If I had ten million dollars

On Wednesday, we had a chance to meet with a fellow named Salvador Baltizón, a physician working for Project Concern International who is currently tasked with writing a grant. USAID has apparently offered $10-25m in aid to focus on improving health in Huehuetenango and Quiché departments. He essentially posed the question, “what would we do if we had millions of dollars to spend to try and improve the health and well being of the people in western Guatemala”.

The question is not a simple as it seems. Huehuetenango alone is a region with nine different languages (including Spanish), two hospitals (Huehue and Barillas 6 hours away), 2 CAIMIs (health centers that can do cesareans when staffing is present), several CAPs (like Santa Eulalia and Jacaltenango - mini health centers that can do vaginal deliveries) and dozens of Puestos de Salud (Health Outposts that can do very basic medical care). There is about one physician per 10,000 people and poverty can be overwhelming. The makeshift road network connecting cities and remote villages is sketchy at best. 

Popti speaking comadronas in Jacaltenango

We did not see only barriers to improving health. Cell phone service is not bad (even in remote villages), and internet with wireless access is becoming more available. There is a hospital in the Quiché department with a similarly modeled “Casa Materna” that actually inside the hospital and patients can deliver without needing to leave the Casa. There are often visiting medical teams offering periodic opportunities for medical and surgical treatment. 

Our vision, along with Casa Materna, has always been to make pregnancy and birth safer, and to empower midwives and women with choosing when and where and how to have their births when possible. To that end, we allowed ourselves a little dreaming. A dream of having contraception readily available (which it mostly is). A dream of local midwives with a standardized training in managing birth emergencies and readily equipped to initiate treatment when needed. A dream of readily available electronic communication for remote communities in order to be able to consult as needed. And for women with higher risk pregnancies, a dream of delivering inside of Casa Materna, with a midwife speaking her own language with the support and respect of the hospital medical team when intervention is needed.

Carly, the "muñeca pero en viva" (real life doll)

Dr. Baltizón brought us to think, almost like a child at Christmas time, what if we had enough resources to take a step forward in the vision of Casa Materna that every woman should have the opportunity of a safe pregnancy and birth within her cultural norms.

Chojzunil, a small remote town outside of Santa Eulalia