Teresa, local Partera

Ninety percent of the women who die in childbirth do so because of postpartum hemorrhage.  Administering drugs like Oxytocin to women who are having postpartum bleeding causes the uterus to contract and very effectively stops the bleeding.  Unfortunately, Oxytocin has to be kept refrigerated.  Another very effective drug for post partum hemorrhage, Misoprostol, does not need refrigeration and is very inexpensive—therefore an ideal drug for the Parteras to have on hand.  Unfortunately, because ‘Miso’ can also be used to induce an abortion, it has not been allowed to be used in the heavily Catholic Tarahumara Sierra. 

Arlene Samen the executive director of One HEART traveled to Mexico City to see if she could get the ban on ‘Miso’ lifted in the Tarahumara Sierra if proper precautions against misuse were taken.  The Mexican authorities who have been extremely welcoming to One HEART are taking Arlene’s request into consideration.  If approved it will be a huge victory for the Tarahumara women and their families.

The Rarámuri are best known for their tradition of long distance running up and down the steep canyon trails.  Some of their races, which they run in sandals or barefoot, last for days.  In fact the Rarámuri are hosting their annual Ultra Marathon on March 7th.  I was told that they hunt deer by chasing the animal until it drops from exhaustion.

The One HEART team was welcomed by the Rarámuri with one of their special ritual Yumaré fiestas which lasted all night.  Two goats were sacrificed and the women brought ceramic jars filled with tesguino (corn-based beer) that is consumed in many Rarámuri rituals.

Around 4 am I managed to get an hour of sleep before it began to get light.  Although the women did drink a little it was the men who really let their hair down. 

The music and dancing went on all night and as dawn broke it was mainly the women who were left standing. 

I have found that preconceived story lines almost always take an unexpected turn and this one certainly has.  If you have seen previous post on One HEART you are aware that I started working with them in Tibet.  This documentary which I originally thought would portray a successful approach to maternal mortality on the Tibetan Plateau now looks like it will be about the political and cultural hurdles one faces when trying to address issues like maternal and infant mortality in the developing world.  The Mexican Government is very receptive to One HEART’s work, however, the drug wars in Northern Mexico and cultural issues with the Rarámuri may pose special problems as One HEART tries to establish its program.  For cross-cultural global health programs it’s critical to ensure that there is compatibility between the values of the program and the recipient culture.  I hope to document the process One HEART goes through to become aware of and bridge the Rarámuri cultural beliefs and values with our western medical traditions.  I will continue to post more about the One HEART story as it unfolds.

However, the media revolution brought about by the internet is nudging all of us still photographers toward multimedia.  Now the space in my backpack that opened up because of the lighting equipment I have been able to get rid of has been more than replaced by audio and video equipment.

On the trip to the Tarahamara in Mexico I brought my Mark II 5D and the Sony PNW-EX1 to shoot video.  Betsy Hershey who is collaborating with me on the project brought her Canon Vixia HF S11 camcorder.  After spending time with all three cameras I’ve come to this conclusion.  The Mark II 5D is not ergonomically built to shoot video.  Even with the Z-Finder it is hard to focus on the move.  The add-ons that you need to purchase to make it somewhat ergonomically efficient make the 5D cost and weigh more than the Sony EX1.  The one advantage it has is being able to use all the Canon lenses and obtain a short depth of field.  From now on I’ll use the 5D for selected shots and usually on a tripod when I need to isolate my subject with a shallow depth of field.

Sony PNW-EX1

Mark II 5D with all the add-ons

The other thing I learned is that the HF S11 does a remarkable job for a consumer grade camera and has many advantages.  There were many times that Betsy was getting the shot while I was still getting my EX1 out of the pack and getting it fired up.  Also, the palm sized HFS11 camera is so unobtrusive!!  This was important in the area we working where there have been many drug related killings and journalists are not especially liked.

Canon Vixia HF S11

Here is some edited footage from the fiesta that alternately cuts between the EX1 and the HF S11.  I see a little less crispness in the image but all in all it isn’t bad!!  Can you see much difference? 

It was just 2 years ago the Panasonic DVX 100 mini DV standard definition was the standard for documentary film makers.  The 1920 x 1080 file from the tiny HF S11 is also a big improvement.

When it comes to catching an intimate moment and getting the shot I don’t mind a slight loss in dynamic range. I’m going to look at the next iteration of the HF S11 (HF S21) which will evidently have a touch and track sensitive LED screen that will allow you to focus by touching the screen on the area you want to focus.

In multimedia you can get away with mediocre images much easier than poor sound.  To get good sound you need to go to an external DAT recorder like the Marantz 661 ($600) or the popular Zoom H4N ($350).   Both have internal mics but to get good sound you need to get some good external mics.   I use the Sennheiser MKH 416 or a wireless lavalier for interviews and the Audio Technica 825 stereo mic for ambient sounds. 

The Automatic Gain Control on the 5D Mark II makes it impossible to record a decent sound track.  When recording sound you want your input volume control to be at a steady level.  The AGC raises the volume setting any time there is a period of silence resulting in weird volume fluctuations through out the recording.  Unfortunately this is not a setting that can be turned off.  If you want to get away from carrying a DAT recorder and the extra hassle of syncing sound in post production Beach Tek has a solution to get around the AGC, but it still does not deliver the sound quality of the Marantz 661 (24bit/ 96kHz).  I decided to beef up the 661 a little further by getting it through Doug Oade who replaces the stock 661 mic pre amps for an extra $160 to increase the signal to noise ratio.  His site is a good source for info on field recording.

And finally it is necessary to listen to your sound throughout your entire recording.  A good pair of headphones is a must.   The industry standard is the Sony MDR 7506 ($100).  You wouldn’t take a picture without looking through the view finder, so why would you record sound without monitoring it. 

I recently watched Sound for Film and Television, which I recommend for a good and entertaining tutorial.  If you have any resources you recommend please share!

Last year I traveled to Malawi, Zambia, Sri Lanka, Peru, India and Tibet to create short multimedia pieces for my ongoing project focusing on the empowerment of women and girls in the developing world. 

In addition to my Canon 1Ds Mark III and various lenses (16-35mm f 2.8;  70-200mm f 2.8;  28-70mm f 2.8;  24mm f1.4)   I was now carrying a Sony PMW-EX1 Camcorder; a Marantz 661 field DAT recorder; shotgun; omnidirectional; and wireless laviler microphones plus the tripod, lights, headphones, etc.

As you may have seen in a previous blog post, here is what it looked like on one of my trips to Tibet!! 

Not only is it a lot of weight that sometimes requires a Yak but in instances like this it makes getting to the equipment quickly a major problem—so much for spontaneity.

I’m on my way to Northern Mexico to do a story on maternal mortality among the Tarahamara Indians living in the Copper Canyon near Chihuahua.  Here is what I’ve decided to do to lighten my load.

One of the great advantages of digital photography is the ability to shoot in low light.  Instead of lugging around my heavy Lumedyne packs, batteries, and light heads I now just carry a Canon 580ez .   In fact, I hardly light anymore and create my highlights in post production (shooting HDR and using the brush tool in Lightroom - see below)  This has helped to lighten my load a lot.

My time in Mexico will determine whether I will replace my Canon Mark III 1Ds with a Mark II 5D to shoot both stills and video when needed.  Though the 5D does needs a few add-ons to make it functional as a video camera.   First, a Z-Finder from Zucuto is a must for getting accurate focus.  Secondly, the Automatic Gain Control on the 5D makes it impossible to record a decent sound track.  More on this in my next blog. 

We are all waiting for the promised firmware upgrade for the 5D that will allow a 24 frame per second frame rate.  Right now I’m not looking to use the 5D to completely replace my Sony EX1 but as I get used to shooting my interviews and B roll with it, I’m looking to the future and hoping I’ll be able to leave my EX1 at home.  The new Canon Mark IV will make high ISO still and video shooting even more available and I assume it won’t be long before these new SLR cameras will be built more ergonomically to allow for easier video shooting.

By 2000, UNICEF reported that only 4 to 5% of Afghan children were being educated at the primary school level. Fewer still had access to secondary and university-level education.

According to the World Bank, “Since 2002, more than 6 million students and teachers have returned to school.” 

The organization, Ayni Education International, has certainly had a hand in the increasing education, especially for girls, in Afghanistan.  Featured this week in the Seattle Times, Ayni was founded by Seattle based Julia Bolz.

From Ayni’s website, “Our main project, called “Journey with an Afghan School,” began just months after 9-11 and the Taliban were removed from power in Afghanistan. It is a grassroots project to build and supply schools for Afghan children. 

With funds raised by communities across the country, we have defied all odds by building and supplying 19 new schools and repairing over a dozen others, serving about 25,000 Afghan students. We also have provided wells; distributed text-books, school supplies and athletic equipment; provided teacher trainings; and set up libraries, computer centers and PTAs. Most recently, we set up two teacher training centers, training several hundred teachers.”

As I continue to add to the “Call to Action” portion of a new website to be launched soon (www.stirringthefire.org) I am continually amazed by the extraordinary people like Julia Bolz that are making a difference.  Thanks Julia for your wonderful work!

Unfortunately, 800,000 Zambian children have lost one or both parents to AIDS, and others are left to care for themselves because their parents have to work in the fields.**

Severe burns happen frequently because a third of the world still uses open
fires for cooking, heating and/or lighting. Overcrowded living conditions, lack of proper safety measures, loose clothing worn by women and insufficient parental supervision of children are other factors.

Because AIDS takes the lives of so many parents, especially the women who are the main caretakers of children many more children are now suffering burns from open fires.

The story of Mateo represents the typical scenario.  He fell into an open fire while under the care of his slightly older sister.  Actually Mateo was one of the lucky ones, many children go untreated but he received help from Interplast partner Dr. Goran Jovic.

The Forgotten Global Health Crisis from Phil Borges on Vimeo.

I traveled with Dr. Jovic as he flew to remote villages around Zambia in his single engine plane to treat severely burned patients that would otherwise never receive treatment and remain disabled for life. 

Burns comprise half of Interplast surgeries, with 80 percent of them being performed at 12 Interplast Surgical Outreach Centers in nine countries. 

*World Health Organization
**Interplast

1. Community based Issues–Are the issues (i.e. girls education; trafficking etc.) that you are interested in addressed in the program?
2.  Field based or classroom based–Ideally you want to be living and interacting as much as possible in the community you are studying or volunteering in.
3.  Study or Research—how much support is in place locally to facilitate your study or research project
4. Local Language immersion and instruction should be a strong component of the program
5. Accreditation—Of course it’s ideal to receive college credits for your time and work while abroad.

As we build out the Call to Action section of our website we will categorize various study abroad programs with these attributes in mind.  Again, please give us feed back or let us know about any firsthand experience you have had in study abroad programs so we can grow our support for those who want to take this path.

I find these numbers a shocking reminder of how insular our country is today.

However, as I traveled around the country promoting the Women Empowered project I found many college and high school students were coming up to me after my presentation and asking how they might get involved.  I began to realize that these students could be a significant source of support for empowering women and girls in the developing world.  For the most part they didn’t have much money to donate but wanted to volunteer their time.  The students who had traveled abroad let me know how much their trips that involved some form of community service had “changed their lives”.  

Of course the most personal way to contribute is to volunteer time.  University students who are not yet tied down with family obligations and mortgage payments are ideal candidates for this type of involvement.  It’s an excellent way to broaden perspectives and get an experiential high by giving to something outside of oneself.

In 2009 I decided to expand and reconfigure the Women Empowered exhibition and website to, among other things, reach this younger demographic by including multimedia pieces and an expanded call to action that offered many more ways to get involved.  I want the exhibition and website to inspire student participation—to make it easy for students to become advocates and to provide resources that would allow them to find study abroad or volunteer programs that focused on the issues faced by women and girls in the developing world.

I’m looking for organizations that have programs that allow university students to take a semester abroad and work with local organizations that empower women and girls.  It would be ideal if the program were structured so the student could choose their specific area of interest (i.e. maternal health, micro credit, girl’s education, child trafficking, etc.)  It would be even more ideal if the student could receive credit toward their degree for their time abroad.  SIT –(School for International Training) is a good example.  If anyone knows of organizations with programs like this I would be so appreciative if you let me know.  I want a list of resources to accompany my website and exhibition Women Empowered as it travels to universities to help students that want to get involved with these issues.

In my work I have had the opportunity to see many of the issues women face in the developing world up close and personal.  I realize that many people that want to help women and girls have not had a face to face encounter with those they would like to help. 

Fortunately, nonprofits have recently evolved some great techniques to make donors feel engaged with the personal stories of those in need.  Along with the desire to feel that person-to-person connection, lenders are becoming savvier and clearly desire an explanation of precisely where their donations are going. 

A recent blog post by David Roodman states, ‘In short, the person-to-person donor-to-borrower connections created by Kiva are partly fictional.”  This information attracted widespread attention.  The “Donor Illusion” debate is outlined well in this article in the NY Times and this is another great source of additional information.

In my opinion the way in which the nonprofit world is evolving is a step in the right direction.  The desire to have a direct person-to-person contribution with no intermediary is in itself an illusion.  Tim Odgen of Philanthropy Action makes this point well.

Kiva gives you a list of photographs and profiles of individuals you can support with a micro credit loan.   Your loan goes to one of Kiva’s worldwide “Field Partners”, (microfinance institutions that service the community where the individual you have chosen lives).  The Field Partner approves and disburses a microloan to the entrepreneur you have chosen and gives them a repayment schedule.  When the loan gets repaid you can collect it or designate another entrepreneur to lend it to.

The Kiva model of lending is currently being used to help worthy students get educational loans in countries where student loans have heretofore been nonexistent. 

Another program for donors (not lenders) administered by CARE that takes off on this idea is Join My Village.  Instead of choosing an individual to contribute to you choose a village in Africa and General Mills matches your contribution dollar for dollar.   The donations to Join My Village support ‘Village Savings and Loan’ programs that enable small groups of women to form their own micro banks.  I visited many of these VSL groups when I was in Malawi last year and was very impressed. 

I created a multimedia piece about the program for CARE if you would like to learn more.

As time goes on I’m sure more programs like these will make giving more personal and transparent.  I would love to hear of your experiences with organizations like these, as well as, similar organization that you have been impressed by?