25 February 2010 was an exciting and momentous day in the lives of our 40 new village midwives – the day of their graduation ceremony after a year-long training course at the Midwives Training School in El-Fasher. It was also an exciting day for KIDS FOR KIDS as we had financed the expansion of the Midwives Training School to make their training possible as we found that lack of capacity was a major constraint on training of adequate numbers of midwives for the villages. They proved to be the best batch of midwifery trainees which we have had graduating with the highest overall marks ever. Their marks ranged from 66% to 97% - and the midwife who passed with 66% was illiterate when she started the course, so a magnificent achievement on her part. It is clear that all the girls have worked extremely hard and we never cease to be amazed at their commitment and dedication to their new profession. A year is a long time to be away from home and family and some of them have had to leave children behind to be looked after by relatives. So the training also represents a huge commitment on the part of their communities and demonstrates just how eager communities are to have a trained midwife.
The midwives have now returned home not only with their medical kits, manuals, new uniforms and the money to purchase a donkey but now a mobile phone as well. This is a new venture which will make a huge difference, particularly in emergencies, enabling them to be in contact with expert advice at the local hospital. For the first time the graduation ceremony was attended by the Wali’s wife, standing in for the Wali, and she returned the next day with gifts of money and sugar for the midwives, recognizing that they would have a lot of people to entertain on their return to the village for which they would have to provide tea. We hope that this will be the beginning of a close contact between the Wali’s wife and the Midwives Training School.
The midwives will be enthusiastically welcomed back by the young women in their villages. Women speak often of the problems they face in childbirth and the lack of any help apart from untrained traditional birth attendants who are basically the older women in the village. Women frequently experience difficult births due to the widespread practice of female genital mutilation and as a result maternal mortality is extremely high and as a consequence the average age of women in the villages is only 34 years. The presence of a trained midwife in the village will quell the anxiety of many pregnant women. The midwives can expect to be busy – one of our earlier midwives, Nadia, delivered 185 babies in her first six months back in the village. On average, our midwives delivered 60 healthy babies in each remote village during a year and importantly referred mothers to hospital in time for caesarean sections, without which, mothers often already with small children, would have died. The presence of the midwives and the services they provide is also an important factor in encouraging families to stay in the villages and thus contributes to the long-term sustainability of the villages. The trained midwives play an important role in reducing the mortality rate amongst women and babies through:
· Provision of delivery services using modern techniques; · Referring difficult cases at an early stage to the provincial HQ which is crucial in saving the lives of both mother and baby; · Provision of extension services to the community, and particularly women, on hygiene, dangerous diseases like HIV/AIDS, and harmful practices e.g. female genital mutilation; · Taking part in immunisation campaigns; · Combating malnutrition and diarrhea amongst children.
The midwives are also able to register births which is of immense value to families who otherwise would have to undertake a long and potentially dangerous journey to the nearest town for this purpose
We are very pleased that the Government has decided to increase the small stipend paid to the midwives – this will be particularly important in the prevailing disastrous drought situation which will make it even more difficult for mothers to make a contribution in kind to the midwives for their services.
We are now preparing for the next batch of trainees. The villages are in the process of selecting their candidates and the next course will start shortly. If we can raise the funds we are also planning to build a Midwives Training School in Mellit the principle town in the north of the province. Villages in this area are far from El-Fasher and it is difficult for girls to travel to El-Fasher for training and hence the villages in this area are losing out on having the immense benefits of trained village midwives.
Graduating midwives receive their kits