Bolivia’s isolated communities given means to survive

تم النشر: 29 أبريل 2004 0:00 CET

Fernando Nuño in Guayaramerín

"Push, the baby is coming," midwife Clementina Rivas encourages young Julia. Meanwhile, her colleague, Creusa Durales, takes the mother's pulse.

"This is going to be the third birth today. This one is a boy and he’s looking forward to being out," Creusa says.

Clementina, 39, has worked for 22 years as a traditional midwife in Guayaramerín, a town of 30,000 inhabitants in the Amazon region of Bolivia. She has helped more than 3,000 babies come into the world. "It can be said that she is godmother to one in ten inhabitants in Guayaramerín," says her colleague.

New methods

The birth has gone well. Clementina looks at the hospital’s clock, washes herself and changes her clothes. She wants to be on time for the handing out of diplomas organized by the Bolivian Red Cross at the local committee.

The Red Cross has trained 10 traditional midwives in community in new delivery methods. "Delivery technique is changing. We must combine the best of tradition with the best of innovation and ensure that everything goes well for mother and baby," Clementina says. These traditional midwifes attend an average of 10 births a week.

Sexual and reproductive health is just one of the components of an integrated community development programme implemented by the Bolivian Red Cross with the support of the Spanish Red Cross.

Targeting some 2,130 people living in vulnerable neighbourhoods, it is one of the priorities of the Amazonico Programme, developed by the International Federation in Bolivia, Colombia, Ecuador and Peru.

Programme coordinator Mary González says family planning is an essential component: "It is not only a question of caring for women during labour. We also have to promote the planning dynamics and to reduce the high rate of adolescent pregnancy."

A healthy cycle

In the street, Clementina meets Mary Geisa Flores, a Bolivian Red Cross volunteer health promoter. Once a week, Mary Geisa goes round the neighbourhood of Los Almendros to check that the dry compost latrines installed in 347 homes are functioning properly.

This system transforms the waste materials into manure and insecticides. It also prevents groundwater and community wells from being polluted by excrement. "The refuse is put into a sealed chamber located at the bottom of the latrine. It is recycled as manure in the family vegetable gardens. These latrines protect the community and the environment," Mary Geisa explains.

As she checks a latrine, a light aircraft flies over the town. "It is arriving later than usual today," says Mary Geisa. Guayaramerín, an indigenous word for “small stone”, is the last stop for the plane, which provides a link the rest of Bolivia.

For several months now, Los Almendros district has had volunteer community health promoters, family violence monitors and first aid focal points. The Bolivian Red Cross has trained 1,200 people. "It is necessary to know how to respond to an emergency locally. The hospital is far away from the community," says first aid trainer Mirta Negrete.

Growing together

Mirta is one of the residents of Los Almendros who benefits from a dry compost latrine. Having taken part in a Red Cross first aid course, she is currently a volunteer community health promoter and domestic violence monitor.

"She is an example of how the community and the Red Cross have grown together as part of this process," says Hernán Zabala, president of Guayaramerín’s local council.

At the hospital, the midwives take a rest in the yard. The light aircraft takes off for La Paz, interrupting their chat.

“They are leaving early because there’s a storm coming,” says Creusa. She looks at the sky and adds: “In the rainy season the flight does not come. We have to manage alone. The rain isolates us from the rest of the world”.