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Our Fabulous Matrones

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The traditional birth attendants we have been training since 2012 with Dr. Bob Skankey and now for that last two missions, with Dr. Becky Jones are known in Niger as matrones.

Matrones arriving for their first day of training at 8:30 AM. They are housed and fed in Tuareg tents near the school and clinic where they retreat for a midday meal and siesta from 12:30 to 3:30 and for the night at 6.

 

The previously trained matrones brought their medical bags and their reports.
Fatima again is in the lead with 70 deliveries since May.  Tinzere is second with 43.  Neither had a maternal mortality and Tinzer had one infant mortality.  Both had resolved problems with hemorrhaging. The totals for all the matrones were 235 deliveries for the past six months with two maternal mortalities—both died after arriving at the hospital and three infant mortalities. We discussed the deaths and what we could have done better.  To date no mother has died while under the care of one of our matrones.  Although we have had a total of 11 maternal deaths out of 835 deliveries, all died after being taken to the hospital. We only have three years of accurate reporting because of staff changes at the clinic, but when we started 1 in 5 had a lifetime risk of death in childbirth.  11 in 835 isn’t bad.
The training began with prenatal care from the first visit.
We always implicate the experienced matrones in the training of the new ones.

Azarra goes through a re enactment of the first prenatal visit with a “patient”—her friend Mariama.

Becky and Pat took turns explaining while I interpreted to Rabi or Moussa and they interpreted to the matrones, with the help of Amouna.  We are–after all–dealing with five languages.

Because Rabi is so busy at the clinic we have an alternate interpreter in Moussa.  He claims he could be a matrone himself and was able to help us all through the training—we tried to avoid the embarrassing situations for him—and the women—since he was the only man in the room and two of the trainees were or had been his mother in laws!  But prenatal care, the explanation of supplies and medicines were right up his alley.

Fatima welcomes her “patient” Lalli who has just gone into “labor” (to deliver a pillow) with Abulkou in assistance.

Dr. Becky found films about preparation for a clean birth and complications at birth. These films were in Hausa which is spoken by almost all the matrones and were simple cartoon illustrations.

Attentive matrones—Atouma, Tayboune, Fatima and Aboulkou

Everyone got training to use the Blood Pressure cuffs since high blood pressure is a killer for pregnant women. If this is understood in advance of a patient going into labor the matrones are trained to counsel (insist) the patient be near a clinic or hospital for delivery. Those who understood the BP cuffs trained those who did not. In the end—they all passed. No one in the medical field here believes we can train these illiterate women to use the bp cuffs effectively, but we have verified it ourselves and know it is saving lives.

 

 

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