Now that we’ve been back home for a week, we’ve had the chance to catch up with our co-workers, including the staff of Mama Maisha. Ellen, our Adviser, has been so active advocating for the women who come from the villages to deliver at the hospital, many of them in emergency circumstances. She told me about one visit to the hospital which showed vividly the impact that Ellen, a retired maternity nurse, is having on behalf of our clients.
One of our Maternal Health Advocates notified Ellen that she was bringing a client to the hospital because her labor did not seem to be progressing well. It was late on a Friday evening, so Ellen met the client at the hospital, paid the motorcycle taxi, and helped her get admitted to maternity. Leaving her in professional hands, Ellen went home for the night. She checked in again on Saturday, carrying food and tea for the expectant mother, to find her still in labor. On Sunday, Ellen returned again, thinking to find a newborn baby, but instead found the mother still in labor. Ellen sought out the nurse on duty and demanded to know what the plan was for this woman who had been in labor for more than 48 hours. The nurse dismissed Ellen’s inquiries, saying that she didn’t know what was happening with this patient. Ellen demanded a consult with a doctor, and when a visiting Dutch doctor arrived, he sent the patient for a Cesarean section right away. The baby was delivered safely and the mother returned home to recover.
Across the ward in another bed was a young woman with her mother. Ellen began to inquire what was happening with that patient, sensing something was wrong. A nurse explained that the woman had had a stillbirth. After additional probing, Ellen got the story, delivered somewhat defensively. The young woman had not told the nurses that she was ready to push (second stage of labor, when the birth of the baby is imminent), and instead was squatting over a bedpan, trying to deliver alone. The cord was wrapped around the baby’s neck, and it seemed that the long period of pushing may have caused the baby distress and eventually claimed the baby’s life. Hearing this story from the nurse, Ellen spoke to the mother of the young patient. “My daughter is mute, she doesn’t speak,” the mother explained. “We told the nurses two times that she cannot speak, but they still are blaming her that she didn’t tell them when she was ready to push. They were sitting there chatting while my daughter was trying to deliver her baby alone.” The family ended up filing a complaint with hospital administration over the treatment of their daughter, but even in the unlikely case that there are repercussions for the nurses on duty at the time, a baby has lost its life and a young mother is bereaved.
For me, this story drives home the importance of the advocacy Mama Maisha is doing in the formal health sector. On the one hand we’re trying to tell women in the villages that the hospital is the best, safest place for them to deliver, but on the other hand, we see systemic neglect and disrespect in the way delivering women are treated by the hospital staff. I’m so grateful that Ellen was there to speak for our client, and I pray that we will have wisdom in how to try to change the negative culture surrounding childbirth.
Speaking of babies we are grateful for, today was Gretchen’s first birthday! Many friends stopped by throughout the afternoon to wish her a happy birthday and get a slice of her birthday cake. She is growing so fast, and we’re so happy to have this joyful, friendly, adventurous little girl as part of our family!