As evening closes on another busy day at the Ruhiira Health Centre, a small crowd gathers around new ultrasound scanners, which have just been delivered. Excited whispers come from children and adults alike.
For Helen, a midwife at the centre, the delivery of this improved technology will mean that problems can be identified and addressed much earlier in pregnancies. But no amount of technology can equal the value that someone like Helen brings to the wellbeing of women throughout the community. Indeed, midwives are the driving force behind restored hope and trust in the institutional healthcare system.
Improving maternal health has been one of the biggest priorities of the Millennium Villages Project in Ruhiira. Partly as a result of the midwife program, institutional delivery has increased from 8% in 2006 to as high as 42% in 2009. Since the program began in 2007, it is reported that not one mother delivering with the assistance of a midwife has died during childbirth, a wonderful example of improved maternal health.
Thanks to a combination of excellent ante-natal care, a finely-tuned referral system between community health workers and clinics, vastly improved medical facilities, and midwife assistance during labor, mothers like Angelica can live to see their children grow up.
My labor was so obstructed. If Millennium Promise was not here, I know I would have died without a child. But instead I am alive and have a beautiful baby girl.
The 25 successful cesarean sections carried out each month are indicative of the difference that a small investment into basic technologies can make, and Ruth is a great example of this difference. When going into labor, she was referred to her local Nyakitunda Health Centre by her health worker, before midwives realized that Ruth’s twin babies were in breach. The ambulance, which prides itself on being less than 20 minutes away at all times, had Ruth at the Kabuyanda Health Centre and in its operating theatre in time for the twins to be delivered safely. Being HIV-positive, Ruth had received consistent counseling on how to stay healthy and prevent transmission to her baby both during pregnancy and after childbirth. This, along with the C-section birth method, will ensure that the chance of the twins being HIV-positive is less than 2%.
Across from Ruth is Mercy, waiting for her ante-natal appointment with Sister Fortunate, Kabuyanda’s resident midwife. Ruth tells of the ways in which the Project is helping her through her first pregnancy, having recently also been diagnosed with HIV.
I am receiving counseling and I come every month to receive treatment and to check on the baby’s progress using the ultra-sound scanner. At first my husband and I weren’t sure if it was wise to try for a baby after discovering that we were both HIV-positive, but the Sister told us that with the right precautions, we didn’t need to feel fear.
The Sister’s warm advice is representative of the importance of the midwives’ role. In addition to medical care, midwives are an invaluable source of social support, providing a listening ear and sound advice to mothers who would previously have had to fend for themselves.