Care-takers of the Community

Rosa Emilia rocks back on her red plastic chair, gestures wildly with her arms as she recounts stories of her 45+ years as a midwife, and fills her front porch with the joy of a woman proud of her contribution to community. And, rightfully so. Like the Midwives before her, Rosa has provided pregnancy and newborn health monitoring and care to many, reducing the risk of death for women and children in her remote community in the BOSAWAS, Nicaragua.

And though she stares right through us with eyes that no longer see, they continue to provide a window to a soul clearly called to serve out of both necessity — in the past, communities did not have health personnel or clinics — and an aptitude for traditional medicine practices passed down by previous generations of women in her family.

While government health posts are present in some of the communities along the Coco River, small communities continue to lack formal clinics. In these small communities, Midwives and Traditional Medicine Practitioners are relied upon to give immediate response to both everyday ailments (herbal teas ease aches and pains) and health emergencies (medicinal plants treat snakebites). And while Rosa may lack knowledge regarding the theory of medicinal plants or even their scientific names, she does know where to find them, what they are used for, how to prepare them, and how to apply them.

In recent years, Midwives and Traditional Medicine Practitioners report that deforestation, climate change, and drought have caused the disappearance of many plants that are used by patients. If it hadn’t been Rosa’s loss of eyesight, the need to cover long distances to seek plants in the forest or along the riverbank coupled with reduced mobility at her age, may have instead sidelined her practice.

But before Rosa lost her vision, before she could no longer fulfill her calling, she passed down the knowledge to a son and a daughter who showed interest, skill, and the gifts blessed to care-givers. This is how its done — the passing of ancestral knowledge. It is part of the cultural identity. It is a calling.

And it is a calling critical to the health of communities. While traditional healers and government health post personnel support one another and coordinate to provide care, Midwives and Traditional Medicine Practitioners are often on the frontlines of care, woven into the fabric of spiritual faith, traditions, cultures, and beliefs.

The Local Knowledge; Global Goals project seeks to prioritize local Indigenous knowledge and gender equality in communities while working with Midwives, Traditional Medicine Practitioners, students, forest rangers, and the Indigenous government to build conservation capacity in order to improve the sustainable management of the BOSAWAS Biosphere Reserve, which is essential to the survival of Indigenous peoples in the face of climate change.

The work of Midwives and Traditional Medicine Practitioners is being strengthened and preserved by supporting the establishment of community gardens to address medicinal plant scarcity, by strengthening the transmission of traditional knowledge, and by equipping Midwives with equipment and materials critical to frontline care.

As for Rosa, and women like her, she plays a key role as steward of natural resources and keeper of Indigenous knowledge. On this International Day of the World’s Indigenous People, let us recognize the role of these brave women.


Bosawas Central America and the Caribbean In The Field Indigenous Peoples Nicaragua