Background
In March 2006, after five years working with Mama Licha to make a new model of midwifery-owned and operated reproductive health facility, ICAS/Juntos Adelante co-founders, Bethany Golden and Angie Rogers visited the remote Bosawas Reserve where they met a group of courageous midwives.
Musawas is nestled into the Bosawas Biosphere Reserve in North Central Nicaragua, which is predominately rainforest and makes up 15% of Nicaragua. The reserve is protected by the Nature Conservancy, an international non-governmental organization that helps the indigenous people establish legal claim to their lands, protect the boundaries and natural resources of the Reserve and determine appropriate land uses. The Reserve houses three indigenous groups, Miskito, Rama, and Sumo/Mayanga. Musawas is the home of Mayanga people located in a remote area of the Reserve, which is inaccessible, by motor vehicles. Only 8,000 Mayanga exist in the world.
This is a land of dugout canoes, thatched roofs, and barefoot children. There is no electricity, no running water, and no phones. But in Musawas you will find a proud, unified, indigenous community that has largely been ignored by their own government. They have sustained their indigenous language and culture. Women of this ethnic minority have no or extremely limited contact with the rest of Spanish-speaking Nicaragua or other outside groups. With low rates of literacy, high rates of poverty, and linguistical isolation, women live the majority of their lives within the Reserve.
In March 2006, after five years working with Mama Licha to make a new model of midwifery-owned and operated reproductive health facility, ICAS/Juntos Adelante co-founders, Bethany Golden and Angie Rogers visited the remote Bosawas Reserve where they met a group of courageous midwives.
Musawas is nestled into the Bosawas Biosphere Reserve in North Central Nicaragua, which is predominately rainforest and makes up 15% of Nicaragua. The reserve is protected by the Nature Conservancy, an international non-governmental organization that helps the indigenous people establish legal claim to their lands, protect the boundaries and natural resources of the Reserve and determine appropriate land uses. The Reserve houses three indigenous groups, Miskito, Rama, and Sumo/Mayanga. Musawas is the home of Mayanga people located in a remote area of the Reserve, which is inaccessible, by motor vehicles. Only 8,000 Mayanga exist in the world.
This is a land of dugout canoes, thatched roofs, and barefoot children. There is no electricity, no running water, and no phones. But in Musawas you will find a proud, unified, indigenous community that has largely been ignored by their own government. They have sustained their indigenous language and culture. Women of this ethnic minority have no or extremely limited contact with the rest of Spanish-speaking Nicaragua or other outside groups. With low rates of literacy, high rates of poverty, and linguistical isolation, women live the majority of their lives within the Reserve.
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The co-founders of ICAS/Juntos Adelante visited the Bosawas Reserve under the guidance of Thelma, the president of the local indigenous women’s organization. On the four-hour hike to the village through the rainforest, knee deep in mud, they learned the basics about the community, politics, economics, gender, and health issues. They learned that no one had ever visited the Reserve with an interest in women’s health or midwifery, providing an incredible opportunity to meet and hear from the midwives of the community about their means of providing health care.
Angie and Bethany spoke to the Musawas midwives about the current status of women health services, pregnancy, labor management, birth practices and traditions and birth outcomes. During the meeting Angie and Bethany learned that mothers and children are at tremendous risk due to lack of access to health services. Women often labor and deliver their babies in isolation, far from hospitals and clinics
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Last year in this community of 3,000 people, 4 women died during childbirth – an extremely high rate of maternal mortality. Musawas Midwives are often the only health providers attending births in the area. Because of their dedication, they walk barefoot at night, in the rain for hours with no poncho, shoes or flashlight to show up at a woman’s house to deliver a baby. They use bamboo to cut the cord because they have no scissors. Although they rely on traditional medicine, they are eager to gain access to much-needed western medication.
At the end of the initial four-hour meeting, the Musawas midwives presented both an oral and written proposal for midwifery trainings, educational materials, medical equipment and supplies. The proposal requested assistance for all fifty women who are midwives or women who are training through birth observation to be future midwives.
From March through August 2006, ICAS/Juntos Adelante shared the story of the Musawas midwives and acquired supplies through financial contributions and in-kind donations. It enlisted a great team to make the project a reality: Maraya Kennedy-Friedman (a certified nurse-midwifery student at Yale University, who helped with fundraising, transporting supplies to the Musawas midwives, and helping to coordinate the trainings), Ramona Alfaro “Monchita” (the Head of Nursing and Midwifery for the Ministry of Health in Esteli who conducted the trainings in August), Dalit Gulak (nurse-midwifery student at Georgetown University who assisted Maraya and Monchita with logistics and coordination of transportation and trainings) and Dana Rogers who helped secure numerous in-kind donations of needed supplies.
Objectives of the Musawas Midwifery Project:
Equip, train and empower the Musawas midwives to indentify complications during gestation and birth and refer patients for additional medical assistance when needed.
Action needed to meet the objective:
1) Deliver the requested medical equipment to the fifty Musawas midwives and midwifery students with a backpack filled with:
a. 1 headlamp with 6 extra batteries, a thermometer, a stethoscope, a blood pressure cuff, a pair of rubber boots, a sweater, 2 large gauze packets, 12 packets of alcohol swabs, 6 packets of antibiotic cream, 10 condoms, a notebook, a pen, a poncho, a packet of string, a metal placenta bowl, a pair of scissors, a bulb syringe.
b. A guide/manual to midwifery, put together by the ICAS/Juntos team, primarily made of instructional pictures because the majority of women do not read or write.
c. 1 emergency portable stretcher for the community.
2) Complete two days of trainings (capacitaciones) for the Musawas midwives led by Ramona Alfaro (“Monchita”) in Spanish, with Mayanga interpreters.
3) Documentation of the project through audio recording, photography and written notes as a resource for remote site learning of indigenous people.
At the end of the initial four-hour meeting, the Musawas midwives presented both an oral and written proposal for midwifery trainings, educational materials, medical equipment and supplies. The proposal requested assistance for all fifty women who are midwives or women who are training through birth observation to be future midwives.
From March through August 2006, ICAS/Juntos Adelante shared the story of the Musawas midwives and acquired supplies through financial contributions and in-kind donations. It enlisted a great team to make the project a reality: Maraya Kennedy-Friedman (a certified nurse-midwifery student at Yale University, who helped with fundraising, transporting supplies to the Musawas midwives, and helping to coordinate the trainings), Ramona Alfaro “Monchita” (the Head of Nursing and Midwifery for the Ministry of Health in Esteli who conducted the trainings in August), Dalit Gulak (nurse-midwifery student at Georgetown University who assisted Maraya and Monchita with logistics and coordination of transportation and trainings) and Dana Rogers who helped secure numerous in-kind donations of needed supplies.
Objectives of the Musawas Midwifery Project:
Equip, train and empower the Musawas midwives to indentify complications during gestation and birth and refer patients for additional medical assistance when needed.
Action needed to meet the objective:
1) Deliver the requested medical equipment to the fifty Musawas midwives and midwifery students with a backpack filled with:
a. 1 headlamp with 6 extra batteries, a thermometer, a stethoscope, a blood pressure cuff, a pair of rubber boots, a sweater, 2 large gauze packets, 12 packets of alcohol swabs, 6 packets of antibiotic cream, 10 condoms, a notebook, a pen, a poncho, a packet of string, a metal placenta bowl, a pair of scissors, a bulb syringe.
b. A guide/manual to midwifery, put together by the ICAS/Juntos team, primarily made of instructional pictures because the majority of women do not read or write.
c. 1 emergency portable stretcher for the community.
2) Complete two days of trainings (capacitaciones) for the Musawas midwives led by Ramona Alfaro (“Monchita”) in Spanish, with Mayanga interpreters.
3) Documentation of the project through audio recording, photography and written notes as a resource for remote site learning of indigenous people.
