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True Life Planet Interview No. 5: Partera and Medicine Woman Dominga Palacio

Friday, May 2nd, 2008

Upon occassion, I come across someone in my travels who I believe is truly making a difference in other people’s lives. When possible, I interview them for this blog… forewarned, this is a long entry!

I realize that many young people under the age of 12 are reading this blog-please STOP reading if you are not an adult and have an adult read this entry first to see if they think it is appropriate for you. There are some things discussed regarding customs that some adults may not find appropriate for children. 

This is a combination of several interviews I had with a Ngobe medicine woman and partera (midwife) named Dominga Palacio. Dominga practiced natural medicine and served as a midwife for the communities of Cerro Limon, Cerro Iglesias, and other nearby villages in the remote mountains of Panama. I met Dominga when I organized a meeting for the local women to discuss what issues they were facing day to day, and Dominga was introduced to me as the woman would would speak for the entire women’s community. She is treated with reverence and respect by everyone, and after that first meeting, I knew I wanted to interview her for this blog.

Interviewing Dominga took finesse and alot of patience, as well as quite a few bowls of cacao and meals shared. Many of the questions I asked are considered very personal, and it is is not the custom for the Ngobe women to discuss childbirth or things about women’s health with outsiders. These topics are taboo even for the Ngobe to discuss amongst themselves.

Interviews were primarily conducted either at Dominga’s house in the mountains, or at a nearby family compound under a mango tree, during the months of April and May 2008.

Additionally, the result of the series of interviews I’ve had with Dominga is that I have decided to help her build a house for the local women to use for the purpose of childbirth. I will be talking about this project in another entry on this blog.

Thanks to Aida Bejerano Valacio, Dominga’s daughter, who is her apprentice, and was able to answer some questions that Dominga could not. Thanks to Liberto Bejerano, who served as a Ngobe translator, and also arranged the formalities and gifts so that the interviews could take place following Ngobe customs. Thanks to Carolin Hahn, who assisted in a myriad of ways.

Q.:What is your name and how old are you?

A.:My name s Dominga Palacio, and..(laughs) I am not sure how old I am! (She pulls out a Panamanina ID card and has me do the math..she is 61 years old.)

Q. How long have you been a partera?

A.About 15 years, I think…

Q.How long have you been a medicine woman?

A. I do not know exactly. For us, for women, this medicine of the forest is just something some of us learn. We learn it from our sisters and our aunts and our mothers. If the women in your family know, they will choose you to learn it as well. We learn it so we will not forget.

Q.Let’s go back to being a partera. Do the women or families pay you for your help?

A.No. They have nothing to give me.

Q.If they can’t pay you, then why do you do it?

A.Because I am a woman, and it is the work of women.

Q.Does anyone work with you? Are you training other women to do your job?

A.Yes-I am training my daughter, Aida. She is 30 years old.She has been learning with me[the job of partera] for 4 years.

Q.Tell me what life is like here for women, here in the remote villages in the Comarca…

A.It is a very difficult life-it is difficult from beginning to end. It is a hard life. We work very hard, we have many children, and we do not have any money to get the things we need.

Q.What age do most women here give birth to their first child?

A.Age 12.

Q.And how many children does the average woman have in her lifetime?

A.Normally, she has anywhere from 8 to 10 children, but sometimes more, up to 15 or so.

Q.What medical services are availible here and in the surrounding mountains?

A. Here we only have a few parteras, sukias[these are holy medicne men/prophets who can foresee the future], and the medicine of the forest.

There is a clinic in Boca Remedias [a steep, rocky climb about 1.5 hours away], and it’s a free clinic. But they never have any medicine, you cannot have your baby there. If you go there for help they will always send you to David [a city 5 hours away and then an additional 3 hour 4 by 4 ride].  we have no emergency care, no medicine, no doctors.

Q. When the women go to David to have a baby, what is the experience like for them?

A. Well, they have to get there first and they may not have any money to do that. When they finally get to the hospital, they have a bad time there.

Q. What do you mean, exactly?

A. Well, they don’t want to go there. It is dangerous for them to even get there-they walk down the mountain, then they get put in the four by four with many people, then they have to get to the public hospital, they have to walk there. We don’t have the money for that-we have no money.

When they get to the hospital, they don’t treat us well there. They treat us like we don’t know what is happening. They make us wait, we are very tired from all the walking and the traveling.

Q.Do they speak Ngobe at the hospital?

A.No, they speak only Spanish. So we are frightened , we do not understand what they are saying to us. They give us forms and papers and we do not understand what they say.[Most women from the mountains do not understand Spanish, although that is now changing, and it is being taught in public schools. Most women cannot read. Many have had very little education.]

Q. So can you tell me more about the experience there for the Ngobe woman who is going to have a baby?

A. Well, like I said, we are tired when we get there, we have been wearing the same dress for a long time. Maybe we have nothing with us but our chakra[a net bag] and another clean dress. There is no food left, and we haven’t had water for a long time. At the hospital, no one gives us food or water. No one asks us what we need. We just sit there and wait.

Then they tell us it is time to have the baby, and sometimes it is-and sometimes it’s not[she is refering to c-sections and enduced labor]. This part, it’s very different for us, because they make us take off all of our clothes. We never take off our clothes, our dresses, in front of people, not even our husbands.

Q.So this is very difficult for Ngobe women?

A.Yes, we can’t do it. It is so hard for us, it is humiliating. Then they bring in a man doctor, and that is so much shame for us, for a man to see us have the baby like that.

Q.After the baby is born at the hospital, what happens next?

A. Well, they send the woman home with the baby, sometimes that very day. She doesn’t stay and rest. They give the baby the baby clothes, they give her some things for the baby. The mother eats something. The woman has to go all the way back home, she has to come up with the money to get back. Then she has to walk back up the mountain, too.

Q.Doesn’t her family come with her?

A. Maybe she would bring her sister, her daughter. Maybe she would have her small children with her. But no, she would probably go alone, how would she be able to pay for all those people? She has nothing. Her husband would not go either. Maybe he has to work, maybe he is with the rest of the family. But also our men see childbirth as a thing for women, the world of women. They do not want to see it and we do not want them to see it either.

Q.To go back to something you said earlier, about “being told it is time to have the baby”, I just want to make sure you are referring to c-sections?

A.We call that “the knife”. They tell us they have to use the knife on us because we are not big enough to have the baby, but we do not think this is true. It is not our way, to cut open. We have a hard time having a baby again after the knife is used on us.

Q.Well, so that’s how it happens in the hospital. Now let’s talk about how it is in the mountains. Do the women here all use a partera?

A.Sometimes she does, if there is one living near her. But- most of the time, someone sends for us and we walk to her.

Q.When you get there, what do you do?

A.We do everything. everything. We clean everything, we clean the house and the bed and her clothes, we cook special foods for her…we make sure the children are not there, maybe with other family or a neighbor. There should never be any men around, either.

Q.This may sound like a strange question, but since the houses are so small-only one single small room-how does she have any privacy to give birth? Won’t people hear her and see her?

A.Well, people will hear her, yes(laughs). But normally no one will see the birth, or even the process, because that’s only for the mother, and maybe a partera or a female family member. It is not something for people to see. It is the secret life of women.

Q.Does the woman always give birth in her house?

A.No, sometimes she gives birth alone in the forest. Maybe she has no place to send her children, and her house has too many people in it. Maybe she has no one to help her. Then she gives birth alone.

Q.Do you think that is dangerous?

A.Well, yes..because if she has problems, she will die, the baby will die. No one will know where she is, and no one will hear her cries. She will suffer.

Q.So, let’s go back to what you do to help the expectant mother. What things do you bring with you?

A.[She shows me a blue medic bag] I use these things, these things I learned to use when I trained at the clinic. They give me these things when I need it sometimes, otherwise I buy them with my own money. [cotton gauze, razor blades, hand pump, and a few other very basic supplies].

Q.Do you use Western medicine?

A.Yes, when I can get it. But I have to buy it with my own money, so I can’t use it very much.

Q.Do you use natural medicine? Traditional medicine of the Ngobe?

A.Yes, we have to use many things we have here in the mountains. We collect many things from the forest to help the mothers with problems…we make a special tea from berries, bark of trees, and leaves and this helps the baby come faster. We have a medicine for if the mother is very tired. We have a medicine to make her strong. We have a medicine to clean the blood. We have a medicine to help her rest. We have a medicine so that her dreams are pleasant.

Q.I am interested in knowing what the birth process is like, what you do, what is the process here in the mountains?

A. Well, first, when we get there, we pray. And, we sing songs. Then we make the tea with plants from the forest, then we clean everything. We have to put clean fabric on the bed, if she has any. and we clean her clothes. We bathe her, we keep the water hot and boiling. We talk to her, we soothe her, maybe she is afraid, but we calm her. When the birth starts, we keep doing all these things, we keep nursing her, helping her, making her strong so she can finish. We make her special teas, we wash her with special things, and we pray alot. Then afterwards, we clean her, we clean the newborne, we tell her how to take care of the baby if she doesn’t know. We don’t leave rght away, we stay with her for a few days, we make her special meals and so on, we do all of her work so she can rest.

Q.Let’s talk about the problems women have in childbirth here. Can you tell me some of the problems that are most common related to childbirth?

A.Well, she may be very tired, too tired to have the baby…her life may be very hard, maybe she has not eaten much food or she has worked too hard. We have to make her strong to have the baby.

Sometimes she is trying to have the baby for a long time, for many days. Sometimes 3, 4 days. One woman recently took 7 days.

Q.Seven days? That’s a long time…Did she live?

A. Yes, she lived but she lost alot of blood.

Q.So, let’s talk about that problem-when the mother loses alot of blood.[I take out a copy of the book, “Where There Is No Doctor”, and show her a drawing of a woman hemmoraging] What do you do when this happens?

A.Well, she will only live if it is a miracle. Usually, she dies. We have nothing to help her. When this happens the baby also dies.

Q.What about when the woman is too small to have the baby? Does this happen often?

A.[Aida, Dominga’s daughter breaks in to answer] We don’thave that problem, the Ngobe women, we are made for babies.We walk up and down the mountain from a young age, we carry our brothers and sisters, we work in the field, we do not complain, it is our life.

    [Dominga answers] Well, now, yes, we do have that problem, Aida. Especially if the woman is very young, she is 12 years old or younger, and it is the first child. We have nothing to help her, and she will die. This happens alot.

Q.[I am very nervous about asking the following questions, and so tread delicately around them hoping not to offend]

What if the woman doesn’t want the baby?

A. Well, then the woman would give the baby to someone else in the family who wants it. We love children, and so it would go to someone.

Q.I don’t want to offend you, but what if the baby is born and it’s not perfect? What happens, des the mother want it?

[One thing that I had noticed with life amongst the Ngobe is that I had never seen a single disabled child. I had never seen a deformed child, a blind child, a child who could not walk, or any obviously mentally retarded children.I had occassionally seen a child with an eye problem, or who children who had autism or fetal alcohol sydrome, but little else. In a culture where food shortages were not uncommon, daily life is hard and physically taxing, health conditions are poor, and conception during alcohol consumption(chicha de maiz) is not uncommon…where are the children who resulted from these pregnancies?]

A.[Silence.] well, do you mean if the baby doesn’t look normal, what do we do?


A.The mother will not want it. She will not want it, she will not keep it.

Q. Will they give it away?

A. [Silence.]

Q.In my country, it is not unusual for a woman do give up a baby she cannot care for or who is different.

A. Ah, we are the same here. but here, the baby will die.[Unless in the hospital in David, where the baby will be given up.]

Q.Who decides that,the the baby dies?

A. The mother. She decides.

Q.How does the baby die?


Q.Are babies born often with health problems here-or with the kind of physical issues that cause the mother to have to decide this difficult choice? What if the mother decides no, and wants to keep it?

A.There are many babies born with problems. We are very poor, we have nothing. The mother will always decide to not keep the child, she cannot afford to care for it. Also if the child is born deformed or with problems, it shames the mother, because in our culture it is the mother’s fault if the baby is born this way…it means that she worked too hard, she did not eat the right foods, and so on. It is her fault.

Q.Do you help her in this task?

A.No, no, we do not. we might help her afterwards, she might be ill, and so on. but we have nothing to do with it. We are only there for the mother, to care for her, to make her well and strong. Sometimes she is trying to have the baby for days and she is exhausted, she has nothing. And then she doesn’t have a child. It’s so hard.

Q. What are your dreams, our goals for the women of this community?

A. My dream is to have a house built just for the midwives of the area and have several rooms in it with beds…so women can come and wait there to have their babies. I would have it very clean, I would have a place for them to wait, and a place for them to be afterwards. They would not have to walk down the mountain.

I would also have a room, where I could have classes about nutrition and prenatal care, so we would have healthier mothers and babies. I would be able to help them all the way thru the pregnancy, instead of just the birth part. They could visit me and I could know how they are doing. I would work with other midwives so it would be a cooperative.

Q.Dominga, thanks so much for answering all these questions. You are really a remarkable woman!

A.The honor is mine. I enjoyed taking about our ways very much with you.

If you are interested in hearing about building the center for women that Dominga was talking about, … it will be in the next entry. I found someone to build the buiding, I found someone to donate the land, and I priced out the materials. Stay tuned.


Culture Shock: Back In the USA

Friday, May 2nd, 2008

I arrived back in the USA about a week or so ago. Exhausted from a series of long layovers, nutty flights, and feeling overwhelmed by the bright lights of airports, I was relieved to arrive in California.

Then culture shock set in, and I have found myself trying to acclimate ever since…

So many things seemed so different to me here-especially after spending more than three months in the jungles of remote Panama, with no clean drinking water, no bathrooms, no showers, no electricity, no phones, not many food choices, and living among the poorest people of Panama.

Some of the things that affected me (and are still affecting me!) are…

1. Enormous Beds…and being able to actually sleep in a quiet environment!…

The first night back, I went to my parents house on the Northeren California coast. A beautiful home, with a small guest house next door. That is, it seemed small to me in the past. This time around, it seemed to be enormous. All this space for just me?

The large air mattress in particular seemed enormous. Eight Ngobe could have comfortably slept on it. It was so perfect, that air mattress, that I could just lie there without moving-there was no shifting around. It was so different than a bed of sticks or a flat board, or a mattress so delicately perched on a hastily made frame that every shift creaked and groaned.

 It was so quiet, I couldn’t sleep-their were no pigs tied up outside my window, grunting thru the night. There were no kids crying or coughing. There were no people listening to the radio thru the night. There were no pesky scorpions to be alert for-and actually, no creeepy crawlies at all. Sleep came slowly, and I ended up falling asleep at 2am and then sleeping thru mid afternoon.

2. Food…

After living on a very small selection of food choices for months on end, such as yucca, green bananas, white rice, salted dry meat, and the occassional granola bar/peanut butter combination, the food choices were overwhelming. My  first foray into a local food coop was alarmingly nerve wracking. So many choices, so many things to decide. All so beautifully displayed, like jewels. Everything perfectly clean and seemingly devoid of ever having been touched by human hands.

 I was used to buying my bananas right from the banana guy, after a hike uphill, and then carrying the enormous bunch back thru the village, giving some away to hungry kids as I walked home. Here, bananas were so expensive I could only buy one banana, covered in chemicals, for the same price of 20 organic bananas in the Comarca. 

I found it impossible to not buy loads of vegetables and fruits, something my body had been craving for months. The Ngobe do not eat many fruits of vegetables-the few that they occassionally still eat  are considered foods of the past, and the culture is moving away from the past into a white rice future, devoid of neccessary nutrients. I couldn’t resist oranges, grapefruits, argula, kale…

Walking past the meat counter was an assault to my senses-cases of perfectly laid out meat, endless meat. Where I lived just 2 days before, people butchered the cow at about 4 am right out in the yard, sold it to their neighbors, who let it hang from tree branches for a few days. (In fact, I watched this process several times, and even participated in killing a cow at one point.) After the meat hung around for a few days, inviting every friend and foe to feast on it from the parasite world,  it was was then salted and then fried in hot oil, and you got a tiny tough piece with a bowl of rice or yucca. When you could get meat, that is. Here, people were buying more meat in one shopping trip than the average Ngobe family could afford for months.

3. Stuff, and more stuff…

Um, how much stuff do we really need again? Answer: Not much. I mean, it’s great that we have everything we do, but we don’t appreciate it. We don’t get it. We just want more. More choices, more more more. Enough said. I don’t want to lecture about something that everyone knows already. Personally, I find my old ways a bit embarassing-what in the world did I need all that stuff for? Everytime I buy anything, I am affecting the entire world. What a shock to realize this, and then to return home where we fill our houses, cars, and so on with tons of unneccessary do- dads.

4. Reduce, reuse, recycle….

#3 leads me to this logical conclusion, and adopting it on a grand scale is one of the present principles of my life.

I have to say that before my trip, I wasn’t the most environmentally concious person-Oh, I tried, but I fell off the wagon alot. And you’d think after living in countries where the environmental degradation, the pollution, the trash, the deforestation, I’d be hopeless about the measly contribution of me recyling my spagetti sauce jar can actually make.

Surprisingly, instead it’s made me grasp how important and vital it is that I contribute whatever I can to cleaning up the world and making it a healthy and sustainable place. I really have grown in this area alot and I understand that it is up to me to make the difference-whether its driving less, living in a smaller, simpler space, growing a small garden, or using solar power.  This means buying less-much less, and leading by example, hoping it will affect some positive change.

5. The absolute, sheer joy, of being a woman living in a Western culture….

After months of living with people who are so conservative that women must bathe fully clothed,  the thought of an Ngobe woman being examined by a doctor is enough to have her be totally mortified, women wear full length to the ground dresses everyday, and begin having babies a age 12, it’s a real pleasure to do the following….

wear pants;

 walk around late at night;

talk to men without hearing comments that insinuate I am having more than a friendship with them;

talk to other women openly about their lives;

encourage young women to have big goals and be in a position to lead by example;

and , most importantly , know that I have the possibility to be or do anything I want to do.

These things are simply not possible for the Ngobe women I lived with-and nor is it possible for the majority of women in the world. It’s joy, complete bliss, to be an American woman. Something I never fully appreciated until now.

6. Going into temporary hibernation….

Feeling a little overwhelmed by the cultural differences, and a little underwhelmed by what is important sometimes to people back at home, I’ve found myself in somewhat of a limbo state, temporarily hiding out and not seeking out alot of social interaction.

 Oh, everyone is really nice, very sweet and all that, but after you’ve been where I’ve been, it’s hard for me to talk small talk. Talk to me about a 12 year old dying in childbirth, talk to me about your worries that your whole family has parasites and are sickly, talk to me about your dreams for your children to go to secondary school if you scrape together the money….those are the kinds of conversations I was having daily just a few days ago. From that to everyday pleasantries-it’s kind of hard sometimes.

5. Joining the around the world traveler’s club…

You know, I’m different now, and I’m not even done traveling yet. I’m so different that I can talk about things that most people know nothing about.

Stories about boa constrictors and scorpions interest me, someone mentioning that they have lice seems perfectly natural(doesn’t most of theworld have lice some of the time?) , hearing of difficult journeys and failures, as well as sucesses, seem like normal everyday conversations to me.

Unfortunately, this does not hold true for most people, who are overwhelmed if you talk about killing scorpions or doing battle with dengue fever. I’ve realized that unless the person is truly interested, it’s better to just not say much about my experiences. Better just to smile and nod and say, ” Yes well, I am having some culture shock, but it was a good trip. So how have you been?”  It’s better to just find that point of commonality.

I’ve now joined a club I never realized existed…the club of people who when they meet, recognize each other as world travelers and gratefully, blissfully, lapse into telling stories of their adventures and calmly listen to travel trials without any shock whatsoever.

6. What’s really important, anyway?…

Wow, people spend alot of time getting frustrated or angry about things that are…kind of not things that seem particularly important anymore….

 Like stoplights and slow drivers and waiting and people being different than you and not sharing your opinions totally and things not being perfect 100% of the time.

I’ve just come from a place where nothing was perfect, ever. Not once.

Whatever I wanted, I usually couldn’t get because for whatever reason it was impossible.

Whenever I had to wait, I just waited, because that is how it was.

Hardly anyone ever agreed with me, and in fact, it was impolite, and completely taboo, to point this out. Disagreement(or arguing) amongst the Ngobe people is not a cultural pastime, like it seems to be here. Here its I’m a this, and you are a that, so we aren’t ever going to get along. This would be so impossible for the ngobe, who must get along to survive. Perhaps we could take a cue from this for our own survival as well?

Just appreciating life, and all I have, is what is about for me at this point. My God, I am so lucky, so completely blessed, that I don’t feel as though I can complain about all that much.

 Discomfort, hunger, and so on have been such a part of my everyday reality that the shower running out of hot water, or someone running late doesn’t seem to bother me all that much.

 It just seems so small in the world of things, and perhaps that is because my world is so much larger at this moment than it ever has been.


Journeying Home: All Men are Brothers

Friday, May 2nd, 2008
Leaving the Comarca in Panama and flying home was crazy. Things are so  different once outside of the Comarca. In the airports on the way back, I found myself overwhelmed at the clothing people wore, the amount of food people consumed, ... [Continue reading this entry]