WUNRN
December 30, 2010
The
indigenous Guarani woman with tired eyes said that it burned when she urinated
and her lower abdomen ached. "I'm worried about cervical cancer,"
said the 45 year-old grandmother of two as she waited to consult the doctor
setting up opening up shop in the one-room brick school house behind her.
Half an
hour later, Otega emerged, relieved. She was in the clear for now, she said.
"I didn't even know what a cervix was before the mobile health units
starting arriving," she added with an embarrassed half-smile:
Otega's
medical care was likely not discussed at the recent U.N. summit on the progress
of the world in meeting Millennium Development Goals by the deadline year in
2015. But it could have been. Her consult is an example of what's helping South
America's poorest country advance in its maternal health goals, as well improve
its populations overall sexual and reproductive health.
Through a
program funded by International Planned Parenthood Federation--which also paid
for some of the costs of reporting this story--three white pick-up trucks
traverse the unpaved Bolivian countryside 36 weeks a year, offering care and
educational workshops to over 100,000 Bolivians, including many of the
low-income women in rural areas who are among those at greatest risk of
maternal mortality. The trucks are known as mobile health units.
"These
mobile units are a great advance for the country," says Jaime Nadal, the
United Nations Population Fund representative in
Every day, about 1,000 women around the world die during pregnancy or
childbirth; 99 percent of them are in developing countries, according to U.N.
statistics.
Destructive Ripple Effect
This
causes a strong ripple effect throughout the women's communities. A child whose
mother does not survive childbirth is 10 times more likely to die prematurely
and motherless children, according to the U.N., are less likely to receive
adequate education, health care and nutrition.
Though
maternal death rates have dropped by 34 percent globally since 1990, the
millennium development goals target a 75 percent decline by 2015 and to achieve
universal access to reproductive health. It's doable, says the U.N. and global
health experts: the vast majority of maternal deaths are preventable if the
right care and supplies are available.
In 1990,
the country registered 416 maternal deaths per 100,000 women giving birth, U.N.
figures indicate. By 2003 that figure was down to 239. It may be as low as 180
now, says Nadal, though reliable data are scarce since most of these deaths
happen in rural areas, off the hospital grid.
Despite
this improvement,
Roaming health units have been used for decades in a variety of emergencies
such as by the International Red Cross to bring medical attention to combatants
in conflict zones.
Rocky Roads and Flooded Valleys
But the
Their
vehicles are packed with a stretcher, oxygen tank, intravenous kits and a ready
supply of dozens of medications for the most commonly seen sicknesses.
"We
have to use what we can," says Dr. Rosario Cervantes, as she glides a
pocket-sized battery-operated ultrasound machine along the belly of a
16-year-old expectant mother stretched out on a make-shift examining table in
Bolivia's Chaco region.
Cervantes
works for the Center for Investigative and Educational Services,
She still
has a headlamp strapped to her head from the pap smear she performed on another
patient moments ago as she speaks sweetly but directly to the apprehensive
teenager gazing up at her. The patient shakes her head sheepishly when asked
whether she has gotten any pre-natal care other than this review.
Gloria
Rivera, a nurse at the center's mobile unit, says it's not just the long and
expensive trip to conventional medical clinics that keeps pregnant women away.
There's a cultural barrier too.
"Most
won't find anyone who even speaks their language," Rivera says, as she
takes the blood pressure of Cervantes' next patient and chats in Guarani--her
native language as well as that of most indigenous here in
For many
women in
The
center's staff creates a different dynamic.
Rivera is
the child of indentured servants. Cervantes uses words such as "aji"
(the common Bolivian word for spicy) to describe a burning sensation. And
clinicians don't chastise teenagers for neglecting to see a doctor.
Beth
Whitfield is a registered nurse who runs a mobile health unit operated in
"If
you bring this knowledge to people and get them to do it, they are more likely
to stay healthy in the long run."