Mothers of the River: raising the ceiling for maternal care in the AmazonBMJ 2023; 382 doi: https://doi.org/10.1136/bmj.p1131 (Published 17 July 2023) Cite this as: BMJ 2023;382:p1131
- Lesley Evans Ogden, freelance journalist
- Vancouver, Canada
Magaly Blas fell in love with the Amazon rainforest in 1999 as a medical student working on childhood anaemia in the region. Graduating from Universidad Peruana Cayetano Heredia, in Lima, Peru, she returned to research infectious diseases. While there in 2010, she learnt she was pregnant.
The news came while she was visiting rural indigenous communities within Ucayali, a region with no access to clean water, electricity, or sanitation. “I was able to see more clearly the huge inequities that exist for women in the Amazon in terms of accessing any type of healthcare,” says Blas. Indeed, rates of maternal and neonatal mortality are disproportionately high there compared with cities in Peru.1
For the approximately one million people living in the Amazon, health facilities are often far away, difficult to access, short staffed, poorly equipped, and lacking in basic infrastructure. Most mothers in these rural areas give birth at home, and infection is a leading cause of neonatal death.
Essential newborn care didn’t exist in these rural areas when she first arrived, says Blas. For instance, in early survey work2 in the region, conducted in 2018 and 2019, she and colleagues found it was uncommon to see immediate skin-to-skin contact with newborns and there were low levels of early breastfeeding, …