In Brazil's Amazon, traditional midwives vital for remote villages

Deep in the Amazon jungle, a pregnant woman needs help. She is about to give birth, but a drought has dried up the rivers that connect her community to the nearest hospital. The exposed sandbanks of the Solimoes River, near Tefe, give an idea of how complicated and dangerous it is to maneuver through what's left of the river.

When heavily pregnant women are stranded in the jungle, midwives like Tabita dos Santos Moraes come to the rescue. She is one of hundreds of traditional midwives who deliver babies in remote villages in the Amazon, the world's largest rainforest. The 51-year-old calls herself the "umbilical mother" to the more than 180 babies she has delivered.

Public health officials say they need midwives to support women they can't reach, like this remote community of Deus e Pai near Tefe. "I keep thinking: my God, how do you provide health care in a territory like this?" Sandra Cavalcante from the Amazonas state health department told the Reuters news agency. But women don't die in childbirth, she said, when the traditional midwifes are there.

Tabita often travels by canoe, accompanied by her dog Priscilla. When the rivers have enough water, it takes her around four hours to get from Deus e Pai, her home community, to the nearest hospital in Tefe. But after two years of record-breaking drought, the same journey can now take over a day — that is, if the river is passable at all.

Tabita prepares a dish known as "charity broth," a soup made from manioc root flour, a pinch of pepper, a little salt, garlic and onions. It is intended to give the patient strength and calm her down. The simple soup is one of many traditions used by midwives in the Amazon region.

Like many Brazilian women, 22-year-old Mayleane planned to give birth to her baby in hospital. But after traveling to the city of Tefe to be near a hospital, Mayleane realized that she would need money and support for a longer stay there. Back home in Deus e Pai, she is now relying on the help of the experienced midwife.

Tabita dos Santos Moraes rests on the boat of her husband, Nonato Lima de Moraes. Her work is voluntary — the government only pays traditional midwives if they have undergone formal training. Even trained midwives in the state of Amazonas often live in precarious conditions, with many earning less than the minimum wage.

Tabita has decided to pass on her knowledge — like checking blood samples for malaria parasites — to her daughter. She comes from a long line of traditional midwives going back to her great-grandmother. But today, fewer young women want to learn the craft. In many communities, traditional midwives are in high demand, but those who still practice are getting older and older.

Mariene dos Santos Moraes, Tabita's 14-year-old daughter, helps out around the house and learns her mother's trade along the way. She can't wait to follow in the midwives' footsteps one day. "I'm very proud of them," said Mariene. "I'm also trying to follow their lead."