BRAZIL - Northeast - City of Recife

Paula Viana
Paula Viana, coordinator of Grupo Curumim.


Meeting Women Where They Are:
Grupo Curumim's work with midwives and
adolescents in northeastern Brazil

"Traditional midwives have great responsibilities," says Paula Viana, coordinator of the Brazilian feminist organization Grupo Curumim. "They are responsible for women's health, and they are leaders in their communities. They need to be recognized and valued, and given the tools to do their work well." For the past 16 years, Paula and her colleagues at Curumim, based in the northeastern city of Recife, have been doing just that. Starting out as a small midwifery advocacy organization in 1989, Curumim has grown into an international reference point for organizations working to improve women's health and reduce pregnancy- and childbirth-related deaths through collaborations with traditional birth attendants.

Although Curumim's work has garnered international recognition, the organization's priorities have stayed local. The northeastern state of Pernambuco, where Curumim is based, has some of the highest rates of maternal mortality in Brazil. And as Paula notes, even the official statistics fail to reflect the true extent of the problem. "It's amazing how we come to find out, from midwives, about deaths of women," she says. "Almost all of the midwives have stories to tell—about a mother who died in pregnancy or childbirth, or a neighbor, or a sister-in-law, or a grandmother. These fatalities are not added to any public health data bank. They are not recorded in any way. So, how do the authorities know what is really happening?" To close this gap, Curumim has worked for many years to ensure that traditional birth attendants can participate in discussions of women's health policy. Curumim's approach is based on respect for midwives' knowledge and perspectives, as well as recognition of midwives as agents of social
Traditional birth attendants participate in a workshop
Traditional midwives from northeastern Brazil participate in a workshop organized by Grupo Curumim.
and political change. "Our goal is not only to provide midwives with technical knowledge, but also to help them negotiate the public health system, to ensure that they have transportation and adequate supplies, and to make sure they are able to participate effectively in local politics," Paula explains.

More recently, Curumim has worked to bring midwives' knowledge and perspectives to bear within the wider Brazilian feminist movement, particularly around the issue of safe and legal abortion. In Brazil, abortion is only legal if the pregnancy threatens the woman's life, or in cases of rape or incest. Despite these legal restrictions, however, abortion is widely practiced in Brazil—and, as in most countries where women cannot access safe and legal services, unsafe abortion is one of the principal causes of pregnancy- and childbirth-related mortality and morbidity. Young women, women living in situations of poverty, and women living in rural areas are particularly at risk, since their rights are often overlooked, and since they generally lack the resources to secure safe services.

Traditional birth attendants identify needs and challenges faced by women in their communities
Traditional midwives from northeastern Brazil share difficulties faced by women in their communities at a workshop organized by Grupo Curumim.
Since early 2004, Curumim has been part of the Brazilian Working Group on Safe and Legal Abortion, a coalition of feminist groups advocating for the reform of Brazil's restrictive abortion laws. By organizing workshops and trainings with traditional birth attendants, rural and indigenous women from across Brazil's northeast, and young women in Recife, the organization has sought to ensure that the working group's priorities reflect the needs and perspectives of a wide range of Brazilian women. In 2004, Curumim organized a series of workshops for traditional birth attendants and other rural and indigenous women from the northeastern sertão region, where water is scarce and health and education services are sparse. The workshops gave women an opportunity to reflect on the obstacles they and other women in their communities face in accessing health services from the perspective of gender, power, diversity, and human rights, and to identify ways that they can gain more legal and political recognition.

Since 2001, Curumim has applied the same philosophy that guides their work with traditional midwives—based on respect, collaboration, and open exchange—to Cunhatã, a new project to educate and engage adolescents. Through Cunhatã, Curumim holds regular workshops on the physical, psychological, and social aspects of sexual and reproductive health for young people living and/or working on the streets of Recife. The workshops deliver vital information on sexuality, reproductive health, gender, and human rights, empowering young people to make healthy decisions in their own lives and encouraging them to participate in local activism and public policy discussions. In their work with these young people, as in their work with midwives, Curumim is not only filling gaps in the public health system, but also building a stronger, broader movement for sustainable social change in Brazil.

IWHC has supported Curumim since 1994 and is the sole supporter of their work with traditional birth attendants and adolescents.


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