October report on Safety in Pregnancy and Childbirth Training
In 2011, Danielle Kellem visited 3 villages with Kenyan nurses Sophie Ndungu and Matilda Mbura, and reached 75 traditional birth attendants (TBAs) with education and medical supplies. These nurses were paid a small stipend at the time, but in Danielle’s absence, Sophie has visited 12 more villages on a volunteer basis and reached a total of 247 TBA’s, with each village group consisting of between 10-45 women. Sophie has been continuing Teaching More’s educational outreach by teaching the TBA’s about safe delivery, emergency protocol, hygiene, family planning, condom use and demonstration, and voluntary HIV testing and counseling.
The village TBA’s, who deliver the majority of the babies born in Kenya, have minimal knowledge and very infrequently have any kind of medical supplies. The vast majority are admittedly self-taught, and still practice dangerously primitive and superstitious birthing techniques.
Upon Sophie’s return visit to some of the villages we reached in 2011, the TBA’s reported a dramatic drop in maternal and infant deaths. The TBA’s, who are now familiar with Teaching More and our return volunteers, had many more questions and once again spoke very openly about their practices. It is difficult to calculate exactly how many lives have been saved by the education given to these women, but the fact that the TBA’s themselves are reporting substantial improvement in fatalities is significant evidence regarding Teaching More’s success.
Though the TBA’s are in desperate need of supplies, Sophie was only able to provide small quantities of sterile gloves to the new and return villages. Upon Danielle’s next visit to Kenya she will be bringing 3 suitcases full of medical supplies to distribute to the village TBA’s where she, Sophie and a few other trained childbirth experts and HIV counselors will go and teach. These much-needed supplies were purchased with money from past fundraisers, and we currently have 80 full medical kits that will last each TBA at least 4 months.
Though Sophie went voluntarily to continue Teaching More’s work, I was able to send her a very small amount of money to reimburse her for her transportation to some of the villages she visited, as several are more than 5 hours away from her home. With more funds to pay the skilled nurses involved with Teaching More, we’ll be able to ensure their continued participation and we hope to be able to have at least $1,000 to pay them for their time during Danielle’s next trip to Kenya.
Story of a TBA
By Sophie Ndungu
“I have been going to communities to teach TBAs and I have had many different experiences. Some touching, some encouraging, but mostly heartbreaking.
During one of my teaching lessons in the village of Mayungu on the outskirts of Malindi, I got a touching story from one of my group members (TBAs). She was the oldest TBA in the group (she thought around 65). She told me that during one of her encounters with a mother in labor a 14 year old girl with her first pregnancy came to her to give birth. The baby was Transverse in lie (sideways) so she had to “massage” for the baby to present cephalic (head down). Immediately after the massage the mother started to bleed. To my shock this was considered normal to her, because that is usually a very bad sign. The mother went on laboring until 11 pm, which according to that tribe is considered a bad omen so the TBA had to leave the mother alone to attend to her after midnight. By 1 am the mother had not given birth so to reverse the omen she was made to go stand outside for some time before she could come back in the doorway again. She stood outside bleeding for a long time and then was permitted to come back in. When she came back inside the baby’s head was coming but when the mother was positioned in the squatting position to push it took so long for the baby to be delivered.
When the baby was delivered it was still and wouldn’t cry or breathe. To try to resuscitate the baby the TBA blew into the mouth, nose, ears, vagina and rectum but the baby didn’t respond. She started splashing cold water on the baby but still no response. Then she started hitting cooking pans with spoons to stimulate the baby. The baby started breathing shallowly and gave a faint cry. The mother was lying in a pool of blood on the floor and the placenta was still inside. The TBA tried to pull the cord and tore the cord. She went on bleeding and was resuscitated with sugar, which did not stop the bleeding. When the mother fainted she was taken to the hospital and the placenta didn’t come out manually. So the only option was operation.”
This mother and child both lived. But stories like this are very common. The untrained TBAs need training and education or the atrocities occurring because of these superstitious primitive practices will continue.
All of the TBAs we have encountered have been open, honest and ask many questions during training. The malady is that they have never been taught nor do they have the proper equipment to assist in a delivery.
With your help I will be able to return to Kenya with medical supplies at least once a year (hopefully 2 times) to distribute supplies and aid in the training of the village TBAs. Thank you for your support.