UNICEF’s main role lies in advocating key issues with counterparts and providing technical assistance to enable effective planning, budgeting and implementation of selected interventions. In addition, we support the monitoring and evaluating of their services to identify health barriers and bottlenecks. Innovative approaches were promoted to tackle challenges such as the high maternal mortality ratio, and partnerships are strengthened at all levels.
Preserving life and health along the Chapare
In the hands of birth attendants
By Delina Garsón
The health centre in La Misión serves a population of about 800 Yuracaré indigenous people. The community is located on the banks of the Chapare River on the edge of the Isiboro Secure national park in the Amazon region, which is home to the Yuracaré, Yuqui and Moxeño Trinitario indigenous peoples.
Dr. Yver Jaylla has been working in the health centre for three years, alongside two other doctors, a nurse and a dentist. “The people we serve live in small communities scattered along the river. As part of our work, we visit families at home and that means organising trips lasting several days. During these home visits we vaccinate babies and children, give pregnant women prenatal check-ups, provide dental and general medical care, and take action to prevent malnutrition. But our work is only possible thanks to the leaders of the local health committees and the community birth attendants. They are like our right arm in preventive healthcare, and the work they do allows us to look after people’s health and lives.”
Facundo Chávez has been helping to deliver babies for 40 years.
One of them is 60-year-old birth attendant Facundo Chávez Roca, who has been helping to deliver babies for 40 years. “I learned how to do it with my wife. My mother taught me so I could look after her when she had our children. I attended my wife’s eight births. It was hard to start with – the first babies are always the most difficult.”
“When you’re helping women give birth, the most important thing is to be patient. You also have to know about the medicinal herbs you can give them. I use three herbs, and especially very strong coffee because it’s good for preventing haemorrhages. It’s very important to prevent bleeding. So far I’ve never had any serious complications.”
UNICEF is implementing the ‘Right to intercultural health for safe motherhood and childbirth’ project in the Tropics of Cochabamba region, together with the Autonomous Departmental Government of Cochabamba’s Departmental Health Service (SEDES), the Tropics of Cochabamba Indigenous Peoples’ Umbrella Organisation (CPITCO) and Family Care International (FCI). The project has six key components: use of mobile phones and SMS messaging, strengthening health staff capacities, setting up of a Skills Development Centre in Villa Tunari, care and follow-up for women who have just given birth and newborn babies in their first week of life, decentralised systems for the monitoring and evaluation of maternal and neonatal healthcare, and strengthening community organisations.
Dr. Yver Jaylla attends Elena at La Misión health centre after received a back pain reliever treatment from Facundo.
The work to strengthen community organisations includes training for local health committees on preventive healthcare and identifying birth attendants. The training has focused particularly on the birth attendants, who have learned to identify danger signs during pregnancy, how to diagnose pre-eclampsia, what to do if a haemorrhage occurs, and how to care for newborn babies.
During the training workshops, Facundo learned how to notice the danger signs during pregnancy. “Yesterday, for example, Elena was suffering a lot and it looked like she was about to give birth. She was lying in bed unable to move, let alone walk. What I did was stabilise her, because the baby was in the wrong position. I helped her to move it round so she was able to go to sleep comfortably. Then I told her to come to the health centre here in La Misión. Now she’s walking around fine and Dr. Jaylla is looking after her.”
The birth attendants were given a kit for newborn care, comprising a plastic bathing tub, hygiene supplies and baby clothes. They were also informed about which health centre to contact if an emergency arises.
The bags that the project delivers to new mothers includes baby clothes and bathing and cleaning.
“We learned a lot in the training sessions,” says Facundo. “I was always careful to disinfect the instruments I use during the birth, but now I know a lot more about how to do it in the safest possible way. I’d never used a tub for washing a newborn baby before, and all these things encourage us in our work. The things we were given are not for ourselves – the clothes and all that are for the babies.”
The training process also includes accreditation for the birth attendants. As Alexia Escobar from FCI Bolivia explains, “The aim is to ensure that their work is recognised socially and economically and their knowledge and experience is valued. Municipal governments should give them a payment, as other municipalities in the Andean region of the country are doing. The idea is to transfer those experiences to this region.”
Facundo affirms that “We are respected in the community. If people place their trust in my hands, they call me and I go to them. Looking after a patient is a great responsibility.”