By Ellen Libby
May, 2019
Today was rough.
I looked out the window over my desk. The skies were gray and looming with pending rainfall hanging over the foothills. The cool breeze blew through the open window, billowing the sheer curtain across my shoulders and touching my face. I had a hard time holding back my tears and was thankful when the rains finally unloaded. The thrumming of the pitter-patter on the rooftops provided relief from any possible conversation to be had for at least another thirty minutes if not longer.
Earlier this morning, Peter, our night nurse from the Matongo clinic, came into our office to do his regular check-in after his evening shift. Peter is often times tired after a long night’s work, but today he had a heavy heart sunken into his exhaustion as he retold his evening events.
Peter talking to Kevin about the evening deliveries.
There were three women in labor with only one available bed. The last one was a young mother, barely a teenager and probably had minimal understanding of the circumstances to her pregnancy. Peter guided her to the maternity ward and propped a fetal scope to her bulging belly. He moved it around searching for the baby’s heartbeat. When he couldn’t find it, Peter asked the young mother when she had last felt the baby move or kick. She had responded timidly that it had been three or four days ago. The labor continued while Peter helped her through the delivery. As he suspected, the baby was stillborn and evidence showed the infant had passed a few days prior to the young mother’s arrival to the clinic.
Curamericas takes pride in their effort to reduce maternal and infant mortalities in the areas they work in. A maternal or infant death is a rare occurrence in our clinics; so when it happens, it is devastating to the team. The Casa Materna model is a community clinic serving the women of a rural area who would otherwise have limited access to quality maternity care. As part of its maternal health programming, Curamericas collaborated with the Ministry of Health on an arrangement to cost-share staffing to provide around-the-clock care at the Matongo location. Our grant helps to fund two nightshift nurses on rotation which provides the community access to care no matter what time a woman goes into labor.
Casa Materna clinics alone cannot prevent maternal and infant mortalities. These clinics are designed to work hand-in-hand with neighbor Care Groups and community health volunteers to promote health education, teach danger signs for pregnancies and infants, and encourage neighbor women to make commitments on newly taught health behaviors. This interwoven relationship between the clinics, community health volunteers, and neighbor women Care Groups ensure long-term health outcomes for mothers and babies.
After inquiring about his emotional well-being and the mother’s, I asked Peter if the young mother was in a Care Group. Peter relayed that she was from outside our catchment area and most likely was referred to the Casa Materna because of the available 24-hour care.
I sat at my desk, looking out over the hillside spotted with homes, wondering how different her experience could have been if she had lived in Matongo. Through the Care Group program, every pregnant mother and mother of an under two-year-old would be captured in a neighbor Care Group. The neighbor women would have encouraged her to attend at least four antenatal visits at the clinic. The Care Group lessons would have exposed her to the pregnancy danger signs and taught her the actions to take to keep herself and her baby healthy. She also would have been visited by a Community Health Volunteer who would have supported the young mother throughout her pregnancy.
I’m not one to get emotional about the challenges in the places I have visited during my global health work trips. Most of the time, I am in awe of the resilience of the community and their resourcefulness to make life work for them despite the incredible barriers they face. Maybe I’m getting a little older and seeing time as finite with so much still to do. Meanwhile, I have three more weeks left in Kenya. My hope is to ensure the adolescent sex health education pilot program is positioned to launch successfully. Maybe the adolescent program can start the change process early to ensure children are informed about their bodies and make choices that will lead to a better future for themselves and ultimately lower the incidence of adolescent pregnancies and its associated mortalities. For now, I will walk through the mud-caked paths alongside the road back to my place up the hill and breathe deeply the cool air brought in by the rains.
As always, tomorrow will be a new day.
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