So I’ve shared a lot about national public health policy in Peru. You might be wondering what this could possibly have to do with my work on the ground, in an indigenous community, up in the mountains.
Policy decisions have remained regressive and are causing harm to the traditional practice of the Quechua. A few examples how:
- A fine against home delivery
- both the family and the midwife are subjected to such fines
- this policy is causing the practice of midwifery to fade, as young people passionate about maternal health are studying obstetrics over midwifery because of the government’s ‘harassment’ of midwives.
- meanwhile, practicing midwives are taking their operations ‘underground’
- Refusal of birth certificates unless the fine for home birth is paid
- There are serious implications associated with not having proper documentation. It restrict’s the child’s eligibility for necessary social services.
- The internationally recognized right to personhood is violated with this practice.
- An abortion ban, even in cases of rape or incest
- though less severe punishments are prescribed for these situations
- no reference to term, so the traditional beliefs of early term abortion as ‘menstrual cycle regulation’ are disregarded
- Lacking adequate accommodations for Andean communities
- Women hours from a facility are required to deliver in one, but they cannot come early to ensure that their transportation is covered
- Attending in Quechua is not a routinely practiced standard of care, causing obvious communication barriers and further dividing the biomedical world from the indigenous community
- Some facilities allow for vertical delivery, a method that’s shown to ease the birthing process and is seen as critical in the ritual of giving birth as recognized by the Quechua.
- Many facilities do not allow for vertical delivery, as it is a more difficult position for the doctor. It seems as though traditional handling of the placenta is even less accommodated.
The volunteer group had dinner at my house a couple of weekends ago and I shared the following Haikudeck. I covered repro history as my last entry recounts. Then I shared cultural barriers to biomedical health settings, and suggested solutions to making care more culturally appropriate. Explore my notes if you’d like, or leave a comment below if you have any questions.