Since Plenty became involved in Belize in the mid- 1980s, one of our long-term goals has been to carry out direct health work with the Mayan population there. This dream was recently made a reality when the Belize office of UNICEF agreed to fund Plenty to implement a midwifery training project in the Toledo District. Project preparations are now in full swing for the project, which will begin in April.

The system of midwifery that developed on the Farm supports women in a respectful and spiritual manner - one which acknowledges the sanctity of the birth process and the bringing forth of new life. Over two thousand babies have been delivered at home births on the Farm since 1971, with the rate of infection, infant mortality, maternal deaths and other complications consistently and significantly low.

The Farm's team of midwives spearheaded the Farm's health care and midwifery philosophy, and have been instrumental as well in the greater midwifery movement in the US. "Spiritual Midwifery," by Farm midwife Ina May Gaskin, which includes a collection of stories written by mothers who had their babies on The Farm, continues to be a classic read by thousands of women all over the world. Farm midwives have helped create a national association of midwives called the "Midwife Alliance of North America" and are active lobbyists in the national and state political arenas, helping to create laws that protect the practice of midwifery in America. Over the last three decades The Farm has hosted visiting midwives from Guatemala, Africa, Native American Reservations, and many other parts of the world, sharing information and skills as well as providing training for aspiring midwives.

Plenty has been able to utilize our Farm background in health care in numerous projects over the years. Plenty volunteers ran a clinic, ambulance, midwifery service, and infirmary in Guatemala in the late 1970's and trained Mayan "Promotores de Salud" (community health workers). Plenty volunteers ran an ambulance and Emergency Medical Technician training program at our Bronx, NY project in the late 1970's and early 1980's. During our Lesotho project in Africa in the 1980's, Canadian nurse- midwife Wendy Day worked for two years training traditional birth attendants and nurses in remote villages.

Midwife Deborah Flowers (left) leaves in April, 2000 to begin training midwives in the Toledo district of southern Belize. photo by Douglas Stevenson

Plenty medical volunteers from the Farm also worked in clinics and orphanages in Haiti, Bangladesh, and most recently, Senegal Africa. The Belize project will continue that Farm connection and tradition, as it will be carried out by a Farm-trained midwife and Farm resident, Deborah Flowers. Along with being a practicing midwife, RN, and midwife trainer on the Farm, Deborah and her husband Doug were also volunteers on Plenty's Guatemala project from 1978-1980.

The impetus for the Belize midwifery 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 45-55% mortality rate (This rate is variable due to the high number of unregistered births. A porous border exists between Belize and Guatemala, and an undetermined number of Central Americans cross over to deliver in Belize). A high percentage of Mayan women are anemic, which puts them and their unborn babies at risk during pregnancy and childbirth, and a high number of Mayan children suffer growth retardation due to malnutrition.

The focus of the midwifery training project in Belize will be on understanding 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. We will be working with the midwives to understand the reality of their work, identify the obstacles they face and where they need supplemental training. With this information we will develop a training course focusing on 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 will emphasize the importance of the midwife in her community as an advocate for women and children and the importance of respect for women in general. The project will touch on other key issues as well such HIV/ AIDS, spacing of children, and domestic abuse. Through these topics we will encourage midwives to become more active in their communities in these areas. While Deborah will be working with each midwife individually in their villages, the group training will encourage sharing of information and experiences, and create an atmosphere of greater trust and friendship among the women.

We're very grateful to UNICEF for their support of this project. We'll be reporting on our progress in the next issue of the Plenty Bulletin.