Childbirth customs embedded in the Afar culture in Ethiopia are killing their women.
With your help we are opening the eyes of the Traditional Birth Attendants (TBA) and for the first time in their lives many are seeing how their traditional customs were causing great pain with many of their women and babies dying unnecessarily.
Thank you for making our training program a success.
In terms of their awareness on health, well-being and in particular maternal health, few of them view life any differently than their ancient predecessors.
The Dullassa community has a total population of nearly 21,000. They are agro-pastoralists and around 70% pastoralists. Their land is the foot-hills of the southern Ethiopian Highlands. The region is inaccessible during the rainy season and in a country with limited health and education capacity the communities are isolated and least assisted. Through a literacy program the TBAs and women are becoming empowered to understand why they must stop their harmful birthing practices.
The BKFA is half way through it latest literacy and training program in Dullassa. Our partner, the Afar Pastoralist Development Association’s (APDA), has reported showing that 4270 birthing kits have been made and distributed and 8010 people have had counselling over many topics from HIV prevention, health, hygiene, sanitation, stopping female genital mutilation, pre and post natal visits and childbirth.
40 TBAs have received annual refresher training asserting that they have stopped 6 harmful practices that injure in the birthing process and that they are performing clean deliveries as well as referring mothers at risk.
There is an earnest need to reach out to more in the community that the awareness can be put into agreed community practice to act for the well-being of the mother and the child. APDA's method of approach is continual relationship with the community through trained community members who daily perform awareness, counselling, Afar literacy teaching along with a community dialogue that is led through the trained community religious and clan leadership. This has achieved communities that have stopped the horrific practice of female genital infibulations and have reverted to a 'lesser' practice of removing part of the clitoris. The former practice actually seals the vagina so it is a minute opening and covers the urethra so that urine is passed with great difficulty leaving the female in constant urinary retention, difficulty in passing menstrual blood and fear of marriage and intercourse.
The other practices that harm in the birthing process include closing the mother's infibulation scar after the birth; preventing her from consuming more than a minimal water and food in labor for fear of 'tipping this on the baby's head' in belief that the uterus and the bladder join; cutting the pulsating cord transversely once the baby has been born to bleed the mother as much as possible; not breast-feeding until 24 to 72 hours after the birth and not washing the mother and babe after the initial wash for another 7 days until the celebration of a slaughter of a goat. The dangers here are clearly both life-threatening and debilitating for mother and baby.
Then through aware and trained traditional birth attendants; women extension workers who mentor them as well as keep constant awareness in the community; literacy that empowers all stakeholders to lift themselves out of mystical thinking to reality and the local religious leaders directing dialogue in the community, change is emerging.
For Afar women childbirth was especially dangerous.
Thank you for making it much safer for a few communities. Your continued donations will help many more Afar women and babies.
Thank you for once again making your donation count
“No mother should die while giving life”
The health system in many developing countries does not have the capacity to look after their women in childbirth, especially in the remote communities. It is here that the BKFA provides the resources and knowledge to assist birthing mothers with good maternal health care.
Working in partnership with the Rotary club of Makindye, within the communities of Kinu, Namwendwa, Nagongera, Pokongo, Nakwasi, Kabila, NKunyu and Kasangate, the BKFA enabled 3,200 birthing kits to be distributed and 8 Outreach trainings to be conducted for Traditional Birth Attendants.
The BKFA has developed excellent working relationships with Ms. Karel Rose Amaranth co- founder of Holistic Care for Mothers and the Rotary club of Makindye to achieve the wonderful outcomes within these 8 communities.
Uganda is the same as many other countries, where Dr Sarah Nkonge, a Ugandan doctor from a small community notes “with all challenges faced by rural women in attaining healthcare, the crumbling state for most of village health facilities, gender inequality, sexual violence, child marriages, high levels of abortions and birth rates, limited use of contraceptives as well as poverty and ignorance all display the true challenges for grass root communities.”
“I am keenly aware of the saddest tragedy of losing a mother during child birth with staggering and painful consequences. If we can all support a safe-birth, we’re one step closer to ensuring healthy and economically secure families and communities” said Paramount Tribal Leader John Balikowa IV of Bakubembo Traditional Area on the Eastern Region of Uganda who supported all the initiatives of this program.
It is in these communities that your donations make a difference. Our partners believe that “birthing kits help to prevent tetanus, sepsis, HIV, infant eye infection and the low immunity, when used properly, the provision of birthing kits encourages more mothers giving birth in hospitals and a reduction in maternal and child mortality.” The kit along with training is such a cost effective way to impact on women and babies lives.
To have a baby in Tigray Province is a wonderful moment for the birth of a child, but can also be a time of trepidation as it can be very difficult and dangerous without health services available. Without birthing kits women and babies are at risk of dying from simple infections like tetanus, but also the transmission of HIV is a very big issue.
Tigray Province in north western Ethiopia is very remote. In the wet season roads are cut and planes cannot land. What could be done to help the thousands of women in this inaccessible region who give birth at home?
The Birthing Kit Foundation (Australia) started working with Abrahams Oasis delivering birthing kits to help these women. Every kit was “More valuable than gold” according to Ruth Kennedy a Director of Abrahams Oasis. It could save a life or prevent infection in this part of the world where medical help of any kind is rare.
The Birthing Kit Foundation supplied as many kits as possible but even this had its problems. Kits were held up at customs and nothing could be delivered in the wet season. The demand for this simple tool expanded too. Women started asking for ‘Kit Deliveries’ even in health facilities where cleanliness is far from ideal.
The solution, devised between Abrahams Oasis and the Birthing Kit Foundation (Australia), was for them to manufacture their own kits. Local women are employed in this project learning skills and earning much needed funds to help their families. Local production creates a consistent supply of kits throughout the year and now Abrahams Oasis can get the kits further into the remote areas of Tigray.
Abrahams Oasis has distributed clean delivery kits since 2010 and is now implementing local assembly of 15,000 kits. Thousands of deliveries are still done in homes and their goal is for each home delivery to be done on a clean sheet with gloves and clean gauze. In this way the work of Health Professionals at all levels is strengthened with a very basic but life-saving tool. The Clean Delivery Kits contain a large plastic sheet, soap, cord ties, razor blade, gauze and gloves.
Donations can ensure that this project is maintained and the supply of Clean Delivery Kits is maintained. Every US$50 means another 30 women have the chance of a clean birth free of infection and healthy baby.
“You are the first people who have taught us anything in our lives” they said and they pleaded for more.
The Dalits are the “outcastes” of Hindu society. As a result, Dalits were commonly segregated, and banned from full participation in Hindu social life.
In October 2013 we evaluated the maternal health training programs for the Traditional Birth attendants and community awareness in Tamilnadu State of India.
Working with local NGO the Centre for Social Action, Women’s Education and Development (SAWED) in Dingigul Districts of Tamilnadu state, India, we held 2 day midwifery training for 200 Traditional Birth Attendants (TBA), Tribal and Dalit women. Many women deliver at home with no assistance except for a previously untrained Traditional Birth Attendant.
SAWED gains trust in a new community by completing some kind of service project such as putting an electricity line to a small village. Winning trust in this way means the locals are more welcoming and accepting when training programmes are introduced.
The training programmes were well received in these communities. The older women, who are the Traditional Birth Attendants, have never received any form of education in their lives. “You are the first people who have taught us anything in our lives,” they said and they pleaded for more.
The evaluators' commented that the local community are hungry and desperate to rise from the depressed and disadvantaged position they are in and for these people the SAWED organisation are the only people hearing them.
For another NGO Society for Women's Education Awareness Development (SWEAD) in a different area of Tamilnadu state, India, they ran 25 Awareness raising meetings to benefit the community as well as the midwifery training programs.
The awareness raising meetings dramatically touched the men. At a meeting with our evaluators, two men stood up to share their experiences. Once understanding more deeply their issues one had stopped drinking and smoking and another had stopped violence towards his wife.
SWEAD said they also wanted to run training in 'adolescent management' and training for girls in reproductive health and preparation for motherhood.
Our evaluators said this was one of the most successful programs they had observed recently with a very strong impact for the whole community.
We have received a new proposal from SAWED to continue our work here and would be very grateful of your support to fund this great work. For more information about Birthing Kit Foundation go to www.bkfa.org.au
Pigmies are the most impoverished of all communities in DR Congo. Life is very hard. They live in remote areas mainly in Congo mountains and rainforest, in brush or dirt huts with dirt floors and grass as a blanket.
Dr Luc Mulimbalimba our partner from Mission in Health Care and Development chose these very poor communities for our recent training program on maternal health and safe, clean birthing practice to improve health and reduce preventable infections during birth which is a major cause of death and disability. The two communities of Mulenge and Lemera each received training for 100 Pigmie Traditional Birth Attendants (TBA’s) over 3 days.
The difficulties of running these seminars were significant but we are very lucky to have Dr. Luc as our partner, who only thinks about how to make things work! Over 30 porters had to carry all the food, bedding, birthing kits and educational equipment. Months ahead Dr Luc talked to the communities and explained the importance of the training, locating 100 traditional birth attendants and organising for them to gather for the training.
Dr. Luc said:
“It took us two days to reach Mulenge because there are no roads so we had to climb up and down the mountains and valleys to reach there. It is still the rainy season here in DRCongo so it was not very easy for us to reach Mulenge. I visited some of their houses.They live in extremely small houses,sleeping on logs of trees and small leaves, Their beds are made of the logs are less than a metre in size.They have no occupation except ploughing for other people.They leave their houses at 6:00am and return at 6:00pm and they are only paid 1 USD.They live at the high mountains of the Mitumba chain of mountains and are near a big forest that is also a national reserve park called Itombwe.They eat meat together with Ugali made by cassava flour.They are leading very difficult lives that I am not even able to write on email."
"We organised a three day traditional midwifery seminar for them and we gave each participant a gift of African cloth and 20 birthing kits.They ate very well and they enjoyed very much."
"After Mulenge we moved on to Lemera where there are roads but not good and more often we had to get out of the vehicle and push it. By good luck we were given security by the government of DRCongo and they were very helpful in leading and also pushing the vehicle. The government gave us a pick up that also assisted us to carry some of the kits and material. It was not easy but we thank God very much because we reached Lemera very well.”
There were also some highlights as Dr. Luc reported:
“The best thing was that while at Mulenge we were lucky to help two expectant pigmee women to give birth by the use of the locally made birthing kits.We have attached the photos of the two newly born babies and also photos of the making of the birthing kits at the Luvungi hospital.Again we are so grateful to the Birthing Kit Foundation for supporting us. We appreciate so much your love,care and support.”
In DR Congo Pigmie communities poverty and lack of educational opportunities are endemic. There is no education or health system. Some cultural practices also create health issues, which is why health promotion projects like this are so important to raise awareness of these issues. For example, most have never washed. There is plenty of water in the many rivers surrounding them but it is culturally not normal to wash. Infections, disease and death are rampant in their communities. When you have never learned about health, nutrition and hygiene the impact of this knowledge changes the community forever. Our programs which focus on maternal health and benefit the women and babies also have an extended impact for the whole Pigmie communities in DR Congo.
Both seminars were successful with the TBAs attending and enjoying their learning. Over 4000 birthing kits were given out at the seminars.Evaluation activities are being undertaken to assess the programs effectiveness and impact including a follow up evaluation with happen in 3 months to ascertain how they have applied the training and any further support required.
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