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| 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
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| 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.
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| 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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