Fatal Flaws - Barriers to Maternal Health

Personal stories: What rights mean on the ground

Amnesty International

Health promoter Teodora Huanca Salazar in San Juan de. ©: Amnesty International

José Meneses Salazar

The mother of José from San Juan de Ccarhuacc, Huancavelica province, died in childbirth in 1999 when he was 15 years old. She had not wanted to go to the health centre for check-ups because she feared the staff would not treat her well there. When she went into labour, the midwife was on leave, so José‘s father and some of his mother’s relatives delivered the baby themselves. However, after the baby was born, the placenta did not come out and they did not know what to do. Two hours later his mother died. The baby girl survived.

The death of José’s mother had a huge impact on the family. José’s `father sank into depression and alcoholism after his wife’s death and subsequently abandoned the family. José had to take on responsibility for his eight brothers and sisters and for the family’s plot of land, which meant that he had to give up his education. His sister also had to leave school in order to help out. As a result, she can barely read or write.

José now lives with three of his younger siblings, his wife and two sons of his own. As a result of his mother’s experience, he has supported his wife in going for ante-natal check-ups and took her to the maternity waiting house before she gave birth. He says that the health centre desperately needs more staff and equipment, especially a scanner so that they can see how the foetus is developing and predict more accurately when the baby will be born. He hopes that they will get permanent health workers who stay in the community, and that there will be better provision for transporting women to other health centres in emergencies.


Fortunato Salazar Sutacuru

Lack of communication can seriously affect access to maternal care and its quality, as Fortunato and his wife Criselda found when they went through the pain and distress of losing their first baby in 2008.  At the time Fortunato was working in Lima due to the lack of employment opportunities in their town of San Juan de Ccarhuacc. Criselda had taken their animals to the field to graze when she slipped and fell. That evening she started to have abdominal pains and went to the health centre. The doctor did not understand Criselda, who speaks only Quechua, and sent her home saying that all was well. She miscarried two days later. 

Fortunato and Criselda believe that the doctor may not have picked up her symptoms accurately because she could not speak Quechua, and interpreters are not provided to facilitate communications between doctors and patients. 


Rosa Quichca Vargas

Rosa Quichca Vargas has been through five pregnancies.  Two of her children died, one in childbirth and one in the first few days after birth, possibly of pneumonia. She lives almost an hour’s walk away from the health post in Ccarhuacc on a road that cannot take vehicles other than possibly a motorbike. She cannot communicate with the doctors which causes her severe anxiety, and so her husband arranges for a Quechua-speaking health promoter to go with her for check-ups

“The first time she [the doctor] didn’t understand what I said to her. I went back and again she didn’t understand… The third time she asked me for my family planning card and I went back with it… I couldn’t speak [to her]… When we went with my husband, then he got the doctor to understand [that I was pregnant].”

“We’re scared when they speak to us in Spanish and we can’t reply… I start sweating from fear …what am I going to answer if I don’t understand Spanish? It would be really good [if they could speak in Quechua]. My husband, when he goes to Lima, leaves me with the health promoters so that they can accompany me. They take me to my check-ups and speak to the doctor.”



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