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Colombia: Midwives Braving Armed Gangs

news source: BBC

By Kiran Stallone and Steven Grattan

Buenaventura, Colombia

 In the stifling heat of Buenaventura, Feliciana Hurtado walks around with a big smile on her face in the neighbourhood where she has delivered many babies over the last 30 years.

 The 68-year-old greets the mothers whom she has helped, and their children.

 Ms Hurtado lives in a relatively safe area of the mainly Afro-Colombian port city on Colombia's impoverished and conflict-ridden western coast, but her work as a midwife often takes her to dangerous and troubled neighbourhoods.

 Buenaventura has a long history of violent conflict, which led to it being dubbed Colombia's "capital of horror".

 Since 1988, armed gangs have battled for territorial control of drug routes out of the port and carried out gruesome dismemberments in "casas de pique" (Spanish for chop houses).

 In 2014, the Colombian military intervened in Buenaventura to regain control from the gangs.

 The intervention provided short-term stability, but Buenaventura is now suffering a new wave of violence, and midwives like Ms Hurtado put themselves at risk by confronting armed fighters to help women living in violent areas deliver babies.

 Ms Hurtado recalls armed fighters stopping her while entering dangerous neighbourhoods in the city to work.

 "Why are you here? Who sent you? Whose house were you in?," they would question her. "I'd tell them I was there to help a pregnant woman and would say which house I needed to go to. Then they would go and verify. Had there been no pregnant woman, I would have been in trouble."

 Mutual support

This traditional type of Afro-Colombian midwifery has been around for centuries on Colombia's Pacific coast. In 2017, the Colombian government declared it as a national heritage practice in an effort to recognise and preserve the women's ancestral knowledge.

 In Buenaventura alone, there are at least 40 traditional Afro-Colombian midwives. In 1988, the women joined together to form the Association of United Midwives of the Pacific (Asoparupa) under the leadership of Rosmilda Quiñones.

 The association supports over 250 midwives all over the Colombian Pacific region who attend to between 4,500 and 5,000 births annually.

 Known as "las parteras" (Spanish for midwives), they use traditional techniques and remedies in their work, such as administering tomaseca, a potent alcoholic analgesic made with medicinal plants to prevent cramping.

 Many Afro-Colombian women say they prefer the services of the parteras to going to local clinics

 Helen González, a 22-year-old who gave birth to a son nine months ago with Ms Hurtado's help, says: "As soon as the contractions start, the parteras provide support. One doesn't feel alone. I wasn't interested in going to a hospital because I would have felt isolated."

 Authority in gang-controlled areas

For other women who live in conflict zones and therefore cannot safely leave their neighbourhoods, there is no choice.

 Colombian gender equality activist Alejandra Coll explains that the parteras often act as a go-between to help women deliver in neighbourhoods controlled by armed gangs.

 "When a pregnant woman needs a check-up or is ready to deliver, the parteras intervene on her behalf with the armed fighters," she says. "They often even have some authority over the fighters because they helped their mothers give birth to them."

 Ms Hurtado, who is one of 14 siblings, has years of experience in dealing with gang members. "I show up and I say hello to them. I ask them how they are doing and I tell them I'm there to work." She emphasizes she is courteous and friendly and that the armed men respond in kind.

 Although local armed groups appear to respect the midwives for the most part, Asoparupa said that some of the women had experienced threats from armed gangs while working in dangerous neighbourhoods.

 They have also been trapped in the crossfire as the gangs battle for territory. "There was one occasion when I wasn't able to leave because there was a shoot-out," says Ms Hurtado of a particularly difficult trip to see a pregnant woman in an area where armed gangs were active.

 Sitting under a flickering light in her home as her neighbours blast reggaeton music from giant speakers, Ms Hurtado quietly organises her birthing tools on a low table. Rubber gloves, a stethoscope and scissors for cutting the umbilical cord are carefully laid out and ready for when she has to rush to a delivery.

 The parteras are passionate about their work, and for many midwifery runs in the family.

 Graciela Murillo, 60, explains that her mother was a partera. She grew up watching her work and wanted to follow in her footsteps from the age of eight. Ms Murillo's granddaughter now wants to go into the ancestral line of work as well.

 The midwives say their pay varies, and in some cases their patients cannot afford to pay at all. They will still see to them, though. "In some cases, we have to reach into our own pockets," says Ms Murillo, who has continued to attend to and support pregnant women even during the coronavirus pandemic.

 But despite the risks in a city as dangerous as Buenaventura, midwives like Ms Murillo and Ms Hurtado remain devoted to their work.

 "It's part of me. When I hear someone's in labour, I'm there," Ms Hurtado laughs. "I don't care about the risk or the time of day."