Tuesday, 2 February 2010

2nd February

Another day, another destination within this beautiful country. This morning we set off to visit one of Oxfam's projects which addresses the issue of HIV/Aids in a remote rural area but one that also is concerned with maternal mortality.
On the way we pass by huge tea plantations. We see a sign which reads "You are entering a child labour free plantation"! We see the tea pickers with huge baskets on their backs picking the shiny fresh green leaves of the tea we so love to drink. They truly are huge baskets. Pickers seems to be all men or all women but not both together.

Now we take a right turn off the main road and encounter people everywhere at a roadside market but only a few yards further on we pass Thyolo hospital sporting the sign on the gate "This is a Child Friendly Hospital" with a painting of a breast feeding woman at its side. A left turn past the hospital and we are on a dirt track which passes through an extensive tea plantation, "owned by someone in the UK" we are told. It is gated and we have to pass through with the permission of the two guards. Right in the heart of this plantation is our destination. The road is tortuous, and driving in anything other than a 4 wheel drive vehicle would be unhealthy never mind uncomfortable. We pass people gathering macadamia nuts from the many trees on the way.

As we arrive in the village we are greeted by many, many children all waving and smiling and a group of women welcome us with song. We are ushered into a low, darkish, building where seated in a line are the people who are in involved in the project. The welcome is delightful and long and everyone is applauded for their position and for what they do. The village head man gives an address and then the officer with the community based organisation working with Oxfam gives us a full run down of statistics and people in the HIV/Aids programme. Finally we come to the issue of maternal mortality and the women in the group begin to speak. One of them was a Traditional Birthing Attendant who is no longer allowed to work according to a government directive. And in his final address the village leader states categorically that there will be heavy penalties imposed on anyone continuing to work as a TBA. We are told later that the TBAs had only received basic training and would often take on more complicated births than they were able to cope, resulting in high mortality rates.

However, one of the main difficulties for pregnant mothers in labour is the ability to get to the hospital. The nearest is only 3 miles away, we passed it, but the road is so treacherous no pregnant woman, nor one in labour, should look at it let alone drive down it. The only mode of transport is a bicycle with a stretcher attached. One man says it is dangerous for the men to ride this bicycle down that road, especially in the dark night because that is when most women go into labour!

Unfortunately, the bicycle is no longer in working order, the back tyre needs attention and we are told later, when viewing the famous bicycle, that the last time it was used the poor lady lying on that stretcher died before she reached the hospital.

Transport is not the only difficulty when it comes to giving birth. A second problem is the question of who takes the decision that the woman should go to hospital and when. It is usually the husband and if he is not there, waiting can be too long and too late; at the same time no one else in the village might know a woman is pregnant - witchcraft of old is still thought of and not knowing whom might be your enemy causes you to hold your tongue! A third difficulty is that very often when a woman does reach the hospital ready to give birth there is no one to attend to her.
One broken down bicycle for the women of 11 villages. It is sad!

After handing out WI pens we move on to visit another hospital with a maternity wing.
Also the site of a college of midwives. This is St Joseph's hospital, a hospital set up in the 1950s by the Catholic Church. We meet one of the two doctors who works there; his colleague is GP trained. In the welcoming group there is also the chief nursing sister (both a nun and a nursing sister).

Here, women from a designated area are treated 'free of charge' and their particulars on the relevant form must come with them to be passed to the government who will then pay the costs. Any woman from outside the area would be treated but payment would be expected. Dr Banda who trained in tropical medicine in the west tells us he came back to work in Malawi because he wants to help those less fortunate.

We are shown the maternity wing beginning with the check in room and the delivery suite. Our standards at home seem sky high in comparison! Then we go to the ward where tiny newborn babies lie in the middle of the beds with their mother. They are to stay for several hours only and while they are there their families must feed them. There is a compound outside the ward where families stay.
With the rain finally falling we are shown across the yard to the school of midwifery where Rose, the principal tells us that in the third year they have 54 pupils but in the first year the have only 3. This is because the government has withdrawn funding as of September 2009. Now students have to pay their own fees. This means that would-be students have to find over 1,000 pounds per year. They cannot do this. Speaking later with 4 third year students, two of them, young men of 22 and 21, tell us that they wanted to be midwives because they wanted to do something to stop the deaths of mothers and babies, wanting to help those less fortunate and one whose twin brother died of asthma who wants to be able to help avoid such deaths. The three year course qualifies them as a general nurse too.

The day is over. We drive back in torrential rain - thank goodness, the rains will help the maize to grow. May it pour all night.