SANA Indigenous Health Autonomy Initiative

Curable diseases are wiping out indigenous people faster than any physical weapons. Depriving people of access to health services is one of the greatest human rights abuses that indigenous people face today. The coronavirus lockdown has brought the world’s informal economy to a grinding halt, threatening to plunge over one-sixth of the world’s population into abject poverty. The white flags of Guatemala, for example, indicated the pandemic and cost of living crisis' deadly side-effect: hunger. That this has significantly worsened malnutrition and led to starvation in children and vulnerable populations is clear and a profound concern. Moreover, this same malnutrition is a risk factor that leaves these children and women far more exposed to curable diseases in general. What is also clear is that any medicine is unlikely to reach indigenous communities, so it is vital that they have access to basic health care and food supplies during the current crisis and beyond. This crisis provides a once-in-a lifetime opportunity to re-introduce traditional health systems and knowledge that will help indigenous communities have sustainable access to free health support irrespective of governmental provision.

In every economic crisis, the worst affected are indigenous peoples. Given that indigenous communities struggle to obtain medicine, it is vital that they have access to basic health care. The current crisis provides an invaluable opportunity to re-establish or strengthen traditional health systems and knowledge in indigenous communities to ensure affordable health care provision irrespective of governmental provision. This project will build the capacity of indigenous women to serve as Community Health Volunteers, building communities that are prepared and resilient in the face of disaster, disease and food insecurity. With AMOR, through SANA Guatemala we are unlocking the potential of indigenous communities to support their own health sustainably. Our vision is to expand to serve the millions of indigenous communities globally without healthcare provision, assist them in achieving health autonomy and so save the lives of the 9.7 million children who die of preventable diseases annually.

Specifically, SANA builds the capacity of indigenous women as Community Health Volunteers (ICHVs) to care for their communities during the cost-of-living crisis and beyond, helping build communities that are prepared and resilient in the face of disaster, disease and food insecurity.

The SANA model has four major components: 

1)    Training young indigenous women in basic community health, midwifery and traditional medicine to build the capacity of indigenous communities to mitigate their risk and prepare and protect themselves from disaster and disease.

2)    ICHVs hold regular clinics and conduct home visits in communities, educating on pandemic preparedness in addition to the prevention of common diseases afflicting indigenous communities.

3)    ICHVs also train others in these same skills, rebuilding traditional knowledge and wisdom in Mayan communities devastated by genocide and creating a strong base of indigenous women’s health leadership.

4)    ICHVs coordinate crisis food parcel distribution to the most vulnerable families.

The training content comprises an introduction to midwifery and traditional medicine and how to use it to strengthen the immune system and protect the respiratory system and kidneys, building resistance to preventable diseases. 

SANA builds the capacity of indigenous women as Community Health Volunteers (ICHVs) to care for their communities during the crisis and beyond, helping build communities that are prepared and resilient in the face of disaster, disease and food insecurity.

This solution focuses on preventative and mitigation measures that strengthen access to affordable primary healthcare systems in Indigenous communities and tackle the health inequality they face by creating autonomy via the implementation of an Indigenous Community Health Volunteer system. This model has potential global application, harnessing indigenous human resources, knowledge and natural technology to help solve an issue that results in millions of unnecessary deaths each year and causes untold suffering.

The target population whose lives this project has been designed to directly and meaningfully improve are the indigenous peoples of the world, in particular mothers and babies. We have begun this work in partnership with Mayan communities throughout Central America. In Guatemala alone, there are 15 million indigenous inhabitants. The President of AMOR is indigenous Mayan and AMOR is deeply embedded in the communities we serve. This solution has been developed in conjunction with indigenous communities throughout all of its stages to ensure buy-in. Such communities lack doctors and public health services. This solution will address the needs of communities with high infant mortality rates to take responsibility for their own health in the same way that they did for millennia, rebuilding traditional health systems and knowledge destroyed by colonisation, and strengthening indigenous women's health leadership.

We firmly believe that now is the time to raise up once more the pillars of the indigenous community, the women who are the shade for their children from the sun, their umbrella from the rain.

This project's innovation lies in its focus on the use of human resources to solve costly health challenges and so eliminate traditional barriers to health for indigenous communities whose lives are being devastated by preventable and curable diseases. By harnessing indigenous human resources, ancestral knowledge and natural technology to help remove these barriers, indigenous people become their own saviours and are freed from the need for charity.

AMOR is a dynamic organisation that is dedicated to helping transform indigenous communities devastated by poverty, war and marginalisation through programmes that support education, health and human rights by reviving indigenous knowledge. AMOR is deeply embedded in the communities it serves. AMOR believes that one of the best ways to bring about positive, profound and permanent change in the world is by empowering indigenous women. 

AMOR is transforming lives using an integratedapproach to development that yields both economic and cultural benefits,
helping people access justice, defend their lands, feed their families, care
for their communities in crisis and build climate resilience, while at the same
time rescuing the vital ancestral knowledge that has been key to their
survival. Importantly, our programmes have helped over 96,700 people lift
themselves out of extreme poverty, as well as empowering families to stay in
their communities instead of risking the perilous US migration route. Key to
our success is the fact that our projects are all Mayan-led and designed,
developed in conjunction with beneficiaries, communities and local and national authorities at every stage to ensure buy-in.

AMOR was founded by Arnulfo Oxlaj, a Mayan human rights activist, philosopher, author and artist from Guatemala and the only survivor of a massacre in which 115 children and countless adults perished. Arnulfo resolved to transform that tragedy into triumph, to help his people rise from the ashes of genocide and contribute their gifts to the world.

AMOR was established as a community association in Guatemala in 2001 and registered as a charity in the UK in 2012 and a UK management committee was formed. AMOR benefits from international expertise and highly trained local teams led by founder Arnulfo Oxlaj. AMOR ́s British Executive Director, Sandra Hannen M.Ed. is an education and policy specialist and a highly experienced non-profit executive with over a decade of field experience. As well as these two volunteer staff members, AMOR has 25 international volunteers and 45 facilitators in Guatemala. AMOR is an advisory organisation to the British Embassy of Guatemala and Honduras. The British Ambassador classified AMOR as the "organisation with the greatest potential impact for Mayan women in Guatemala".

850 ICHVs trained, 85,000 indigenous Mayans served.

AMOR is a low-resource, high-impact organisation with a burning ambition to transform the lives of the indigenous people, long excluded from traditional funding sources. However, demand has skyrocketed with the challenges of the pandemic and global financial crisis, with many more communities requesting our services than we can assist. At the same time, a dent in income as a result of the pandemic threatens to undo many of the gains made. We urgently need a boost and the benefit of expert assistance in increasing our capacity and diversifying funding sources and reviewing our business model to meet the exceptional demand for AMOR’s services. We also see that new funding opportunities have arisen from this crisis for which our Executive Director currently has no time to apply due to the need to manage communications and help manage our programmes. Additionally, opportunities have arisen for expert pro bono assistance of which we would like to take advantage to emerge better through this crisis. Finally, AMOR currently has three board members, but we would like to recruit two more, with expertise in marketing and business planning, to help us with the different issues we will face as we grow.

This project's innovation lies in its focus on the use of human resources to solve costly health challenges and so eliminate traditional barriers to health and maternal and baby care for indigenous communities whose lives are being devastated by preventable and curable diseases. By harnessing indigenous human resources, ancestral knowledge and natural technology to help remove these barriers, indigenous people become their own saviours and are freed from the need for external assistance or intervention.

Our impact goals are:

• In the next year, to reduce by one-tenth premature mortality from non-communicable diseases through prevention and treatment in indigenous communities in Guatemala.By 2029, to reduce by one-third premature mortality from non-communicable diseases through prevention and treatment in indigenous communities in Guatemala.
• In the next year, to reduce the indigenous maternal mortality ratio in Guatemala by one-tenth.
• In the next year, to reduce neonatal and under-5 mortality by one-tenth.

• In the next five years, to reduce by one-third premature mortality from non-communicable diseases through prevention and treatment in indigenous communities in Guatemala.
• By 2030, to reduce the indigenous maternal mortality ratio in Guatemala to less than 70 per 100,000 live births
• By 2030, to end the preventable deaths of newborns and children under 5 years of age in indigenous communities in Guatemala, with the aim of reducing neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births

Maternal mortality ratio

Proportion of births attended by skilled health personnel

Under-five mortality rate

Neonatal mortality rate

Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease

To build the capacity of indigenous women who are Community Health Volunteers (ICHVS) to inform, protect and serve their communities during the cost-pf-living crisis and beyond, helping to build communities that are prepared and resilient in the face of disaster, disease and food insecurity.

Output 1. By September 2024, 2,250 Indigenous Community Health Volunteers (ICHVS) from 450 communities throughout Central America are trained to better inform, protect and serve their communities to meet their basic health needs and provide excellent maternity and baby care.

Activities linked to Output 1:

1.1 Provide training to 2,250 indigenous women in community health, midwifery and traditional medicine that will help build the capacity of indigenous communities to mitigate their risk and prepare and protect themselves from disaster and disease.

1.2 Community Health Volunteers hold weekly clinics and conduct home visits in their communities, educating their communities regarding basic mother-baby care and the prevention of common diseases affecting indigenous communities. 

Short-term outcomes: Indigenous communities are more resilient in the face of pandemics and better able to deal with the health challenges they face. Women's leadership is strengthened. Mother and baby outcomes are improved.

Long-term outcomes: Indigenous communities globally have health autonomy, the risk of death by preventable or curable disease is minimised, and vital ancestral knowledge is unlocked with the potential for positive outcomes for global health as a whole.

Our project is fuelled by the power of indigenous women, traditional ancestral health knowledge and natural technology to solve health challenges that would usually incur huge costs to solve.

This indigenous and natural technology has been used by indigenous women for millennia to meet their health care needs, with success. For instance, when the Europeans arrived on American shores, there were an estimated 90 to 112 million Native Americans alive and well and inhabiting the continent, a number that was reduced to 10 million during the first century of invasion, much of that through deliberate infection with mortal disease. Indigenous people have suffered centuries of oppression and genocide, but they are still here, fighting for their lives and dignity. Indigenous people deserve the opportunity to recover their health knowledge, to survive and thrive once more. This ancestral knowledge also has the potential to help solve health challenges beyond indigenous communities. During our pilot phase, we have seen a 55 per cent reduction in avoidable deaths and great improvement in mother0baby outcomes, a statistic that provides great promise for indigenous futures.

Indigenous upholders of culture, knowledge and tradition throughout the ages have faced centuries of discrimination and oppression and represent the most oppressed and criminalised group. AMOR is committed to supporting the most vulnerable and is vehemently opposed to discrimination in its myriad forms and to protecting all those who share protected characteristics. These values are at the heart of everything we do and are and are reflected throughout all our processes and procedures. 

Firstly, AMOR confronts forms of structural oppression in several ways. AMOR is transforming lives using an integrated approach to development that yields both economic and cultural benefits, helping people access justice, defend their lands, feed their families, care for their communities in crisis and build climate resilience, while at the same time rescuing the vital ancestral knowledge that has been key to their survival. Access to ancestral knowledge is key to this endeavour if indigenous communities are to survive, overcome and end the successive genocides committed against them, and at the same time retain their cultural heritage and strength, their traditional ways of surviving and thriving in harmony with the natural world. Moreover, we at AMOR believe that only by unlocking indigenous women’s potential will we build a safer, more peaceful and prosperous world.  As Guatemala rises to the challenges of the new global health realities, indigenous girls and women must be at the heart of our response. Indigenous women suffer from discrimination on multiple levels. To counteract this, both gender equality and ethnic equality are central to AMOR’s processes and projects, which uphold the highest standards in terms of safeguarding and protection. AMOR is deeply embedded in the communities it serves and for fifteen years has been promoting women’s pollical and economic empowerment, protection from violence, SRHR and girls’ education, building evidence and community partnerships to challenge and change unequal power structures and ensure that no woman or girl is left behind. This project steps up for women and girls during the current health crisis. It will be led by indigenous women and developed in conjunction with women trainees throughout all of its stages to ensure buy-in and support the strengthening of indigenous women’s leadership and capacity.

SANA helps restore indigenous health knowledge and empower indigenous women by providing training to community midwives that results in improved maternal and child health indicators, and free community health clinics that serve the health needs of areas of extreme poverty and marginalisation, where there are no existing health services. and where traditional knowledge and culture have been suppressed, prohibited and demonised for 500 years.

Our path to financial sustainability resides in sustained donations and grants. We have grown by word of mouth over the past 5 years with no marketing budget, demonstrating the market need for this solution. Our customer acquisition cost is therefore zero. Our ICHVs are volunteers. We are also interested in the possibility of digitalising traditional health knowledge and sharing it globally to create an earned income stream.

We have received a significant number of smaller grants for this project since it commenced totalling $80,000, including from the UK government.