The problems identified by the Maya midwives were daunting. Our group set out to address all of these obstacles simultaneously to the limits of our resources. These are our achievements to date.
ACAM MIDWIFERY AND BIRTH CENTER
The ACAM Midwifery and Birth Center was built with donations of North American midwives and other private donors and completed in 2003. The midwives and other community members were directly involved in construction of the building. 1300 people attended the opening. It is the only medical facility in Guatemala owned and and operated by indigenous midwives. Over 1300 babies have been safely delivered there and many more at home by ACAM midwives.
The two story building consists of four birth rooms, 2 exam rooms, waiting area, small pharmacy, midwife and apprentice call rooms, kitchen, laundry, traditional sweat lodge, medicinal plant garden, large teaching/community meeting room, learning lab with computers and medical models, office, and a 3 bedroom guest apartment.
The center is staffed by two paid Maya midwives per 24 hour shift, a part time Mam speaking MD and volunteer midwives, physicians, and public health specialists who mainly offer workshops and do clinical mentoring of the midwives and apprentices versus direct care.
Prenatal, birth, postpartum, family planning, and primary care services are provided for token fees which are often waived entirely. The midwives presently bring in about a third of their operating costs and the remainder comes from donations. The small salaries received by the midwives have enabled them to send their daughters to school and now some of those daughters are becoming midwives committed to continuing the work of ACAM!
Community midwives come to the center for monthly meetings and training sessions and can get or replenish birth supplies. The Center is also available to community groups for meetings and workshops.
MIDWIFERY APPRENTICE PROGRAM
The midwives have developed an apprentice program given in their Mam language for young women they have selected as suitable midwives. The first year is midwifery training sessions and computer classes. The second year is apprentice clinical experience at the ACAM Center and at Mobile Clinics in the community. The program is currently offered free of charge and has been in part grant supported. Two classes have graduated with a total of 39 literate midwives with expanded skills. Upon graduation each apprentice receives a full midwifery kit which is funded by sponsors or donors. Click here to see the contents of the kits. Additional support is needed to expand this program to other areas and provide salaried positions for graduates.
A grant was received from Virginia Gildersleeve International Fund to purchase sophisticated medical models and offer computer classes. These models have been used in apprentice training and also shared with the physicians who come to do the monthly training sessions from the local health center. This has allowed teaching methods more suited to the larger midwife group where issues of language and literacy are an issue.
The ACAM Center has five computers and internet access. Many of the midwives now have computer skills which allow them to communicate with their midwifery colleagues in the U.S about clinical or other issues via Skype and email. The apprentices have even set up a Facebook page for ACAM! They feel that they are no longer isolated from the world and can access all the useful information available by computer. This opportunity was not available to them elsewhere. Most of the midwives also now have cell phones which allow them to call for advice or help in the field.
A van was donated in 2004 which is used to transport patients to the hospital in emergencies and to offer mobile clinics in the isolated areas of the community. We are in need of a four wheel drive vehicle for mobile clinics and hospital transport in remote areas.
A grant funded by the Virginia Gildersleeve International Fund supported a pilot program of Mobile Clinics offering prenatal, family planning, and primary care to six isolated communities without a health facility or health provider. These continue on a limited basis as we seek financial support and the donation of a four wheel drive vehicle to allow year round access to these communities.
National Midwifery Organization
The ACAM midwives are officers in the fledgling national organization of indigenous midwives. This group meets four times a year to develop and implement strategies for preserving, improving, and promoting indigenous midwifery at the local and national level.
We also have established a collection of wonderful and valuable partnerships.
Guatemalan Women's Sector
This organization offers workshops to midwives and apprentices on topics such as domestic violence and human rights under the Guatemalan Peace Accords. The ACAM midwives received a national award from the Guatemalan government in 2014 for their work on Women's Rights and access to Health Care. Antonina Sanchez, first President of ACAM, was elected to represent the Department of Quetzaltenango on the Presidential Committee on the Rights of Women. The midwives serve in many other local organizations. They also offer advice to groups of indigenous midwives in other parts of the country as they begin to organize.
This organization has partnered with us in an ongoing project to improve safe medical transport to the hospital and improved capacity for local personnel to effect medical rescues in difficult situations such as landslides, floods, or vehicles going off the roads in high mountains. This project has resulted in donation of sophisticated equipment for the local ambulances such as AED devices for cardiac defibrillation, birth kits, IV supplies and many other items. An infant respirator and EKG machine was donated to the local hospital and ACAM received an Ultrasound machine, AED device, EKG machine, and IV supplies. Shur, Inc. volunteers offered workshops to the midwives, apprentices, MD, and local volunteer firemen who serve as EMTs in the use of all this new equipment. They will return on a regular basis with additional supplies and continuing education.
Virginia Gildersleeve International Fund
ACAM has received two generous grants from VGIF. One funded the Learning Center and computer classes. The other funded our pilot mobile clinic program, development of basic lab services at the ACAM Center and advanced midwifery skills and computer workshops for graduate apprentices. We look forward to working with VGIF in the future.
A large ambulance was donated to ACAM by Mercy Trucks, Inc. It proved too large to be useful in the areas needed so the midwives donated the ambulance to the local Red Cross. In return the Red Cross agreed to be available for transport of any ACAM Center patients requiring transport to the local hospital in Xela.
American Rock Climbers
We solicit ongoing donations of rock climbing equipment to be used by local firemen in rescue and transport work in difficult terrain and during local disasters. The local firemen received training in the use of this equipment from the government but were not provided with the equipment.
We solicit donations of hand knitted hats, sweaters, blankets, and socks to give to each baby born at the ACAM Center and to many of the newborns delivered by ACAM midwives at home. ACAM is in a mountainous area and temperatures fall at night. Families often have no clothing for the newborn and take the infant home in an old towel. Mothers do not begin to weave the traditional clothing until the baby is born and they are sure the child will live. Families are delighted with these gifts and it has proven to be an incentive for them coming to the ACAM Center for their births.