Bienestar Indigena Ecuatoriano en Salud Urbano-Rural: BIENSUR

Created in 2023, BIENSUR is dedicated to improving the well-being of Ecuador’s underserved indigenous women. Central to the mission is the delivery of holistic care and support, ensuring that the multifaceted needs of these communities are met with empathy, efficiency and cultural sensitivity. The initiative seeks to implement long-term sustainable solutions tailored to the unique challenges faced by these communities. Through collaborative efforts, BIENSUR aims to create lasting positive impacts on the health, well-being, self-efficacy and mental resilience of indigenous women in Ecuador, especially those living in vulnerable conditions.

In 2024, BIENSUR conducted a pilot project, Yo Decido (I Decide), in collaboration with the NGO TARIMIAT Cultura Amazonica led by Shuar leader and poet, María Clara Sharupi Juá

The project’s motto is: Yo Decido. Yo reafirmo mi vida por mi cuerpo y mi salud. (I decide. I reaffirm my life for my body and my health). The pilot enrolled 25 indigenous women ages 18-54 who have, for various reasons, migrated to Ecuador’s capital, Quito. Over 6 months, the women participated in a series of training modules, totaling 100 hours, designed to promote sexual and reproductive health, create awareness of the prevention and eradication of gender-based violence against Amazonian indigenous women, and increase self-care, self-esteem and cultural expression. Childcare and special child-focused activities were provided at every meeting. A graduation ceremony with participation diplomas marked the women’s successful completion of the program.


 
 
 

Program Modules

Module 1: My Body, My Territory

Led by María Clara Calisto, Psychologist. The women explored the fundamental principle of “My Body, My Territory” with the goal of gaining sovereignty over their own bodies through activities fostering reflection, experiential learning, and active participation in a safe environment.

 

Top left to bottom right: 1) María Clara Sharupi Juá, director of TARIMIAT, welcomed the women. 2) María Clara Calisto, psychologist, used the metaphor of the four elements – water, fire, earth and wind – to understand and manage the expression of strong emotions. 3, 4) The women engaged in an activity, the Circle of Stability, to foster trust and safety among the group. 5, 6) Each woman sculpted clay and presented their piece, describing how it represented their identity.

 

Module 2: Empowerment, Self-Esteem, Biocultural Expression

Led by María Clara Sharupi Juá, Director of TARIMIAT. To promote empowerment, self-esteem and biocultural expression, the women discussed the realities of their lives and the conflicts they face every day.

 
 

The women and children read and discussed the stories of Nantar and Babalú, a part of Shuar tradition. The stories were a tool for the women and children to understand their physical and emotional transformations while showing responsibility and respect for their own bodies and selves. Also addressed were the taboos related to sexuality and stigmatizing cultural differences.

 
 

Module 3: Human Rights, Floating Families, Domestic Violence

Led by Mr. Alexis Sharupi, Attorney. The women learned about identifying when women are victims of violence, preventing violence, women’s legal rights, courses of action to take, and ways to support indigenous women living lives free of violence. Challenges facing women in “floating families” – indigenous families who migrate to the city but are not recognized by the local government – were discussed.

 
 

Top left to bottom right: 1) Mr. Sharupi instructed participants on gender-based violence. 2) The children participated separately in age-appropriate activities. 3) Through touch, the women built trust and safety amongst themselves. 4) Mr. Sharupi led the women and their families in activities to prevent violence against women in the family nucleus.

 
 

Module 4: Sexual and Reproductive Health

The women received reproductive health services and education about the importance of preventing teen pregnancies and sexually transmitted diseases. They received Pap smears, HPV screening, mammograms, breast ultrasounds, medical consultations and surgeries when needed at partner NGO, the Fundación Hospital de los Valles.

 
 

1) The women received mammograms… 2) blood tests…. 3) and posed with the FHDLV staff and Executive Director, Luz Elena Coloma.

 
 

Program Evaluation

Data was gathered, using a questionnaire, from all the women after each workshop, and after the final meeting. Here is how participants rated the program.

  • 100% found the workshop content very important for their wellbeing.

  • 68% believed that they learned a large amount of new information, and 28% believed that they learned a moderate amount.

  • 63% rated the workshops as excellent and 29% as very good. 

  • 23% reported they wanted to learn more about mental and emotional health; 18% wanted more about cultural connection and support; and 15% wanted more about gender equity and violence.

Learning Level

Workshop Quality

 

Testimony from Participants

“It's very beautiful, I like it a lot, and I hope this project continues for a long time ... It's like we've been absent, like we don't exist.”

“The first time I went, I almost cried... The customs and traditions, I used to see them as a child, but now at this stage of life, they moved me a lot. I never thought I would experience them again. I have truly loved it.”

“What I liked most was … Communicating, the integration among us, speaking without fear. We can talk about any topic without anyone saying anything negative. Listening to each other, that I have liked.”

In December, 2024, BIENSUR and the Fundación Hospital de los Valles provided women’s health services to another 25 women living in the rural Barrio Collaquì within the metropolitan district of Quito. They received Pap smears, vaccines, mammograms and, if needed, genetic testing and colposcopies. They have had little to no access to women’s health care and are concerned about HPV. They heard about the services provided by BIENSUR from the Amazonian women who participated in Yo Decido and sent a letter requesting similar services and more information about HPV.

What comes next?

BIENSUR will be working with indigenous Ecuadorian women in the Northeast Amazon basin with QuinaCare as a health care partner. So far, BIENSUR has worked solely with indigenous women who have migrated from the Amazon to Quito, the capital. The next step is to prevent migration to the city, and to meet women’s needs locally.