Midwifery & Health in the Americas: Marrying Mayan & Western Medicine - Guatemala
Service Trip May 26- June 2, 2012 – Summary
Hosted by the VCU Institute for Women's Health in partnership with the Highland Support Project, Partners in Service Program, and the Association of Highland Women (AMA)
The work of a midwife in Guatemala is an ancient art form, using philosophies and techniques that are virtually unknown in Western medicine. Her practices are founded on the belief that we must achieve and maintain a balance between humans and the environment. In the highlands of Guatemala, midwives are often the only health care providers for many miles in isolated, rural communities. They are eager for more knowledge of medicine and the opportunity to develop their abilities in order to improve the quality of care given to their patients. The program allowed the team to share time in Quetzaltenango with Mayan women, midwives and health promoters from a number of rural villages both learning about their practices and sharing expertise around health, pregnancy, birth and mothering.
A multi-disciplinary team of 18 people including participants from Virginia Commonwealth University Institute for Women's Health, Department of OB/GYN, a VCUHS labor & delivery nurse, nursing and pre-med students from VCU, along with a family medicine doctor, community holistic health educator, childbirth educator, physical therapist, an EMT practitioner, a special education teacher and several family members. The group was primarily from Richmond, Virginia, but a few participants came from places like New Jersey, North Carolina and the New York. Guided by the community organizing of the local Guatemalan group Association of Highland Women (AMA)we worked together outside Quetzaltenango, in the Western Highlands of Guatemala with indigenous women from the villages of Chuicutama, Chuiquisies and Xeabaj 1.
The group decided this year to develop a series of three presentations on topics requested by local women including gestation, from fertilization to birth, maternity exercises and pain relief, and caring for babies including dehydration and first aid. The 40 women including area midwives, health promoters and women’s circle participants from surrounding villages joined the team at El Refugio a training center outside of Xela. After forming a circle, introductions were shared across languages (English, Spanish, and K’iche’a Mayan language ) a game that had everyone passing a ball over their heads and running to the head of the line - with everyone laughing and cheering each other on the groups went to 3 separate training rooms. Three sessions were held over the two day period and included presentations and shared lunches. Circles opened and closed each day’s activities.
Group 1 team was lead by Janet Eddy, MD and included presentations on infant rehydration, a presentation by an EMT on first aid, infant and adult CPR and emergency response for choking and a special education teacher discussing child development and developmental milestones.
Group 2 team was lead by Keith Bell, a Richmond area acupuncturist/holistic health instructor and focused on maternity exercises, birth positions and exercising for pain relief, including techniques for utilizing acupressure during labor and delivery. The group included presentations from a VCU labor & delivery nurse and area physical therapist.
Group 3 team was lead by Therese Hak-Kuhn and focused on gestation- from fertilization to birth and included information on the menstrual cycle with instruction from Christine Isaacs, MD via the ‘cycle beads’ on this natural family planning option that can be used as birth control or to plan a pregnancy. Women learned how to track their period cycle and know which day’s pregnancy is possible.
The presentations were video-taped with a plan to have the information available for future use in village women’s circles. At the end of the two days of training the group came together for lunch and the presentation of individual certificates by the team members for the women who had attended. The Mayan women then offered a gift and a hug to each of the team members. It was a lovely exchange captured in group photos of all the participants.
On Wednesday the teams took the presentation on labor/birth exercises and cycle beads to the villages of Chuicutama and Xeabaj 1. Community women from area women’s circles joined the team with between 15 to 20 women attending in each of the communities.
On Thursday the team traveled to Concepcion Chiquirichapa to participate in a traditional Maya ceremony and plant trees on a hillside outside Zunil. We had lunch at ACAM, Asociacion de las Comadronas del Area Mam, a Midwifery Project and Birth Center in Concepción and learned about their practice and center. In the afternoon the team met with a Mayan bonesetter and learned about traditional medicinal plants and healing. The day ended with a stop at the hot springs - thermo sources that eminate from the Zunil volcano and flow into the place known as FUENTES GEORGINAS for a relaxing soak.
The group thought carefully about how to approach our time together and how to provide a safe space for indigenous women to share their experiences and concerns. The team felt clearly we wanted the sharing to be equitable, knowing we would learn as much from them as we might share from our own experiences. The women started with soft voices and perhaps some hesitation. Translation from K'iche' to Spanish at first seemed slow, but a rhythm developed and as the sharing continued, speech became more rapid, and with time the women became open and animated on occasion interjecting comments and opinions all at once, excited about the topic. At times the laughter and chatter was all consuming on both sides, with a sense we had found solidarity with stories and shared experiences as women. A number of times women shared great relief to fine their experiences of menstruation, pain and birth were ‘normal’ and seemed to glow in the learning about their own bodies and health. The discussions evolved across the continuum of women’s health from maternal and child health to family planning, pregnancy, birth, labor and post-natal care and afforded opportunities for the exchange of hands on skill building and illustrations of both Western and Mayan practices.
Overall, the trip itinerary had a wonderful balance of cultural, community and service related activities. Time in the villages included participation in a traditional Maya ceremony, meetings with a Mayan bone-setter, midwives and health promoters and women’s circles members, all with an emphasis on respect, equality and mutual sharing. We had lectures on Mayan Health and Cosmo-vision and learned about the Mayan calendar and our ‘Nawal’ which based on your birth date and year is your helper and guide in life. The group had a presentation from our host organization AMA on their women’s circle model and their approach to working with communities. We also had a chance to experience some of Guatemala’s many cultural sights and activities including a boat ride across Lake Atitian to a small village San Juan La Laguna to visit a women's weaving and natural dye cooperative: FEDEPMA, The Federation of Mayan Women Textiles. They shared how they dye cotton with natural materials such as herbs and bark. We toured a local organic coffee farm – the Cooperative La Voz, bathed in a sacred Temescal, learned to make tortillas, and shopped at artesian markets in Panajachel and Antigua. It was a very full week.
Mostly we came as strangers to each other, but left as friends having shared an amazing experience, transformed as professionals and people, richer for our time together with our Compañeros in Guatemala, looking forward to future opportunities to share and learn together.
Janett Forte 6/5/12