| There is no doubt that midwives worldwide are | | | | traditional midwives give to the impersonal care of |
| very special people. They possess a unique ability | | | | the local hospital; "The midwife offers love and |
| to care for women and newborns and it takes a | | | | trust and confidence and she doesn't do it |
| distinctive set of skills to qualify for the job. More | | | | mechanically like the nurses and doctors. |
| than 60% of the world's babies are helped into | | | | However, I don't mean to offend these health |
| the world with the hands of a midwife or | | | | care workers, who do the best job they can. For |
| traditional birth attendant. In Central America, | | | | example, a woman goes to have her baby in a |
| midwives are generally referred to as "traditional | | | | hospital. In the room she will find a nurse, a |
| midwives". | | | | person who cleans and another woman in the |
| Central American traditional midwives are usually | | | | next bed to her. The doctor arrives and says |
| well known and respected in their community. | | | | "let's see lady, open your legs", and the woman |
| Many traditional midwives say they felt a calling to | | | | feels ashamed. On the other hand if a midwife |
| be a midwife and learned their skills through | | | | attends this woman in the privacy of her own |
| apprenticeship and experience rather than formal | | | | home, the woman experiences trust." |
| training. | | | | Doña Alicia went on to say that she didn't |
| But Central American midwives have a tougher | | | | want to offend the doctors because they do |
| job on their hands than their counterparts in | | | | offer good care when they are needed. But that |
| wealthier countries. In countries such as | | | | they do not possess the kindness of a midwife, |
| Guatemala, Honduras, Costa Rica, Nicaragua and El | | | | and often lack the patience the midwife has. |
| Salvador midwives can often be found working | | | | Josefa Mira, a midwife from El Salvador, explained |
| under appalling conditions, depending on how | | | | that the midwives are constantly monitoring the |
| unstable their country's health system is, and the | | | | progress of the labour and when a complication |
| majority of these women do not get paid for | | | | presents itself they organize immediate transfer |
| their hard work. | | | | to a hospital. "And we don't only care for women |
| PAHO (Pan American Health Organization) | | | | of the community during pregnancy and birth", |
| estimates that there are about 22,000 maternal | | | | she said. "We also look after the general health of |
| deaths per year in Latin America and the | | | | women and their families, domestic violence and all |
| Caribbean with an aggregate ratio of 190 deaths | | | | the illnesses that are common in our communities." |
| per 100,000 births. PAHO also estimates that | | | | However, lack of transport is a major problem in |
| under-reporting in many regions can be as high as | | | | most areas and women in high-risk conditions |
| 70%. | | | | often cannot be moved to a hospital for medical |
| In Central America, traditional midwives attend | | | | help due to this dilemma. The same problem |
| most of the deliveries where the maternal | | | | exists if there are not enough basic medicines to |
| mortality is the highest due to poverty. The | | | | treat disease in pregnancy. |
| contribution of traditional midwives to the health | | | | The Central American Midwives plea is to be |
| of nations has been undervalued by governments | | | | recognized and accepted for the value of their |
| and insufficient resources have been allocated to | | | | knowledge, to work as a team with health care |
| providing midwives with the equipment, training | | | | services, to be adequately trained and equipped, |
| and medicines that they need to carry out their | | | | and rightfully compensated. This issue needs to be |
| job safely and effectively. In April 2004, a group | | | | recognised as an important, pressing matter. |
| of midwives from these five countries took a | | | | Let us help those who bear the hands that hold |
| ground-breaking step by coming together in Costa | | | | our future generations. Let us help the Central |
| Rica to share their experiences as midwives in | | | | American Midwife Crisis. |
| their respective countries. Their tales reflect their | | | | Guatemalan midwife MarÃa Cecilia says; |
| love and devotion to their work, and their ongoing | | | | "What I would like most for our country |
| commitment to the many women they have | | | | Guatemala is health for everyone, that having a |
| helped through childbirth. | | | | baby would become safer, that we would have |
| They tell their stories of how unjust their health | | | | safe and healthy childbirth, and that society would |
| systems are and share harrowing accounts of | | | | give importance to mothers and the work of |
| health care systems which fail its people. | | | | mothers. When we are expecting our babies we |
| Central American Midwives, the charitable | | | | should feel cared for and receive love. And the |
| organization that funded this assembly, produced | | | | other thing I wish for is that one day midwives |
| a DVD depicting these women's stories. In the | | | | would really be part of the health care system |
| documentary, one of the Nicaraguan midwives, | | | | and have a salary that we can enjoy. |
| Doña Alicia, compares the care the | | | | |