Building partnerships across borders for better maternal health
On a warm 2017 summer day in Oaxaca, Mexico, Daniela Bermea huddled around an easel of drafting paper with almost a dozen indigenous or Afro-Mexican women.
With markers in hand, the women brainstormed a long list of title options for the collective photo project created during a three-month seminar called “Community intervention in favor of maternal health.” Eventually, they narrowed the experience down to one word: renacer, the Spanish word for rebirth.
“They chose that word because it represents the social change that the women are trying to bring about in their communities,” said Bermea, a master’s student at the Steve Hicks School of Social Work. “The second piece was that it reflects the need to repaint maternal health beyond raising awareness.”
The seminar was one result of the fruitful partnerships that the Steve Hicks School of Social Work has built with various agencies in Oaxaca, where students can get involved in projects that allow them to gain social work and bilingual skills while making meaningful contributions to the community.
“We will not initiate international placements unless we believe we can sustain a mutually beneficial relationship,” said Tanya Voss, who is assistant dean for field education at the Steve Hicks School of Social Work. “We don’t want to be guilty of academic tourism or exploiting agencies.”
The seminar that Bermea facilitated was in collaboration with the Mexican research center CIESAS-Pacífico Sur and GESMujer, a Oaxacan NGO focusing on gender issues. The goal was to work with local women as they explored maternal health issues in each of their communities through participatory methods such as interviews and photovoice.
“Every single one of their experiences and their communities were different,” Bermea said. “Some [participants] focused on adolescent health, some focused on midwives in the community, while others focused on teen pregnancy and a lack of contraceptives. It really varied, and through their community assessment they identified what they wanted to work on.”
Social work master’s student Monique Vasquez also participated in the seminar. She said she learned a lot about maternal health in Mexico thanks to the research the women conducted in their communities.
“It really woke me up to the disparities that exist in maternal health, particularly among indigenous women in Mexico, similarly to black and Latina women here in the United States,” she said.
One of Vasquez’s goals during her time in Oaxaca was to develop grant-writing skills. She took notes on the women’s findings and used them to draft a grant proposal for GESMujer, which the NGO later used to develop an application for funding.
Meanwhile, Bermea helped to facilitate sessions, conduct focus groups, and train the women in how to use cameras for the photovoice component. Participants then returned to their respective communities to photograph people, places or objects related to their chosen topics in maternal health care.
Bermea found that photovoice specifically allowed women to articulate cultural norms that posed challenges to maternal health.
She remembered one participant who interviewed a husband who said he worried his wife would
get involved with another man if she was using contraceptives. Another told the group, “I just recognize that we’re not in charge of our own bodies here. The man is. They hit us and treat us like we’re just sexual objects.”
“We had one participant tell us that in her community, a man became a man when he got a woman pregnant,” Bermea said. “And for a girl to become a woman, she had to become a mother.”
Through photovoice, women were able to engage in a dialogue about gender equality that empowered them to seek positive change in their personal relationships as well as their communities, Bermea said.
Bermea added that the seminar guided participants on how to use their specific interests and skills to develop activities in their respective communities. For example, one woman created an action plan for using the theater skills of students at the local school to educate their community about gender issues and access to contraception.
“The seminar was full of capacity-building, training and education that it might have been inaccessible in any other way,” Bermea said. “Through this process, they learned how to do a community assessment, mapping, conduct interviews, and how to formulate an action plan. Now they have all these tangible skills for any job they’re interested in pursuing or for continuing this work.”
For Bermea, the collaborative nature of the experience was groundbreaking because academic institutions, community members, health providers and NGOs “met in a middle ground.”
“This is how we should be addressing health issues,” she said. “We’re all having a conversation at the same table, which allows us to identify the deepest roots of health disparities and the actions we can take using the resources that are available to us.”
By Lynda Gonzalez. Photos courtesy Daniela Bermea.