ABOUT US

Luna Maya

Our Context and Community
 
Our goal in Luna Maya is to empower women through the wellbeing of women and families and through safe motherhood, thereby contributing to a reduction in maternal mortality in Chiapas. We are a group of people who work together to respect, celebrate and protect natural cycles in women´s lives, including pregnancy and birth. Since 2005 we have worked in the urban center of San Cristóbal de Las Casas and in the rural indigenous region of Tenejapa.  
Mission Statement: Luna Maya Birth Center works to ensure that all women in Chiapas have access to humanized health care, including safe and humanized birth. We believe that women in Chiapas have the right to make informed choices about their bodies and have access to the necessary resources to ensure health and wellbeing. We believe in access to safe motherhood as a human right leading to the empowerment of women, enhancements in quality of life, and the strengthening of families.
Luna Maya's work is based on three principal goals:
  • To provide quality, humanized health services to women and families in the Chiapan highlands. In our Birth Center we offer holistic health services, prenatal care, natural births, and pediatric care. Our center is operated by professional midwives and is self-sustainable and autonomous.
  • To train women and men who work in health care and in healing, especially those who work with women. We coordinate training programs for local, national and international midwives and for local health care providers that are based in the integrity of body and mind and in respect for the natural cycles of human beings.
  • To educate and to inform the public about safe motherhood, sexual and reproductive rights, including humanized birth as defined by the World Health Organization, and about perspectives toward health that are based in individual intention and responsibility and in a deep connection with oneself and with nature.
Our staff includes two midwives, one apprentice midwife, a pediatrician, a massage therapist, a prenatal educators, two prenatal yoga teachers, a family therapist,  an acupuncturist, a homeopath, and two receptionists.
  

Our Context and community

Location
Area and Population
Economy
Education
Health
Reproductive Health in Chiapas
Maternal Mortality in Chiapas
Traditional Midwifery in Chiapas
 

Location

San Cristobal is located in the highlands of Chiapas, the south western state of Mexico, with its state capital in the lowland town of Tuxtla Gutierrez and borders with Guatemala to the south and Oaxaca, Veracruz and Tabasco to the west and north. Chiapas caught the world's attention in 1994 through the Zapatista uprising. This movement brought to light the conditions of poverty and racism that still exist in the state.
Since 1994 the pluriculturalism that has always existed in the city of San Cristobal has grown even more. Within the city, indigenous, mestizo, y expatriate worlds coexist, each one with its own subcultures, priorities, and challenges. It is true that this "colonial" city (as it is known in other places) boasts lovely architecture, landscapes and cultural events, at the same time that the awareness and changes brought by the 94 movement continue to reveal the inequality and the discrimination lived on a day to day basis.
After many years of being a lost mountain city, both tourist and political movement have resulted in the construction of a new airport and highway that have facilitated access to Los Altos. Currently the city finds itself in a state of rapid expansion that is not yet guided by a responsible, sustainable and just public policy.
Despite, or perhaps because of, the challenges faced here, San Cristobal and Los Altos continue to be nuclei for new ways of life, new ideas and new freedoms, where many people, both Mexican and foreign, search for deep meaning and new possibilities in human existence and coexistence. In the professional spheres there are notable concentrations in activism and socio-political work (especially in human, women?s, and indigenous rights), in art and music, in the preservation of indigenous cultures, and in healing and alternative medicine.

Area and population

Chiapas is a large and varied state. It is the 8th largest state in Mexico, with an area of 75,634 square kilometres and a range of climates and habitats from the hot and humid southern coastal area to the cooler central mountains. 		 

The population of about 4 million peoples includes an astonishing variety of ethnic groups, with indigenous groups making up about 25% of the population. Of these, the principal indigenous groups are Tzotzils (36% of the total indigenous population of Chiapas), Tzeltals (34.5%), Choles (17-4%), Zoques (5%) and Tojolabales (4.7%). Other groups, including Mames, Lacandones, Katchikeles and Mochos, make up the remaining 2.3 % of the state's indigenous population. The fertility rate is the second highest in the country, 3.47 children per woman, and the population of Chiapas increases by over 2% per year.

According to the Secretary of Social Development of Chiapas, 2003, the indigenous population is young, 45% being 14 years old or below.

Economy

The vast majority of the indigenous population of Chiapas work in agriculture (83%) and the per capita income of indigenous people is equivalent to only 32% of the income of non-indigenous people in the state. Increasing numbers of tourists are attracted by the natural, cultural and historical variety of the area. However, the tourism industry has had little impact on alleviating poverty.

While tourism is a major industry in Chiapas, the state also generates half the hydro-electric power generated in Mexico, and has important natural resources which include oil, gas and minerals, such as uranium, iron, aluminium, copper and amber. The natural diversity of the state includes a huge range of natural species and habitats. Chiapas is thus a very rich state. However, many of its people remain extremely poor, particularly in the rural areas, where standards of housing and in health and other social services are abysmally low.

Education

Only a tiny minority of indigenous adults have completed primary school, while there are still considerable numbers of school age children who do not attend school in the rural areas. Chiapas has the highest illiteracy rate in the nation, at 22.91%, compared with a national average of 12.6%. This rises to 42% for indigenous people. The illiteracy rate for women is almost double that for men.

Health

Malnutrition and the diseases of poverty, especially respiratory and intestinal diseases, are rife in Chiapas. Housing conditions are extremely poor: over a third of homes in indigenous communities lack electricity and running water and the vast majority have dirt floors and cook on wood or charcoal fires.
Health care in the state remains woefully inadequate. Chiapas has the highest rate of infant mortality from diarrhea-related illnesses and 34.8 babies die for every 1000 live births. Maternal mortality rates are also extremely high: 117 women die for every 100.000 live births. (The rate in Mexico is 51 per 100,000 while in industrialised countries the average is 10.) Causes of maternal mortality include poor or non-existent health facilities, malnutrition, domestic violence, unwanted pregnancies and inappropriate interventions during labor and birth.

Sexual and Reproductive Health in Chiapas

Maternal mortality has not significantly decreased in Mexico in the last ten years, while adolescent pregnancy rates have increased. Chiapas holds the highest fertility rate in Mexico (4.6), as well as the highest levels of STIs in the country . In 1999, the percentage of births among women under 20 was of 16.9% . Additionally, in Tuxtla Gutierrez, the state capital, the number one cause of school and university desertion is due to pregnancy.		 

Maternal Mortality in Chiapas

The maternal mortality ratio for Chiapas is among the highest in Mexico at 70 per 100,000 live births. In municipalities where over 69% of the population speaks indigenous languages, maternal mortality doubles the state rate. In these municipalities most women die without medical care. There is significant increased risk of indigenous women dying during pregnancy, labor and the post partum period in the state of Chiapas.

Traditional Midwifery in Chiapas

Typically, midwifery is conceived of as a spiritual gift that is received through a dream that God gives to the midwife in which He concedes her the gift. Currently in Tenejapa, a rural indigenous municipality in Los Altos, due to cultural changes and to the destruction of natural spaces, midwives now do not have spaces in which they can dream; hence a women becomes a midwife by attending her own birth or by attending that of a family member. Midwifery is a community role which traditionally has signified a certain degree of power and respect for the midwife, although currently this respect does not exist in the same way as before due to persistent violence against women.

A traditional midwife is responsible for prenatal care, basing her work in accomodating the baby; for the birth, attended in the traditional manner with the mother kneeling and with some modern customs such as the immediate severing of the umbilical cord; and of newborn care. Midwives do their work with the help of medicinal herbs, home remedies, massage, and in some cases, prayer.

Local midwives, although they may hold a relationship with health institutions, are chosen on a community level by women, mothers-in-law or husbands to attend to pregnant women. That is, within our public policy framework, they function as private service providers. Thus, their roles in the vigilance and reference of women in times of obstetric emergency is limited, unless the women in question is the client of a particular midwife and she is able to negotiate transport with the family and local authorities. Most midwives in Chiapas are over forty years old, monolingual (in their indigenous languages) and without literacy skills. Given their age, more and more rural communities and urban neighborhoods of San Cristóbal are finding themselves without a midwife. As a result, births are increasingly being attended by family members who have no medical training.  
The relationship between local midwives and health authorities is tense. Despite attempts to register and train midwives, it is widely known that midwives are under-registered, and many midwives are resistant to medical training and feel threatened and demeaned by the medical system. In the same way, institutional initiatives have frequently ignored the midwife, aiming to systematically eliminate her from health care provision.

Although midwife training does exist, there is no certification or systematization of technical skills. Interviews conducted with midwives during the baseline study for the Social Network indicated that midwives lack the skills to identify the need for referral in cases of obstetric emergencies. Technical disparity has also been noted among them, given that training is voluntary, theoretical and non-systematic. Midwives who have contact with the Health Sector are given basic delivery kits that include chord scissors and occasionally hemostats.

It is important to note that training for midwives is given by doctors in physical spaces representing school rooms, where the midwives all face an "expert". Until recently, trainings were held in Spanish, a language which few midwives speak. Training is theoretical and based on allopathic medical assumptions, which may not be understood or known by traditional midwives. As a result, midwives often state that training is "pointless" and a "waste of time".

Luna Maya was created to provide a space for practical, hands on training to midwives within a holistic model that incorporates safe traditional practices, evidence based medical practice with a focus on obstetric emergency management. Luna Maya is the only site in Chiapas where practical training is carried out.