Health care at the limits
Emma Fuell, a midwife from Devon, spent a year as a Skillshare International volunteer in a remote and semi-arid area of Tanzania. She worked with traditional birthing attendants (TBAs) in Simanjiro district, where people often have to walk for a day or two to reach their nearest health facility. In an area where health facilities are vastly inadequate and the nearest one is often an empty building without water, supplies or equipment, the role of TBAs is critical for the health of pregnant women and the safe delivery of their babies.
The aim of Emma’s placement was to improve the district’s mother and child health services. When we asked Emma what her greatest achievement had been, she told us straight away that the training programme she ran for 45 TBAs would have the greatest impact on the lives of local people.
"When I arrived at Simanjiro there were no statistics on maternal mortality or birth rates. TBAs were often concerned that they would be blamed if a mother or child died, so reporting was not regular or reliable. I tried to remove the need for literacy as many of the TBAs are illiterate and so I developed a picture chart to record statistics which the TBAs could use. The workshops also increased verbal reporting by raising awareness of the importance of keeping records of births."
While much of Emma’s placement focused on training TBAs and improving health care systems, she was also involved in more hands on work, including the emergency delivery of baby Solomon…
"During one workshop, I got a message that one of the TBAs was attending a woman in labour in her village and she asked me to go there after I'd finished the session. When I arrived, everything seemed fine and I thought the TBA could do the delivery, but something made me stay. The labour seemed to slow down at intervals, which isn't completely normal. We took her to the nearest basic health facility, three hours away, where the clinic’s midwife and I examined Naserian and realised that she had a pro-lapsed umbilical cord. We immediately put her into the back of a 4x4 and raced to the nearest hospital - six hours away. We spent the journey supporting the baby's head with the mother-to-be on all fours so the umbilical cord didn't get compressed and cut off the blood supply to the baby. This was critical to the survival of the unborn child, but was made infinitely harder by the fact that we were travelling on a bumpy, ungraded road and suffered from two punctures! By the time we arrived at the clinic, the doctors said it was too late and the baby would already be dead. Using all our powers of negotiation we persuaded them to do a caesarean delivery. Finally and remarkably, baby Solomon was born to a delighted mother!"
Before her placement, Emma raised money by speaking on her local radio station in Devon and through fundraising activities with her church, which also paid for mosquito nets. Find out more about how you can get involved in fundraising and building suopport for our work...