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The Community Health Assistant, a Critical Link in the Continuum of Care


High in the mountainous region of Simojovel, in the southern state of Chiapas, Mexico, known for its amber mining under rough conditions, life can seem isolated from the more bustling city of San Cristóbal de las Casas, nearly four hours away by car, when it’s not raining. This is where 21-year-old Lesvia, who works as the community health assistant, grew up, in the small village of Chapayal, with a population of 443 people, all of whom speak the Maya language Tzeltal as their first and often only language. In this village, with an average educational level of 3.48 years, Lesvia was one of the lucky ones, completing high school, making her one of the few bilingual speakers of Tzeltal and Spanish.

Lesvia was elected to her position as health assistant through a community assembly a couple of years ago, and provides an essential service to her community by being responsible for the health of pregnant women. She is the critical link between the traditional midwives in her area, whom she works side by side with, and the nearest health center in Santa Lucía-Aquiles Serdán, Pantelhó, a good 30-40 minutes away, where she is the liaison.

Lesvia is the one who local midwives and families call when a woman experiences a life-threatening emergency during childbirth. She is the one responsible for organizing the transfer and admittance of the woman to the main hospital, back in San Cristobal. She works with the families when they don’t want to send the woman for formal care either because they lack the money, or are distrustful of being treated in a health center.

Last year, Lesvia attended Global Pediatric Alliance’s maternal and infant health courses in El Roblar, Pantelhó because she wants to provide the best service she can to her community. Her grandmother was a midwife, and taught Lesvia about her work in the surrounding communities, and instilled in her a belief in the vital importance of supporting the local midwives. Until recently, no health services existed in the area. In Chapayal, and the surrounding villages, where upwards of 90% of women give birth at home, recognizing a medical emergency early can mean the difference between life and death. Lesvia wants to make sure she has all the tools possible at her disposal.

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Global Pediatric Alliance promotes grassroots empowerment and community-based healthcare to improve the lives of women and children, and reduce maternal and infant mortality in Latin America.

Photos courtesy of Marcella Spera, Monica

Jarosz, Nikhol Esteras, and Stacey Ramirez

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