At the beginning of this year we expanded our program to support the provision of home based care to critically ill postpartum moms. Our Malawian sister nonprofit, Chimwemwe mu’bereki (Joyful Motherhood) hired 10 part time nurses to provide 6 visits to 60 women. At this point 60 women have been enrolled and the majority have received at least two visits.
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.
A story in the works: Tricia is 18 years old. She is HIV positive. Well before the ninth month of her pregnancy she began bleeding heavily and was diagnosed with placenta previa. She received a c-section to save her life and delivered a 2lb baby. She lives with her mother. She has no husband and she and her mother are very poor. She has turned to prostitution as a means of survival. A nurse is working with Patricia to counsel her about HIV, to assist her with accessing treatment, and to work with her to find a alternative to prostitution.
After a difficult delivery Kathryn developed a fistula between her bladder and vagina which left her in a state of constantly leaking urine. Her husband refused to live with her and so she moved in with her mother. A nurse from Joyful Motherhood was able to add Kathryn’s name to the list of those to be repaired, assist her with self-care during the waiting period (women must wait several months after deliver before they can be operated on and during that time it is common that they develop sores on their legs from the constant irritation of leaking urine). The nurse educated Kathryn and her mother on caring for her newborn, and counseled her husband. Last week Kathryn was accompanied by her husband to the hospital and repaired surgically. She told the nurse that she was grateful for the program’s assistance in getting her the referral, in helping her with information about how to better care for her baby, and her family said they are very happy with her recovery. This story had a happy ending but Kathryn’s life in general contains the tragic elements that are all too common in the stories of poor Malawian women, Kathryn has delivered five babies but only has two surviving children.
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.
