We had another amazing time in Guatemala this year training further comadronas. We spent our time in the Department of San Marcos, in 2 different areas. During our first week, we trained 40 from rural areas NW of San Marcos itself, near the base of Tajumulco volcano.
Some of the hamlets were more than 2 hours away. Many of our participants were young women with the desire to become comadronas in their communities. There were also 4 volunteer paramedics in the group with the remainder being comadronas with varying degrees of experience.
Our second week was in Sipacapa, which is the center for many very small and remote rural communities. This town of 18,000 has a very poorly equipped Public Health Unit and there are no physicians. The nearest National Hospital is at least 1 hour away and often lacks necessary medications and equipment and at times, the necessary trained personnel. The area has a lot of infrastructural issues as well, which we experienced first hand. For many communities the only access is via poorly maintained dirt roads. The town is frequently without electricity and/or water. Thirty participants were comadronas with a lot of experience, 2 were volunteer paramedics and the remaining 8 were aspiring to become comadronas.
Both weeks, we had the support of the municipalities as well as ADIMAM, which is a group with oversight over 16 municipalities to ensure that locals benefit from funds given specifically to improve quality of life. They provided a midmorning snack and hot lunch for all participants, as well as accommodation and meals for the team. They also provided good spaces in each town for the training to take place.
This year our team was composed of 4 Canadians, Dr. Ruth Brighouse, an obstetrical doctor from Kamloops, Birte Paschen, a registered midwife from Vernon, Shannon Greenwood, a registered midwife from Haida Gwaii and myself, a maternity nurse from Salmon Arm. We continue to be blessed to have our Guatemalan teammates: Cenaida Juarez, our co-ordinator, Gloria Cutuj, our practising comadrona, and Gaby Castellanos, a nutritionist and comadrona. All are amazing educators!
Our course gives the students the knowledge and skills to assess pregnant women during their pregnancy to help prevent complications from arising as well as skills needed should an emergency arise during the birth. Once again, it was remarkable to see the students so intrigued by what they were learning. In spite of some having had some previous training, their desire to learn was palpable! We continually heard that this was the first time they had experienced a “hands-on” type course. Of course, the hands-on nature of our course also ensures that the students learn the skills we teach. We are also able to assess their newly learned skills and knowledge as we continue throughout each week.
The courses were very well received and during our final talking circles (at the end of each week-long course) we heard from many, how valuable the training was that they had received, how they found the “hands-on” format to be very useful, and how they felt very grateful for the opportunity to participate in our course. Even the comadronas with up to 50 years of experience, said they had learned new skills, and that this was the first time they had a course where they were shown, and then, practised the skills.
We had wonderful graduation ceremonies to celebrate the students completing each course and each student received their diploma and manual, as well as a kit of supplies to help them during their next number of births.
Our team has already been asked to bring our course to other municipalities within the Department of San Marcos. In the coming year our Guatemalan teammates will do further training in some of these areas and then the Canadians hope to be back in Guatemala again next year for continued training in the areas of need.
The Ministry of Health continues to give us their approval and hope that we will be able to reach many other remote areas of Guatemala in the coming years. Although we have not been able to get definite statistics, the interviews done in communities where we have taught, revealed that the comadronas and the Public Health Unit personnel gave resounding approval of the courses. The comadronas feel much more confident in their assessments of pregnant women, prenatally and during birth. The health personnel are seeing the comadronas refer many more mothers to them when they determine that there are risk factors that need to be addressed.
This year, we were interviewed by national TV and newspapers and this has further spread the word of the importance of training traditional midwives.
Thank you all, once again, for your much appreciated support of this project, helping many Guatemalans learn safe birthing skills and saving lives! Muchas gracias!