Midwives Vital to Curb Death Rate

The Citizen (Dar es Salaam)

Mkinga Mkinga

24 May 2011

Dar Es Salaam — As the government strives to reach the Millennium Development Goals (MDGs) by 2015, a fight to reduce mortality rate remains a vital mission.

Tanzania is a country in which health resources are minimal and much help is required.Lack of staff is a massive problem and the hospital and maternity wards where nursing and midwifery are supposed be together in every course.

A traditional midwife, as a source of knowledge, attitude and skills needs support in their efforts to serve mothers and infants as notes Ms Fatma Abdallah, 85, a local midwife and resident of Ubenazomozi in Chalinze, Coast Region.

Ms Abdallah, who has been in the local midwifery service for over four decades, says she has been happy to be involved in the earliest process of assuring human being lives at the delivery stages. She monthly attends about 4 to 5 women.

She remember being transformed and enabled to do midwifery services by her mother who died more than 37 years ago at Ubenazomozi village and the recognises other three in other two villages surrounding her home village.

“I am very famous here in the village since I have been also receiving other pregnant women from other villages…I have been attending them using the experience and knowledge that I have through several trainings I have undertaken at Bagamoyo District hospital,” she asserted

She said using her finger tips she can understand how long it would take for a pregnant woman to deliver. She says if she inserts her fingers by two inches then touches the body of an infants, it could take two to three hours to delivery.

“My projection of delivery has been reflecting the truth, if I tell a pregnant woman that she will deliver within three hours, it happens at exact time. And if her case is complicated or beyond my level of knowledge, I refer a patient to the hospital,” she says.

She says complications during the delivery has been a big challenge to her profession.

She says sometimes complications do occur, but mostly it depends on how the infant has been set in the placenta. She says she has faced a few cases in which pregnancy complications were far beyond her capacity.

Long distance to the nearest hospital or clinic has been the major obstacle to the expecting mothers at Ubenazomozi. Ms Abdallah says most mothers fail to travel to Chalinze, 22kilometres from Ubenazomozi, for delivery.

She says gets between Sh5000 -Sh10000 from a single delivery:, “It’s very cheap if a woman delivers safely under her custody while has to pay over Sh100,000 to a qualified nurse/midwife with some of the expenses being a quick transport service a delivery centre.

Attending a seminar for midwifery

Though she is a traditional midwife, Ms Abdallah says has attended several midwifery seminars she admits have equipped her with modern skills on how to handle pregnancies at a village level. She confesses they have been very useful in a country that faces acute shortage of trained midwives.

“I have attended several seminars at Bagamoyo Hospital and off-course they have all helped me considerably.

The skills has enabled me to earn some little money from mothers who appreciate my services,” she said

She remembers the certificate she was awarded by Bagamoyo Hospital recognising her as a trained traditional midwife, but she also notes that about 200 women have safely delivered under custody since she started the service 45 years ago.

Unlike other traditional midwives, Ms Abdalllah is aware of the deadly killing HIV threat where she categorically tells her customers to bring three important tools before a delivery service, naming them as razor blades, two pairs of gloves and soap.

She said before getting down into business a pregnant woman is should bring two pairs of gloves, which the first pair used to check if the she can deliver safely at her hands, while the other pair is used for an emergency.

Ubenazomozi village gets a dispensary from Saadani National Park

Saadani National Park through its scheme known as Support for Community Initiated Projects, has financed the construction of Ubenazomozi dispensary by 70 percent of the total cost which is sh62.99 million.

Speaking at the handing over ceremony, Saadan Chief Park Warden Alhaj Hassan Nguluma said the construction has been done as part of the social corporate responsibility aimed to encourage the surrounding community to be part of conservations of the national park.

But since Ms Abdallah has been trusted by most of her colleagues in the village, she doesn’t fear the opening of the dispensary since it would help her and the whole community to curb maternal deaths to the women in the area.

“We have been experiencing lack of health personnel even at the Chalinze health centre…my doubt here is, will the government dispatch enough staff to our dispensary?,” she queried

According to the National Health Policy, each village is supposed to have a dispensary; however the goal seems to have shifted from having a dispensary to one primary health unit in each village.

Also the policy wants people not to walk more than five kilometers to look for health services. But contrary to the policy, Ubenazomozi villagers walk 22 kilometers to the nearest dispensary at Chalinze town.

Regardless her age limit, she still dreams to be part of the staff in the just handed over dispensary as a midwife, “I think I’m still energetic and I can work tirelessly to serve lives of my fellow Tanzanians,” she says.

Maternal mortality and morbidity is fundamental issue of human rights which must be addressed in accordance with agreed international human rights standards, which Tanzania has committed.

Although Tanzania has been able to make significant progress in reducing child mortality, it is only likely to meet goal 4 that targets reducing child mortality (at under-five mortality to about 54 per 1000 live births by 2015), according to recent estimates.

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