A successful Birth in Kumbarumba Village

Vivien called again tonight. This time her number came up on my screen so that when she dropped out I was able to call her back. And it worked.

Her call caused me to get up from my soft couch in front of the television, under a cooling fan. I went outside as the kids were a bit noisy after finishing our takeaway dinner of chicken. Our indulged dog started barking loudly at rats running along our fence line. It was weird. And here I was talking to Vivien in the remote village of Kumbarumba in the East Sepik region. She would be standing under a tree (apparently that’s the best mobile phone reception), barefoot and in the pitch dark – no electricity in the villages. She would have finished dinner with her family, of rice and some greens. Maybe a banana and piece of paw paw too.

This time I managed to have a reasonable conversation, getting used to speaking using simple words again. I asked her if she had done any teaching and she said she had done many teaching sessions. I asked what she’d been teaching and she answered, ‘what you taught me’. I then asked if she was enjoying it and she said ‘very much’. ‘Have you had any babies born?’ I queried. Suddenly her tone changed and she lit up as she said she had been with a woman through her labour and had caught the baby. She was so excited. I asked her if the mother and baby were well and healthy and she said they were. She then added that she used the three rop (3 ties) to tie off the cord and then cut the cord. She said she used the plastic. ‘So everything was very clean?’. ‘Yes’ she answered. Wow, that is amazing. Here is the Village Birth Attendant in Kumbarumba telling me of her first positive experience of assisting someone to give birth using the birthing kit and the techniques that we had taught in Yamen. She was genuinely thrilled and delighted with herself for what she had achieved. I told her that this was such good news and that her confidence will grow stronger the more births she helps with.

It was a huge thing to hear that she was with the woman throughout the labour because most of the women labour alone and end up only calling the VBA when things are going bad. Vivien’s education sessions to the women and building relationship and trust with them seem to be helping. The ripples are flowing and in the right direction.

“Thank you Sara” she said at the end. “Isaac sends his good wishes to you and your husband”.

It is such a blessing to have these little spurts of conversation with Vivien who is at the coalface of dealing with the epidemic of maternal and newborn deaths in remote PNG. I’m really looking forward to seeing her again and hearing more about what she has been doing in her village.

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A Letter to Jenny and Ellen

Dear Jenny and Ellen

Whenever I think I can’t do anything for the women in Papua New Guinea I remember your faces.

I remember how you bravely came up to the house where we were staying in the village of Yamen to sit with us and ask for some help. I remember how you shared about the fact both your village birth attendants had died recently in childbirth and now you had been elected by your village to come to Yamen for training and to be the new VBAs. I remember how you told us that many, many women were dying in pregnancy and childbirth. I remember your look of ‘being overwhelmed’ with the responsibility of trying to help the women in your village, Bupatan. And I remember your beautiful smiles – smiles that radiated love and kindness.

I can’t forget you.

I won’t forget you.

Last week I watched a television documentary on SBS here in Australia. It was called ‘Why Poverty? Is it better to be born poor or to die poor”. The documentary showed 3 settings for birth in poor areas, a hospital for the homeless in the USA, a hospital run by Medisans sans frontiers in Sierre Leone and pregnancy care for a woman with AIDS from a poor village in Cambodia. The footage was heartbreaking, especially from Africa and Cambodia. It took me back to Yamen and gave a picture to the stories you told us about the number of women and babies dying in your villages. The program showed a woman arriving at the hospital after being in labour for too long, with a dead baby still inside her. It showed the baby being delivered by caesarean section. It showed another woman who had lost a lot of blood because her uterus had ruptured during a long labour. The baby had died. After surgery to sew up the uterus, the woman died later that night. The experienced male Obstetrician was in tears. It showed a 13yr old girl giving birth to a baby at 27weeks of pregnancy. The baby took a few gasps and then died. It showed how a 12yr old boy had to visit the AIDS clinic on behalf of his mother to get her tablets because she was in hospital giving birth to a baby. He saw about 4 different nurses, with different instructions for different medications. The new baby died after 2 months.

One Obstetrician working in the hospital in Africa said that there was no difference between the women there and in a developed country except their access to medical care. I disagree. Medical care is an important factor in reducing morbidity and mortality, but the women don’t have the same access to contraception, a well-balanced diet and transport that we do.

So, how can you make a difference in your village without having the luxury of a hospital and good transport? You can make a difference, Jenny and Ellen, by building relationships with the women so that they trust you and your judgement. Then they’ll listen to your advice and take heed of your recommendations. Remember the things you learned in Yamen about what a healthy pregnancy looks like, and a normal labour, then when something is not right you will know to refer them to the health centre early on (rather than waiting until it is too late). Talk with the women about spacing the babies by understanding how their bodies work. Show them the diagrams we drew and explain to them what happens each month when an egg is released from the ovaries. Talk to your husbands and encourage them to talk with the men about how important it is to space the babies. Get them to spread the message to the men to listen to the women and take their wives to the health centre for specialist care when you suggest it. Also to take the women and the children to the centre for regular immunisations and medicines when sick.

I wonder how you are right now? I had a call from Vivien yesterday and she was able to tell me that she had received the book I sent her before the line was cut. That’s good news. I hope you haven’t run out of birthing kits, I did give you extras. I will be posting some more after Christmas.

I’m thinking about some lessons to run when I visit again next year. I’m hoping to have some written material to give you all to help you teach the women in your villages and to support other VBAs in villages even further afield. I’d also like to get some feedback from you about how you were or were not able to use the information I gave you last time, an evaluation.

I wish I could talk to you now.

I will pray for you. And I will keep preparing and planning to see you again soon.

With Love

Sara x