The indigenous Nancue Ñomndaa health promoters are an important health resource in Xochis. In 1987 we began collaborating with these groups in Xochis on a research and capacity building project for active surveillance of tuberculosis (TB) in rural Guerrero. Trained by CIETmexico and armed with plastic microscopes, the health promoters performed sputum smears for tuberculosis (TB) detection. They also supervised treatment when TB was diagnosed.

Abraham de Jesús (second from the right), CIET field coordinator, 
leads training for two community health promoters Angélica y Don Carmelo

During the measles epidemic of 1989-1990 in Guerrero, CIETmexico and medical students from the University of Guerrero trained the indigenous health promoters to diagnose these diseases and treat the most frequent complications. In 1991, in the context of a cholera epidemic, they learned to treat diarrhoea with homemade dehydration salts.

Throughout the years, these volunteer health promoters kept building on their research and health care skills. Among other things, they learned to diagnose and treat common skin infections in their communities. In 2003 and 2004, a group of 30 indigenous health promoters took part in several workshops on a range of health topics, such as first aid, medical emergencies, patient transportation, ophthalmology, dental health, sexually transmitted infections, and newborn care. They also took a leading role in intercultural health in the Costa Chica region, as they combined this learning with their knowledge of traditional indigenous medicine. In 2005, they formed the Indigenous Nancue Ñomndaa Community Health Promoters Network.

Around 2007, the health promoters and their Xochis neighbours saw the need to preserve and increase human resources within the traditional indigenous health system. After a discussion of our 2008 baseline results with the communities, they agreed that training new traditional midwives were the priority. This is the origin of the Safe Birth in Cultural Safety initiative.

As part of the intervention, community health promoters received training on pregnancy alarm signs and obstetric bleeding. They learned how to take blood pressure and how to help women if their pressure is high or low.

The community health promoters offer support to midwives in caring for mothers and newborns. They visit pregnant women’s homes and the community birth centres to take their blood pressure. After deliveries, they weight newborn babies and register their birth.