woman with their help and be there while the midwife helped the woman birth and help if any complications arose. This is exactly the kind of thing we have been hoping for!

During our 2nd week, we returned to Chirijox to teach the remaining traditional birth attendants from that area. We also had 2 women (a mother and daughter) that heard we would be teaching in Chirijox, walk 5 hours the first day, having left home @3 AM! Catarina, one of our team members opened her home to them for the duration of the course so they wouldn’t have such a commute to deal with. Each week during our closing circle, we heard many women expressing their thanks to us. We heard some eloquently express that this was the first time they had received any hands-on training and how useful this was for them. After doing many demonstrations and role playing situations, they felt quite confident that they had learned the information. This was obvious to us as well.

The Ministry of Health in Guatemala has also come on board this year. We have always intended and hoped for their involvement, so it is great after these 8 years to have this official recognition! Dr. Christian from the public health unit came to the graduation ceremonies and signed the certificates and stamped them with the Ministry of Health seal.

Word of our course continues to spread. We have been asked to come to 7 other towns in the coming years so Cenaida, our Guatemalan team leader, will be assessing which towns we will start with. Apparently, some of the towns are very difficult to access requiring a 4 wheel drive. It’s also unsure as to whether there will be a room appropriate for a teaching space in some of the towns. So, some sleuth work is required.

We plan to return to the highlands of Guatemala in Feb. 2011 to continue this project.

December 10th, 2010 | Category: Uncategorized | Leave a comment

In Feb. 2009, we spent one week in Chirijox, a lovely Mayan town, teaching 29 traditional midwives our hands-on course. It was great to see the positive impact of our trainihg, through the smiling faces of the women as they demonstrated their newly acquired knowledge and skills. Our second week , we taught an “obstetrical emergency” course to 2 doctors and 32 nurses in the Nahuala area. These were people who were trained in Guatemala and had a good knowledge base but had very little practical hands-on training. They found the course to be invaluable. It was also a great opportunity to have discussions about the important role that the traditional midwives play and the importance of mutual respect as well as to encourage problem solving in their specific situations. Gloria, our Mayan team member, was very dynamic in sharing her story and in her teaching. We hope that our couse will help to bridge the gap and bring more equality to the Mayan people. In speaking with a public health nurse about our traditional midwife training, she stated, ” This project must continue! I have seen a great improvement in the skills and confidence in the women you have taught.” We have been asked to return to Guatemala in 2010 and teach our course to traditional midwives in Sta. Catarina Ixtahuacan.

November 30th, 2009 | Category: General | Leave a comment