September 2018 Activity Report

September 2018 Activity Report

In September…

  • 9 babies were enrolled. 6 orphans (including a set of triplets), and 3 whose mothers were not producing any breast milk.
  • Nurses visited 139 babies in their homes.
  • Joyful Motherhood is currently following 249 babies
  • 4 women were enrolled, 2 with severe infections, and 2 whose uteruses ruptured and required hysterectomies
  • Nurses visited 25 women and are following 30 women.

Mother Care Admission Story

26-year-old Nazilinga went into labor on September 14th, she had had two previous c-sections, but this time she had a normal delivery. Her daughter weighed just under 4lbs and so Nazilinga and her baby were admitted to the kangaroo ward.  Kangaroo care is a low cost alternative to conventional intensive neonatal care.  Mothers are taught to keep baby wrapped skin-to-skin between their breasts for as many hours of the day as possible and to exclusively breastfeed.  Kangaroo care has been show to improve temperature control, decrease rates of infections and generally improve survival of low birth weight babies. Ten days after her delivery Nazilinga started to have trouble breathing and complained of chest pain.  She was admitted to the critical care unit, there she was told that she had fluid in her lungs and around her heart. She was diagnosed with a severe infection in her blood.  Finally on October 6th she was discharged and able to return to be with her baby.  Our nurses will continue to follow mother and baby at home.

Baby Care Admission Story

24-year-old M. Develias was pregnant with her second baby.  She received regular prenatal care and believed that she knew what awaited her, having experienced a normal pregnancy and delivery two years previously.  In late June she felt that her water was leaking and she went to the clinic.  There she was told by the midwives that all was well, but they admitted her to await her delivery in the health center.  One week later she started bleeding, initially she was just spotting but the volume increased over the following three days.  Finally the midwives decided to transfer her from the health center (there are no operating rooms in health centers) to the district hospital.  Unfortunately she delivered on the way to the hospital and bled to death before arriving.  This story illustrates the tragic fact that even when a woman seeks care in time, she is not guaranteed to receive the care she needs.  Her family was sent home with her body and her newborn.  They managed to provide for baby Chimwemwe until the end of September when they ran out of money for formula.  They sought help at a rural hospital and were eventually referred to Joyful Motherhood.

Faith

Faith was born January 28, 2018.  Her birth was uneventful and the next day her 23-year-old mother, Salimba, took her home to meet the rest of the family.  On February 14th Salimba became ill.  Her family says her face and feet were swollen and she started vomiting.  On February 18th they took her to the closest health center.  She died there before she was ever evaluated by a clinician.  Faith’s grandmother was then directed to Joyful Motherhood.  Overwhelmed and grief stricken she told the nurses she didn’t think she would manage.  She had five other children at home to raise.  With support from Joyful Motherhood nurses, Faith’s grandmother has done a wonderful job; today she glows when talking about her granddaughter.

Precious

In the face of this beautiful woman you can see lines of grief, determination, and quiet joy.  She is holding her grandson Precious who was born on the day her daughter died.  Her daughter delivered Precious and then as she lay back to embrace her new son she began to bleed.  The bleeding continued despite efforts of those with her to slow it down.  Her life washed away in a sea of red. Her mother clung to her newborn grandson and gave him a name from her heart.  She worried about her ability to keep him alive and well, without breast milk and without money for formula.  Within the week after telling countless people her story, she was directed to Joyful Motherhood for support.  Precious is now 8 months old.

 

Juliet

Nineteen year-old Juliet was nearing the end of her pregnancy.  She had gone for her prenatal visits at the Mitudu health center, she had taken the antimalarial medications as instructed by the midwife, had the necessary blood work, and regular blood pressure checks.  Everything seemed to be going well until the day she collapsed and started seizing.

Pre-eclampsia is one of the most dangerous diseases of pregnancy.  Even as our knowledge about it continues to grow, our ability to predict who it will effect remains limited.  The onset is often sudden and occurs towards the end of pregnancy.  One of the warning signs is a rising blood pressure.  Pre-eclampsia can affect all the major organ systems, damaging the liver and kidneys, resulting in bleeding in the brain, seizures and death.

Those around her took Juliet immediately to the health center and from there she was transferred to Bwaila, the district maternity hospital.  Without a well organized EMS this process of just getting her to a place where she could be helped took several hours.  When she arrived at Bwaila, Juliet was unconscious and still seizing.  The midwives – familiar with this presentation – quickly administered magnesium sulfate, the only medication shown to help control and prevent eclamptic seizures.  Even with the medication, the only cure for eclampsia is delivery.  Once a woman reaches the point of seizing her life is in grave danger and if she is not delivered within a relatively short period, both she and her baby will die.  Unfortunately even delivery does not guarantee that the mother’s life will be saved.  The clinician at Bwaila delivered her 5lb baby by C-section and Juliet was sent to the ICU, where she remained unconscious for 4 days.

This is where our nurses found Juliet. After talking with her family, she was enrolled in our Mother Care program.  Juliet regained consciousness and after a short period she was discharged from the hospital. The nurses planned to visit her six times in her village.  During their first visit, nurses found Juliet still swollen and convalescing, still struggling to care for her baby.  This picture is from their second visit.  As part of her home based care, nurses will counsel her on the disease and help her community members create an emergency plan for such events in the future.  They will also provide some education on the care of her baby and help set up an income generating project.