Meeting a Traditional Midwife in Malawi
Marianne Littlejohn and I volunteer for Operation Smile by teaching the Helping Babies Breathe (HBB) programme. In June of 2014 we were flown to Malawi to teach at the Kamuzu Central Hospital in Lilongwe . Over five days we taught approximately 40 people each. Malawi is an amazing country. It is incredibly poor but we were really pleasantly surprised by the hospitality and kindness and receptiveness of everyone we met. What I love about the HBB programme is its focus on normal birth, its simplicity and its adaptability to whatever environment it is presented in. We have so far taught in high tech hospitals, to home birth midwives, low resourced settings, to doulas and mothers. Each course is different because it works with the experiences and environments the people being taught bring to the workshops. Kamuzu Central Hospital is a reasonably well equipped hospital with sensitive and compassionate midwives. Some of the people we taught were very experienced midwives, doctors and paediatric nurses with many years of experience with very compromised babies. There was interesting discussion and sharing of stories and knowledge – we definitely learned a lot from the people who attended these workshops. One of the women we taught, Violet, a highly experienced midwife, told us about the work she used to do providing training and education and equipment to Traditional Birth Attendants (TBAs) in her region. TBA is the term used to describe traditional or lay midwives who have no ‘officially’ recognised training. Usually they have learned their skills from other traditional midwives. It is a controversial title as it takes away the centuries old title of ‘midwife’ from those women who have always attended pregnant and labouring women and who often carry skills and knowledge passed down through generations. Violet told us about a TBA living in a village not far from Lilongwe and offered to take us to meet her if we could organise the transport. The following day we organised a car and a driver and were driven about 45 minutes outside of Lilongwe over dusty and bumpy clay coloured roads, past simple handmade clay brick homes and thorn trees and goats and women wearing colourful cloth skirts. Along the way, Violet told us that TBAs had been the backbone of maternal care for a very long time in Malawi. She told us that the Malawian government had trained many TBAs in basic midwifery skills to provide care for pregnant and labouring women. The government had also provided updates and further education every month to the TBAs to ensure their skills were kept up to date. The government had also provided the TBAs with equipment and medications. It had been Violet’s job to provide these updates and education to ensure that the TBAs were following best practice when caring for pregnant and labouring women. Violet’s duties had also been to ensure that the TBAs were stocked with the medicines and equipment they needed. She had enjoyed this work. She had enjoyed the travelling and admired the TBAs she was responsible for. Two years previously, in a drive to encourage women to seek care from hospitals, the Malawian government had banned TBAs. This had not really changed the birth statistics in the hospitals, Violet said, all it had done was driven the TBAs underground and yet most rural women still sought care from the TBAs they knew and had grown up with, and who had probably attended their mothers when they themselves were born. Lack of transport to the hospitals made it difficult for mothers to get to the hospitals even if they wanted to. The government...
Read MoreA Little Gypsy is Born…
Today 25 years ago my sister Gypsy was born. Seven years ago she was killed in a car accident along with my mother and step-father. I was 9 years old when she was born. This is the story of her birth as I experienced it on that day: Our mother went into labour on a Sunday morning in the warmth of November 1989. We were getting ready to drive to Cape Town anyway as my sister Kate and I stayed with our grandparents in Constantia during the week so that we could go to school. Since our mother was in no state to drive, our step-father, who we called Baas (it was his nickname since childhood) took the driver’s seat. We left Droëland, our farm near Ceres, driving slowly over the rocks, so as not aggravate our mother’s labour pains. We got to the first gate at Bloubank when our mother suddenly remembered that she’d left her birthing book behind. She insisted that Baas turn the Nissan Langley around so that she could go and get it. He did it, grumbling and when we got back to our little labourer’s cottage, our mother rushed into the house. Frau Züllig, our mother’s former teacher and friend from her days at a Swiss finishing school, was visiting for three months and was busy sweeping the kitchen floor when my mother rushed in. “I’ve come for my birthing book,” our mother panted, “I’ve forgotten how to breathe!” Once back on the road, the drive was slow and tiring. Kate and I sat quietly on the grey back seats of the car, watching our mother sighing and breathing and moaning softly to herself, lifting herself up onto her arms when the pains became extreme. The car felt hot and dusty. Arriving in Cape Town after three hours was like a breath of fresh sea air. It was cool and overcast. It was lush and green after the sandy dryness of Droëland. Everything seemed to go in slow motion. Our mother moaning softly to herself in labour. The pedestrians in shorts and T-shirts, going about their business, oblivious to the happenings in the car. We arrived at Mowbray Maternity hospital and our mother was admitted into the labour ward. Kate and I were told to sit in the waiting room. We felt sad and cheated at being locked out of that sacred space of giving birth. Were we not, after all, not also her children? Of her womb? Why was Baas was allowed in with her? We’ve known her longer than he has… We did not have to wait long. The birth was quick. Kate and I were allowed in after our sister was born. The baby was tiny and wrinkly and pink and she lay between our mother’s large brown breasts, eyes closed with a hospital towel draped over her. Kate and I sat on either side of our mother and looked at this new member of the family. “After the long drive to get here, you should call her Gypsy!” the doctor joked. Kate asked the nurse what the IV drip was. I felt embarrassed at Kate asking but the nurse commented on how good it was that Kate had asked. The nurse then took the baby from our mother and inviting Kate and I along, she carried the newborn to another room. There we watched her wash and dry and weigh our vulnerable little sister. We watched the nurse examine her and check all her reflexes and then put a disposable nappy and some clothes on her. When she was returned to our mother, we were told that Baas would take us to our grandparents. We felt sad leaving our mother and this new creature that was our sister and we wept quietly the entire way to our grandparents. Baas dropped us off at the top of the driveway of our grandparents’ home and we walked down the long lonesome...
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