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, they believe they have done unspeakable acts in previous lives, that god did not love them, that they were born to serve the upper castes and that they had no right. They expect and live a poor life in all regards.
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, and 25 Awareness raising meetings to benefit the community. 90% of women deliver at home with no assistance except for a previously untrained Traditional Birth Attendant.
In October 2013 we evaluated the maternal health training programs for the Traditional Birth attendants and community awareness in India.
We found that SAWED had built a toilet which the local community had requested to build trust within the community. Trust is an important step into a new community.
These women had never been taught before. “You are the first people who have taught us anything in our lives,” they said and they pleaded for more. The TBA's said they wanted training in 'adolescent management' and training for girls in reproductive health and preparation for motherhood.
They understood the content of their training and the importance of hygiene in a delivery and how to use birthing kits. The evaluators assessed the training as highly effective from all key indicators.
The awareness raising meetings dramatically touched the men. At a meeting with our evaluators, two men stood up to share their experiences. One had stopped drinking and smoking and another had stopped beating his wife.
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.
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.birthingkitfoundation.org
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.
10% of the total global deaths of under 5 years old is in Nigeria. This is a country that needs your help.
Your donations are supporting our midwifery programs that give lifesaving information in a country with 1 million children dying under 5 annually. The Maternal Mortality Ratio in Nigeria is 840 : 100,000 and as mentioned previously the provision of birthing kits addresses only one small aspect of what is killing the women and babies. To really have a sustainable solution in a community they need to be educated about all other aspects of health, hygiene, nutrition and midwifery.
Your donation has helped the Birthing Kit Foundation work with Sweet Mother International(SMI) to distribute its clean birthing kits along with local health training programs. In April this year SMI distributed 400 birthing kits at a seminar. They worked in collaboration with Lafia Hospital Apata Ibadan. Marton of Lafia Hospital is a community health worker of 23 years, who sensitised the 40 community birth attendants to the objectives and benefits of the kits. After the training each woman is given 7 kits to start with, knowing they can get top ups when needed as the supply is ongoing.
Another similar program was held at the Primary Health Care Centre Byazhin, Bwari Area council FCT Abuja in Nigeria. Here SMI worked with the Citizens Health Education and Development Initiative to hold its health training program. Many guests were at the opening of the program including the village heads of the 10 communities in Byazhin, nurses, TBA representatives and many pregnant and nursing mothers. Here the message is for the women to give birth at the hospital or clinic, however, if it is impossible to get the birthing mother to a clinic then a birthing kit supplies the basics for their clean birth. They have found that many deaths can be avoided by education and directing the pregnant mothers to the hospital or clinic with plenty of time. Much of the training is on prevention of malaria, prevention of HIV, hygiene, nutrition and responsible pregnancies and contraception.
We also partner with Rotary International, where 4,700 birthing kits were handed to the polio campaign coordinators for distribution within the northern states of Kano, Kaduna, Katsina and Borno as well as the southern state of Imo. These birthing kits were distributed in November and December 2012 to birth attendants in rural areas. 3,000 birthing kits were also distributed in April 2013 to the 20 selected hospitals participating in the Maternal and Child Health Project. These birthing kits are stored in the health facilities and will be distributed to Skilled Birth Attendants in the surrounding communities when they are trained by project midwives.
As Nigeria is such a high risk country for maternal and child health it will continue to be a priority country for the foundation.
Success!!! 3 organisations in Ethiopia are now make their own birthing kits, while providing an income for disadvantaged women.
Over 30,000 birthing kits were made locally in Ethiopia.
The program targets impoverished women who earn an income while assembling kits so as to become more independent.
A recent monitoring visit in November 2012 by two BKFA directors reinforced the success of this program that spreads across Ethiopia to the Afar, Tigray and central regions.
Thank you for making it possible for women in these regions to look after their own women and babies – sustainability is being achieved.
Desta Mender is an extension of the Hamlin Fistula Hospital. It is where women with untreatable fistulas from severe childbirth injury, live in beautiful surroundings and now call home. The production of their 10,000 kits was part of the re-integration program for 5 women who were each paid 5000 Birr. They formed the “Birthing Kit Club” with the aim to make them financially independent. As the project coordinator writes “we have learnt that they are waiting for the second phase with bated breath”
At Abraham’s Oasis in Tigray region there is one qualified nurse and one vulnerable woman, who are assembling the kits and being paid 350 Birr per month. They are employing an extra helper to finish the making of their 10,000 kits in time.
In the Afar region Valerie Browning through the Afar Pastoralist Development Association organised for 10,000 kits to be made. Similarly local people were employed to make the kits. To accompany this there was also extra training of the Health Extension Workers with 73 from 36 kabelles attending a 1 day course – again funded by the BKFA.
The Foundation again thanks its supporters who have enabled us to initiate early sustainability through 3 partner organisations to large sections of Ethiopia.
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