Two years into what my sons describe as a lackluster retirement from a hectic career in midwifery and nursing education, I was delighted and excited to be invited as a volunteer on a mission with the Nomad Foundation in Niger, Africa. My obstetrician sister, as the new medical director, invited me to travel and work with her. Filled with excitement, anticipation, and a touch of concern about how I could direct my energy and skills toward this once in a lifetime opportunity, we arrived in Agadez, Niger. In short order we began to see my role evolving and how I might make the most significant and lasting impact on the traditional birth attendants/”matrones” we were going to be visiting.
Descending the stairs of the plane, the heat rose up through my nose promptly whisking away any trace of moisture. Within moments we were being embraced by Leslie Clark and were meeting Sidi, the Nomad Foundation’s representative in Niger. Surrounding us were signs of on going construction for a more modern airport terminal and dry dirt/sand as far as the eye wandered. In just moments I was luxuriating in sensory overload.
What followed were two weeks packed to the brim with work, fun, and education—by and for me. Parlez vous Francais? Uh, non. While the whiteness of our skin literally drove toddlers screaming to clutch their mothers, we managed to make peace and move forward. Daily we were provided opportunities to peer into the Foundation’s prior projects including construction of the local well, (the sole drinkable water within miles), the school, housing, and the health clinic. Each project had brought some success and many lessons about viability and sustainability. It is often said that out of small acts may come profound improvements in life outcomes. Introduced to the matrone project, I knew immediately where I felt I could contribute most. No project interested me more.
In 2011, at the request of the nomads, Dr. Robert Skankey initiated a program to train traditional birth attendants within different nomad communities to attempt to reduce the high maternal and infant mortality rates. A few years following their training, matrone statistics indicated that learned interventions seemed to have a positive impact. On this mission, we examined current matrone activities and protocols. First we first went to each encampment, meeting the matrones in their home environment. Getting together in the encampments provided an opportunity to introduce the new doctor and get acquainted before the matrones came to stay at Tamesna Center. There, as a collective group, we were able to share past experiences and develop new skills.
There is universality to the birthing process that transcends spoken language. Eager matrones enthusiastically demonstrated their skills and were engaged and active participants in the childbirth simulations we developed for them. Grunting when pushing during delivery seems to be a common phenomenon. We all mimicked laboring women in a similar way. No language required.
These dozen amazing women bravely support pregnant and laboring women in their communities in a country that has the worst maternal mortality rate in the world. They are not paid. They provide their services in the hope of keeping women safer during this particularly dangerous time of their lives. There were chubby babies in all of the camps, which supported the premise that support and intervention can help. We saw robust twins swinging in a cradle, a week old newborn with newly painted eyebrows following baptism, toddlers rambling around, tiny children sitting at desks eager to learn, and older children tending huge herds of animals with tiny sticks. Barely beneath the surface of success sits the hidden truth of moms and babies who do not survive. We met with orphans whose mothers died giving birth. If we can’t save all of the moms and babies in the US, we are not likely to be able to save all of the moms and babies in the world’s poorest country. But, we can help them make a difference.
The Nomad Foundation has engaged in programs for education, housing, food sources, nutritional counseling, community, finance, employment and more. Under the direction of Leslie Clark, the foundation work repeatedly demonstrates how much can be accomplished with so little. I was humbled to be part of the mission. Engaging the brave resourceful matrones in the hope that what we shared might impact on the preservation of their cultural tradition of birth was truly an honor.