Today, TBAs in Guatemala are registered with the Ministry of Public Health. They receive training and work in partnership with health centres. But this was not always the case. Until just a few years ago, TBAs faced discrimination, insults and even physical attacks from health workers. And the indigenous women they served were receiving poor treatment at the health centres.
The TBAs in Patzún municipality were determined to change this situation. Their first step was realising the need to unite. Supported by the Christian organisation Asociación Vida, the TBAs decided to form a committee. Asociación Vida helped them understand their rights and the laws in Guatemala, which were in favour of communities providing services locally.
The TBA committee used meetings, demonstrations and letters to ask the health centre to provide them with proper training. They faced opposition and even death threats from local health officials, but they kept going. And in the end, the health officials agreed.
Encouraged by their success, the TBAs began working with the local development councils. They even travelled to Guatemala City to meet the Minister of Health and ask for improvements in Patzún. Over several years, they successfully advocated for a new maternal care centre, medicine deliveries and better care for patients. They also influenced the health centre to employ a director who could speak the indigenous women’s language.
‘We want to serve our neighbour as God commands and do good work, quality work,’ says María Francisca Boch, the head TBA in Patzún. ‘Without God, we would not have been able to do this.’
Loida Carriel Espinoza is Tearfund’s Regional Advocacy Officer for Latin America and the Caribbean.
Improving patient care in Kenya
Alice Mwongera runs the Morris Moses Foundation, which works to improve health care in Kenya and beyond. She set up the organisation when her husband and later her brother died tragically after receiving poor treatment in a hospital.
As a Christian, when I started my work, the first group I reached out to was the church. I thought the church could speak up about the way patients are sometimes mistreated. But the churches really did not understand how to engage.
After a lot of frustration, I stopped trying to engage the churches. I formed a group of motivated campaigners, mainly university students. We set up a movement called Silent No More to campaign for changes in the health sector. It received a lot of interest and the media got involved. When we started appearing on TV and radio, the government had to pay attention.
We managed to establish the first‑ever Patient Rights Charter for Kenya. This clearly states patients’ rights – for example, the right to receive emergency treatment in any health facility, whether or not you can pay. Another success was establishing the Africa Patient-Centred Care Model. We are training doctors, nurses and medical students to treat the human being and not just the disease.
I wish I could have the opportunity to train a few people in the church about advocacy. If churches are willing to engage with us, we can show them how to go about it.
Visit www.tearfund.org/ccmadvocacy for resources to train your church in advocacy.