Mujeres Aliadas: A Rural Women’s Health Care Project

“The doctors told us that our hips were too narrow for babies, that we needed Caesarean sections,” said Margarita Ascencio de Jesús Flores, community outreach worker for Mujeres Aliadas. She gestured past her waist-length black braid toward her legs, toned perhaps by years as the star of her village basketball team. That indigenous Purépucha women in this rural area of Michoacán  – some short and round, others as slim as Margarita – had delivered babies without surgical intervention for thousands of years seemed lost on the medical experts. I scanned the surprised faces of my students. All are from middle-class families and different regions of Michoacán but few had visited Purépecha villages or knew of midwifery as a viable alternative to hospital birth.

On a bright April day, we’d come to Erongarícuaro, a pueblo of about 5,000 on the edge of Lake Pátzcuaro, from La Universidad Latina de América in nearby Morelia. One of the goals of my class, “Telling Lives: Reading, Recording, and Writing Life Stories,” was to discover and write about lives different from our own. Each student would interview a staff member of Mujeres Aliadas, a health care project based here, and write profiles. I had met Margarita and companion outreach worker Veronica Pureco Farías at a staff meeting three years before. I knew Mujeres Aliadas offered a reservoir of compelling stories hidden from a broader public. (see or

Mujeres Aliadas was the brainchild of Chicago midwife Brenda Madura and her epidemiologist partner Richard Ferguson. Both had worked for a large Chicago hospital where Brenda often treated women from Michoacán. “They told me stories of life there,” she says, relating one that deeply affected her. One day a woman described bringing her very sick baby to a doctor. “She knew the baby was dying,” Brenda recalls, “So she ran to a local private clinic … She started banging on the door and screaming, ‘My baby’s dying …’ And they said, ‘Show us the money.’ She said, ‘I don’t have money. My baby’s dying … ‘ They locked the door and she had to sit out on the curb and watch her baby die. And I said, ‘This can’t be.’” Within five years, Richard and Brenda had moved to Pátzcuaro and organized a group of local Mestiza and Purépecha women to form Mujeres Aliadas – “Women Allied,” working together.

Mujeres Aliadas supports multiple programs. A birth center, originally in Brenda and Richard’s home, now nestles into the verdant grounds of the organization’s base in Erongaricuaro.

The first students in the midwifery training, which began in February 2011, are about to graduate as licensed professional midwives and specialists in women’s health. Community programs includes adolescent sex education, talks on women’s reproductive health and options, and “platicas,” informal conversations where village women (and sometimes men) discuss critical, often silenced, concerns. At the top of the list are the unnecessary Caesarean sections, which account for a third of all births despite local women’s expressed desire to avoid them. A Mujeres Aliadas survey revealed that many women have no idea of the risks involved in C-sections (see for research and survey results). High rates of maternal and infant mortality as well as cervical and breast cancer complicate the picture.

Perhaps most devastating are women’s stories of being herded through an impersonal medical system, told to strip naked without a sheet to cover themselves, and denied other basic forms of dignity. In the documentary Birth of a New Consciousness (Alumbramiento de una Nueva Consciencia), directed by Richard and staff member/filmmaker Ondine Rosenthal, one woman feared showing her face. The camera scans her scruffy, shuffling Mary Janes as she describes a doctor’s abuse. The image haunts the viewer – a symbol of what women have endured, not knowing they had other options or where to seek information. The illiteracy rate is 13% for the region but twice as high among indigenous women.

Under these accounts hovers another story: that of social ills that plague postcolonial settings throughout the globe: alcohol abuse, domestic violence, and depression. A standard mental health questionnaire Richard distributed in the Lake Pátzcuaro region showed that 67% of the women suffer from clinical depression. Statistics on domestic violence are harder to assess; reporting is spotty and shame pervades conversations. But stories of violence surface during the “platicas,” often tied to alcohol and machismo. Harvard researcher Sousan Abadian has chronicled how these problems result from collective trauma endured in worlds as diverse as the Rwandan genocide and her own heritage of Zoroastrians persecuted since the Arab invasion of Persia 1,400 years ago. But nowhere, Abdian argues, is the damage more widespread or enduring than among indigenous people. Unlike refugees who can create a new base somewhere, “native peoples had no equivalent of an ‘America’ to which they could escape…”

As I watched the students interview the staff, rapt and sometimes troubled, I remembered the other half of Abadian’s documentation: the path to recovery. Suffering is cultural as well as individual; healing must address both domains. The eight Mujeres Aliadas staff members assembled for our class (two were in Mexico City for meetings that day) are forging a path to healing on both fronts.

The staff has grown and changed in the three years since I met Brenda and Richard. Turning control over to local women was always their goal. In January 2013, Brenda moved to an international consulting position based in the U.S., while Richard remains on the Mujeres Aliadas board of directors.

UNLA student Dhilery García Hernandez (right) interviewing Interim Director Ondine Rosenthal

Ondine Rosenthal, an Erongarícuaro local, is now Interim Director. In addition, she continues to direct the adolescent education program. She gives talks on sexual development and created a “cine club” for teens. International films such as Persepolis opened a cross-cultural window otherwise closed to rural teens during the adolescent danger zone of summer. UNLA student Maribel Barcena Lopez, inspired by our visit, returned in June to teach sex education and self-esteem workshops through this program.

Amalia Cabrera Cruz and Eluvia Pedro Mateo, professional midwives who graduated from the Casa Midwifery School in San Miguel de Allende, live on the grounds of Mujeres Aliadas. They offer onsite births, gynecological attention, and educational resources. Additional staff include Liliana Campos Zúñiga, receptionist/secretary; Rocío Mendiola Navarrete, Assistant to the Director; Anabel Rosas Rosas, Educational Coordinator; and Juana Abundez Capilla, midwifery student and Coordinator of Community Programs. Bianca Vargas Escamilla, a graduate of the medical school of the Universidad Nacional Autónoma de México (UNAM) in Mexico City, contributed to the project as a volunteer doctor in residence during 2013. Margarita and Veronica share the outreach work to forty villages, a remarkable feat that may ask more sprinting of Margarita than even her basketball practice. For the entire staff, the work poses challenges: the constant need to raise money; the swim upstream through rivers of red tape for educational accreditation; the struggle to gain acceptance in the medical realm; the despair that stories of suffering induce. But each of the staff members affirmed that the rewards counter every hardship built into the work.

Staff meeting of Mujeres Aliadas

The staff’s passion for their work and belief in change imprinted deeply on the UNLA students. Carlos wrote later: “These are beautiful women …with bright eyes and strong voices that want to be heard. They taught me a lot of things about the rights, value and the importance of women, things that I already knew, but that are now marked in my mind, helping me see with a more human perspective.” Law student Grecia wrote: “I learned that people can engage in projects to contribute to the community. This is an everyday journey. Little by little we can change the collective mind and challenge threats to women. Like these women, I want to discover my vocation and to be really committed to a cause.”  Everyone commented on the beauty of the setting: the grounds of the Rosenthal home, an old villa Ondine’s family bought in 1971 when they founded a local hand-painted furniture workshop/collective, MFA/Eronga. Dhilery wrote: “With the fresh air and birds singing, this looks like the perfect place to welcome a baby. “

As we sat around the rectangular table, magenta bougainvillea bursting into bloom beyond the windows, I remembered the dreams expressed at a much smaller staff meeting in Brenda and Richard’s house three years before. Students now about to graduate had just begun their midwifery studies. The film had yet to be made. As a teacher, I had my own fantasy: to bring students here to bear witness to the passion that generated and sustains this project. Now, this UNLA group has realized that dream. The project inspired two other class members, Talía De Niz Pérez Negrón and Dinorah Ambriz Cárcamo, to return this summer as student interns.

In the next few weeks, I’ll post staff profiles drawn from interviews conducted that April day. They offer a glimpse of this remarkable organization, and of what students learned. But I suspect that deeper understanding will continue to unfold for them.