Two documentary makers record the struggle to reduce infant mortality rates in the remote mountains of north-western Vietnam. By Nicole Precel.

It’s the rattle of beads that echoes from Ying as she races through the mountains of northern Vietnam.

Thick mist encircles us, breaking upon dark mountaintops as director Nick Ahlmark and I lose breath catching up to the Flower Hmong woman as she races on foot to the aid of a pregnant 16-year-old, seven kilometres away.

The 20-year-old works as a midwife in the remote ‘frontier’ Chi Ca commune in Xin Man, a contentious belt of land on the border of China and about a 16-hour drive from Hanoi.

We are filming her for The Mountain Midwives of Vietnam, one part in a series of documentaries covering maternal health issues across the world for Al Jazeera English’s Birthrights.

Strong and self-assured, Ying trained for 18 months in a United Nations Population Fund program that aims to teach ethnic women basic midwifery skills.

But there are many obstacles that stand in her way.

Midwives in the mountains of Northern Vietnam by Nick Ahlmark & Nicole Precel record the struggle to reduce infant mortality rates in north-western VietnamXin Man, Ha Giang is one of the poorest and most remote pockets in the country.

The tiny district is about 1,500 metres above sea level and enveloped in heavy clouds that rise and fall giving sight to windowless clay homes sitting within ascending rice paddies.

The area has a maternal mortality rate 10 times higher than other parts of the country. Ying is one of 49 ethnic midwives trying to lower that statistic.

It’s also a deeply spiritual region. Hmong believe in the power of Sharmans, who conduct rituals for health or to appease spirits.

One such ritual is the burying of the placenta immediately after birth in their homes. It is believed this is important for the spirit’s reincarnation and for the baby’s health.

Fluorescent figures are dotted high in the fields, their brightly coloured Hmong skirts bring light to the arduous ploughing of the fields.

It’s a vastly different world to the bright lights of Hanoi.

The spindly roads are carved from limestone mountain edges, and each turn is met with a sharp horn to stop oncoming collisions, but most villagers we meet on foot.

No traffic lights here, the province is devoid of foreigners.

At the beginning of our journey we are accompanied by a large contingent, including the Ministry of Foreign Affairs translator, two workers from the Ha Giang health department, the local doctor and two police officers.

It’s a constant and frustrating struggle to keep the group from getting into our shots, or from speaking while we’re filming.

The presence of so many people made it difficult in delicate interviews with Hmong women, speaking frankly about the births of their children.

Gaining entry to Xin Man was also no mean feat.

Piles of paperwork, department stamps and meetings with the chairman of the people’s committees in almost every village we entered ensued.

The combination of this and the harsh environment made it one of the most difficult shoots we’ve ever done.

At Chi Ca, our home for almost two weeks would be an empty room in the health commune. There is a bed that we strap a mosquito net around, and a mark on the wall that looks like a blood-stained handprint.

Carrying heavy camera equipment across rugged uphill terrain with little water, we trek towards a girl married shortly

Watch The Mountain Midwives of Vietnam