The “matrones” arrived today. We have a reduced training session since one of our original trainees was ill herself and another was absent to visit a sick aunt. But we went ahead and try to catch the others up as we visit their camps later in the week.
We were anxious to find out how the ladies have done since their first training and asked them each to tell us about their work.
When Miriam arrived from the very isolated Wodaabe community of Tedbouk she was the only one of the trainees who had never delivered a baby. The woman who had been chosen from her community had travelled and she did not want her community to miss the training. Although her husband is officially chief of the community it is she who is the dynamic one and in most situations acts as chief. So although she had not been known as a midwife in her community she is highly respected and decided to take on the role. She is bright and seemed to understand the training well. Here is her story:
The first baby she delivered was her own first grandson. There was a problem with the umbilical cord wrapped around his neck, but she solved it and the baby and mother came through healthy. She described her other deliveries. In the last two months she helped 11 women deliver babies. As the word spread that she had training people came from long distances. She helped not only Wodaabe, but Tuareg women who have different birthing traditions –the Wodaabe kneel, the Tuareg lay on their side.) but she adapted as necessary Of the eleven patients two had post-partem hemorrhaging and she administered the misoprostil that Dr. Skankey had trained her to use and the women came through fine. Her only problem was a set of triplets. The mother had come to her well into labor having never seen her before, but word of her success had spread and they called on her for help. The woman was in labor for three days, each day delivering one baby dead. Since Mariam lives so far away she was unable to call the clinic and had no vehicle to evacuate her. Apart from the triplets who died, not totally unexpected here with premature babies and triplets, she delivered 10 healthy babies from 11 healthy mothers.
Azzara, a Wodaabe from Foudouk had delivered several children before the training. When she went back to her community there were four women in the last two months who delivered, two of these had hemorrhaging but were administered the misoprostil and came through healthy and with healthy babies. There was another problem with infection which was solved with antibiotics.
Fatima is a Tuareg from Aboye. This community is one of the reasons that provoked this program because they have lost so many young mothers in childbirth. They never knew why. We started trying to get them prenatal vitamins and iron, but until this program there was no regular distribution of prenatal vitamins and NO distribution of other lifesaving medications. In the two months since the training she delivered three healthy babies to three healthy mothers, one with a hemorrhage which she solved with the proper medication.
Fatima kept a record of the women she helped and their husbands in Tifinagh, the writing system of the Tuareg. We have been calling them illiterate, they are not, but their writing system has few publications and its own alphabet, so they do not read French or the latin alphabet.
We will never know how many women’s lives were saved by the practices of cleanliness, the use of sterile gloves, birthing pads, sterile blades and sterile string to tie the cords, by drinking plenty of water and better prenatal care, or by prophylactly administering antibiotics in late labor, but we can assume at least the five who had severe post-partem hemorrhaging.
What we do know is surprising. The women were totally accepting of the suggestions we made, to drink more water, to use sterile technique and even those to improve nutrition. Their communities saw improvements in health almost immediately with the moringa powder we gave them so they started buying it and planted the seeds we gave them so they could harvest their own. Many of these things we expected to take some time to be accepted. We were ready to accept any progress as a success, but this was beyond our expectations. The intelligence and hard work of the women is a large part of this successs, but above all the thorough preparation by Dr. Skankey who managed to figure out how to get complex theory across to uneducated women. Now people from other regions are seeing how effective this training has been and are asking us to expand.