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I visited Doña Tina Velasquez Garcia, who is 65 and who lives in a rural community just outside the town of Pochuta, about 100 km west of Guatemala City.
Doña Tina is a comadrona, or a traditional midwife. Comadronas either inherit the role from their mothers or it is a vocation to which they are called.
A voluntary contribution of around £25 (€35) for her accompaniment during pregnancy, birth and in the 40 days after birth is expected. However, Doña Tina explains that most families in the community cannot afford this, so very often she doesn’t get paid but she would never refuse to accompany a pregnant woman on this basis.
She is sometimes paid in kind with chickens or food and to ensure enough of an income to live on. Doña Tina also takes in washing and ironing.
Doña Tina participated in a project funded by Trócaire Gifts, which supplements the traditional learned skills of the comadrona with additional training on many aspects including techniques for dealing with babies in the breech position, managing infectious diseases, how to deal with haemorrhaging and on improving the management and sterilising of equipment.
She was also provided with a midwife’s kit including clamps, scissors, gloves, towels and sterilising equipment that she brings to every birth. She demonstrates the various techniques she has learned with great enthusiasm, and she was bursting with pride as she showed me her comadronas certificate. She has now delivered over 800 babies since she began 38 years ago.
Doña Tina is also an expert in the healing properties of local plants and herbs. Above: Doña Tina with Doña Pilar Ramirez of Trócaire partner CERNE.
The training Doña Tina participated in was delivered by Trócaire’s long-term partner organisation CERNE – the Centre for Nutrition and Education – that is based in Pochuta, Guatemala.
Pochuta is located in one of Guatemala’s poorest regions where the only work available is as poorly-paid day labourers in the surrounding rubber, banana or sugar cane plantations. It has alarming rates of malnutrition among children and it is among the six regions with the highest prevalence of HIV in the country.
In addition to the training of comadronas, they have provided medical care for people living with HIV, programmes to prevent violence against women and children, as well as providing direct support to survivors of gender based violence over many years through support from Trócaire.
Violence against women is a huge issue in Guatemala, particularly in rural areas. Physical violence and psychological, economic and sexual abuse is extremely common and often considered a normal part of life for women and children in Guatemala.
The focus of CERNE’s work is to raise awareness and change attitudes as well as directly assisting survivors of gender based violence which is achieved by working at many levels – with local authorities, the judicial system, in strengthening women’s networks, and with programmes targeting men and boys to reimagine gender roles and identity.
Doña Tina has been working and training with CERNE for years. She has learned many skills aside from those she uses in her work as a comadrona.
She has learned about women’s rights and to identify and challenge violence against women and has seen the direct result of her activism in the fact that violence against women in the community is decreasing.
She has helped couples resolve conflict without the use of violence and the men of the village know that she is keeping an eye on their behaviour and is not afraid to intervene if she suspects that there is violence happening in a family.
Doña Tina is also an active defender of the important role of comadronas in providing essential health care for pregnant women.
She and her fellow comadronas are mostly illiterate, indigenous women and thus often face bias and discrimination by doctors and nurses in the public health system.
She told me that she has been empowered and trained on her rights and so understands what hers and other women’s rights are: “No one can shut me up for being a woman”, she says loudly and defiantly.
In her role as comadrona, she now insists that the fathers are present to support their partners during the birth. She asks them: “Do you have a plan if anything goes wrong? Do you have a car? Who will look after the other children”, and so on.
She is formidable and impressive.
In communities such as this, the comadrona is highly valued and respected by all. Doña Tina is using that position to change attitudes and behaviours. Midwife, community leader, defender of women’s rights, trade unionist, and health vigilante – she carries enormous responsibilities.
She and the thousands of comadronas throughout Guatemala like her, also carry the hopes for a future in which the dignity, opportunities and aspirations of each child she brings in to this world are not diminished by virtue of their gender, and where no one will be silenced for being a woman.
Every Christmas, thousands of people in Ireland buy Trócaire Gifts as presents for their friends and family. One such gift that has been bought over the years is the gift of safe motherhood, and so it was a privilege for me to travel to Guatemala to see how that generosity was helping to contribute to better maternal health there.
By Kevin Donnelly, Regional Manager for Trócaire in Belfast