Stand Up for African Mothers

I guess one of my favorite things about Esther Madudu was her laugh – almost a cackle at times – but unleashed with such gusto that it was impossible not to join her.  And she laughed a lot – on this, her first trip to the USA.  She laughed and took everything in stride, as if being in New York, the largest city in the country, was nothing different than living on the premises at the Tiriri health facility where she works as a government employee  in rural Uganda.  But in Tiriri, there’s no running water or reliable source of electricity to help her look after the 45+moms she sees and up to five babies she delivers daily.

One of the most frequent questions Esther was asked at the events in New York, Washington DC and San Francisco where she met Amref Health Africa donors and partners, was about the challenges she faced as a midwife in a remote, low-resource setting.  Her answer – lack of infrastructure.  This meant that most of the women in her community cannot even make it to the health clinic because of lack of decent roads, available transportation, gas for ambulances, great distances to the health clinics and no money to pay for taxis or ‘boda bodas’ (motorcycles that are used as local taxis). 

Esther’s most harrowing story involved a woman who almost was a victim of that lack of infrastructure. While walking miles to give birth at the health facility, this very pregnant woman collapsed on the side of the road due to the long distance she had travelled.  Concerned bystanders managed to contact Esther at her facility, but without gas for the ambulance, she had to pay a boda boda out of her own pocket to race to the woman’s side. 

Upon arrival, she found the baby already crowning and immediately dug in to deliver.   Esther quickly wrapped the newborn and handed her off to an onlooker, while she prepared to deliver the placenta.  Instead, she found the feet of a second baby dangling out of the mother.  Moving quickly, Esther had to maneuver the breech birth, but was able to deliver the baby in good health.  Another quick wrap and hand off to a bystander.  About to deliver the placenta once more, Esther met yet another baby, successfully delivered the third one, and took off her own sweater to wrap it, as the mom had no other supplies with her.

Quickly Esther rented four boda boda’s to get the mom and babies to the health clinic.  In the nick of time, she hooked up the mother to an IV drip of oxytocin – her last dose of the life-saving drug that reduces postpartum hemorrhage in women. The mother survived.  Not only did she survive, but apparently she was sitting up in bed an hour later demanding food…

A good luck story that could have ended in tragedy, but for Esther’s quick thinking and her skills as a midwife, many of which she learned in her advanced training with Amref Health Africa.  This was just one of many stories she shared. It is really astonishing what difference a (single) health worker can make in a community.  Talking about the challenges she faces, Esther also laments the lack of drugs, medical supplies and male involvement in births, which is slowly changing though, as men are being educated on the important role they have in helping their wives experience healthy pregnancies and healthy births.

Another highlight of travelling with Esther was observing how effortlessly and joyfully she interacted with midwifery colleagues from the American College of Nurse-Midwives (ACNM) in New York and DC.  In fact she told me that when she’s with midwives, ‘she feels at home’.  No wonder Esther is the face of Amref Health Africa’s Stand Up for African Mothers global campaign.  Launched in the US in 2012, this campaign aims to train 15,000 additional midwives in 13 African countries by 2015.  One skilled midwife can care for and educate 500 women each year, ultimately benefitting over seven million African women annually.  The campaign also draws attention to the unacceptably high rates of maternal mortality, where almost 200,000 African women die every year from preventable causes in pregnancy and childbirth.  On behalf of all African midwives, Esther Madudu is also seeking candidacy for the 2015 Nobel Peace Prize to draw attention to the plight of African midwives. 

The US-based midwives were extraordinarily accommodating – inviting Esther to tour their facilities in both a hospital setting (Mount Sinai in New York and MedStar in DC) and the Developing Families Center, a birth centre, maternity care home, day care and source of guidance for new families targeted to low-income African-American families in DC.  Amidst all this activity, Esther also found time to address Foreign Affairs staffers on Capitol Hill, hosted by Congresswoman Karen Bass, about the critical role of frontline health workers like herself, in creating lasting health change in Africa. 

Her stories of what inspired her to become a midwife (her grandmother was a traditional birth attendant ), her passion for looking after women and the way she seems to overcome so many hardships – hardships that would paralyze most of us in a second – so  inspired our donors, friends, partners and supporters at Amref Health Africa.  I don’t think many Americans really understand under what kind of conditions Esther and other midwives like her actually work.  It was a humbling experience to listen to her and to witness the profound satisfaction that comes from her work, despite the innumerable challenges she faces every day.

One impressive woman, Esther Madudu has dedicated her entire life to being a health care worker. 

Everyone around her was completely taken by her passion and commitment to the ‘job’ she has made her life’s calling.  Those women in Katine are lucky to have her – and so are we at Amref Health Africa!

Links:

• Esther Madudu on NPR's Tell Me More