Empowering Indigenous Achuar women in Safe Birthing and Community Health

Empowering Indigenous Achuar women in Safe Birthing and Community Health

Ecuador
Organization type: 
nonprofit/ngo/citizen sector
Project Stage:
Growth
Budget: 
$10,000 - $50,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Since 2007, The Jungle Mamas Program has been working in solidarity with the indigenous Achuar women and men of the Ecuadorian Amazon in safe birthing and basic community health. Our team of dedicated midwives works to train birth attendants in prevention, treatment of birth emergencies and basic health issues, with an intercultural approach that also values local healing and birth traditions. In addition to post-partum hemorrhage, diarrhea from water contamination is one of the biggest threats to the health of Achuar women and children. We have been working with communities to reduce water and soil contamination through ecological dry toilets. Using the knowledge and practice necessary, Achuar women are able to provide their people with the most culturally adequate healthcare available.

About Project

Solution: What is the proposed solution? Please be specific!

The Jungle Mamas Program is the first of its kind to address the indigenous health in the South Central region of the Ecuadorian Amazon that uses the empowerment of women as the key solution to improving well-being of the Achuar people. By training indigenous Achuar women and men in safe birthing and basic health, Jungle Mamas is not only reducing maternal and infant mortality, but also providing communities with the tools they need to solve health issues from within their territory, thus reducing dependence upon hospitals that are poorly staffed, uneasily accessible, and culturally inadequate in practice. Jungle Mamas is an intercultural program in that it respects cultural birth traditions and health practices, while simultaneously providing useful information from other midwifery traditions and basic health approaches from the United States, Mexico, and Denmark. Our most recent Safe Birth and Family Health workshop in September was successfully facilitated by 3 Achuar women, trained as birth attendants in the native language of Achuar Chicham, which is opening up the doors to more workshops within the territory facilitated by empowered Achuar women. The Achuar name of the program, Ikiama Nukuri, or Women as Keepers of the Forest, emphasizes the invaluable role that women play in the protection and health of the Amazon Rainforest and the Achuar people. Jungle Mamas is the first program in the Ecuadorian Amazon that has recognized that the health of the planet and its rainforests is inextricably linked and dependent upon the women and men who live within it.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

Jungle Mamas’ primary activities are conducting Safe Birthing and Family Health workshops, using critical awareness and participatory learning methodologies, training individuals in planning, prevention, and treatment of birth emergencies. We have designed a curriculum that is culturally adequate that consists of an easily understandable picture-card teaching booklet especially designed for the native Achuar speaker. For individuals committed to improving the health of their communities, Jungle Mamas collaborates and facilitates the training of skilled birth attendants by providing in-depth apprenticeships outside of the community in a high-volume birth clinic. Skilled birth attendants are trained in the use and implementation of safe birth kits, which includes the necessary materials for attending a birth, including misoprostol, which can save the life of a mother during a post-partum hemorrhage. Having identified water and soil contamination as the two primary causes of illness and infant mortality, Jungle Mamas has been working with community leaders and the local Achuar women’s association to educate and build capacities in the importance sanitation and have worked towards improving the local water system. In an effort to reduce infant mortality caused by contamination and water-borne diseases, Jungle Mamas is also collaborating with three Achuar communities in the education and implementation of a pilot ecological urine-diverting dry toilet project.
About You
Organization:
Fundación Pachamama
About You
First Name

Robin

Last Name

Fink

About Your Organization
Organization Name

Fundación Pachamama

Organization Phone

005933332245

Organization Address

Gonzalo Serrano #345 y 6 de diciembre

Organization Country

, P

Country where this project is creating social impact

, S

How long has your organization been operating?

More than 5 years

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Innovation
What stage is your project in?

Operating for more than 5 years

Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.

There are approximately 6,500 Achuar people living in the Ecuadorian Amazon, whose ancestral lands spread across nearly 2 million acres of primary rainforest. Early in the 20th century, the Ecuadorian Government granted oil concessions in the rainforest, which also opened the door for other resource extractive activities. The Achuar territory had an advantage due to its proximity deep inside the jungle and lack of access via roads. Achuar leaders initiated a partnership creating The Pachamama Alliance and it's sister organization based in Ecuador, Fundación Pachamama. The Achuar people have a history of being warriors, meaning that contact with the western world did not officially take place until the 1960s upon arrival of Missionaries, who built airstrips within the territory, increasing the access from the outside. As there are currently no roads into the territory, the only way to access Achuar territory is via canoe or airplane.This means that access to cities and hospitals is significantly limited to the Achuar. In the past, the Achuar were nomads and moved around periodically within the territory. With the introduction of airstrips, people settled in communities and began heavily populating one area, thus putting pressure on the surrounding environment by contaminating water and soil resources. Traditionally, Achuar women gave birth by themselves in the forest without the assistance of a birth attendant or even their mothers. This change in community lifestyle has negatively impacted maternal, child, and overall community health of the Achuar people.

Share the story of the founder and what inspired the founder to start this project

Jungle Mamas was established in 2007 and was recognized as an official program of Fundación Pachamama in 2008. The program started when Margaret Love, Jungle Mamas’ founder and director, traveled deep into the Ecuadorian Amazon to visit an Achuar community on a trip led by The Pachamama Alliance, Fundación Pachamama's sister organization. Once people in the community found out Margaret was a midwife, pregnant Achuar women throughout the community asked her to examine them and listen to their stories. Margaret realized she was being called to play a role in stopping all preventable maternal and infant deaths in the Achuar territory. After this first encounter, Margaret Love then met the current Jungle Mamas local coordinator, Narcisa Mashienta, an empowered and indigenous Shuar woman (the Shuar people are another indigenous group of the Amazon, sharing a history with the Achuar people) who had married into an Achuar family. Narcisa and Margaret shared the common dream of improving the health and well-being of the Achuar people by training people in safe birth and family health workshops. In 2009, Margaret met Robin Fink, who began working as the Ecuador-based Jungle Mamas program manager. It is the solidarity and vision shared by Margaret, Narcisa, and Robin that has enabled Jungle Mamas to slowly begin expanding its work within the Achuar territory.

Social Impact
Please describe how your project has been successful and how that success is measured

As of January 2010, approximately 90% of all births in the 3 communities we are directly working in have been attended by skilled birth attendants. In September 2011, two Safe Birth and Family Health workshops were lead and facilitated by Achuar birth attendants, with the presence of one American midwife solely to provide feedback and teaching support. In the past, our workshops hosted an average of 15-20 participants, but since we have transferred the teaching to the Achuar themselves, the average number of participants has grown to 30, with people traveling from 11 communities within Achuar territory. We measure our success subjectively by the increasing willingness and interest of Achuar men and women to talk about and implement family planning methods (specifically the use of the Collar-Rhythm Method). There have been 0 maternal deaths relating to postpartum hemorrhage and 0 infant birth-related deaths, and people have been actively using the safe birth kits we pass out in our workshops, effectively preventing birth emergencies. We have successfully implemented 4 ecological urine-diverting dry toilets in two communities and all of the families are using them and understand their use and maintenance. By the end of 2011, we have planned 7 more toilets in the three communities as a pilot project. As a result of this initial stage, other families have shown interest and requested the construction of dry toilets in their homes, thus reducing water and soil contamination from human waste. We have conducted 2 water pheasibility studies in two communities, and together with male and female community representatives, have presented a proposal for fixing the existing water system with solar panels, and have received approval from the Municipal Government, which has agreed to fund and implement the project so far in one of the solicited communities.

How many people have been impacted by your project?

101-1,000

How many people could be impacted by your project in the next three years?

1,001-10,000

Winning entries present a strong plan for how they will achieve growth. Identify your six-month milestone for growing your impact

In six months, we hope to be conducting workshops that could impact a population of up to 2,000 people within the territory (~4 workshops). At least one community (40) equipped with dry toilets.

Task 1

Effectively coordinate with Association leaders to achieve permission from Achuar Federation (NAE) to conduct Safe Birth workshops in at least 3 other associations

Task 2

Train 6 more people as Skilled Birth Attendants by receiving more in-depth outside training in a high-volume birth clinic

Task 3

Create a participatory work plan with community members and begin implementing strategy and construction of ecological dry composting toilets

Identify your 12-month impact milestone

At least two communities will have fully-equipped birth houses where women from surrounding communities and territories will arrive to give birth and receive education about family planning.

Task 1

Establish a participatory workplan and list of responsibilities for construction of the birth houses among the communities and Jungle Mamas

Task 2

Establish participatory management system of the birth house and its materials, including a plan for follow-up and evaluation after 6 months.

Task 3

Implement construction of the two birth houses.

How will your project evolve over the next three years?

In the next three years, we hope to be working with the entire Achuar population of Ecuador, including people living in the provinces of Morona-Santiago and Pastaza. We hope that with workshops lead by Achuar birth attendants and health workers themselves, a greater difference will be made in effectively reducing water-borne illnesses in babies and children, so that there is a significant reduction in maternal and infant mortality and overall increase in quality of life. Our goal is to have formed a partnership with the Ministry of Public Health's Provincial branches and other institutions to have ecological urine-diverting dry toilets available for every family in Achuar territory, assuring that there is no more water contamination due to leakage of human waste in potable water sources.

Sustainability
What barriers might hinder the success of your project and how do you plan to overcome them?

As our project is currently divided into to aspects: fundraising from the United States and work carried out on the ground in Ecuador, there are a lot of language and cultural barriers that need to be crossed effectively in order for our work to be successful. While we have been working well with these communication lines, we hope to eliminate these barriers by transferring all of our operations (fundraising) to the Fundación Pachamama office in Ecuador by the end of 2012. On another cultural level, the empowerment of women can only be achieved by working in solidarity with and empowering the Achuar men. As it is only a recent development that Achuar men are recognizing the importance of the role women play in the health of their communities and families, we have to be attuned and prepared for potential conflicts with male leadership along the way. Our current strategy to prevent and eliminate this obstacle is by increasing our partnership and alliance with the NAE leadership (see description below), which not only empowers the NAE leadership to complete its objectives of protecting the territory and its people, but will also garner legitimacy among the male Achuar population in communities that are significantly more prejudiced against female participation and leadership.

Tell us about your partnerships

Jungle Mamas, a program of Fundación Pachamama, has a principal partnership with the Achuar Federation, known as NAE (Achuar Nationalities of Ecuador). NAE is the overarching governing body of the Achuar of Ecuador that coordinates with the communities throughout the territory in Ecuador. Without the support and commitment of the NAE leadership, Jungle Mamas would not be able to operate within the Achuar territory. Fundación Pachamama has a sister organization, The Pachamama Alliance, which has served as a primary source for contacts with other organizations for the Jungle Mamas program. Jungle Mamas also partners with the organization, EcoSan, based in Ecuador, which provides technical assistance with the education and implementation of urine diverting ecological dry toilets. Jungle Mamas has also collaborated with the Ecuadorian Ministry of Public Health and Intercultural Health in order to increase access and representation in the Achuar territory. Due to the limited budget of the Ministry of Public Health, access to healthcare to the Achuar is also limited. However, because of Jungle Mamas' focus in Achuar territory, we have collaborated with the Ministry of Public Health to make sure that they are indeed reaching the Achuar population. Jungle Mamas also partners with Aerotsentsak, the only entirely Achuar-owned aviation company based in the town of Shell, Pastaza.

Explain your selections

The Jungle Mamas program within Fundación Pachamama has received funding from private donors who are members of the Pachamama Alliance. We have also received funding from the Good Works Foundation, and have held fundraising events. The fundraising element is largely conducted by Margaret Love in the United States with the Pachamama Alliance, while the work is being implemented on the ground in Ecuador by Fundación Pachamama.

How do you plan to strengthen your project in the next three years?

Due to its position within both the Pachamama Alliance and in Fundación Pachamama, Jungle Mamas is looking to transfer the fundraising component to Fundación Pachamama, so that the program is completely managed and directed out of Ecuador, thus eliminating the need for English - Spanish - Achuar translation. All Safe Birth and Family Health workshops will be conducted in Achuar by Achuar trained birth attendants, reducing the need for translations and increasing the overall sustainability and cultural adequacy of the program.

Challenges
Which barriers to health and well-being does your innovation address?
Please select up to three in order of relevancy to your project.

PRIMARY

Lack of physical access to care/lack of facilities

SECONDARY

Limited human capital (trained physicians, nurses, etc.)

TERTIARY

Restrictive cultural norms

Please describe how your innovation specifically tackles the barriers listed above.

Because of a lack of roads in and out of the territory and access to hospitals, Jungle Mamas' focus on safe birthing and family health workshops places the theoretical and practical knowledge necessary to address these issues directly into the hands of the people themselves. Instead of having to pay a large amount of money for a flight, or waiting for rainy weather to clear up before they can evacuate (and in some cases, there is no way to evacuate due to weather), the skilled Achuar birth attendants and community health workers are able to save the lives of mothers and babies from within their own communities using their own language and ability to provide culturally competent care.

How are you growing the impact of your organization or initiative?
Please select up to three potential pathways in order of relevancy to you.

PRIMARY

SECONDARY

Enhanced existing impact through addition of complementary services

TERTIARY

Influenced other organizations and institutions through the spread of best practices

Please describe which of your growth activities are current or planned for the immediate future.

Jungle Mamas is in the process of expanding its reach and impact from one association, consisting of 7 communities, to two associations, creating a total of 15 possible communities impacted for 2012. We are actively working with the Achuar Federation (NAE) and hope to reach all 34 of the Achuar communities (approximately 50% of the Ecuadorian Achuar population) within the province of Morona-Santiago in the next three years. Our involvement with NAE and the Ecuadorian Ministry of Intercultural Health has already catalyzed other health initiatives within the Achuar territory, including HIV/AIDS awareness education.

Do you collaborate with any of the following: (Check all that apply)

Government, NGOs/Nonprofits.

If yes, how have these collaborations helped your innovation to succeed?

Through our collaboration with the Ecuadorian Ministry of Public Health (MSP), Jungle Mamas was able to provide 5 Achuar participants (4 women, 1 man) in training of the trainer workshops that will provide HIV/AIDS awareness, prevention, and treatment education within the Achuar population living in the province of Morona-Santiago. The MSP has recently detected cases of HIV in the neighboring Shuar population, which presents a risk to the Achuar. The discussion of HIV/AIDS has enabled Jungle Mamas to talk about the use of the condom as a means of STD prevention and family planning, a subject that was previously forbidden to talk about due to cultural taboos. Our collaboration with Ecosan has also enabled us to succesfully implement ecological dry toilets, thus improving overall health.

Comments

Jacqueline Cutts's picture

Dear Robin,

Bravo! I really like the intercultural approach that you take in your work. Based on a similar approach that we take in Uganda, I had a suggestion/question. I noticed that you had a big focus on education and that one of the problems you were wanting to overcome was the constant need for translation; I was wondering if your curriculum included ways for the women being educated to take active part in the training? When my organization--Safe Mothers, Safe Babies--started in 2008, we had a lecture-based model of birth education. In doing post-course surveys, we realized that we needed to encourage more participation. By training women's groups to embed the education in dramas and songs that they would then perform in their communities, they both learned more and were able to reach a greater number of people than our educators could by themselves, as it eliminated the need for regular translation and could be incorporated into other community events. Most of the women in our target communities can now sing the signs of complicated labor, and other songs about the signs and treatment of malaria, etc. This was effective for us, so I thought it might help you too. Just a thought! If you'd like to discuss this, or anything else, I'd welcome the opportunity to collaborate with you. Please feel free to message/email me if you'd like.

Robin Fink's picture

Jacqueline,

Thank you so much for your feedback! I actually just got back from two Safe Birth and Family Health workshops in two Achuar communities in the Amazon this past week! I find it serendipitous that you brought up the issue of women taking active part in the trainings, because in these two workshops, we did just that! Three of our most active birth attendants and participatory workshop participants in the past were actually leading as facilitators in the two workshops. The midwife we work with, who in the past was the workshop facilitator, sat as an observer of the workshop and did not teach a single subject, but rather served to provide support and evaluation of the three women Achuar facilitators! In our workshops, we have always emphasized the importance of active participation, including writing and singing songs to teach participants and providing re-enactment demonstrations of safe birthing, involving the participants in the dramatizations. The entire workshop was conducted in the native language of Achuar Chicham and the only translating that was done was for us into Spanish, so that we could provide a useful evaluation during breaks. I am really interested in the work that you are doing with SAFE, and feel that there are a lot of similarities in methodology and experience, so I would love to be in touch! Thank you for your feedback!

Robin Fink's picture

Jacqueline,

Thank you so much for your feedback! I actually just got back from two Safe Birth and Family Health workshops in two Achuar communities in the Amazon this past week! I find it serendipitous that you brought up the issue of women taking active part in the trainings, because in these two workshops, we did just that! Three of our most active birth attendants and participatory workshop participants in the past were actually leading as facilitators in the two workshops. The midwife we work with, who in the past was the workshop facilitator, sat as an observer of the workshop and did not teach a single subject, but rather served to provide support and evaluation of the three women Achuar facilitators! In our workshops, we have always emphasized the importance of active participation, including writing and singing songs to teach participants and providing re-enactment demonstrations of safe birthing, involving the participants in the dramatizations. The entire workshop was conducted in the native language of Achuar Chicham and the only translating that was done was for us into Spanish, so that we could provide a useful evaluation during breaks. I am really interested in the work that you are doing with SAFE, and feel that there are a lot of similarities in methodology and experience, so I would love to be in touch! Thank you for your feedback!

Hari Pant's picture

Kudos the team of "Jungle Mamas" !! By looking at the model you are following for this project it encouraged me to understand that how we can try to improve the maternal health even in the remotest part of the world. In my country India, we have a larger population living in rural India where medical facilities are absent most of the time especially for maternal & neo-natal health. Your model can be a great example for them & for the ngos who are trying their best to provide help to these remote areas. Please let me know if you are interested so that I can have some organisations contact you for further discussions. Thanks again .... Madhuwanti (Volunteer).

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