HISTORICAL CONTEXT:

CODECOT is a coordinating group of traditional midwives in Guatemala. They work and live in Quetzaltenango, a state that stretches high into the western highlands of Guatemala, and parts of which were deeply affected by the 36 year-long civil war which officially ended in 1996 with the signing of the Peace Accords.  Un-officially, the long-term impacts of the internal armed conflict and the injustices which sparked it, remain tightly woven into the social fabric of the people and institutions of this country.  These serious social problems include: personal and systematic racism particularly geared towards the indigenous Mayan people, severe poverty, rampant political impunity for governmental corruption and violent criminal activity, narco-trafficking, increasing violence against women which has been called a “femicide” by international human rights organizations, and one of the highest maternal/child death rates in the world.  Economic desperation makes Guatemala increasingly dependent on the tourist industry and vulnerable to the exploitation of international “development” projects and “free-trade” agreements which tend to plunder and mine away its resources without a second thought for the people who have been living on and loving this land for hundreds of years.

With this tragic context, Guatemala is unique in that its indigenous have remained the majority of the population, maintaining a strong and vibrant culture despite systematic oppression since its colonization. At least 23 languages are still spoken here. As well, many people, both indigenous, ladino, and non-national take part daily in a strong movement which works to improve the state of social health, human and indigenous rights both locally and nationally.  One of these groups is CODECOT.  Because of the midwife’s essential and respected role in many rural communities in Guatemala, midwives are uniquely suited to be active participants in this work. 

STATISTICS:

Quetzaltenango has a population which is 68% Maya and 32% non-Maya.  The people come from three main language groups: Mam, K’iche and Spanish.  The total population of the state is 624,716 and constitutes 6% of the national population.  52% of the population is female and 48% male.  70% if the people live in rural areas.  The majority of births are attended by midwives, particularly among the indigenous population.  Often, there is little or no access to clinics and hospitals, as many rural areas are not easily accessed by bus, car, or ambulance, so midwifery care represents the primary care a woman and child will receive in her lifetime. 

HOW WE GOT STARTED

Since the 1980’s, many diverse institutions and non-governmental public health-related organizations have worked with traditional midwives in Guatemala and supported programs that improved their technical knowledge and organizational capacities.  However, in accordance with their institutional objectives, they haven’t permitted or supported the development of community leadership or autonomous initiative with the reasoning that the people aren’t prepared to guide themselves in their own process.

At the beginning of 2001, some of the midwives of this foundational base began a process of organizing themselves in different communities and areas of the state of Quetzaltenango, coming together to re-shape the organization. On the 13^th of September, 2002, we were legally and formally constituted as the Coordinadora Departamental de Comadronas Tradicionales de Quetzaltenango (Coordinating Group of Traditional Midwives of the State of Quetzaltenango) or CODECOT, through the work of the base of traditional midwives and midwifery trainers who for many years have dedicated themselves to serving pregnant women and their children.  From this process rose a thorough analysis of the current situation facing traditional midwives that are working far and wide and who are guided by different institutions and non-governmental organizations that work in the area. 

CODECOT has succeeded in involving the participation of traditional midwives in public health forums such as with the Consejo Departamental de Salud (state health department), Comision Neonatal del Hospital Regional de Occidente (commission of hospitals with neonatal departments in the western region), and various working groups for local development, thereby improving the quality of maternal/infant care in the western region of Guatemala.  Through their active political and educational involvement in the public sphere, they have helped to educate hospital staff and the general population about the important historical and strategic role midwives, with their unique knowledge base and position of honor in communities, have always played in improving quality of life through traditional healthcare systems. 

OBJECTIVES:

1. Contribute to the improvement of maternal/infant health in the rural communities of the western highlands through the implementation of health projects with the active participation of local midwives and other traditional health practitioners.
2. Strengthen the coordinating group through continuation of health training, as well as training in community organizing and social justice, so that midwives have the capacities to take part in creating tangible solutions to community health problems in the political sphere of public health. 
3. Encourage and participate in activism to promote community health by being involved with local health committees, state, regional and national agencies (both governmental and non-governmental), to help prevent sickness and promote wellness.
4. Give direct, loving, attention to the mothers and children in our communities
5. Arrange and coordinate technical training programs for groups of midwives, both through governmental and non-governmental organizations.
6. Offer training to groups of midwives in community organizing and social justice.
7. Vision and manifest community health programs and workshops in rural communities.
8. Promote the theoretical and practical knowledge of traditional Mayan medicine.
9. Participate in local, state, and national political spheres to play an active role in shaping public health policies.