Reaching Out: Courtney Beyer
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MGOBLUE

This summer, four University of Michigan women's swimmers took time away from their personal lives by traveling to parts of Central America and the Caribbean to give aid to others. The first account in a four-part series is written by senior swimmer Courtney Beyer, who volunteered at a humanitarian medical mission in Nicaragua.

"How common are midwives in Nicaragua" I abruptly asked Rosa, a translator working on the USNS Comfort.

"Midwives" she repeated.

"Yeah, women that help women during birthing," remembering that there was a specific name for midwives in Nicaragua, "Pateras"

"Ah patera," an intrigued look formed on Rosa's face, "yes -- pateras are commonly used in Nicaragua, especially in the rural areas."

Excitedly I asked, "Did your mother use a patera"

And the conversation continued, with me asking Rosa everything that she could possibly know about birthing practices in Nicaragua. Before that day I was just a civilian working as an NGO on the USNS Comfort, a massive 500-bed Navy Hospital Ship visiting the last Latin American country, Nicaragua, on its Continuing Promise 2009 mission and Rosa was just a volunteer translator from Matagalpa, a medium size city in Nicaragua. She had helped me translate a few times on the ship, but our conversations were minimal, but now we had much to talk about and learn from each other.

My initial interest in maternal health stemmed from my Anthropology of Childbirth class that I took last fall at the University of Michigan, where I am currently an undergrad. Since then I have always kept an eye out for anything relating to maternal health, especially in foreign countries. Before the trip, Dr. Warren Lockette, a U-M professor of medicine, who organized my participation in the program, asked me to generate a presentation on some aspect of Nicaragua. I naturally drifted to researching maternal health.

Having a little extra knowledge about some aspect of Nicaragua greatly enriched my experience on the trip and enabled me to not only engage in important conversations about maternal health but also make connections with individuals.

Once I was aboard the ship I met other NGO nurse volunteers and military public health personnel with interests in maternal health. I immediately started conversations with these healthcare workers about their experiences in helping women as well as their views of combating maternal mortality in Nicaragua and other countries. Our conversations would flow from maternal health to other health issues facing different groups of people to their personal interests and backgrounds.

When I was talking with Rosa she was able to validate most of the research I had done in regards to midwives in Nicaragua, which gave me a lot of confidence for my presentation. But more than supporting my confidence, I learned that Rosa's mother had used a patera for the births of Rosa's three older siblings. We also discussed programs that are currently set up in Nicaragua to help lower maternal mortality and how adjustments can be made to support pateras. For me to show a strong interest in an aspect of Rosa's life was important to her and enabled us to achieve a deeper level of understanding about each other that would not have otherwise been achieved. Reciprocally, it meant a lot to me when she took time off work to attend my presentation.

A few nurses heard about my presentation, and I was flattered when they asked me to give my presentation again. Giving the presentation to nurse-midwives allowed me to share my knowledge but then learn about the experiences of these women and their views on maternal health issues. Our conversation shifted from the usage of pateras in Nicaragua to the usage of midwives in the United States. It was extremely interesting to hear about their desire to help women have empowering birthing experiences.

Near the end of the trip, Dr. Lockette amazingly arranged for an audience with the U.S. Ambassador to Nicaragua, Robert Callahan, and later we were invited to the Ambassador's residence for a lively Air Force Band concert; of course I met the one pregnant woman at the party. She was from Managua, the capital city of Nicaragua, and I immediately asked how she planned to have her child and what she knew about birthing practices in Nicaragua. Being a modern urban woman she was going to have birth in a hospital but was very aware of pateras and their wide usage in Nicaragua.

These encounters proved to be very useful when later at the U.S. Ambassador's residence I found myself having a conversation with the tall white-haired Ambassador and a few Foreign Service workers. I was telling them about the trip and they were asking what I had learned so far. I was able to share with the Ambassador the conversations I had with Rosa. The Ambassador was deeply pleased that these types of connections were being made between Nicaraguans and Americans.

Reflecting on the trip I realized I had the unique privilege of talking to three different groups of people about maternal health. For Rosa, maternal health directly affects her and she has a personal investment in its improvement. The NGO volunteer nurses have the medical knowledge to help improve maternal health, and finally the U.S. Ambassador and Foreign Service officials have the connection to policy makers and funds to make changes. I had the chance to learn each group's point of view and understand what they knew about the subject and what their concerns were.

My job on the ship and while I was working at the on-shore health clinics allowed me to not only help patients and contribute to the mission but also interact with a variety of people. I wanted to talk to people and get them excited about helping women. The mission was not directed at lowering maternal mortality rates, but talking with people about this issue generated awareness about the issues and the different ways of improving birthing in Nicaragua.

Before the trip Dr. Lockette stressed to make the most out of every opportunity during the mission. After the trip I wondered if I had failed at that by not watching a surgery or going to see the ship's engine room, but I now understand that instead of watching a surgery I was talking to Rosa and instead of viewing the engine room I was giving my presentation to nurses. I realized that I did make the most out of every opportunity, and for me that was making connections with people. I will always remember being on the back expansive patio of the Ambassador's residence and directly passing on Rosa's thoughts to the U.S. Ambassador.