Cristobalina Santos, Panama
Nothing has gone right for Severino Caballero since his wife died in childbirth two years ago.
Caballero, 55, lives in Quebrada Cañas, a tiny mountain community of the Ngöbe tribe in Panama's predominantly indigenous Chiriquí province. His wife, Cristobalina Santos, developed complications after giving birth to the couple's 12th child, squatting according to tribal tradition on the floor in their straw hut. The placenta did not emerge, and that night Cristobalina developed an aggressive infection.
"I would have taken her to the hospital if I could," Severino said, but the nearest clinic was a three-hour walk away in Hato Chamí. "I tried to get together enough people to carry her to the clinic, but there was no one around," he said. Cristobalina died at 3 a.m. She was 36 years old.
The loss shattered the family. Severino was devastated and too weak to work. "I felt sad for a long time," he said. The couple's surviving seven children suffered too. "They were sad and pale," he recalled.
The Ngöbe are among Latin America's poorest and most traditional indigenous people, many of whom are suspicious of modern health services, such as family planning, antenatal care or skilled midwifery at delivery. While Panama's overall maternal mortality rate is a moderate 70 deaths per 100,000 live births (among the ten best in the region), the rate for some of the country's indigenous areas is 658, higher even than Haiti's, the Western Hemisphere's worst at about 600 deaths per 100,000 live births.
To help, UNFPA (United Nations Population Fund) has joined IFAD (the International Fund for Agricultural Development) and the Panamanian government to invest US$800,000 over the next four years to improve maternal health services among the Ngöbe and Buglé indigenous populations. They will seek additional funds from local coffee growers and other private sector sources, reminding them that better maternal health translates to higher overall productivity and economic growth.
It may be too late for Severino, however. A few months after Cristobalina's death, a tree fell on him while he was working in the fields, injuring his back. Now he can only do light work, such as cleaning coffee beans and bananas before bringing them to market. As a result, the family is barely surviving, cultivating small amounts of coffee, bananas and a few vegetables, and receiving help from the local church.
Severino has not remarried. He has thought about moving closer to the clinic in Hato Chami, but he has no money to move. Neither is any road likely to come soon through the steep hills and jungle ravines to Quebrada Cañas.
Asked how his family might get better access to health care, he fell silent. Cristobalina, he said at last, "was the one who took care of the house, the children and me." He shook his head. "She loved me so much."