Birthing kits and training in Tamil Nadu
When Dalit (untouchable) women in the southern Indian state of Tamil Nadu give birth they must select one of two risky choices. They can either have their baby at home or go to a government hospital. At home this will probably mean giving birth on a dirt floor in a dwelling with no running water. The trip to hospital is little safer. Undersupply or corruption have left the hospitals with huge infection risks in the form of dirty mattresses, unclean scalpels, no gloves, soap or clean ties.
The Birthing Kit Foundation of Australia (BKFA) supplies birthing kits to and has educated over 1,000 traditional birth attendants in Tamil Nadu. Each one now takes a kit along for every birth she attends, whether it is for use at home or as a back-up when she accompanies a mother in a government facility. A traditional birth attendant armed with a birthing kit can be a life saver wherever a birth takes place.
Education programs in Tamil Nadu, funded by the Birthing Kit Foundation (Australia), make sure more than just the traditional birth attendants get the message. Husbands and caretakers get involved and find out how they can play a part in a clean, safe birth or act as a back-up if a woman does need hospital support. Adolescent girls are also being educated on the health challenges they face when they become mothers. For the first time whole communities in this state now understand the importance of a clean, safe and healthy birthing environment.
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
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