Written by Nina Kuhnel, Save the Children Bolivia
Bolivia is home to more than 35 different ethnic groups and their traditions. Newborn and maternal mortality remains high, with 229 maternal deaths per 100,000 live births and 27 newborn deaths per 1,000 live births. Most women in rural areas still deliver their babies at home, often with the help of midwives, who work on a voluntary basis, using knowledge that has been passed on from one generation to the next. Newborn mortality rates are particularly high in Bolivia’s altiplano (highlands) due to traditional norms, lack of health facilities and other factors. In Oruro, for instance, the newborn mortality rate was reported to be at 43 newborn deaths per 1,000 live births. Unofficial sources indicate an even higher number.
With the aim of helping to reduce newborn deaths, Save the Children began working in Oruro in 2013. One of our goals was to bridge the cultural gap between traditional customs and modern medicine. “We created spaces so that doctors and traditional midwives could start sharing their experience and expertise and identify ways to collaborate in order to reduce maternal and newborn mortality in the region,” explains Dr. Patricia Barrios, Save the Children’s project coordinator. Joint meetings to prepare medicine using local herbs and plants proved especially popular and helped build mutual trust.
On October 21, 2015, a fair showcasing traditional medicine was organized in the city of Oruro with about 100 people, including health care personnel, midwives, Save the Children staff members and local health authorities to promote this positive collaboration publicly, advertise local medicine and explain the importance of regular controls during and after pregnancy.
“Collaboration between us, the midwives, and the doctors is going really well”, says Maria, a midwife aged 76 with more than 30 years of experience. “And this year I have not seen any newborn or maternal deaths. In the past, the doctors did not want to listen to me, but now they are begging me to be present in the deliveries”, she explains laughingly. And Dr. Luis Gutierrez from the Health Service Department in Oruro adds that “the knowledge traditional midwives have really contribute to the reduction in newborn and maternal mortality”.
Leonor Paco, another midwife participating in the fair, adds that a lot of Bolivian women do not want to go to the hospital. “They still feel intimidated by the doctors. But when we accompany them, they go.”
Referral systems are now in place in every province in Oruro. Doctors and midwives together agreed on the major risk signs in pregnant women and newborns and established a system of vigilance and referral when detecting these signs. A major change that has come about is that the ambulances arrive now and bring women from the rural area to the next hospital if needed. “This has helped to save a lot of lives”, concludes Sixta Condori who started working as a midwife when she was 15 years old.
Save the Children is proud to have played a role in bringing doctors and midwives in Oruro together, to save the lives of newborns and their mothers.
All statistic numbers used for this article were extracted from the public opinion poll that the Ministry of Health and Sports published in 2008.
