Seven months pregnant with her second child, no one was expecting Madalitso Cosmas’s mother to go into labor so soon. Her labor pains began after she had suddenly become very ill, but the symptoms of severe headache, confusion, and delerium made it impossible for her call for help. Despite this, she delivered a tiny but healthy son in her home, by herself. She began to lose consciousness shortly after the delivery.

Realizing her daughter had just given birth, Madalitso’s grandmother, Queen, made the difficult choice to leave her sick, now unconscious daughter and take her newest grandson immediately to the hospital. Weighing 1100 grams (2.4 pounds) at birth, little Madalitso was entered into the kangaroo care nursing unit with Queen. Queen later learned that her daughter, Madalitso’s mother, never regained consciousness and died the next day. She was now the caretaker for little Madalitso and his 3 year old sister.

 Madalitso’s weight went up and down, but after just under two months in the hospital, he and his grandmother were allowed to go home. Joyful Motherhood first visited the family at home 3 days later and found a small but thriving baby. Madalitso had already gained 200 grams since his discharge, bringing him up to 1700 grams (4.3 pounds). Queen received formula, porridge, information and encouragement on how to care for her small charge.

With continued support and education from the nurses of Joyful Motherhood, Madalitso was discharged at the age of 1 year, at the weight of 7 kg. Beatrice says of Madalitso Cosmas: ‘’Now [he] can walk; [He’s] a big boy now. This is one of our successful stories. The grandmother, the chief, the community; they are so grateful for the help JM gave to this baby and they always say that they could not make it without the food, the care, the educative topics we have been teaching them.’’

Joyful Motherhood first learned of the twins Memory and Nelson Lodzani while they were still in the hospital with their mother. Maonekedwe Lodzani had been diagnosed with cardiac failure before her pregnancy. After delivering a healthy boy and girl, weighing 2.4 kg each, she slipped into a coma. Maonekedwe and her twins were sent to the hospital. Unable to breastfeed, the family was referred to JM for formula and assistance. The twins’ weights were increasing, but their mother’s health was deteriorating. A month after giving birth, Maonekedwe Lodzani died of a heart attack in the hospital, leaving Memory, Nelson, and their nine-year-old sister in the care of their grandmother, Grace.

JM began regular visits to the family after their discharge home. After an initial misunderstanding of formula preparation was corrected (and JM visits increased from once to twice a month), the twins have been growing ‘’tremendously.’’ They doubled their birth in four months and continue to thrive.

Despite the joy and relief of two healthy babies, there is never a shortage of obstacles, as Nitta explains.  ‘’The family is very poor, and without our support they sometimes lay these children on clothes. But since we have some donations, we try to give them some small blankets. They are very far from town and the hospital. I am looking at twins who are orphans being taken care of by the grandmother and a nine-year-old. The nine-year-old sometimes doesn’t go to school to accompany her grandmother to the hospital. So this is affecting the little one, the girl, with her education.’’

Though we have big dreams, at this point African Mothers Health Initiative (AMHI) and Chimwemwe mu’bereki (CU) are surviving hand-to-mouth. Because Bwaila is a referral hospital, women come from villages all over region to deliver there. This is our starting point. Nurses in the nursery maintain a log of all the babies who need follow-up at home, they obtain maps to their homes and then give the information to the our tiny staff of home care nurses.

A single visit commonly involves a 40 minute ride in a minibus followed by an hour long ride on the back of a bicycle.

Our Malawian sister nonprofit, Chimwemwe mu’bereki (Joyful Motherhood) also staffs part time nurses to care for at risk and recovering mothers after discharge to their home.

Here are a few of their stories:

Though HIV negative, Mary was severely malnourished and anemic and at the age of 23, immediately after delivery, she weighed only 84lbs. Because of her poor nutritional status she developed a severe infection after delivery and was hospitalized for some time. Still frail, she was discharged home and a nurse from Joyful Motherhood began following her. The nurse provided her with soya beans, maize, and ensured that she took her iron tablets. She has since gained 15lbs and has been able to successfully breastfeed her baby.

Tina had a difficult prolonged labor which resulted in a ruptured uterus. A hysterectomy was performed due to the rupture, which left her sterile. In her village because people believed that the rupture was caused by her infidelity and as a result of this misconception her husband left her and she experienced some stigmatization. The Joyful Motherhood nurse visited her in the village and monitored her recovery, and during those visits she also counseled Tina’s husband as well as the village elders to explain the reason her uterus ruptured. After several visits the community members understood the cause of the rupture and the urgency of getting a women to the hospital who is experiencing a difficult labor. Tina’s husband returned.

Christy has six children and with her most recent pregnancy she developed severe pre-eclampsia. Even once she returned to the village after delivery, her blood pressures hovered around 200/110 (high enough for a stroke or seizure). The Joyful Motherhood nurse checked on her regularly at home and served as her advocate ensuring that she was seen by a clinician until her blood pressure stabilized.

All the nurses report that the women who have received assistance, their families, and their communities express gratitude for this program each time a visit is made. Interestingly, the nurses themselves have also expressed their gratitude for the program. We have a policy of only hiring nurses who are working full-time for the government or retired nurses so as not to recruit nurses away from the public sector which is already stretched very thin. The government nurses typically earn anywhere from $80 to $200 each month (depending on their years of service), which – even in Malawi – is very hard to live on. They say that the salary they receive from their part-time work with Joyful Motherhood has assisted their families and improved their standard of living.

We are so proud of the work that is going on and of the nurses who are caring for these women and mothers. We hope that you also share this pride, as you are certainly an integral part of the force behind this work. We ask that you continue offering whatever monetary support you are able and, keep spreading the word.