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Saturday, August 18, 2007

The midwives’ traditional methods were superior: Infant mortality and medical error

Midwife Filomena’s (CNM - Certified Nurse Midwife) story:

I had returned to Brazil after receiving my public health degree in the U.S. I was invited by the Organization of Indigenous Nations in Brazil to assist in organizing a health training for indigenous health agents in the south west Amazon in efforts to help reduce the rate of infant mortality in those communities. For the most part, these communities were healthy– they farmed their own food, did not use refined sugar, had plenty of game and fish and clean water. Nevertheless, many of their newborns were dying, and we had to find out why.

I discovered that scissors had been introduced there recently, and were highly prized as something new – shiny, sharp, metal, with many uses. Midwives had now begun using scissors to cut newborns’ umbilical cords. But they had no concept of Western germ theory or sterilization as we understand them, and anyway, it’s not so easy to find rubbing alcohol to sterilize scissors in the middle of the rain forest! In earlier times, midwives had used a special shell, sharpened long and carefully against a whetstone, to cut the umbilical cord. The slow grinding of the shell’s edge creates enough heat and friction to kill and remove bacteria, allowing for safe use by the midwife. Specific herbs were also placed over the cut umbilical cord to promote further healing. It was evident that the more modern use of the non-sterilized scissors caused tetanus infections that proved fatal. After we taught the midwives that their traditional methods were superior, their infant mortality rates improved greatly.

Advice: Remember that modern technology often may prove less effective than traditional methods.

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