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Health-care workers from Guatemala share knowledge

Cecilia Nasmith

By Cecilia Nasmith, Northumberland Today

CECILIA NASMITH/Northumberland Today
From left, Cobourg Police Detective Constable Vanessa Gerasimow, Cornerstone Family Violence Prevention Centre executive director Nancy Johnston and child and youth community counsellor Lucy Caldwell, Dr. Hannaly Nohemy Ruiz Barrios (head of obstetrics and gynecology at the Totonicapan provincial hospital in Guatemala), Association for Health Promotion, Research and Education equality co-ordinator Lucecia del Rosario Pisquiy Pac, Horizons of Friendship community-outreach and communications co-ordinator Raul Scorza, midwife trainee Valenzuela Cos Matul and Cobourg Police Sgt. Cindy Reeves (the force's domestic-violence co-ordinator) were participants in a panel last week for a knowledge-sharing forum between Cobourg service providers and the three Guatemalan hosted by Horizons.

CECILIA NASMITH/Northumberland Today From left, Cobourg Police Detective Constable Vanessa Gerasimow, Cornerstone Family Violence Prevention Centre executive director Nancy Johnston and child and youth community counsellor Lucy Caldwell, Dr. Hannaly Nohemy Ruiz Barrios (head of obstetrics and gynecology at the Totonicapan provincial hospital in Guatemala), Association for Health Promotion, Research and Education equality co-ordinator Lucecia del Rosario Pisquiy Pac, Horizons of Friendship community-outreach and communications co-ordinator Raul Scorza, midwife trainee Valenzuela Cos Matul and Cobourg Police Sgt. Cindy Reeves (the force's domestic-violence co-ordinator) were participants in a panel last week for a knowledge-sharing forum between Cobourg service providers and the three Guatemalan hosted by Horizons.

Last week, Horizons of Friendship hosted a panel to provide a knowledge-sharing forum on violence against women, from the perspective of Cobourg service providers and from that of visiting Guatemalan service providers. Part one focuses on the stories shared by the visitors.

COBOURG -- The latest chapter in the multi-million-dollar four-year partnership between Cobourg's Horizons of Friendship and Guatemala's Association for Health Promotion, Research and Education happened recently, when Horizons welcomed three visitors from the province of Totonicapan.

Pursued under a funding agreement with Global Affairs Canada, the project has as its focus the strengthening of maternal, newborn and child-health services for the thousands of Indigenous Maya women, children and families of the province.

Initiatives include the training of more than 1,000 traditional Maya midwives as well as exchange visits like this one -- which welcomed Association equality co-ordinator Lucecia del Rosario Pisquiy Pac, midwife trainee Valenzuela Cos Matul and Dr. Hannaly Nohemy Ruiz Barrios, head of obstetrics and gynecology at the Totonicapan provincial hospital.

Last week's panel discussion with representatives of the Cobourg Police Service and Cornerstone Family Violence Prevention Centre was one of several activities designed for an exchange of knowledge during their visit, along with such outings as a visit to the birthing suite and other obstetric facilities at Northumberland Hills Hospital.

Moderator Raul Scorza, Horizons community-outreach and communications co-ordinator, who provided translations for all parties, pointed out that the province of Totonicapan is overwhelmingly Indigenous, located in the western highlands of the country -- a rural place with difficult access.

The World Health Organization declared in 1996 that violence against women must be recognized as a public health priority, Scorza said.

"A larger issue is violence against women, and that kind of gender violence also has an impact on maternal and child health."

In her work, Lucrecia del Rosario Pisqiy Pac has seen violence against women as an issue that affects them physically, emotionally and financially, but it also affects their rights as women.

Violence can be understood as a social issue, and therefore it should concern the state, she said. There should be state responses and policies in place to prevent and respond to violence.

However in Guatemala, it can't really wait for the state to come up with policies and programs, because it affects Indigenous women right now. So an important part of their work is the prevention they strive to achieve through education, information and outreach to remote communities.

The visitors agreed that the roots of violence against women can really be traced to a patriarchal social order which, in turn, can be traced to efforts of other countries to colonize Central America in past centuries.

With 51,525 cases of vilence against women in 2014, Guatemala ranks second-highest in the world in that particular statistic. Most of the victims of femicide are aged 21 to 30. In 2012, the most common perpetrators of violence against women were the victims' live-in partners. In Totonicapan, two out of three women are experiencing or have experienced violence perpetrated by a partner. The victims are not just the women, but collateral victims (usually their children).

The Law Against Femicide and Other Types of Violence Against Women was announced in 2008, which put a legal framework in place. It should have been a turning point but, for many reasons, enforcement has fallen through. For one thing, of Guatemala's 22 provinces, Totonicapan has the second-lowest number of cases reported. But just because the women are afraid to report these cases doesn't mean they don't happen behind closed doors.

Often women have no idea where to turn or how to make a report. Or they may hesitate because of stigma or because of financial or emotional dependence on the perpetrators -- and Guatemala has one of the highest levels of economic inequality in the world.

The lot of too many woman is to have little to no autonomy over their own bodies while being overworked, both in the home and in the workplace, and getting little respect from spouses.

They talk to women in women's groups about preventing violence, but the women often don't recognize that there can be emotional and other forms of violence. Putting women down verbally is seen as normal.

Another challenge is that the women don't believe they have the right to decline sexual relations with their partners who, in turn, see it as their right to claim them at any time.

The 2008 law is in place, and the country's constitution has a section on preventing violence. Everything is on paper, Hannaly Nohemy Ruiz Barrios said.

But in practice the situation is different People don't really know about these laws or access to services, and public institutions don't follow the protocol outlined in these laws.

The doctor's commitment now is making sure her patients know about these laws and these resources.

Within families, violence is the quite common. Young midwife Valenzuela Cos Matul once saw her mother physically assaulted by her father in front of her and all her brothers and sisters. But women don't speak up out of ignorance or fear.

Between January and September this year, the doctor has seen 54 sexual-abuse cases, 16 women physically assaulted and 14 pregnant girls under the age of 14 (six of them as a result of sexual abuse).

The idea of family planning is not widely accepted, and even here violence and intimidation pay a role in a country where the maternal mortality rate is 168 per 100,000 live births. Women do not necessarily make their own health decisions, and some high-risk cases are delivered at home with a husband, brother or mother-in-law calling the shots.

Valenzuela Coz Matul said there's a cycle of violence that takes hold in Indigenous communities. A woman who has been physically assaulted and seeks counsel from community leaders is told to make peace with her husband and forgive him. This cycle repeats itself until the death of the woman.

In her role as midwife, and her training as a community educator, she hopes to be able to show male Indigenous leaders that wome have rights, and that they can and should stand up to violence.

cnasmith@postmedia.com

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