continue... global academic partners

C & M Foundation has partnered with--and received financial support from-- an impressive list of international organizations including; UNESCO,  UNICEF,  The World Health Organization (WHO), The Pan American Health Organization (PAHO); The World Bank;  National (USA) Institutes of Health (NIH), Division of Allergy & Infectious Diseases,  ICIDR);   United States Agency for International Development (USAID) Child Survival and AIDSCAP Projects; PRICOR-University Research Associates  and Brazil´s National Council for Scientific & Technological Development (CNPq), Ceará Society of Pediatrics, Ceará State Secretary of Health Viva Criança Program,  Family Health International  (FHI) to start.  

C & M Foundation´s medical & social science  professionals have served on an array of highly esteemed National and International  Scientific Steering Committees, providing expert guidance health policy and setting governmental priorities, including: Brazilian Ministry of Health, National Program for Control of Endemic Diseases (PNUD); Brazilian Ministry of Health, Special AIDS Projects, Expert Scientific  Steering Committee of  National Program on  the Prevention of STDs/AIDS  and  the World Health Organization´s  Expert Scientific Steering Committee on Maternal & Child Health, Geneva, Switzerland.    

C & M Foundation--and its researchers-- have an equally admirable track record collaborating with global philanthropic foundations to improve the  health of Brazil´s most vulnerable individuals, families and  communities, including:  W.K Kellogg Foundation;  People-to-People Foundation (Project HOPE), Child Survival Project;  Bill & Melinda Gates Foundation;   Edna MacConnell Clark Foundation; John D. & Catherine T. MacArthur Foundation; David Rockefeller Foundation; Pathfinder of Brazil; Brazilian Association of Family-POMMAR;  Family Health International (FHI);  John Snow do Brazil, lnc.;  PROMUNDO- Global Project for Orphans and more. 

Finally, C & M Foundation researchers have ministered hundreds of trendsetting  courses, seminars, workshops,  talks, lectures, invited symposiums and Key Note Addresses around the world, including:  "Gender, Moral Reputation & AIDS Among Poor Women in NE Brazil" at the Symposium: "Promoting Health at the Margins in Latin America: Perspectives from the Field"  at Harvard University Medical School in Boston, MA. in 1997;  the  Symposium Culture & Humanization of Care at the VII Latin American Congress of Social Sciences & Health, Angra dos Reis, Brazil in 2003 ;  "Disease-Illness Process: An Anthropological Approach"  at the   International Forum for Social Sciences and Health (IFSSH) World Congress: Health Challenges of the Third Millennium in Istanbul, Turkey in 2005;   “Visions and Voices from Heaven: Perceptual Plasticity and Recovery from Infant Death Trauma in NE Brazil” in the session Local Responses to Trauma & PTSD: Therapeutic Mechanisms sponsored by the Society for Psychological Anthropology at the 110th Annual American Anthropology Meetings in Montreal, QB, Canada in 2010--  examples of our global research impact.   

In 2022-23,  C & M Foundation is sealing NEW institutional partnerships, including: UNILAB International Integration Lusofonia- Afro-Brazilian University, Freedom Campus Redenção Ceará; Gonzaga Mota District Hospital Barra do Ceará and The Center of the Developing Child, Harvard University.

 In 1997, the Brazilian Ministry of Health and the City of São Paulo´s Secretary of Health  invited C & M Foundation´s Dr. Nations to present the lecture: "Prevention of STDs/AIDS among Low-Literacy Populations: Contribution of Anthropology" at  EducAIDS 97,  the 1st National Meeting of the  Association of Educators for AIDS Prevention & Treatment.   
C & M Foundation has a 30-year history and star-studded team of creative visionaries passionate about empowering lay people--ordinary folks,  respected healers  and community activists -- with life-saving health knowledge and autonomy-enhancing self-help .       

Open the Roads and Close the Body Against AIDS. AIDSTECH-Association of Family Health-Brazil-Family Health International(FHI),  1996;  Mystery of the Sertão. Federal University of Ceará Medical School  [Video on popular religious movements & health in NE Brazil], 1992;  Sexuality of the Orixás and the Orixás of Sexuality. UFC Medical School [Video on sexuality in Afro-Brazilian Umbanda Community], 1990;  PROAIS: Innovative Primary Health Care in Northeast Brazil. W.K. Kellogg Foundation/UFC Medical School [Video about innovative primary health care programs in Northeast Brazil], 1986;  Child Survival NOVA-Adventures in Science Series. WGBH Educational Television Station, Boston, Mass. [Video about child survival in Northeast Brazil], 1985
 

In  2022, C &M Foundation is  re-vitalizing our links with Hollywood film producer, Dr. Neal Baer (producer of popular American TV series such as Emergency Room and Law & Order).  We are getting back on track to produce a full-length documentary film about our passion project, Daddy´s Embrace.  

Our C & M  Foundation researchers and community partners were invited to present our impact data at numerous national and global conferences;  we published results in the  respected medical journal,  Tropical Doctor.  In 1998, the  Brazilian Ministry of Health awarded  C & M Foundation First Place in its "Creativity in AIDS/HIV Educational Materials Award"  for our fortuneteller´s Love Cards.  And USAID/AIDSCAP/Family Health International  awarded, in 1996, C & M Foundation its " Outstanding  Achievement in HIV/AIDS Prevention Certificate of Award."  

Our third, and most recent awards, goes to our DADDY´S EMBRACE innovation.   In  2010 ,  Dr. Nations was honored  as a "Friend of the Public Maternity Hospital in Messejana (HDGMM)"  for her contribution to promoting  fathers' inclusion in birth.  In  2015 , DADDY's EMBRACE was selected as a  Grand Challenges Bold Idea by the  Bill & Melinda Gates Foundation.  

We take  pride in  our  creative  imagination  &  sassy solutions  to  social and health challenges. And we are grateful for the global recognition of our "Quest for Excellence!"   

(Mestre) Ivo Soares de Oliveira, Father-of-the-Gods (Pai-de-Santo),    Spiritual Center of Umbanda Índia Guacriai Índia. Fortaleza, Ceará, Brazil.
José Alberto Ferreira Nunes, Father-of-the-Gods (Pai-de-Santo), Spiritual Center of Umbanda Santa Bárbara, Fortaleza, Ceará, Brazil.
José Francisco Soares, Father-of-the-Gods (Pai-de-Santo),  Spiritual Center of Umbanda Santa Bárbara. Fortaleza, Ceará, Brazil.
Dr. José Galba Araujo, MD. Founder-Director, PROAIS- Alternative Primary Health Care Delivery Program (Traditional Midwife Program). Director,  Maternity Teaching Hospital Assiss Chauteubriand, Federal University of Ceará Medical School. Fortaleza, Ceará, Brazil.
Rosarina Sampaio, Founder-President & Militant of APROCE, Ceará Association of Prostitutes.  Co-Founder, Brazilian National Federation of Professional Sex Workers.  Fortaleza, Ceará, Brazil. 

Dr. Kris Heggenhougen, PhD  Professor, Dept. of Global Health &  Social Medicine, Harvard Medical School. Editor-in-Chief, Social Science & Medicine, Boston, Mass, USA .         
Dr.  Mário Chaves, MD,  DDS. WHO/PAHO, WK  Kellogg Foundation Representative for Latin America. Rio de Janeiro, RJ, Brazil.    

 GATES PHASE 1 REPORT 

Father-Baby Bonding for Infant Health & Societal Non-Violence  Dr. Marilyn Nations OPP1118507  

Phase I:  Duckies in a Row  

Rational & Activities to Achieve Proof of Principle:  Testing our hypothesis that father-baby bonding at birth will enhance newborns´ health and reduce intra-familial/ societal non-violence demanded creativity, flexibility and tenacity of our transdisciplinary team. In 2015, as preliminary findings emerged and the Brazilian crises deepened, we adapted to the challenges at Gonzaga Mota District Hospital of Messejana (HDGMM)--situated on the extremely violent periphery of Fortaleza, Brazil. Ten  (10) tasks/hypothesis testing strategies emerged to achieve proof of principle. Task #1, we recovered, computerized and analyzed 27,863 Delivery Room Birth Registries(Dec. 2009- Jan. 2015), handwritten in often “missing” ledgers. Yet the scribbled notations were the only retrospective data on neonatal outcomes and mothers´ social support during birth: a.) child’s father; b.) woman;  c.) alone. Unexpectedly, our results disproved HDGMM´s 2012 estimate“approximately 50% of births engaged fathers”--statistic disseminated in local and national news broadcasts. Table 1 confirms that fathers´ participation never exceeded 21%. Yet remembering that at baseline-(July 2009) no man was permitted to enter the delivery room at HDGMM—and all public hospitals in Brazil—this modest increase (relative to estimates) is a radical and hard-won change. Number of father-support births jumped from 11 in Dec. 2009, to 389 between 2009 and 2010, increasing more than 35 times in 12 months. In 2012, the number increased 103.6% relative to 2010. Yet, we observe a drop of 21% of father-support births in 2013, and 33% in 2014 relative to 2012. Father’s support increases again only in 2015--during Gates´ Phase 1. A spin-off success of our project was a drastic reduction (90%) in women birthing alone from 3,839 in 2010 to 393 in 2013.  

  Table 1: Frequency distribution by mother’s social support   during childbirth and year of birth.   DATA NOT SHOWN

In 2013, we noticed that something happened: the trend reversed. The proportion of social support (father or woman) decreased, while mothers alone increased. Missing information, too, increased 2013-15. Qualitative data 

corroborated a dramatic change in administrative paradigms--from a popular participatory to biomedical-centric one—after elections, change of ruling political party and hospital director. Hence, Task #2 was to re-code the 27,863 birth registries according to the dominant paradigm of hospital administration. From July 2009- April 2013, a participatory model advocating “open-visits,” father empowerment and co-administration with community members prevailed. Afterwards, a restrictive, authoritative, disease-centric model and OB-GYN Residency Training was implemented--less aligned with humanized childbirth. Political agendas of appointed directors, it became painfully clear, appeared as pivotal  to father-engagement as health benefits to poor families. This was a rude awakening for our team.  

Figure 1: Temporal variation in mother-support during the childbirth

The pattern of variations between mothers´ social support and type of delivery--natural and C-sections-- is fairly similar (Fig. 2(b), 2(c), 2(d)). Father-support increased for both types of delivery but, until 2015, was much larger in natural delivery than in C-sections. This is an important result since humanized childbirth aims to stimulate father’s support especially during labor and natural delivery. A worrisome result, however, was that father-support decreased more in natural delivery (from 19% to 11%) than in C-section (from 14% to 11%) from 2012 to 2014. In 2015, perhaps reflecting the new biomedical paradigm, fathers participated more in C-section births than in natural deliveries, inverting the intended goals of the innovative 2009 Father-in-Birth Program. The change in hospital administration-- and political affiliation-- seems to have affected the program in 2013, either by changing priorities relative to the program, or by affecting the monitoring process of this “social” (non-biometric) variable (Fig 2(d)).    

  Figure 2: Variation in mother-support  during childbirth by type of delivery

We observe (Table 2) that averages are very similar when comparing mothers with father or woman support, except, importantly, for C-section. The prevalence of C-section for the first group of mother is 31%, whereas the second group exhibits a prevalence of 44.6%. When comparing mothers with fathers’ support and those alone during childbirth, differences regarding birth outcomes—such as birth weight and congenital malformation--are significant only at 10%. Differences are significantly larger for childbirth characteristics. The prevalence of C-section is 11.8% smaller among mothers with fathers’ support relative to mothers without support. The prevalence of doctor delivering the child is 5.9% smaller, whereas obstetrical-nurses delivering is 5.8% larger (may reflect focus on fathers in natural births and physicians performing C-sections). Regarding mother’s characteristics, those with father-support experience fewer pregnancies than those who were alone during childbirth. 

Table 2: Descriptive statistics and differences by social   support during childbirth. 2009-2012 n=13,143 births

DATA NOT SHOWN 

Note.   Standard deviation in parentheses. * p-value < 0.1, ** p-value < 0.05   and ***p-value < 0.01.

The prevalence of miscarriage and stillbirth (Table 3) is about 0.4% for mothers with fathers’ support, 0.1% for mother with woman support, 0.9% for mother without any support and 1.9% for mother with missing information. Regarding differences, we find the prevalence is 0.4% smaller for mothers with fathers’ support in comparison with mothers who birthed alone. However, the difference is significant only at 10%.

Table 3: Prevalence of miscarriage and/or   stillbirth by mothers’ social support

Note.   Standard deviation in parentheses. * p-value < 0.1, ** p-value < 0.05   and ***p-value < 0.01.

Intrigued by results, Task #3, was merging data from the Ministry of Health’s Declaration of Live Birth (DNV) database, requiring additional ethical approval. Results verified, for instance, that 14% of women have fathers’ support, 32% have woman support, and 45% were alone during childbirth. Task #4, we computed an Index of Child Health (Table 4) using birth outcomes (birth weight, mean Apgar score between the 1st and 5th minute after birth, dummy variable indicating whether the child born with more than 36 weeks of gestation, child height, thorax perimeter, and head perimeter.  

Table 4: Index of child health at birth by   mothers’ social support during childbirth 2009-2012 (n=13,048) 

Note.   Standard deviation in parentheses. * p-value < 0.1, ** p-value < 0.05   and ***p-value < 0.01.

Computing averages of mothers according to social support, we discovered that mothers with father-support exhibit the larger mean value of the index, 0,062.  Moreover, only father-supported mothers exhibit positive and significant difference relative to mothers who were alone during childbirth. Task #4 we employed Linear Regression Approaches--Ordinary Least Square and Multinomial Logit Regression Models (Cameron A. C. & Trivedi, P. K. (2005). Microeconometrics: methods and applications. Cambridge Univ. Press)—to identify potential predictors of the prevalence of mothers´ social support during childbirth. MNL regression (Table 5) reveals that child health at birth is positively associated to the probability of mothers having social support during childbirth. A variation of 1 score increases the chance of having support from a woman in 4.6%, whereas the same variation increases the probability of father support in 5.5%. C-section is negatively associated to social support. If the child is delivered through C-section, the probability of woman’s support decreases in 12.7%, while the likelihood of father’s support drops 51.1%. The time of delivery only has association with the chance of a woman’s support, which increases in 18.6% when childbirth occurs from 6am to 12pm. Interestingly, prenatal visits contribute only to increase the chance of father-support to mother. Mothers with 1 to 3 prenatal visits exhibit an increase of having father-support in 52.9%, whereas mother with 4 to 6 visits have their chance of father-support increased in 61.7%. Mothers with >7 prenatal visits have the probability of father-support increased in 97.4%. The health professional who delivers the child has influence over the chance of social support. If the health professional is a doctor, the probability of father's support decreases in 19.4%. The likelihood of woman-support is not sensitive to the health professional performing the delivery. Surprisingly, child gender has no influence on the probability of social support. Married mothers (formally married or cohabiting) have the probability of father-support increased in 118.8%. The relative risk ratio decreases with mothers’ age. Mothers aged 40-45 exhibit about a 70% decrease in the chance of father-support. However, mother’s education is a strong predictor for support from the child’s father. Moreover, the relative risk ratio is larger for more educated mothers. Mothers with 1-3 years of schooling have their probability of fathers’ support increased in 291.7%. The probability of father’s support increases 466.7% for mothers with 4-7 years of schooling, 552.3% with 8-11 years of schooling and 719,3% for those with 12  or more years of schooling. 

Table 5: Relative   Risk Ratio from Multinomial Logit Regression

Note. Authors’   elaboration. Robust standard errors are in parentheses. Dummy variables for   year and month to account for birth seasonality were included in the vector   of explanatory variables. ***p-valor<0.01, **p-valor<0.05, *p-valor<0.1.

Preliminary analysis of Stork Network variables in 2015  (Task #5) and Medical Chart Review 2015-2016 (Task #6) (see Researchfish) suggests that fathers´ presence is positively associated with less use of oxytocin during labor, greater frequency of initiation of breastfeeding and skin-to-skin contact with newborns within the first hour after birth. Father-supported women in labor appear to arrive at HDGMM at an earlier stage of cervical dilation and experience shorter periods of labor as compared to women alone. Given mounting evidence that father-support during birth is beneficial to newborns and mothers, Task #7 addresses the vexing question of WHY the frequency of fathers´ participation in birth is relatively low, started declining in 2013 and, recently, is higher in C-section surgeries than in natural deliveries? Drawing on 07 qualitative databases (see Researchfish), we conclude that: 1.)  9 of the 15 original father-baby bonding technologies created and implemented in 2009 have, since 2013, been gradually altered, mischaracterized or completely eliminated by hospital authorities; 2.) the recent (2015) insertion of men in C-section surgeries--over natural births--has diminished staff’s interest in father-friendly pain control methods; 3.) due to financial crises, after-hour birthing encounters for pregnant couples have been cut-back; attendance by fathers has also declined; 4.) shift in paradigm of administration has resulted in a preference of older women-supports over fathers in natural births and favoring of fathers´ participation (when it does occur) in C-Section deliveries; 5.) systemic violations of women’s rights to humanized birthing care--guaranteed by the Brazilian constitution, laws and policies--infuriating male partners; 6;) men´s resistance to structural violence suffered at HDGMM  (i.e. threatening receptionists, punching holes in clinic doors, painting hospital walls with inflammatory graffiti) fortifies professionals´ pejorative stereotyping of impoverished fathers;  7.) 2015 police massacre of 11 random residents of Messejana--most young males of color--has heightened hospital staffs´ fear, stigmatization and discrimination of fathers, frequently viewed as dangerous suspects and hardcore criminals; 8.) high rates of homicides and violent crimes in Regional 6—amongst the highest in Brazil—appears to inhibit professionals´ and staffs´ abilities to care in diversity—reaching across class, ethnic, racial, and lifestyle barriers; 9.) professionals do not, in general, link violence in the region to obstetrical violence suffered by couples inside the hospital; 10.) building a violence Vulnerability Index for Families (see Reachfish) requires approval for access to individual records of the Secretary of Public Defense and Safety.  

Hence, Task #8, was created to bolster--in an exploratory way--the radical practice of father-baby bonding at HDGMM.  At the invitation of Hollywood film producer, pediatrician and Harvard graduate, Neil Baer, we created an ethnographic film trailer--Daddy´s Embrace (Braço de Papai)-- to bolster poor fathers´ moral reputation and to sensitize HDGMM professionals and the general public about the social relevance of fathers´ radical engagement in birth and early childhood development (https://www.youtube.com/watch?v=hBjcJ9-x12c&amp;amp;amp;amp;feature=youtu.be ). A manual is being finalized by a local popular artist to reinforce the birth technologies to promote father-baby bonding (Task #9). Finally, given the dearth of official databases about fathers, we have undertaken a series of academic studies in the Graduate Program in Public Health at UNIFOR (Task #10) to elucidate fathers´ socio-epidemiological profiles, paternal role in newborn death, grieving and postpartum depression--all based on inquiries arising during fieldwork at HGDMM. 

II. Challenges:  a.) Weighty bureaucracy; b.) lack of computerized medical records; c.) chaotic filing and retrieval system; d.) hospital directors´ political agendas that override scientific research; e;) monetary devaluation of Brazilian Real; g.) cut-back of government scholarships and increased teaching loads with current financial crises; h.) dangerous context, especially during community outreach. Overcoming: a.) Allow extra time for approvals and equipment purchasing; b.) data entry by Gates team; c.) pay bonus to hospital clerks for medical records they successfully locate; d.) retain scientific posture, engage clinical staff as co-investigators, select graduate students from HDGMM professionals, co-author, present data at yearly hospital scientific meeting; e.) exchange grant $ bi-yearly; g;) allow for student scholarships; h.) build Dotting Daddy Network with cell-phone apps to reinforce baby-bonding messages at-a-distance.    

III. Other Funds: FUNCAP Edital 02/2014 International Collaboration UNIFOR-Harvard C130093000280100/14 R$39.500,00; National Council for Scientific and Technological Development (CNPq) Scientific Productivity 308061/2014-4/ 3073461 R$80,00,000.00 and R$39,600,00; Kathryn W. Davis Foundation -Davis Project for Peace Award 1003pro Michelle Sunjoo Lee US$10,000.00; CNPq Accupunture and Mindfulness in Pain Control 40/045/2013-7 MCTI/CNPq/MS/SCTIE R$67,393.00; Coordination of Higher Education Personnel Training (CAPES) International PhD Training at Harvard University VRPPG no 06/2015 US$10,000.00 and R$14,400.00; FUNCAP BMD-0008-0010801 34/13--- edital VRPPG no 14/2014 $43.000.00. 

Publications: (see Researchfish) Nations MK, Braide AS, Arruda, CN et al. Vínculo Pai-Bebê: Promoção da Saúde Materno-Infantil e da Não Violência na Sociedade. Saúde Soc v. 25, sup. 2016 p. 768. 

--Mendonça FAC, Nations MK, Sampaio, LRL, et. al. Percepção do pai acerca da escolha do tipo de parto. Atas CIAIQ2016  2016. pp. 1137-1145, . 

--Mendonça, FA, Nations MK, Sampaio, LRL. Cuidados prestados pelo pai ao recém-nascido no alojamento conjunto do Hospital Gonzaguinha de Messejana. CIAIQ2016, 2016 pp. 1137-1145. 

Our justification for partnering with Umbanda priests and devotees are numerous:  1.)   The invitation to embark on this quest for human rights originated from the  Umbanda Union; 2.)   Since the official   founding   of the Afro-Brazilian religion of Umbanda, on November 15, 1908, in Niterói Brazil,  devotees have suffered  systemic racism,  social stigma,  discrimination and been the  targets of  violence, as were Dandara and Sofia ;  3.)  Umbanda priests in Fortaleza vividly remember police raids on their worship centers  in  the 1950s and unlawful arrest of leaders; 4.)  An extensive  network of "hidden" centers  and  " sacred  brotherhood" exists,  in the “shadow” of the authorities , in the most marginalized communities. Some  400  centers exist in Fortaleza and 20,000-25,000 in the state of Ceará; 5.) Priests are  widely respected for their supernatural powers and are the voice of social justice ; 6.)  Centers are community-based " safe havens" and "strongholds" for LGBTQIA+ persons given their  tolerance --indeed,  celebration-- of racial and sexual diversity and fluidity of gender  identities; 7.)  Incorporates African and indigenous healing traditions; 8.) Adheres to a "system of justice from  above, " including moral codes and rever Gods or Orixás  who are "justiceiras"  (justice seekers),  such as the almighty African King, Xangô ;  9.) Culture & Medicine Foundation has a 30-year history partnering with the Spiritual  Union of Umbanda,  creating and implementing  the  award-winning AIDS & Umbanda model project.

In the past,  C&M Foundation has received generous funding,  for numerous projects, from  the Ministry of Health, National STD-AIDS Program, including: “Mobilization of Afro-Brazilian Cults (Umbanda) ifor STD-AIDS Prevention  in Ceará” (1994-1995) ; “Don't Break Umbanda Chains of Defense Against AIDS” (1996-1999) among many others.
This project builds on our  past productive partnership with Umbanda. C & M Foundation  and  Umbanda partners propose to :  1.) Create an innovative Human Rights Promotion  for  LGBTQIA+ Persons in Umbanda; 2.) Create  Problem-Based Learning  (PBL)  instructional films  and educational materials based on real-life cases of LGBTphobia, violence and  conflict negotiation and  peaceful resolution,  incorporating the United iNations' Universal Code of Human Rights; 3.)  Training of Umbanda community mobilizers to share  the model innovation and empower the Federation of Umbanda in violence prevention ;  4.) Scaling-up  to Umbanda Centers  in Fortaleza and Ceará state; 5.) Critically   evaluate the impact  of our model on the knowledge and empowerment of the LGBTQIA+ community  and on the reduction in violent gender-based crimes and  injustices against its members.   

Indigenous leaders have suffered ongoing violent threats due to their heated legal battle against developers. Surrounded by The Mandaú River Ecological Sanctuary (established in 1999), the 1,596 hectares of federally-protected land is rich in biodiversity; it is an ideal setting to implement our BOLD Ethno-Nature solution for planetary survival.

Today, an estimated 3,500 Tremembé live in 4 aldeias: São José, Buriti de Baixo, Buriti de Meio and Mungba. Since 2016, CETRA--Center for Studies of Work and Assistance to Workers-- has advocated for Tremembé human rights and revitalization of cultural traditions. Indeed, the European Union has, in the past, financed the Action Tremembé Project. Such community-based organizations, indigenous leaders (cacique, pajé, etc.) and youth/women´s networks in the 4 aldeias will be our valued initial partners. The community mobilization and implementation of this project will expand to the nearby fishing villages of Flecheiras and Guajirú where most local residents are Tremembé native descendents.

Scaling-Up Sites: In the third project year, we envision scaling-up to other coastal localities inhabited by Tremembé native peoples as well as Tapeba, Anacé, Jenipapo-Kanindé coastal indigenous tribes in Ceará; C & M researchers have previously partnered with members of these communities which facilitates access to the aldeias. Amazon Connection: Through C & M´s 20-year partnership with ethnopharmacolgist, Dr Flavio Nogueira Costa, professor at the Federal University of Amazon in Itacoatiara, AM (project partner), we will share the Tremembé experience with two ethnicities--Mura and Ticuna--located in Canaçari and Saõ João, AM. 

We expect that empowered survivors will be transformed into informed, high-spirited and vocal critics of feminicide and Brazil’s culture of violence against women. . A sustainable community-based training methodology that radically engages survivors-- and their voices—will be created. Our provocative ethnographic film will provoke critical reflection among participants, usher in a new consciousness about gender equity and promote nonviolent modes of social interaction--especially between intimate partners. Evaluation data will verify a statistically significant change in the way participants perceive the incapacitating quality of burn trauma. The intervention group will adopt more proactive, protective and self-preserving outlooks and behaviors as compared to controls.
Overall, we predict that, after the intervention, profound social transformations will occur in gender stereotypes that legitimate hierarchical dominate/subordinate relations and exacerbate violence against women and girls in Northeast Brazil. 

--Nations M. Dead-Baby Dreams, Transfiguration and Recovery from Infant Death Trauma in Northeast Brazil. Transcultural Psychiatry, 50:5:662-682, 2013. Doi: 10.1177/1363461513497501
-- Nations M, Rebhun LA. Angels With Wet Wings Won´t Fly:  Maternal Sentiment in Brazil and the Image of Neglect. Culture, Medicine & Psychiatry 1988 Jun, 12(2)141-200. doi 10.1007/BF00116857.     

 --Nations M.  Infant Death and Interpretive Violence in Northeast Brazil: Taking Bereaved Cearense Mothers´ Narratives to Heart. Cadernos de Saúde Pública 24 (10) 2008.  Doi: 10.1590/SO102-311X2008001000005.  This  article  was selected  by the Brazilian Ministry of Science & Technology as a finalist in its competition for The Most Outstanding Scientific Article in 2009.  

In 2011 ,  Dr. Nations was invited  to present  the lecture, “Visions and Voices from Heaven: Perceptual Plasticity and Recovery from Infant Death Trauma in NE Brazil.” at a Special Session, Local Responses to Trauma & PTSD: Therapeutic Mechanisms, coordinated by Dr. Devon Hinton, MD, PhD, Harvard Medical School,  and sponsored by the. Society for Psychological Anthropology at the 110th Annual American Anthropology Meetings held in  Montreal, QB, Canada. 

 C & M Foundation researchers have ample experience with aging, acupuncture, mindfulness,  and  the human rights of older Brazilians.  Dr. Ximenes Junior is a recognized national leader in acupuncture with specialized training in Chinese traditional medicine in China; Dr. Nations was Principal Investigator of  a 3-year study (2014-2017) on mindfulness in the treatment of chronic headaches in poor women funded by the Brazilian National Counsel of Scientific Development and Technology (CNPq).

Dr. Rosendo Amorim is Vice-President of the Ceará State Commission on the Rights of the Older Person.  Together these researchers and other partners will continue to promote the holistic healing of poor older women--a largely discarded and invisible group-- who have endured a lifetime of human trauma and suffering. About time these women are empowered with  holistic healing,  tender loving care and raised consciousness of their legal right!   Join us.