Segment 1

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Tococori, Peru. September 2008

PHIL BORGES [Documentary Filmmaker and Photographer]

Lorenzo told me his wife didn't stop bleeding after she gave birth.

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Lorenzo Quispe, Farmer

PHIL BORGES

He left her and the baby with his mother-in-law and set out on his bicycle to get help. Peddling in the dark for 10 miles in the pouring rain, he barely made it to town. He finally found a doctor but, by the time they got back to the house, three hours had passed. Lorenzo's wife died just as they entered the room. Adolfo is now a year old, survived by being breastfed by his aunt. Lorenzo's son Juan dropped out of school to help take care of his brothers and sisters. And Lorenzo's health has worsened since his wife's death. The family is struggling just to survive.

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Somewhere in the world, every 52 seconds, a woman dies in childbirth.

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Most of these deaths are preventable.

PHIL BORGES

For Gladys, the emergency was different, but it could have been just as deadly.

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Gladys Huamani, Ayacucho, Peru

PHIL BORGES

The fetus was in a dangerous breech position. A well-trained team performed the emergency C-section. Because Gladys had regular prenatal care, and a trained midwife that knew when to refer her to the hospital, she and her baby avoided a potential tragedy.

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Vigilantes de la Vida

PHIL BORGES

Maternal mortality was all too common in the Southern Highlands of Peru. Fortunately, in the past five years, the number of maternal deaths has fallen dramatically. I came to Peru to see what had made such a difference. In Ayacucho, I met Bacilia Vivanco, a midwife who had helped spearhead the change.

BACILIA VIVANCO [Midwife]

Ayacucho was averaging 35 maternal deaths a year. In 2004, we gathered the midwives, doctors, leaders from the regional hospital, and began to formulate a set of guidelines for obstetric emergencies. We brought in all the people from the rural health posts. Over 200 people worked on it. CARE facilitated the process. We are so proud. The 2004 guide is now famous and is being implemented all over Peru.

PHIL BORGES

These guidelines were a crucial step in addressing the problem of maternal mortality. The next hurdle was to get them implemented. Eugenia raises llamas and sheep in the high plains of Southern Peru. Like most Quechua woman, she gave birth to her three children at home. She just didn't see any benefit in going to the local health post. Three years ago, she began training with CARE to become a citizen monitor, or what they call a "vigilante." One day a week, she rides six miles to the health post to volunteer her services. Her presence builds the trust between the healthcare providers and their clients. That trust is the key to the extraordinary improvement that has taken place in Peru's maternal health program.

EUGENIA ITME [Citizen Monitor (Vigilante)]

At first the women did not trust the health post. The doctors did not speak our language, or honor our traditional methods of birthing. I asked the women, "Do you trust the treatment you are getting? Does the doctor speak Quechua? Do they treat you with respect?"

PHIL BORGES

The suggestions and complaints that Eugenia and other vigilantes gather help create the understanding of the Quechua views and traditions. Their findings are then sent to Peru's health ministry to be addressed.

EUGENIA ITME

For me, it was very important to learn about my rights in the trainings. It meant that women didn't have to limit ourselves to the home. We could go out and have responsibilities with groups. We could go and speak with authorities about what we need and want. This has given me strength!

PHIL BORGES

What a brilliant strategy: an army of volunteer women, women empowered just by learning their rights and getting a forum to share their insights. They're now bridging the cultural divide that had kept women from seeking and obtaining the healthcare that they were entitled to.

PHIL BORGES

Like most Quechua women her age, 20-year-old Tarcila was born at home.

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Tarcila Sulca, Vilcashuaman, Peru

PHIL BORGES

However, two years ago, because of the recent improvements, Tarcila's mother decided to give birth to her last child at the health center. Following her mother's example, Tarcila and her husband Jorge came to the local health post to deliver their baby. Bacilia assisted. Just hours after giving birth, Tarcila left the hospital with her baby. Bacilia and I followed as she, Jorge, and her mother, took a taxi to the base of a steep, rugged trail. At 12,000 feet, it was all we could do just to keep up as she made the hour-long climb up to her home with her baby strapped to her back. Tarcila and Jorge's days are filled with hard work and few comforts, but as I watched Bacilia instruct Jorge on how to attend to his wife, I had a feeling that Tarcila has what she needs to keep her and her baby healthy. As I walked back down the mountain, I thought to myself, healthcare for the poor can't be solved simply by building more hospitals. What matters is what happens in those hospitals. CARE brought the right people together to create a system that respects local culture and improves the quality of healthcare. The result is women's lives and the families that depend on them, are being saved.

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CARE's goal is to make pregnancy and delivery safe for 30 million women in 10 countries by 2015.