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"I Started GPA 14 Years Ago, And Here I Was Hearing the Story that Inspired Me to the Core.&quo

Maria, the midwife in the middle, with her young son

On a mountain ridge overlooking precipitous cliffs, meandering trails and lush green valleys, I was awestruck being back in the field with GPA. My family and I spent this past summer in Chiapas, Mexico and one day we traveled with the team to San Juan Cancuc, the principal town in a region surrounded by small villages, so I could conduct a refresher workshop for 24 midwives on newborn resuscitation, a critically important skill for those who attend deliveries. 10% of all newborns require some form of intervention immediately after birth to prevent newborn death. Many of these newborns require a simple intervention of rapidly drying the baby and sometimes giving a few artificial breaths to the baby's lungs. This group of midwives had taken an earlier GPA course led by a professional midwife on the same topic back in May. Studies have shown that infant survival increases exponentially if providers are offered frequent refresher courses in Newborn Resuscitation.

The midwives settled into their seats dressed in the typical textile dress; a vibrant array of colors with stunning symmetric designs. Indigenous midwives share a deep bond with one another. Their work caring for women during their pregnancy and attending births is sacred. They walk in oppressive heat or blinding rainstorms, daytime or night, sometimes miles along a mountain trail or road, to attend a birth in a neighboring village. Being trained by their grandmothers and mothers, their work is uncompensated.

After the short lecture, it was time for the practical part of this workshop. The group was divided into thirds and each midwife practiced her newborn resuscitation skills on plastic dolls. Maria, a midwife in her early forties with a 2-year-old boy wrapped on her back in a colorful blanket, completed her practice with efficiency and precision. She pulled me aside and motioned to our staff member to approach. Juan Carlos, an indigenous man who has worked with GPA for years, was asked by Maria to translate her story for me, from her Mayan language, Tzeltal, to Spanish. Using hand motions as she spoke, I could see her calloused, cracked hands with swollen knuckles, which reflected years of the hard life she had led. Her face was wrinkled, worn from years of laborious work in the shadeless fields with a machete cutting corn, years of walking miles every day to collect water, and caring for her family while being a leader in her village for women’s health. There was also a lightness to her as she spoke to Juan Carlos. A seriousness to her appearance and tone was complimented by a glow in her jet black eyes, a warm inviting smile; her posture was humble yet proud.

While Juan Carlos translated the story, Maria took a step closer towards me and looked me in the eye as I listened. It was after the first GPA workshop on this same topic 2 months ago where Maria first learned neonatal resuscitation techniques that she was called in the middle of the night to attend a delivery. She walked the 3 miles to a neighboring village to attend to a woman in the late stages of labor. As she delivered the baby, she noticed he was not breathing. Immediately she remembered what she had learned in the recent GPA workshop. "I dried the baby with vigor using a clean towel," she said. "I noticed the baby still was not breathing and was blue, so I dried and stimulated the baby more with a second towel. Yet still the baby was not crying. So I made a seal with my lips over the baby's nose and mouth and gave 3 breaths." As she watched me listen to the story she took a step closer to me, not taking her eyes off of mine. Juan Carlos finished the story describing how Maria gave the baby 3 more artificial breaths, "just like I learned at the GPA workshop, and the baby started to cry loudly and turned pink.” The entire room had been quiet, as the midwives listened to Maria recounting this experience. I looked over Maria's shoulder out the window and could see the vast green mountains of the local landscape. It occurred to me that this story, if told within the confines of an American hospital, would be routine. Perhaps it would not even be shared amongst physician and midwife staff. However, in this remote region, so far from hospitals, where Maria and her colleagues trek along these valleys to help women in labor, this story had deep meaning. It struck me profoundly that 14 years ago I started GPA, and with your financial support, here I was hearing the most important and real story; the human story that inspired me to the core.

I was visibly moved. Maria, all the time making eye contact with me, took a step forward. She reached up and grabbed me around my back with her short muscular forearms. With her baby asleep on her back she pulled me in and gave me a tight hug. We squeezed each other tight, with our entire strength. We were in that moment celebrating the life of this anonymous infant and Maria's new skill that saved the baby. While hugging each other for that moment we were oblivious of everything save the presence of our joy, thrill and gratitude. How long did the hug last? Perhaps 10 seconds, 15 seconds, I’m not sure. And then reluctantly, we both let go. Maria took a step back, looked at me with her humble and proud shining eyes, and said, "Gracias."

Scott Cohen and Juan Carlos Pérez at the Workshop

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