Midwives go door-to-door amid flooding in Peru, reaching thousands with critical health services

PIURA, Peru – In the first months of 2023, torrential rains flooded the streets of Veintiséis de Octubre in Peru’s northwestern Piura district, interrupting city services and trapping people in their homes. For 30-year-old mother-of-two Miryam Coello, it added another level of anxiety to her pregnancy. 

Getting to check-ups became difficult – the dirt roads in her neighbourhood were waterlogged, and there was no money for alternate transport. Even worse, plagues of rats, flies and mosquitoes had arrived with the floods, bringing with them the threat of water-borne disease. 

“We had to disinfect everything. But I still caught dengue fever,” Ms. Coello told UNFPA, the United Nations sexual and reproductive health agency. 

Climate emergencies present particular dangers for women and girls, cutting off access to essential sexual and reproductive health services, elevating risks of gender-based violence and heightening vulnerability to illness. During the flooding emergency in Piura, one out of five maternal deaths was associated with or caused by dengue.

Ms. Coello had already been told that her pregnancy would require special attention, given she’d delivered her first two children via Caesarean section. Doctors warned a third surgery could be risky. 

Still, she struggled to get the care she needed. That is, until she heard a knock at the door. 

A life-saving initiative 

Ms. Coello’s visitor that day was a midwife serving as part of a group organized under the UNFPA-supported Saving Lives project, implemented together with local partner organization Prisma. 

As thousands of women like Ms. Coello were prevented from visiting health centres due to flooding, economic issues and care-taking duties, the Saving Lives project brought care to their doors.

“I had no one to leave my children with because my husband was away working as a fisherman,” Ms. Coello said. “The group told me they were coming to see me for my check-ups.”

Since May 2023, trained midwives have been visiting women like Ms. Coello across the flood-affected regions of Piura, Tumbes and Lambayeque. Members have been able to identify and support nearly 150 pregnant women with services like prenatal check-ups, and to enable more than 4,500 women to access sexual and reproductive health services. 

“They go tirelessly door-to-door to provide sexual and reproductive health counselling and identify pregnant women. They haven’t given up,” said obstetric health coordinator Bertha Liñán, whose health centre collaborates with the UNFPA-backed project. 

“​​They helped us increase our staff numbers and reach places we couldn’t before.” 

Checking up, changing lives 

For Ms. Coello, the care provided by the midwives has made a major difference in her pregnancy. She no longer feels endangered. “My life has changed a lot since they arrived,” she said.

Midwives save lives – and yet, the world has far too few of them. According to UNFPA, nearly 1 million are missing from the workforce, despite being able to meet about 90 per cent of global need for essential sexual, reproductive, maternal, newborn and adolescent health interventions.

After consulting with midwives, Ms. Coello made the choice that she will not have any more children. “I made that decision with my husband as part of our family planning,” she said.