The Silent Strength

Uncovering The Unseen Responsibilities of Midwives Assisting Victims of Gender Based Violence

When Maria embarked on her midwifery career, she never imagined the harrowing challenges she would encounter in Salcajá, one of the top 10 municipalities in Guatemala with the highest rates of GBV.  In 2020, 117 cases were reported to the Ministerio Público.  That same year, Ruby Esmeralda Siquiná Villagrán, the Deputy Director of the Salcaja Municipality Women's Office, was murdered in an act of femicide, casting a dark shadow over the town. 

The Silent Strength

The realities Maria Macario faced in Salcaja, would ultimately change her life and put her 17 year career on a completely new trajectory towards counseling survivors of GBV.

Resources for victims were scarce, and knowledge of how to report incidents was limited. Maria recognized the formidable task of changing Salcajá's context but also understood its absolute necessity as a midwife and local leader.

Many of my patients are victims," Maria observed, "and sometimes they don't even realize it."

The Silent Strength

One particular encounter stayed with her: a woman who had to endure forced sexual relations with her husband simply because they were married. "She told me she had to do it," Maria recounted, "but I insisted that she is the owner of her body."  Maria sees this type of violence and knowledge gap in her patients frequently, but Maria firmly believes in the possibility of fostering community resilience, and transforming the reality for both men and women. Midwives like Maria play an essential role by offering informal psycho-social support and resources when formal aid was lacking. Thus, she decided to embark on a mission to explore the available resources in Salcaja.

In March 2023, Maria, alongside 15 other midwives representing nine communities in Salcajá, embarked on a transformative journey. They participated in a series of 10 workshops organized by the Asociación Mujer Tejedora del Desarrollo (AMUTED), in collaboration with the Central America Regional Initiative (CARI) of USAID's Office of Transition Initiatives (OTI). These workshops addressed therapeutic healing processes and empowered participants to collaborate with institutions and official channels to combat GBV. Thanks to this workshop series, Maria and her fellow participants extended support to 15 women identified by AMUTED. 

Sometimes words are not enough," Maria mused, "but these workshops have equipped me with additional tools to assist my patients who've experienced violence."

Now, when fearful women sought her help, she could provide a more reassuring presence.

Maria Combined the resources at her disposal with her newfound knowledge to identify and respond to various forms of violence, offering improved services to her patients. "We may not be able to attend to all the women," she conceded, "but we're taking the necessary steps toward change."

Maria understands  that her role today extends beyond providing prenatal care. "I support entire families; I take care of my community," she declared with unwavering conviction. Moreover, she is confident that AMUTED's workshop series has raised awareness about midwives' potential to deliver healing services to victims.  Moreover, she is confident that by improving access to holistic therapeutic and healing services, it is possible  to break the cycle of violence and nurture social, physical, and emotional well-being for victims.

These workshops also help us involve more women," Maria affirmed, "so that they can empower themselves and recognize the value they have."

For anyone needing help or needing to report cases of physical violence, sexual violence, exploitation, or child abuse please contact the Public Prosecutors Office in Salcajá, the direct line is: 77688731 


Zeina Hijazi Dubray, Creative Director for USAID Guatemala and Luis Martínez Balcárcel, Central America Regional Initiative (CARI)

The Central America Regional Initiative (CARI) in Guatemala contributes to USAID’s strategy to address the root causes of irregular migration from the Western Highlands, a primarily indigenous region with high levels of poverty and marginalization. To build a foundation for communities to organize and act on behalf of their collective priorities, the program creates spaces for marginalized women and youth to become active community members through co-created and locally relevant development projects. The program also strengthens community-based governance structures and social networks, such as youth groups, migrant cooperatives, and networks of midwives and indigenous leaders to address the many challenges that not only drive irregular migration but hinder historically excluded communities from seeing themselves as agents of positive change.

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