Since 1999, Maya Midwifery International (MMI) has served as the U.S. based 501(c)3 advisory and fundraising partner for the Association of Midwives of the Mam Speaking Area (ACAM), based in Concepción Chiquirichapa, Guatemala. ACAM is a cooperative of 40 Maya midwives that formed after the Guatemalan Civil War to devise solutions to the many health issues facing their indigenous communities.
MMI’s mission is to improve reproductive, maternal and newborn health (RMNH) by preparing and sustaining ACAM’s indigenous midwives. MMI’s model is grounded in an approach of listening to local midwives and their communities to holistically consider women’s economic and community empowerment, cultural respect, educational attainment and health with an overall goal of improving RMNH outcomes. A major focus of our partnership is to ensure that the ACAM midwives are trained and equipped to meet the urgent RMNH needs of their communities.
Approximately 50,000 people live within the communities served by the ACAM midwives. The vast majority (80%) are indigenous Maya with rich traditions and customs which helped sustain them through historical hardships spanning from the Spanish conquest to the 36-year Guatemalan civil war, which ended in 1996. Poor health outcomes, food insecurity, low levels of education, gender-based violence and poverty are endemic in Maya communities in Guatemala. Local maternal and infant mortality rates remain among the highest in the Western Hemisphere, and indigenous populations, especially women, experience widespread discrimination and violence when they interface with the health system.
Within Maya communities in Guatemala, midwives are highly respected health care providers and integral community members. This puts them in a unique position to influence and support health-related decisions and empower Maya women and their communities through midwifery care. The ACAM midwives speak the Mam language of their communities and understand local cultural practices. This helps ensure provision of culturally appropriate, quality, respectful RMNH services.
The ACAM midwives provide much of the client care in their birth center in Concepción Chiquirichapa (built in 2003) and through regular mobile clinics in focal partnership communities. The birth center is the only medical facility in Guatemala owned and operated by indigenous midwives. ACAM services are provided at a nominal fee and waived for clients who cannot afford to pay. Core services include prenatal and postpartum care, attending normal births, provision of family planning services, cervical cancer screening and treatment, basic obstetrical ultrasound, and well-woman care. In recent months, the midwives have also become a trusted source of critical education and information for communities in relation to COVID-19, and have rallied to adjust their practice in order to adhere to internationally recognized standards of prevention, while maintaining the delivery of essential RMNH services.
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Asia Blackwell, Executive Director