Renfield Award

Gabriela Meléndez-Peláez
Nurse-midwife and Maternal Health Advocate
Founder of Asociación Corazón del Agua

Gabriela Meléndez-Peláez, a Guatemalan nurse-midwife, maternal health advocate, and the Founder of Asociación Corazón del Agua, will receive the 2022 Penn Nursing Renfield Foundation Award for Global Women’s Health for her tireless work in addressing maternal health inequities in Guatemala. The recording of the award ceremony, held virtually on March 29, 2022, can be accessed here.

“Gabriela Meléndez-Peláez is addressing maternal health inequities, including maternal mortality in Guatemala’s population of Indigenous Mayan women directly,” said Penn Nursing Dean Antonia Villarruel, PhD, FAAN, “but her approach is anything but simple. As a well-respected Guatemalan nurse-midwife and maternal health advocate, founding Asociación Corazón del Agua to prepare midwives to integrate Mayan traditions into their practice and encouraging graduates to work in areas of high need—while advocating for midwifery at the local and national levels—is changing the fate of women in Guatemala. She is an exemplary recipient of the Penn Nursing Renfield Foundation Award.”

About Meléndez-Peláez and Asociación Corazón del Agua

Meléndez-Peláez founded Asociación Corazón del Agua in 2014. In partnership with Galileo University, they began Guatemala’s first university-level midwifery degree program. In a country where Indigenous Mayan women are twice as likely to die from pregnancy and childbirth-related complications than non-Indigenous women, this midwifery program is the only one in the country to incorporate Mayan traditions and knowledge around pregnancy and birth in its 3-year curriculum.

Corazón del Agua specifically recruits Indigenous Mayan students from some of the most underserved, high maternal mortality areas of Guatemala into its direct-entry midwifery program. During their training, students are linked with a traditional midwife, or comadrona, in their home communities to ensure traditional practices and knowledge are learned and incorporated into their clinical practice. Upon graduating, students are encouraged to practice in their communities or similar underserved communities. To date, three cohorts of a total of 32 young midwives have graduated and a new class will begin the program in July 2022. Through this work, Meléndez-Peláez is working to build Guatemala’s maternity care workforce to improve access to safe, respectful, and equitable maternity care in the most remote regions of the country. Through her work at Corazón del Agua, Meléndez-Peláez also seeks to advance the profession of midwifery through the development of the country’s first Association of Professional Midwives.

“I accept this award in recognition of all the hard work carried out by many midwives without resources, acknowledgement, or respect for their rights in Guatemala. This award will uplift our efforts to advocate for the national recognition of midwives as key health care workers to improve women’s health particularly pregnancy and childbirth outcomes and experiences, particularly among the most underserved,” said Meléndez-Peláez. “It will accelerate Corazón del Agua’s capacity to support young Indigenous midwives as they begin their work at the community level to ensure they have the resources and support they need to provide safe, quality, and respectful maternity care. I am proud to receive the Penn Nursing Renfield Foundation Award, which highlights the critical role of midwives as change agents for maternal health improvements in Guatemala.”

Impact and Advocacy

Corazón del Agua is working with leaders at the local and national level to advocate for changes that recognize the important role midwives play and support better integration of their services. Meléndez-Peláez is actively advocating for the Guatemalan Ministry of Health to officially recognize the midwifery profession and eliminate barriers that prevent midwives from fully exercising their work. The formation of the Association of Professional Midwives will further strengthen these efforts.

To date, more than 15,000 women have received sexual and reproductive health services by the three cohorts of midwives who were in training between 2013-2021. In addition, Corazón del Agua graduates started a Midwife Network and Midwife Cooperative which allow them to order medical supplies in bulk to significantly lower costs and serve more women and girls in low-resource settings. An app was also built to make it easier for the team to gather and analyze data in a way that is efficient, requires less time from midwives, and allows midwives in training to generate reports.

“The Center for Global Women’s Health is delighted to present the Penn Nursing Renfield Foundation Award for Global Women’s Health to Gabriela Meléndez-Peláez,” said Monique Howard, EdD, MPH, Senior Director, Women’s Health Initiatives. “As a midwife, her work is paramount to reducing maternal mortality among Indigenous Mayan women, which is closely aligned with the Center’s strategic priorities. The Center is excited about this partnership and the ability to support the training and development of Indigenous Mayan women.”

Daron G. Ferris, MD
Founder and President, CerviCusco

Daron G. Ferris, MD, the Founder of CerviCuso, is the recipient of the 2020 Penn Nursing Renfield Foundation Award for Global Women’s Health for his dedication to cervical cancer prevention among the indigenous women in Cusco, Peru. Ferris created CerviCusco, a non-profit organization that ensures all women, including those with limited economic resources, have access to high quality and affordable health education and care, including screening, diagnosis, and treatment of cervical cancer.

“Dr. Ferris is a leading clinician, educator, and researcher whose focus on cervical cancer treatment and prevention has improved the lives of countless women, and their families,” said Penn Nursing Dean Antonia Villarruel, PhD, FAAN. “His innovative approach to establishing health care access for underserved women, establishing international partnerships with nurses and other interdisciplinary colleagues, and building community capacity to improve the lives of women – make him – and CerviCusco – exemplary recipients of the Penn Nursing Renfield Foundation Award winner.”

Peru has one of the highest rates of cervical cancer in the world. The country of 32 million people has a large rural and poor population. The Andes region of Peru (including Cusco) is disproportionately impacted by cervical cancer, in particular. There are multiple barriers to prevention programs: physical distance to healthcare services; a lack of culture of preventative medicine; poor literacy skills; language barriers; and fear and stigma associated with gynecological issues.

As a result, the disease is often not identified until it is at an advanced stage and symptoms are present. At this stage, treatment options are severely limited. Caught early, pre-cancerous cells can be removed or treated. However, a late-stage diagnosis requires chemotherapy or radiation therapy – which is not available. This makes it prohibitively expensive for most of the population. Without treatment, many die painfully from this preventable disease. In resource-poor regions, the death of a mother places an important burden on the family. Children’s health and education suffer, prolonging the socio-economic deprivation of the next generation.

According to the International Agency for Research on Cancer (IARC), cervical cancer is a leading cause of cancer among women in Peru, with an estimated 4,000 new cases annually. About 1,800 of those women will die from the disease, making it the second most common cause of cancer deaths among women. The incidence of cervical cancer in Peru is over 50 percent more than the South American average and the mortality rate over a third higher. Taking note of these numbers, in 2008 Dr. Ferris set about changing the plight of women in the Cusco region through the creation of CerviCusco.

 

What CerviCusco Does

The non-profit CerviCusco is dedicated to cervical cancer prevention in this region of Peru. The organization delivers cervical cancer prevention, screening, diagnosis, treatment, and other women’s health services. It ensures that all women, including those with limited economic resources, have access to high quality and affordable health education and care.

“CerviCusco was founded on the principles of compassionate care and medical excellence, and these remain of utmost importance to us today,” said Ferris. “We are dedicated to the people of Cusco and use advanced screening and medical technology — not available in many parts of this region – ensuring all of our patients, regardless of their ability to pay, receive the care and treatment they deserve. This award will ensure that our services will reach an even greater number of people, and for this, we are thankful.”

CerviCusco maintains a regional medical clinic in Cusco to deliver high quality and affordable medical care to women. It conducts outreach campaigns to disadvantaged indigenous women to provide critical preventative care and educates healthcare providers and the public about cervical cancer and screening. CerviCusco is advancing scientific discovery in the area through clinical research studies that normally would not be performed there. To ensure it has a presence for many years to come, CerviCusco develops strategic partnerships to gain further access to advanced medical and laboratory technology that will bring another level of access to much needed health care.

CerviCusco’s Impact

Since its founding, CerviCusco has crossed a significant number of thresholds including:

• 25,000+ people vaccinated against HPV
• 65,000+ Liquid-based Pap tests
• 10,000+ diagnostic examinations and cervical pre-cancer surgical treatments
• 1,000+ cancer prevention and screening out-reach campaigns
• Cancer prevention health care in all 13 rural districts of Cusco and other departments
• 2,000+ medical and helping hands volunteers
• 17 Medical Research studies conducted

 

Dr. Vandana Gopikumar
Co-Founder of The Banyan and the Banyan Academy of Leadership in Mental Health

On March 21 2018, Dr. Vandana Gopikumar, an inspiring advocate for women’s mental health, will receive the 2018 Penn Nursing Renfield Foundation Award for Global Women’s Health for her work in helping women with mental health problems in India.

The Banyan began as a spontaneous and heartfelt response to the visible gaps in care and attention for homeless women with mental health problems, who in the eyes of society simply did not exist. There were no services to help them recover their lost lives. In the beginning, The Banyan offered a transit care facility that offered shelter, safe spaces, and crisis intervention.

When it started in 1993, Gopikumar originally set up a shelter for homeless mentally ill women in order to provide care and basic treatment. But she was struck by the realization that the problem was much deeper since India’s mental healthcare system had several missing components. Furthermore, she saw that the homeless mentally ill required not just medical attention, but a whole spectrum of healthcare and psychosocial services ranging from their rescue off the streets to rehabilitation and reintegration. Thus, over the last 25 years the services have expanded to one that tackles a growing public health crisis in India. The Banyan services an 800,000 population, has reached out to over 10,000 individuals in distress, and offers persons with mental health issues (particularly from vulnerable groups) access to a comprehensive range of services that include emergency and recovery focused care, wellbeing oriented community based care, and inclusive long term care for persons with high support needs.

The Banyan’s core philosophy is that every individual should have access to opportunities, be aspirational, and live life to their fullest potential. The focus is on socio-economic and cultural participation, and seeks to shatter myths and misconceptions around mental ill health. It established psychiatric clinics, social care programs, self-help groups and ultimately a resource center, the Banyan Academy of Leadership in Mental Health (BALM). BALM focuses on developing partnerships with the government, civil organizations, universities, and individuals to further the development of mental health services in the region.

“Dr. Gopikumar embodies the very essence of The Renfield Award, which is given to an individual who demonstrates leadership in improving women’s health,” said Penn Nursing Dean Antonia Villarruel, PhD, FAAN. “Over the past 25 years, she and her team have helped more than ten thousand people with mental health issues in India to reintegrate into society. Her devotion to helping this community is steadfast and tireless. We are happy to recognize her and The Banyan with this much-deserved award.”

 

Dr. Denis Mukwege
Obstetrician and Gynecologist
Panzi Hospital & Panzi Foundation, Democratic Republic of Congo

On March 24, 2016, Denis Mukwege, a decorated humanitarian and outspoken advocate for women’s rights, will receive the 2016 Penn Nursing Renfield Foundation Award for Global Women’s Health for his work in treating and highlighting the plight of women in the war-torn eastern part of the Democratic Republic of the Congo (DRC).

The eastern part of the DRC has been mired in regional warfare – since the late 1990s – resulting in more than five million deaths, brought about by disease, hunger and violence. Militias and rebels terrorize the region’s women and children – from infants to the elderly – with mass rape and sexual violence. Fear of being victimized renders women unable to farm and feed their families, so they flee. Their destination for years has been Bukavu, a city in the region. This migration over the years has created a health care crisis. In the past 15 years, the population of Bukavu has swelled from 250,000 people to more than one million.

This crisis attracted the attention of Dr. Mukwege, a trained obstetrician and gynecologist, who lives and works there. In 1999, he established the Panzi Hospitalin Bukavu, offering much-needed health care to women. The hospital has become known worldwide for the treatment of survivors of sexual violence and women with severe gynecological problems. Mukwege and his staff have performed reconstructive gynecological surgery on more than 21,000 females injured as a consequence of war, including those subjected to rape. He also established a nurses training program, the Institute de Techniques Medicales de Panzi, to provide education and clinical training to about 50 nurses per year, so that the standard of clinical care can be maintained.

“The Renfield Award is given to an individual who demonstrates leadership in improving women’s health. Dr. Mukwege embodies the essence of this award in his tireless and courageous efforts to deliver health care and other social services to women in an area that has seen far too much violence, Dr. Mukwege has been their voice for justice, not only in this region, but across the world.”

- Antonia Villarruel, PhD, FAAN, Dean, University of Pennsylvania School of Nursing

 

Edna Adan Ismail
Founder and Administrator
Edna Adan Maternity Hospital, Somaliland

On May 15, 2014, Edna Adan Ismail, an inspiring advocate for women and girls, whose maternity hospital in Somaliland is an oasis of healing and care for the country’s women became the inaugural recipient of the Renfield Foundation Award for Global Women’s Health is Adan was nominated for this award by Nicholas Kristof, columnist for The New York Times and co-author of Half the Sky: Turning Oppression into Opportunity for Women Worldwide. This book features Adan among its many stories, which serve as a call to action against the oppression of women and girls in the developing world.

Adan was born and raised in Somaliland, and was the first Somali girl to be awarded a scholarship to study in Britain. She studied nursing, midwifery and nursing management for seven years before returning to Somaliland, where she became the first qualified nurse-midwife in the country and the first Somali woman to drive a car.

Adan later married Somaliland’s prime minister, Ibrahim Egal, and she became the first lady of the country. After the two divorced, Adan joined the World Health Organization (WHO), where for years she advocated for the abolition of harmful traditional practices like Female Genital Mutilation (FGM). When she retired from the WHO, she sold all of her possessions, and returned to Somaliland to build a hospital. The Edna Adan Maternity Hospital officially opened in 2002.

The health of the people of Somaliland is among the worst in Africa, with one of the highest maternal and infant mortality rates in the world. Every year, one baby in eight dies in infancy while nearly 4,000 Somali women die in childbirth. The Maternity Hospital is dedicated to training fully-qualified health care professionals, and to training and dispatching 1,000 midwives throughout the country. It also remains committed to Adan’s mission to fight the practice of FGM.

“Edna Adan has been a passionate leader not only as a hands-on nurse in Somaliland, but also in building a hospital and a training system to produce more nurses and midwives to work in remote areas across her country. She has been a tireless force to end female genital cutting in her country. The result is that largely by force of will, Edna is saving lives every day — and putting in place public health systems that will save lives for many decades to come. She’s a force of nature, and it’s a privilege to watch her in action.”

- Nicholas D. Kristof, columnist for The New York Times and co-author,
Half the Sky: Turning Oppression into Opportunity for Women Worldwide