Suzy consulting with Tarahumara mothers

Alisun’s findings prepared the way for Suzy Messer another university student who is currently pursuing her Master’s in Public Health with a concentration in Maternal  Health through Boston University’s School of Public Health.  Suzy is now the Field Coordinator for the rollout of One Heart’s pilot program in Chihhuahua, Mexico and is using her work there to complete the requirements for her master’s in Public Health.

Suzy visiting villages in the Tarahumara

As I’ve been speaking around the country on women’s issues for the last few years, many university students have come up to me and asked how they could get involved.  Like most students they didn’t have money to donate but they wanted to do something.  One of the most exciting parts of the Stirring the Fire website is the call to action that offers a myriad of ways — like working with organizations like One HEART — to support women and girls around the world.

When you get a chance check out Take Action on our website with its searchable database of organizations.

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.

The One HEART Staff in happier times.

Today I learned that Arlene has decided to donate all of the One HEART assets in Tibet to the Tibetan Staff in hopes that they will be able to continue their work.  They are currently looking for foundational support out of Hong Kong.  It’s great to see that they are not giving up!  I just hope they make it. 

After Arlene left I decided to stay and document some of the drokpa families (nomadic families) in the areas where One HEART was about to expand its work.   Since I couldn’t document One HEART’s work I decided to document the typical families they were working with.   I hired a guide and three yaks and took off on a five day trek into the beautiful high mountain valleys north of Lhasa.

I watched nervously as Tenzin the Yak herder put my camera bags into a flimsy gunny sack and precariously roped it to the back of a Yak.

Yaks have three times more red blood cells than the average cow.  With its long hair and ability to survive in oxygen depleted air the yak thrives in the high altitudes where cows would perish.  Just as the buffalo was central to the life of Native Americans the yak is critical to the survival of the Tibetan nomads.  The milk is made into cheese, yogurt and butter which is used in butter lamps and the omnipresent butter tea.   The yak hair is woven into tents, blankets, bags and rope.

Yaks are great pack animals but are almost impossible to herd when they are alone.  So anytime you need to hire a yak for a trek you need at least two.  The typical price is about $6 per day per yak—the yak herder is free!

I held my breath every time the Yak crossed a river or creek and prayed it wouldn’t decide to lie down to cool off.   I carry my equipment (Canon Mark III 1ds; Sony EX1 Video Camera; lights and sound equipment in two bags).

The article states:  “There’s a growing recognition among everyone from the World Bank to the U.S. military’s Joint Chiefs of Staff to aid organizations like CARE that focusing on women and girls is the most effective way to fight global poverty and extremism. That’s why foreign aid is increasingly directed to women. The world is awakening to a powerful truth: Women and girls aren’t the problem; they’re the solution.”

I just returned from a heartbreaking trip to Tibet where I planned to continue my work on women’s issues.  I went to document the work of the NGO ‘One HEART’ which has been addressing the high rate maternal and infant mortality — especially among Tibet’s nomadic population.

Tele who is 63 with his grandson Sonam Choedon. Sonam was born near Lake Namtso where One HEART hoped to start working this year. Like most Nomad children he was born only with the help of family members. Luckily the birth went without complications.

As in many parts of the world, indigenous people don’t get or seek medical help because of different cultural beliefs and misunderstandings.  Many Tibetan Nomads believe that in the critical moments after birth the infant is very susceptible to a ‘Hungry Ghost’ that can jump onto and occupy the newborn.   These ghosts that can be carried by any stranger are believed to make havoc in one’s life.   Needless to say a Nomad doesn’t want a doctor or midwife that they barely know attending the birth of their child.  They also believe that the blood of childbirth offends the spirits of the house.   Therefore many births take place in a cold and dirty stable away from the warm fire in their yak-hair tents. It’s no wonder that an estimated three women died for every 100 births and one in ten infants did not survive their first year of life.   

Adu, 26 and her husband Tadro, 31 live at 16,000 feet where they raise yaks and goats. Since the Tibetan’s have never had a midwife tradition, both of their children were born at home without any prenatal, birthing, or postnatal care.

To address these cultural beliefs One Heart’s Tibetan staff trained local nomadic women to be midwives and provided a plastic sheet to contain the ‘spiritual blood pollutants’ that could be taken out of the tent after the birth.  The ten year old program has been extremely successful.  Last year there were no maternal deaths in the two counties they worked in.   Unfortunately, One HEART’s contract to continue their work was not renewed.  

It is often said when a mother dies the family dies—students drop out of school to help take care of younger siblings, and fathers strain under the added workload.  It is such a shame that a program that was so successful at saving families from the devastating effects of losing a mother had to end.

Nomadic life in Tibet is changing fast.  Solar panels, cell phones and satellite radios are starting to appear.  The cell phone is becoming an important tool in the campaign to reduce maternal mortality.

Thank you for visiting my blog! I welcome your comments and look forward to hearing what you have to say.

Phil Borges

PS: If you didn’t have a chance to read my previous blog postings from Tibet they can be found here:

Microsoft Pro Photo Blog – Post 1 of 2

Microsoft Pro Photo Blog – Post 2 of 2