The Warmi methodology, first developed by Save the Children in Bolivia in 1990, aims at reaching out to women, including those with indigenous backgrounds, and integrate them through a participatory approach into the formal medical care system to improve maternal and newborn health – a highly important issue considering that Bolivia presents one of the highest maternal and neonatal mortality rates in Latin America and the Caribbean. With this at the forefront of my mind, I travelled 140 miles south of La Paz to Oruro, where Save the Children's maternal and newborn health project is now being focused. It was a back to school day for local doctors, who were to receive training on how best to provide treatment for women with indigenous backgrounds. Self-reflection and reevaluation of medical practices were set to be the key ingredients.
The day started with an inspiring speech given by Dr. Luis Gutierrez; a doctor professionally responsible for the accreditation and improvement of medical centres in Oruro. In his speech he addressed the Warmi methodology, as well as wider issues within Bolivian medical practice. He spoke frankly about the ways in which doctors, and medical services at large, have been failing those in need.
He talked of the necessity to provide outstanding treatment to people from indigenous backgrounds, so as to ensure their faith in the medical system, and prevent them from becoming disheartened. It often only takes one bad experience to deter people from revisiting such westernized hospitals. Faith in the system can therefore be won and lost on no more than a few basic interactions.
Some of the participants challenged the doctor's criticisms, citing the logistical issues, such of lack of transportation, and understaffed hospitals. He listened patiently to such complaints, but was then unswerving. A solution can only be found when each person takes personal responsibility. "It is for each doctor to provide the best possible level of care: be the change you want to see."
A break for lunch was followed by training exercises for the doctors. They were asked to consider and analyze the different approaches in treatment required by women from indigenous communities. The participants were split into groups - one doctor took the lead by holding up placards with pictures representing various pregnancy related medical issues. The others in the group then collaborated to agree on how best to address the issue, in light of cultural sensitivity.
Later, when talking to doctors one-on-one I was struck by their passion for tackling the obstacles faced by Bolivia's medical institutions: "We have to involve the family, especially the husband in maternal and newborn care, because there is so much sexism," one doctor told me. Another saw the opportunity for the methodology Warmi to combat these social problems. "Through Warmi we will reach out to a larger number of women in the community and they will become empowered with their rights."
On my journey back towards La Paz, I was afforded time to reflect on what I'd been witness to. I'd seen firsthand the work of Save the Children, and how an approach, based on cultural sensitivity from the viewpoint of women is crucial in saving mothers' and newborns' lives. A fascinating day spent in Oruro had now passed and I felt privileged to have been part of Bolivia's wider conversation – one of equality in this fast changing nation.