Volunteers’ Stories: Elly and Anneke
Elly’s and Anneke’s Story
“There was no permanent midwife at the Kachere Health Centre (KHC) when we arrived, and then there was a temporary nurse/midwife for a few weeks before we left in March 2005.”
We are from the Netherlands and worked as volunteers at Mwaya and Kachere Health Centre from 14 November 2004 to 8 March 2005.
In the Netherlands, we both work as nurses on a maternity ward in a hospital, and we followed a course in tropical diseases and community health in our country before we started our placement.
There was no permanent midwife at the Kachere Health Centre (KHC) when we arrived, and then there was a temporary nurse/midwife for a few weeks before we left in March 2005. This meant that the ward attendant/cleaning lady, Mrs Nkhoma, assisted with deliveries, and when there were problems she called the medical officer, Mathias Sichali. The women who came for an antenatal check-up were sent home. During the time we were at KHC, there were not many deliveries due to building work to install electrical wiring and probably also because many women delivered at home with a traditional birth attendant (TBA) since there was no ‘official’ midwife. While we were there, we took the antenatal clinic in the mornings, and Mrs Nkhoma translated for us because the pregnant women didn’t speak English most of the time. We also assisted Mr Manda, the Health Surveillance Assistant of KHC, with the Under Fives Clinics and we gave health talks about, for example, nutrition, diarrhoea, vaccinations, development of pregnancy, etc., for the Under Fives Clinic and the Antenatal Clinic. Mr Manda, Mr Longwe and Mr Milanzi (from the VCT (Voluntary Counselling and Testing) for HIV/AIDS) did then the translation for us.
We found out, after a conversation with Mr Manda, that there were a number of untrained TBAs in the area because the government doesn’t have the money to pay for the official 28-day training course. So we developed a three-day briefing at the Kachere Health Centre for 10 untrained TBAs, and the subjects covered included pregnancy (the development of a pregnancy, what is normal and what are the ‘danger signs’), and delivery (what happens inside the woman’s body during delivery, what the ‘danger signs’ are, what can you do about it while waiting for transport). We also talked about care for the mother and baby after delivery, what is normal and what is not. The information we gave was basic but, for the TBAs who had never received any training before, it was a real ‘eye-opener’. We hope this training can contribute a little bit to safe motherhood and that the TBAs are now more aware about what is normal during delivery and what the danger signsare. We also hope that we gave them some practical tools to help them when there are problems and that they will know to refer women in their care when necessary. Part of the material we used for the course we brought with us from home, and the other things we made at Mwaya. The books “Helping Healthworkers Learn” and “A Book for Midwives” were very useful for this purpose. Mr Manda acted as translator, and he also invited all the TBAs — he really helped us very much.
Elly keeping the records at the Under Five’s Clinic …
… while Anneke weighed the babies
Because this course worked out so well, we also gave the course twice at the Health Centre at Kande. Here our contact was Caroline from the restaurant at Kande Beach. Together with the Health Centre staff, 10 trained TBAs were invited first for a ‘refresher course’ and a few weeks later 10 untrained TBAs attended. All attendees were from the Kande area, and the staff of Kande Health Centre translated for us. It was really a pleasure for us doing these courses and the TBAs themselves found it very useful and interesting. We chose to have no more than 10 TBAs at a time so that there could be participation and interaction, and that worked out well.
We also held two Cooking Clubs, one at Mwaya and one at Kachere. It was for women (although the workers at Mwaya also wanted to join in), and it was held on one afternoon a week for six weeks. In Mwaya, the women were invited by the chief (we had asked his permission and asked him how we could pick the 10 women). In Kachere, Mr Manda invited the women, and some of these were women who had malnourished children (found during screening at the Under Fives Clinic) and some were neighbours who joined in. In Mwaya, Mr Joey Banda (the chief’s secretary) was our translator, and in Kachere Elizabeth Banda, Mrs Nkhoma’s cousin, was our translator. In the first part of the afternoon, we discussed nutrition (for example, how to eat a balanced diet with the different food groups, infant feeding, how to eat healthily without meat or fish, how to make food more nutritious without spending extra money, how to preserve food, etc.), and in the second part of the afternoon we cooked with the women. We provided most of the ingredients, and the women brought firewood and sometimes cooking equipment (for example, for pounding groundnuts or making nsima) or things like pumpkin leaves. We found out that they were all very ‘narrow-minded’ and only cooked like their mother and grandmother had done. We came with recipes which used locally available ingredients, and it gave the women some new ideas about cooking and more awareness (hopefully) about preparing a healthy meal. Here the book “Helping Healthworkers Learn” and “Where There Is No Doctor” were very useful in preparing the lessons, together with the Malawian Cooking book we found in a bookshop in Mzuzu.
During these cooking clubs, we got the idea about drying fruit (such as mango, pawpaw, banana, etc.) and selling it to lodges, for example, as an income-generating project. We also thought about selling cassava crisps. We worked on this idea, together with Diana (another volunteer at Mwaya Beach), and so the cooking club at Mwaya will also carry on as a Fruit Drying Club. Diana will continue with this idea after we have left the project. A prototype of a solar dryer was almost finished when we left Mwaya Beach, and there will probably be more solar dryers made to give this project a better chance of succeeding. The women were also interested in making and selling jams. Kande Beach was interested in all of these products, so hopefully it will work out. We hope that other lodges also will be interested, and we are curious to hear how it will carry on!
Elly and Anneke (Volunteer Nurses, November 2004 – March 2005)