Midwives' Solution to Maternal Deaths Among African Women

By Melati Mohd Ariff KUALA LUMPUR, June 26 (Bernama) -- Keraya Esimeal, Amina Bedru, Nalumu Scovia Duku and Benneth Marona Elia have one common aspiration—to become midwives. They are among the successful candidates chosen to pursue a career in midwifery, under the "Stand Up for African Mothers" (SU4AM) campaign organised by the African Medical and Research Foundation (AMREF). All the candidates have their own reason to pursue this noble career and their passion and determination have been featured in a small handout called 'Training to Save Africa's Future,' produced by AMREF. Keraya, 25, for example, is from the Afari community in Ethiopia, where there are many health problems plaguing the community, particularly high maternal mortality rate among pregnant women. When she finished high school, she chose to be a health worker and underwent training. In 2010, she joined the Semera Health Science College, Afar, Ethiopia, to be trained as a midwife. She hoped that after completing her midwifery training, she would be able to make a difference to her community and save more lives. HOPE FOR CHANGES Amina, 20, who attended the same college as Keraya, chose midwifery as her career after witnessing too many mothers in her community bleed heavily during deliveries. She took up the midwife-training programme after completing high school. Nalumu, 24, gained interest in midwifery after her aunt died during her delivery. Her bad experience at the hands of midwives, when she herself went into labour at a health centre, prompted her to become one. She wanted to provide proper care to pregnant mothers. Benneth Marona Elia, 25, might be a male but he too shared the aspiration of becoming a midwife. He was quoted in the handbook as saying he had developed a passion for midwifery after witnessing the suffering of his cousin during her delivery. He also wanted to change the perception in his community that men can never be good midwives. TRANSFORMING AFRICA Strong-willed youngsters such as Keraya, Amina, Nalumu, Benneth and other midwifery students are carrying the torch of AMREF's hope for better health services for Africans, especially pregnant women. The writer actually chanced upon AMREF, which was one of the exhibitors participating in an exhibition, organised during the three-day Women Deliver 2003 conference held in Kuala Lumpur recently. More than 100 exhibitors were present at the event. AMREF was founded in 1957. It has its headquarters in Nairobi, Kenya, and seven offices across the African continent. Dubbed as the 'Flying Doctors of East Africa' in its early days of operation, it provided critical medical assistance to remote communities in the region. It has since expanded its services, providing a full range of medical and health-related services. According to Gaye Agesa, AMREF's media and public relations officer, the organisation's operations currently cover 33 countries in Africa. "We have a strong outreach. We deal mainly in maternal health, and we offer clinical services. "The organisation also has projects related to water and sanitation to improve the health of Africans," Gaye told the writer. She also said the organisation believes the power to transform Africa's health lies in her communities, particularly women and children. According to her, even though AMREF has trained over 500,000 health workers, including midwives, over the last 50 years, more need to be trained to deal with the high death rate among African mothers during pregnancy and childbirth. In 2010, about 162,000 women died during pregnancy and childbirth in sub-Saharan Africa, representing 56 per cent of the global total. AMREF'S CAMPAIGN Elaborating on the SU4AM campaign, Victoria Kimotho, the campaign coordinator, told Bernama that the organisation has targeted 13 African countries for the said campaign launched in 2011. The countries are Angola, Kenya, Uganda, Tanzania, South Sudan, Ethiopia, Malawi, Burundi, Zambia, Rwanda, Lesotho, Mozambique and Senegal. "Our target is to train 15,000 midwives between 2011 and 2015. The respective countries will play a huge role in this programme, and they will also identify the candidates. "The training will be expanded to other countries once more funds are raised," she said. According to Victoria, AMREF's role in the SU4AM campaign, among others, is to help with the training modules, provide instructors and get funds from donors. As for the training schools for nurses and midwives in the participating countries, she said they are run by the respective governments. However, AMREF would help with the expansion of such schools to enable them to accommodate more students. "To date, we are on the 5,000 mark. We are getting there slowly, and the number will increase in the coming year. "We are confident that we will be able to deliver 15,000 midwives by 2015," she added. QUALITY STUDENTS Every year, there are more high school students such as Keraya applying for the midwife-training programme. This has enabled more students to be admitted into the programme. "Previously, from 1,000 applications, only 30 would be accepted. "Now that we have high school students with certificates applying for the programme, we would be able to take in 1,000 students," Victoria said. In terms of gender, she explained that the choice would differ from country to country. She gave an example in Kenya where male midwives are being trained. However, the criteria for selection remain the same—candidates must complete high school with a certificate and in some cases, they must have a pass with a "B" and above. There are no specific guidelines on the age, but again, Victoria stressed it depends on the participating country. "In our country, midwifery is an attractive career. People just want to become midwives," she said. ULTIMATE GOAL The SU4AM's ultimate goal is very clear, as stated by Victoria. It wants to see more and more African women gaining access to quality care during pregnancy and childbirth. This way, there will be no fear among pregnant women while giving birth. "If she fears death, she will not be happy giving birth. "Now that we have midwives, women will be aware of themselves. They are aware of the services available to them and they have access to those services," she said. For women who stay far from health centres, AMREF has made arrangements to place health workers at strategic places. Some women even make an attempt to move to places closer to health centres when they know they are about to deliver. PEACE PRIZE In an attempt to draw global attention towards the role of midwives, AMREF is trying to get one of its midwives nominated for the 2015 Noble Peace Prize. A midwife from Uganda, Esther Madudu, has been named for such purpose. According to Victoria, Esther, 34, is a frontline health worker who dedicates all her time to delivering mothers in a very remote health centre in Atiri, Uganda. The conditions in which she works, she said, are very challenging—she has to deliver babies without electricity and sometimes, she has to use light from her mobile phone to deliver babies. A mother of two children, Esther, recently won the Real Award in the US. The award is given to frontline health workers working in remote areas. "Esther is a symbol of an African midwife, a normal person of whom nobody talks about. "AMREF would like midwives to be recognised globally, and it would be great for us if Esther wins the 2015 Peace Prize," said Victoria. -- BERNAMA