| Childbirth Education and Training in Toledo |
The impetus for the Belize Childbirth Education project came from our experience working with the Kek'chi and Mopan Mayan people in the Toledo District.
Spread out over approximately 40 rural villages, these people have the poorest health indicators of any population in Belize.
Mayan infants (birth to age 3 months) have an astonishing mortality rate and a high percentage of Mayan women are anemic, which puts them and their unborn babies at risk during pregnancy and childbirth. |
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Over the duration of this project, twenty-two midwives and traditional birth attendants (TBA's)have been trained and equipped to serve in their villages throughout the Toledo district . Some have taken the initiative to learn more about health care so they can be called upon in their villages when there are medical emergencies.
Continuing Education
Continuing education sessions, “village visits” with each midwife, and the provision of basic supplies were conducted to reinforce the initial training. Plenty has also sponsored two-day “Annual General Meetings” for the midwife group along with Ministry of Health and other project collaborators.
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Additionally, a series of 17 twice-weekly literacy classes were held for all midwives who wanted this help. Due to these classes all of the women have gained a much better grasp of the written language – both reading and writing. They are now able to fill out the birth forms required by the Ministry of Health and have gained self-confidence and greater self-esteem with their new abilities. |
| The Role of Midwives and Traditional Birth Attendants |
One focus of the midwifery training project in Belize was to understand the role, skills and techniques of traditional Mayan midwives, as they are culturally the first line of care for pregnant women and babies in the villages.
Plenty's training course focused on teaching essential skills, such as how to minimize infection using sterile technique; when they need to refer a pregnant women to the medical system; and pregnancy and newborn care.
The course emphasized the importance of the midwife in her community as an advocate for women and children and the importance of respect for women in general, touching on other key issues as well such HIV/ AIDS, spacing of children, and domestic abuse.
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| Along with the training provided to each midwife individually in their villages, group training encouraged sharing of information and experiences to create an atmosphere of greater trust and friendship among the women. |
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Languages and Translation |
The women being trained spoke three different languages (Mopan and Kek’chi Maya, and English), making translation a necessity. Plenty' volunteer and midwife trainer Christina Kahlou describes the training:
" When a topic was initiated by the trainer, it was first discussed a little by the English-speaking participants.
Then the dialog was summarized into Kek’chi or Mopan by Remigia, the group translator, and it was the Mayan women’s turn to light up, as they discussed the various points that were made and added stories of their own.
Afterwards, Remigia would return to the English speakers and translate back. At times it was a slow process, but it ensures that the important points are being heard by everyone. It was refreshing to see the women’s patience with each other as the dialog unfolded." |
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| Community Nurse’s Aides (CNAs). |
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Continuing education and training also included include Community Nurse’s Aides (CNAs).
The CNAs represent the front line in handling medical emergencies in the often-remote Mayan villages by diagnosing and referring patients to the local hospital when necessary, by monitoring public health in the villages, as well as treating minor medical problems.
Strengthening the skills of the CNAs and the working links between them and the TBA's has resulted in an improved network of care for Mayan women and children.
TBA's and CNA's ready for advanced skills received additional training through an arrangement with the local hospital. |
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| Healthcare in Remote Villages |
Many of the remote villages do not have health facilities and only receive medical help during “mobile clinics” organized by the local Ministry of Health every six weeks.
The primary purpose of the project has always been to ensure that mothers delivering babies far from medical services had access to a trained local community member if they wanted or needed help.
Not only are many of the midwives called for childbirth emergencies, but also, as they become known and are accessible in their villages, many are being asked to help with other health issues and medical emergencies as well. |
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One of the midwives, Maria Ak, talked about an emergency delivery she managed.
After delivery, the mother hemorrhaged for three minutes and fainted. Her husband didn't know what to do, and Maria told him “she dead” if she didn’t get to the hospital right away. They managed to find a vehicle to transport her.
After arriving at the hospital, the receiving nurse told the husband “this TBA saved your wife’s life.” |
(left) Plenty' volunteer and midwife trainer
Christina Kahlou |
We want to express our heartfelt thanks to Deborah Flowers, Mary Kroeger, Christina Kahlou and literacy trainers Reva Kidd and Katie Townes for their great help and support for the midwives!
Our sincere thanks also go to the Belize Ministry of Health, Daniele Agostino Foundation, the International Foundation, New Road Map Foundation, Trull Foundation, James R. Dougherty, Jr. Foundation, UNICEF, and our donors who earmarked funds to the midwife training project. |
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