TulaSalud focuses its attention on remote rural communities in the highlands of Guatemala, and places particular emphasis on maternal and infant health. We, and all our partners in Guatemala, fully support the traditional midwives (comadronas) and the work they do in their communities, and favor wherever possible that births take place at home. Of course there will be circumstances when complications dictate that patients be transported from their home communities to the regional hospital (Hospital Helen Lossi de Laugerud) in Cobán.
The health professionals in Alta Verapaz recognized that the disruption and cultural dislocation caused by transport from a traditional community to a large hospital in an urban center can create severe anxiety. This anxiety may make the patient balk at the prospect of transport , and in any case will cause unnecessary suffering and perhaps adversely affect the outcome of treatment. Since 2010 TulaSalud has partnered with the hospital under the leadership of Dr. Edwin Winter to address this issue. (Notwithstanding his European name, Dr. Winter is a native of Cobán.) Dr. Winter is the coordinator of the indigenous care module (MAI) at the hospital. TulaSalud’s initial role was to implement in 2010 a telemedicine system that allowed for videoconference connection between the hospital and the home community. This system allowed the family with the help of a the local community health worker to stay connected electronically with the patient during the hospital stay. Telemedicine was however only one part of the MAI initiative. In February 2011 training was conducted for eight midwives, five cultural facilitators and five child care advocates. The trainees provide welcome, emotional support, spiritual support and translation services for clients visiting the hospital from traditional communities. Between February 2011 and December 2012 the Ministry and TulaSalud shared financial support for the program. Based on the success of the program the Ministry now provides full financial support.
Most recently, in January 2013 TulaSalud collaborated in the construction and equipping of a delivery room incorporating vertical birth (which is the tradition among the indigenous people of Guatemala). In April 2013 the hospital held a workshop to facilitate vertical birth and to train medical and nursing staff in vertical delivery.