Posted on Aug 28, 2022
Dr. Miriam Rittmeyer (center), founder of Phalarope (logo at top), and the community leaders of Phalarope's Programa Manchichi that seeks to partner with and educate comadronas to reduce maternal mortality in rural Panama
Imagine being pregnant in a community high in the mountains of Panama that is accessible largely by foot. Would there be anyone trained to help you in case something went wrong? Dr. Miriam Rittmeyer, our speaker at the August 28, 2022 meeting, founded Phalarope to help women in situations like this. Phalarope seeks to empower women through education and community outreach to enable families and communities in Latin America to reach their full potential. Phalarope has six priority areas, and in her talk Dr. Rittmeyer focused on projects to improve maternal and community health.  
Phalarope took the unique approach of partnering with comadronas, women who are highly respected and trusted community leaders. Comadronas carry out traditional birth practices in indigenous communities in Latin American countries like Guatemala and Panama. In rural Guatemala, Phalarope implemented a vocational training program, Programa Ixchel, to equip comadronas with medical skills and tools to monitor fetal development as well as detect hypertension and high blood pressure. Using these skills, the comadronas could identify signs and symptoms of high-risk pregnancy that can endanger the life of both mothers and their fetuses. This training is critical to reduce the rate of maternal morbidity and mortality, which can have long-lasting effects for families and communities.  
Building on the success of Programa Ixchel, Phalarope secured a Global Grant (G-2658) to start Programa Manchichi that will help six communities in the mountainous region of Panama. The Global Grant allowed expansion of preliminary findings from a Phase I project in which teams in these communities teams compiled detailed regional maps that identified where families are living, and the health status of family members. These data were used to generate a dashboard with health indicators that could provide alerts from the field when patients were in need of higher-level care.
The Global Grant funds a training program with a curriculum that focuses on cultural competency that respects traditional practices while allowing for active monitoring and response to high-risk situations as they emerge. The training is conducted within the remote communities where comadronas receive instruction in identifying high-risk pregnancies in addition to preventative screening for other communities members, many of whom are affected by chronic conditions like diabetes. The curriculum also includes training in prenatal care, particularly coaching to optimize maternal nutrition, determining fetal presentation, as well as post-partum care that is critical to reduce maternal mortality.
Dr. Rittmeyer is a native of Guatemala. She earned her MD in Guatemala and received a Ph.D. in Nutritional Epidemiology at the University of North Carolina as well as a Master’s in Public Health from Johns Hopkins University.
In 2021, the Rotary Club of Del Mar International Services Committee partnered with Phalarope on this innovative Global Grant through the donation of $2,500 from the club and $2,500 District Designated Funds (DDF).