I posted awhile back about horses in Detroit. My friend and former coworker Pasha Ellis organizes monthly equestrian events for kids in his central Detroit neighborhood with the group Motor City Horsemen. He envisions a future Detroit where horses become a prominent form of transportation.
It may seem like a bit of an esoteric goal. In an interview we did this summer, he explained his thinking. He said horses are about:
Bringing people closer to who they are. Helping people find definition without things, objects, man-made products. Yo, riding a horse is an exhilarating experience man, especially for people who’ve never rode a horse before. It’ll definitely cut down on pollution, and it will spark an interest, I feel, in nature and being closer to nature.
As the leader of the Fenkell and Dexter Community Coalition, Pasha organizes a wide range of projects in the neighborhood—tending gardens, cleaning streets, building community spaces in vacant lots. He argues that American consumer culture perpetuates an internalized mentality of white supremacy in distressed black Detroit neighborhoods. Improving the city’s quality of life therefore requires confronting that culture. Beyond the free fertilizer and saved fossil fuel, horses have a role to play in that work:
I think all aspects of nature have a healing aesthetic, whether it’s planting gardens, riding a horse, raising livestock, since it’s our natural element as people. It just puts us in a better place health-wise, overall. And like I say for these kids, these city kids, definitely just bringing them closer to nature and their humanity, opposed to, you know, ‘ooh I like that new car, that new car!’ You know, fuck that pollution, get up on this horse and stop next to that car. See how majestic you really feel!
Co-authored with Gustav Cappaert at Latin Correspondent.
Even though most maternal deaths are preventable, every day 800 women across the globe die due to complications during pregnancy and childbirth.
Peru is one of only two South American countries expected to hit its maternal mortality Millennium Development Goal, one of a set of UN-backed global poverty reduction targets that culminate in 2015. Peru today has a ratio of 67 maternal deaths per 100,000 live births, down from 265 in 1990.
The Andean nation remains behind industrialized countries like Japan (with a rate of six) but way ahead of the world’s least developed nations: in Sierra Leone, which has a maternal mortality rate of 1,100.
Help for expectant mothers
“The principal problem Peru has had is access to maternal health services,” said Mario Tavera, Health Specialist for UNICEF Peru. “Global evidence demonstrates that the reduction of maternal mortality is associated with medically-attended birth in health care centers,” he said.
Peru has made strides on this front, 80 percent of women now give birth at a medical facility, compared to just one quarter in the early 1990s. Over 90 percent attend prenatal care visits.
According to Tavera, Peru has more than doubled the number of state-run health facilities in operation, greatly increasing access to care. Some clinics operate associated casas maternas which allow women who live in remote areas to stay for up to a week as they wait to give birth.
But perhaps the most important change has taken place inside of clinics. “There’s a set of very distinct customs” in rural Peruvian communities, Tavera said. “The people were permitted to bring into the clinic customs from giving birth in their homes.” Family members were allowed into the birthing room for the first time; women were allowed to give birth sitting or on their knees; they could bring a rope to hold onto — another traditional custom.
There are wrinkles in this success story, though.
Creating a one-size-fits-all policy is uniquely difficult in Peru. Its three major regions: coastal desert, mountainous center, and Amazon jungle each demand a different approach dictated by culture and geography.
On the traditionally wealthy coast, the average maternal mortality ratio was 56.4 between 2007 and 2011. In the poorer highland and jungle regions it was considerably higher, at 152 and 137 respectively.
“Peru is one of the most unequal countries in Latin America…Parts of Peru have European levels of mortality, other parts have African levels,” said Tavera.
In the mountains, a long history of discrimination against the majority indigenous population makes some women reluctant to visit government health posts. For one, health care providers rarely speak Quechua, the native language in most of highland Peru.
“Those that speak Spanish ignore us, those of us from the town, from the communities that come down. They humiliate us sometimes or don’t treat us well,” said Teresa Echame Vargas, a health promoter in the rural community of Huilloc.
Perhaps not surprisingly, home birth is more common in rural areas. Although official policy is to support traditional birthing methods and attend home births if possible – a practice supported by medical evidence – in reality it depends on the clinic. “We would like the health posts to attend at home, but they say they can’t,” said Vargas.
Fueling claims of discrimination is the illegal but common practice of imposing fines on women who chose to give birth at home.
Keri Baker, the executive director of the health promotion organization Ayni Wasi, recalled a patient who suffered complications during a home birth, “She hadn’t expelled her placenta all the way which can cause hemorrhaging. We saw her at that point, and she hadn’t sought medical care because of the fact that she had given birth in her home.”
A 2009 survey of women in the coastal community of Huaycan – the majority of whom had migrated from the highlands – found that 46.5 percent of women who elected home birth did so because they’d had a bad experience on a previous hospital visit or knew someone who had. A majority of women in a similar study in 2005 cited discrimination and a feeling of violation by health care providers as reasons to give birth at home.
In a jungle region like Madre de Dios, in Peru’s southeast, communities’ distance to health facilities makes professional attention a challenge. The Spanish-speaking population is transient – attracted by the lucrative business of illegal mining. Women that live in mining camps rarely make the river trip to attend prenatal visits, said Nelva Miraya, the government’s Coordinator for Community Strategy and Reproductive Health for the region.
The area’s far-flung indigenous population of 60,000 is another challenge. Communities in Madre de Dios speak 12 different languages, and live in settlements up to three days away from the nearest hospital. The lack of government presence in these areas raises the possibility that deaths go unreported.
“(Until recently), in the entire region of La Salvación, there was only one obstetrician. She was the only one to intervene in native communities that are two, three, four days away by boat,” said a nurse in Madre de Dios’ capital of Puerto Maldonado.
Although recent progress on maternal mortality is encouraging, Mario Tavera of UNICEF warned about diminishing returns. “(Peru is) starting from a very high rate,” he said. “A country like Chile had 30 (maternal deaths per 100,000 live births). Getting to seven is more difficult.”
I wrote about the correlation between gun violence and economic insecurity:
Even in cities with strong gun laws, the correlation holds. Buzzfeed notes that “the average rate of gun deaths in Chicago’s five poorest neighborhoods was over 12 times the rate in its least poverty-stricken.” A map of murders in Washington, D.C. shows that killings hardly ever occur in the city’s wealthy western swath of neighborhoods.
Mind you, this is correlation and not causation. But there’s plenty of reason to believe that poverty leads to gun violence and greater economic security decreases it.
In his classic study of inner city Philadelphia, sociologist Elijah Anderson demonstrates how racism, social alienation, and the absence of economic opportunity combine to create a “code of the street” in which wielding the “credible threat of violence” is the only way to ensure one’s safety. Needless to say, the code leads to a pattern of confrontation and killing.
“Only by reestablishing a viable mainstream economy in the inner city, particularly one that provides access to jobs for young inner-city men and women, can we encourage a positive sense of the future,” Anderson wrote.
Continued at Generation Progress.