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Daniel Quesada, Migrant Worker Coordinator

As part of the 2016 Migrant Worker Outreach Program in partnership with Northumberland County, we're proud to present to you a monthly blog. We'll be keeping you up-to-date on the latest news regarding our program, and sharing special events, pictures, and interviews from the field! 

This week we're happy to present to you a blog entry written by David Galka, a 4th-year Political Studies and Economics student at Trent University. Hailing from Oshawa and now living in Peterborough, David reached out to me to learn more about our Migrant Worker program. After our conversation, David was feeling inspired and decided to write a short piece about our program. Stay tuned for more updates!


Horizons and Northumberland County Team Up To Help Migrant Workers

Possibly one of the highlights of my summer so far has been the chance to take my little thirty-month old niece to pick raspberries from wild bushes that grow in a family friend’s backyard. One of my favourite childhood experiences is when I would do the same on my great grandmother’s fruit and vegetable farm. It’s in these moments that I find it impossible to ignore the fact that we live in a region as fertile as Durham, where wild raspberries grow no matter how many times you accidentally trim them with the lawnmower.

This got me to thinking about the Seasonal Agricultural Workers (Migrant Workers) that I used to see when I would visit my Farm Gram (as she was known), who always amazed me growing up. She made it clear to me at a young age that Migrant Workers are an essential part of many agricultural operations. Of every description, colour and creed, I was taught that they came from many faraway places to help the local farmers maintain their crops. I was shown how they comprise a vital part of the engine that drives the truth behind the oft heard slogan on my University campus; farmer’s feed cities.


Asael Hernandez, a Migrant Worker from Mexico working in Northumberland County

In the contemporary global economy, much of the agricultural labor has increasingly been drawn from Latin America and Caribbean nations, with many traveling hundreds of miles, and contending with an extensive administrative process, all in the hopes of being able to work for minimum wage or less. These resilient and adventurous individuals have come to a strange land, in so many ways unlike their home, that it’s not difficult to imagine a significant element of “culture shock”, for some if not most.

I wanted to find out what sorts of challenges Migrant Workers face, so I spoke with an old friend from Trent University, Daniel Quesada, who’s working as the Migrant Worker Coordinator at Horizons of Friendship (Horizons), a non-governmental organization (NGO) working towards improving the lives of those in need both abroad throughout Latin America, and at home in Canada. Horizons, in partnership with Northumberland County have assembled a dedicated Outreach Team to work with Migrant Workers in the Northumberland County region who might be in need of some guidance, assistance, or support.


Migrant Workers celebrating Father's Day at St. Michael's Parish in Cobourg, ON

What I think appeals to me the most all the efforts I discussed with Daniel was hearing the emphasis on the human element, and doing whatever can be done to make their summer of hard-work far away from home, feel a little more like home. For example, Horizons met with William McGrattan, the twelfth and current Bishop of the Roman Catholic Diocese of Peterborough to organize and secure a Spanish language Mass at St. Michael’s Parish to help our hard working brothers and sisters practice their faith without any loss of connection or meaning from their perspective. I think this is a powerful signal of respect and solidarity that makes me happy that these particular Migrant Workers found their way to us.

Another aspect of this program that really spoke to me was the lengths the Outreach Team has gone to ensure that Migrant Workers receive medical attention. Horizons and Northumberland County, in collaboration with the Port Hope Community Health Centre hold bi-weekly health clinics with a Nurse Practitioner (NP), while ensuring that members of the Outreach Team speak fluent Spanish so that Migrant Workers are understood by the NP, and that any potentially disastrous miscommunications may be kept to a minimum.

When I think about how much of my time is spent setting up appointments, traveling to and from specialist after specialist, and all the layers of confusion and potential sources of error that must be grappled with at each step of the process, I couldn’t begin to imagine how I might go about the same feat, in a far off country, with an entirely unfamiliar medical system, filled with complex networks of rules and procedures that are hard to understand at the best of times, let alone in a foreign language! I can only feel a deep sense of appreciation for the work Horizons and Northumberland County are doing, to help our friends from faraway feel a little bit more at home, and more than anything, to ensure they always feel just as human as the rest of us, at every step of the way.

In the end, what began as a particular fondness for overripe raspberries led me on a journey. I was able to peer through a window into the lives of these tireless individuals who work so hard to ensure that our local grocers and farmer’s markets have a superior quality of fruits and vegetables that we are proud to serve at our dinner tables. It makes me feel proud to be Canadian and to know that the Outreach Team is working just as tirelessly to ensure that at every step of the way, we always put human needs first.

- David Galka

Raul Scorza blog

Raúl Scorza
Community Outreach and Communications Coordinator

Welcome (back) to our bi-weekly blog series on our maternal, newborn and child health (MNCH) project. Thank you for visiting us every second Monday to learn how this initiative, with funding from Global Affairs Canada and alongside our local partner PIES de Occidente, will transform Indigenous lives in Totonicapán, Guatemala. In our previous post, we interviewed our Program Manager, René Guerra Salazar, to go over how the project aims to improve MNHC, how these strategies fit into the current situation in Guatemala and how Canadians can support these efforts.

Today, we will talk more about one particular way in which Canadians can contribute to this project: participating in knowledge-exchange visits between Canada and Guatemala.

To help Canadians become more engaged in advocating for improvements in MNCH, Horizons is organizing international exchanges where knowledge and experiences will be shared between members of vocational groups concerned with MNCH in Canada (ranging from physicians, midwives, nurses, and community health workers to specialists in public health and early childhood development) and MNCH providers and leaders in Guatemala – including traditional Indigenous Maya K'iche midwives.

Over the four-year duration of the project, five exchange visits from Canada to Guatemala, each involving ten Canadian participants, will take place. Similarly, five exchange visits from Guatemala to Canada, each involving five Guatemalans, will be carried out during the project’s lifespan. Horizons will strive to involve, in particular, Canadians that work with underserved populations like marginalized urban communities or Aboriginal peoples.

The exchanges from Canada to Guatemala will allow Canadians that are professionally involved in MNCH to witness first-hand the challenging realities faced by women, children, families and care providers in Totonicapán, a province with one of the highest maternal mortality rates in Guatemala. This in turn will enable exchange participants to be credible ambassadors in supporting the project and international cooperation, with Horizons providing guidance on reaching out to health and community networks here in Canada, both pre- and post-departure.

MNCH Knowledge Exchange Info Session September 13

Visit our Facebook page for more details

It is important to note that these exchanges are not designed to be service-based missions, as is common with medical brigades.

There is a need for traditional Indigenous midwives, the main primary care providers who attend approximately 70% of live births in Totonicapán, to strengthen their MNCH practices – a need that will be met by the rigorous and culturally-relevant training PIES will provide for 1,040 traditional midwives as part of the project. But why, in the first place, are births in institutional settings in Totonicapán below 30%? Why has Totonicapán, a province that is predominantly Indigenous, experiences strenuous levels of poverty and lacks infrastructure and a significant state presence, continuously reported one of the highest maternal mortality rates for over 15 years? And why do traditional midwives use the words “discrimination” and “dismissal” when describing how they are treated by the formal health sector?

These are questions that hint at persistent, systemic inequalities, a legacy of Guatemala’s turbulent political past. With a social justice lens on MNCH, the exchanges will provide opportunities for participants to go beyond a solely ‘technical’ medical intervention. For example, Canadians visiting Guatemala will learn about the social and economic structures that create gaps for Indigenous peoples in the country’s already unstable health care system from a Guatemalan public health expert. They will also listen to how gender discrimination and violence affect MNCH from the Guatemalan Observatory on Reproductive Health.

In addition, the exchanges will stress the fact that knowledge-sharing is a fundamentally reciprocal process that occurs between equals.

Horizons is convinced of the importance of Indigenous approaches to health, and firmly believes that recovering and respectfully promoting them can create spaces for traditional and Western medicine to not only coexist, but learn from one another. This is why the exchanges are designed to be two-way avenues of learning. An example: Canadian visitors to Guatemala highly trained in the ALARM International or Neonatal Resuscitation Programs will introduce basic concepts to appropriate Guatemalan counterparts, but will also learn of traditional medicine and midwifery from traditional midwives and will have a chance to accompany them in their day-to-day.

The knowledge-exchanges will therefore invite participants to address global health from a social justice perspective, to open the door for a critical introspection of their practice and experiences, to foster long-term solidarity that could lead to further international cooperation and to raise awareness of the need to improve MNCH in Totonicapán.

Horizons will release a call for participants for the first Canada to Guatemala exchange visit, planned for February 2017, in early September. A number of information sessions that will cover full details (dates, selection criteria, expectations, activities, itinerary) of the exchanges will be held in the coming weeks. The latest are scheduled for:

  • Tuesday, September 13th at 7pm in Horizons of Friendship’s Offices

  • Tuesday, September 20th at 5:30pm at Peterborough Public Health

The first of these sessions specifically invites Canadian midwives and nurses to attend, as they will have the opportunity to contribute to designing the activities planned for the Guatemala to Canada exchanges.

Please visit our events page on Facebook for more information and to RSVP for both.

Thank you for your generous and continued support, which makes this project possible.

If you want to know more about the exchange visits, the information sessions or the project, please contact Raúl Scorza at rscorza@horizons.ca.

Raul Scorza blog

Raúl Scorza
Community Outreach and Communications Coordinator

Thanks for checking back on Horizons' bi-weekly blog series on our maternal, newborn and child health (MNCH) project in Totonicapán, Guatemala - out every second Monday of the month! In the last blog entry, we delved into the meaning of MNCH, its global importance, and Canadian efforts to help strengthen it abroad. For this post, we sat down for a conversation with René Guerra Salazar, our Program Manager for the MNCH project. We hope you enjoy the interview as René speaks to project details, the Guatemalan context in which it will take place and how Canadians can help. Shout out to Candace Ellison for helping us with this post!

Horizons: How would you briefly summarize Horizons of Friendship's new MNCH project? 

MNCH René Blog Interview

Program Manager René Guerra Salazar, wearing a traditional Mayan tzute as a baby carrier

René: It’s an ambitious initiative that aims to directly benefit more than 200,000 Indigenous Maya K’iche women, children and their families by improving the delivery and use of culturally-relevant MNCH services.  The project spans the entire Guatemalan province of Totonicapán, which has some of the poorest health indicators in the country.  It’s a social justice intervention as well, as it targets the significant health gaps faced by Indigenous Guatemalans – product of the structural racism Indigenous Guatemalans suffer daily. The project also aims to engage Canadians on the importance of MNCH locally and globally.

H: So what is the current Guatemalan context in which the MNCH project will take place? 

R: In one word: crisis. The Minister of Health resigned only a few weeks ago given the dire state of the public health care system. Multi-million dollar corruption scandals, including in the health sector, have rocked the country over the last couple of years. In the meantime, Guatemalans continue to suffer from a lack of quality health services. Community health centres are severely understocked and patients often have to take their own medicines when seeking care, even under emergency situations. This is worse if one happens to be Indigenous.

That said, there is hope. The newly appointed Health Minister, Dr. Lucrecia Hernández Mack, was Guatemalan civil society’s preferred choice. She’s known for her public health expertise and also happens to carry the social justice legacy of her martyred mother, Myrna Mack Chang – a respected Guatemalan anthropologist murdered by government security forces for her defence of Indigenous peoples’ human rights.

H: Given that crisis, what are some of the ways in which the project plans to contribute to the reduction of maternal and child mortality and improve MNCH in Guatemala? 

R: We can start with the impressive goal of training more than 1,000 Indigenous traditional midwives and 250 community health promoters in updated MNCH practices. This is essentially the entire body of community-based primary care providers in Totonicapán. Despite their importance to the health of women and children, traditional midwives and health promoters aren’t properly recognized by Guatemala’s formal public health care system. They’re discriminated against, undervalued and under-resourced. This project aims to help change that. With proper training and better equipment, they’ll help save lives – plain and simple. We’ll also work with Ministry of Health personnel and medical/nursing students to increase their knowledge of, and respect for, traditional Indigenous health practices – the very same practices that the overwhelming Maya K’iche population of Totonicapán is familiar with. 

MNCH Comadronas

Traditional midwives will be trained using a "train-the-trainer" approach

We’ll also be fully stocking 170 community health posts with essential MNCH medications and medical equipment – again, clear cut measures that will save lives. Because improved nutrition is also key in improved MNCH outcomes, we’re providing protein-rich, fortified nutritional supplements and micronutrients to tens of thousands of women and children, all of this over four years.

In addition, we will seek to work with male partners and extended relatives. One of the major barriers to proper MNCH care for women and their children is that they ultimately do not have the final say over their care. We’ll be working with communities in terms that are culturally appropriate to help women gain greater sovereignty over their bodies.

One final measure I’ll mention is a mass-media, province-wide MNCH promotion campaign focusing on some standard best practices: exclusive breastfeeding, full vaccination, family planning, improved nutrition and early detection of high-risk pregnancy warning signs. The campaign will be culturally appropriate, with communications in K’iche and other Indigenous languages in addition to Spanish.

H: What makes this project unique compared to Horizons' previous initiatives and other projects in general?

R: Mostly its scale and scope. Horizons has been working in Guatemala and with PIES de Occidente, our local partner, on community health projects for years. It is that successful collaboration that has prepared both organizations to take on this challenging and much-needed initiative. The project is the biggest for both organizations, and it demands some serious commitment. I’m glad to say that we have the right people on board to guide it through to success.

More generally, the initiative is interesting because of its focus on MNCH that is culturally appropriate. In that sense it’s not a simple “technical” health care intervention. While that component is robustly present, the project is one that strives for greater social justice: greater respect for life-saving Indigenous knowledge and practices, greater sovereignty for women over their bodies and health care, and reducing health gaps for Indigenous peoples that have been historically marginalized.

H: Why is MNCH important to you, and why should it matter to Canadians?

R: Health outcomes, and thus MNCH outcomes, tend to be direct indicators of broader social injustice. Why is it that in general terms, poorer populations have worse health outcomes? Why are Indigenous peoples the world over (including in Canada) disproportionately afflicted by health threats? And why do women tend to bear the brunt of most of this? Unless you subscribe to the rather dangerous idea that poorer, more marginalized people are somehow inherently responsible for their poorer health outcomes, the reasons must lie elsewhere. And they often lie in social inequality and discrimination, whether it’s socioeconomic, race, class, and/or gender based.

MNCH Indigenous women

Photo Credit: Paul Caldwell

We see it in comparative MNCH outcomes in Guatemala. Indigenous women and children almost without exception suffer significantly worse MNCH outcomes than non-Indigenous Guatemalans. You’ll find the same gaps in other socioeconomic indicators including education and access to basics such as potable water.

Despite the gloomy picture, it’s well-documented that strategic investments in MNCH improvements can lead to positive lifelong impacts for women and children. Improving the chances of women and children to lead healthy lives strengthens communities and ultimately societies as a whole. So, while MNCH can be a marker of social inequity, it’s also a vehicle for positive change – should we decide to support it.

Fortunately, the health of women and children is a key part of Canada’s official international cooperation program. It’s something we should be proud of – even if there’s still much more work to do as Canadians to contribute to global social justice

H: What then, can Canadians do to support the project and raise awareness of MNCH in Guatemala?

R: Donate! Seriously, we need it! It’s a $13.2 million project for which we’re very grateful to count on Global Affairs Canada’s support. Our government contributes 85% of that budget, and Horizons has to raise the remaining 15%. That’s about $450,000 per year. The good news is that our government’s significant contribution means that for every dollar you donate, it matches it six times.

Further, we want to help Canadians become more engaged in MNCH and other social justice issues. We’ll work hard to talk to folks about MNCH’s importance locally and globally, and would love to connect with interested audiences. For example, we have partnered with a local elementary teachers’ federation to involve youth in raising awareness on MNCH, are reaching out to champions of Canadian-based Indigenous MNCH initiatives and are also organizing knowledge exchanges between Canadians and Guatemalans to help build longer-lasting solidarity. So please, stay in the loop and share this information with your communities. All this work is impossible without the generous support of fellow Canadians.