The UN estimates that there is currently a gap of 3.5 million health workers in low-income countries. Skilled health workers are desperately needed there. However, skilled and fully trained workers require extensive training and support as well as functioning health systems to work in – which takes time. Some people don’t have that time. Health care is particularly scant in rural and indigenous communities where there are no or under-resourced health facilities, most notably for maternal health and childbirth. This is where the work of Health Poverty Action comes in; we support communities which have usually been forgotten by their government’s development of health services. With only four years left for the Millennium Development Goals there is somewhat of a last minute panic to achieve them. But – apart from many countries not being able to achieve the goals – all that is required is submit overall national figures. Unfortunately this does not reflect the marginalisation of rural and indigenous communities who have little or no access to health care. Health Poverty Action has been working alongside those poor and marginalised communities in developing countries to train Traditional Birth Attendants (TBAs) to ensure that every mother is getting a fair chance.
Traditional birth attendants have been criticised as not being medically qualified or even illiterate; worse, they sometimes employ methods, such as heavily massaging a woman’s belly, that are dangerous for the child’s and/or woman’s life. However, their value is underestimated. TBAs can be trained to identify when a woman needs to be referred to a clinic due to complications or risks. TBAs help to put the woman at ease during labour and can also act as support and in some cases as interpreters when health workers do not speak the same language as the pregnant woman. They perform basic antenatal checks to identify any problems and check the overall health of mother and baby. They thus fill a health worker gap but much beyond that they are respected community members whose knowledge and role within the village fulfil many other functions of wellbeing.
Amelia Emilio is a traditional birth attendant in rural Nicaragua, Central America, and like many TBAs she learned her skills from her mother. Health Poverty Action helped her build on her knowledge and training and provided her with the much needed medical equipment for cases where mothers choose to give birth at home or they are unable to get to a clinic. Amelia is now more confident to know when she is able to assist with childbirth and when the woman should be referred to a health clinic. Not only this, she is also able to advise teenagers and adults on sexual health and she encourages men to take a more active part during the pregnancy and childbirth of their partner.
Amelia is one of sixty-seven TBAs that has been trained by Health Poverty Action and has provided much needed care and information to mothers and mums-to-be in indigenous and rural communities. Women like Amelia will continue to play a critical role in the wellbeing of Mothers on the Margins.
