At 34 Emma was healthy and pregnant with her second child. On April 27th, she delivered him by c-section. Within 24hours Emma’s abdomen began to swell and when clinicians reopened her surgical wound, they discovered a perforated bowel. Part of her treatment involved the creation a temporary colostomy. After this surgery Emma remained hospitalized for a month. In Malawi hospitals provide occasional meals to patients depending on availability of funds, but generally patients rely on family members to bring food. Emma’s mother and her husband were her only support. To lessen the financial stress on Emma’s husband, her mother took their toddler back to her village several hours away. Emma’s husband was left to cook and bring meals, wash Emma’s clothes by hand, care for the baby, and search for day labor to keep them going. Her husband was attentive, but Emma was often alone. Sometimes there was no food. Emma’s appetite diminished with her hope. Over the month Emma became emaciated. Her milk stopped flowing. This is how and where our nurses found her. While still in the hospital they began visiting Emma and enrolled her baby in our program. Once she was discharged, Emma returned to the one room home she shared with her husband. In her condition she could no longer care for her baby or even herself. During the early visits the nurses found her despondent, lying on a grass mat. In response to their questions about her health, she would talk about dying. At each visit the nurses brought enriched porridge and beans, they would assess her baby and educate her husband on how to care for the baby and for Emma. They met with her neighbors and encouraged them to sit with Emma while her husband was out. The nurses returned monthly and slowly Emma regained her health. Eventually she had a final surgery to anastomose her bowel. Before she was discharged from our program, she received the equivalent of $10 to start a small business. Emma began selling vegetables, her profits now provide the couple enough on a weekly basis to supplement their diet. Recently Emma told the nurses that she had been sure she would die, but their visits gave her hope. At times the beans and porridge supplied by the nurses were the only food items in the home and that nutrition enabled her body to recover. Emma’s story illustrates the impact of severe maternal morbidities, which often are unseen and uncounted. Her unexpected health crisis during delivery led to financial strain, depression, threatened the survival of her healthy newborn and almost resulted her own death. In the end Emma credits her survival to the compassion offered during brief monthly visits, several kilograms of beans and porridge, and $10. We can do this.
In August Joyful Motherhood nurses enrolled 20 babies (including 9 orphans, 7 babies whose mothers are critically ill and hospitalized, 1 baby with spinal bifida, and 3 babies whose mothers are not producing milk) into our programs. Two women were enrolled, both with severe postpartum anemia. Nurses conducted 190 visits to women and babies this month.
Baby Admission Story. Edina was 21 when she delivered Moses on June 16th. He was born on a grass mat laid over the packed dirt floor in her village home. Rather than slide out after him with one final push, the placenta clung to her uterus and she started to bleed. The blood flowed over and between the weave of the matt and into the floor. Edina died beside her newborn.
Edina’s family pooled their resources and bought a tin of formula; they stretched it as far as possible. Moses ate the white then grayish water. When it finished, they bought another and another. Each time worrying about his thinning cheeks and about how they would afford one more tin. In desperation they brought Moses to a health center and he was referred to our program. Moses is emaciated, still hovering around his birth weight but now he will receive the support he needs from our nurses while living with his grandmother.
Ida was only 22 when she delivered her fourth child, Merelina. At that time, she was living in Mozambique and Merelina was assisted into the world by a traditional midwife in their village. Immediately following the birth, Ida bled heavily, but the bleeding slowed and she appeared stable. So, rather than seek medical help, Ida stayed in the village breastfeeding and caring for her newborn. Two weeks later Ida developed shortness of breath and it suddenly became clear that her health demanded urgent attention. Initially the family took her to a traditional healer who nursed her with herbs, but she did not improve. From there, her husband’s family took her across the border to Mchinji District Hospital in Malawi. Ida died at the hospital before receiving any treatment. Desperation and grief mixed. The family lived in deep poverty and could not afford formula for Merelina. After losing Ida they feared losing Merelina. The midwives at the hospital referred Merelina and her family to Joyful Motherhood for assistance. Joyful Motherhood only serves babies within Malawi, so Ida’s mother-in-law who lived in Malawi agreed support her father in caring for the newborn. And Merelina’s father moved to his mother’s village with his three other children.
Nurses immediately began visiting Merelina in her maternal grandmother’s home. They taught the family how best to care for Mereina, how to prevent infectious diseases, the importance of sleeping under bed nets, when they should seek care at a hospital, and how to prepare and nourish her with formula. During those early months Merelina grew well. At six months, nurses began providing porridge to supplement the food she started eating. At eight months nurses noticed that her growth deviate from the normal expected trajectory. This is common in households suffering food insecurity. Once a child’s diet transitions from milk to solids, they begin to suffer the hunger experienced by the rest of the family. Nurses educated Merelina’s family on the types of local foods they could add to her diet to improve her nutrition and the frequency of meals. Once again Merelina began to grow and develop normally. Over the monthly visits nurses watched Merelina learn to sit, then crawl, stand and walk. Merelina was finally discharged from the program just before her second birthday.
Most people in Merelina’s village where she lives with her grandmother and her father never expected her to survive. The experience of people in the rural areas is that babies inevitably die without a mother’s milk, regardless of the care and love provided. Merelina’s survival was a victory not just for her family, but for the entire community. Today Merelina’s grandmother continues to support her son in caring for Merelina and siblings (ages 10, 8 and 4) while he takes whatever job he can find to support them all financially.
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In June nurses enrolled six babies (including 5 orphans and 1 baby without access to breast milk) and two women. Nurses conducted 169 visits to infants and critically ill postpartum women.
Baby Admission Story. Edess was living in a rural part of Mozambique close to the border of Malawi. She was pregnant with her fifth child and the labor started hard and strong. There was no time to make the trip to a hospital, so a traditional midwife in the village was with her during the birth. The delivery happened smoothly and quickly but the placenta did not follow and so Edess was forced to travel to the hospital.
At the end of a pregnancy the placenta receives approximately 500ml of blood every minute. Normally within minutes after a baby is born, the body will release the placenta and blood vessels feeding the placenta will shut down by a combination of the contracting uterus and clotting factors. When the placenta does not deliver within 30mins of a birth, the risk of hemorrhage increases exponentially.
Traveling from a rural community to a hospital in an emergent situation never happens quickly in Malawi or Mozambique. There is no functioning EMS system. In the majority of communities like Edess’ the only transportation vehicles are bicycles or ox carts. Roads are unpaved and rough. And, once a woman reaches the main road, she will need to wait for a passing bus or car to pick her up and take her to the hospital. Edess finally reached a rural hospital in Malawi, but tragically, she died on the same day. After her death, clinicians at the hospital referred her mother and baby to our local partner, Joyful Motherhood. If you would like to ensure that nurses visit Edess’ baby on a monthly basis in her village and provide formula and later porridge, please DONATE. Thank you.
In May, nurses enrolled 14 infants, including 7 orphaned singletons, 1 orphaned set of twins, 2 babies of mothers without breast milk, and 3 babies of critically ill mothers. Two sick moms were enrolled in our program. Nurses conducted 190 visits to women and infants in their communities this month. Both young women this month delivered by c-section and their life-threatening illnesses were caused by accidents during surgery which were not promptly identified.
This month our local partner, Joyful Motherhood, received a donation of K1,500,000 (US$1,500) from a local bank towards formula.
Baby Admission Story. Baby Florence arrived at the office of our local partner, Joyful Motherhood, with her grandmother. They had been sent all the way from a neighboring district because we are the only organization in the region doing the work of supporting babies without access to breast milk in their homes. Florence’s young mother had delivered normally and returned home, but soon after delivery she became critically sick and her family returned with her to the hospital. She ended up staying in the hospital for six weeks, and as her body focused on its own survival, her milk dried up. The fact that a district hospital would tell a grandmother to travel several hours to find an organization which would provide formula for her hungry granddaughter speaks to the need for our services. The fact that the grandmother would use her limited resources to find transportation and travel several hours with her hungry granddaughter to find us, speaks to the love and sacrifice families have for their most vulnerable members. Our program successfully saves infant lives because we are meeting a basic need and partnering with the best caregivers… grandmothers, aunts, mothers and fathers. Please support our work by donating HERE.
This month we enrolled 18 babies and one critically ill postpartum mom. The babies included 4 orphaned singletons, 4 orphaned sets of twins, 2 babies of very sick mothers, and 4 babies without access to breast milk. Nurses conducted 210 visits to mothers and babies this month.
Baby Admission Story. Jaqueline delivered her twin boys normally, but she hemorrhaged afterwards and because of that, her return home from the health center was delayed for several days. During that time, she did not receive a transfusion or additional treatment, she was simply kept under observation. Within a week, Jaqueline was discharged and returned home to introduce the babies to their three older siblings. Unfortunately, Just a couple days after arriving home, she began complaining of dizziness, shortness of breath, and chest pain. This time Jaqueline ended up at Kamuzu Central Hospital (the regional referral hospital) where she was diagnosed with severe anemia and a necrotic uterus. They removed her uterus and transfused her with 5 pints of blood, but 25-year-old Jaqueline died. Unfortunately, the nurses at KCH had not realized that Jaqueline was a mother of newborn twins and so the family did not receive a referral to Joyful Motherhood. It was only when the nurses were visiting another orphan enrolled in our program in a rural area that they learned of the nearby hungry twins and enrolled them. Jaqueline’s babies boys are living with her mother now. We will provide monthly home visits from nurses and formula now, then porridge after six months. Our nurses will continue to visit them in their community for up to two years. Without that fortuitous visit, it is likely that Jaqueline’s babies would have quickly followed her in death. The family had the desire to care for the babies, but they are too impoverished to purchase formula and they had no idea where to seek help.
If you would like to support Jaqueline’s twins, please donate HERE.
Twenty-one babies were enrolled this month (10 orphans, 5 babies whose mothers are admitted in the ICU, 1 baby whose mother is not producing milk, 1 set of orphaned twins, 2 babies of mothers with severe mental health illness, 1 one baby whose mother left her with the grandmother). Two women were enrolled, both of whom lost their uterus due to birth complications – they are 19 and 20. Nurses conducted 190 visits to mom and babies this month.
Baby Care Story. Hannah’s mother was diagnosed with breast cancer and started chemotherapy but when she unexpectedly became pregnant at 40, she stopped her treatment. She delivered Hannah prematurely. Hannah weighed just over three pounds at birth, but she quickly put on weight with her mother’s breast milk. After two months her mother’s health began to deteriorate at a precipitous rate, and she returned to the cancer treatment center to resume her chemo. Hannah’s grandmother brought Hannah to us, requesting assistance with formula and nursing support.
Mother Care Story. Loveness was just 20 and pregnant with her first baby. Her labor was long and hard. She headed to health center when her labor started and was watched by the clinicians there. But,health centers do not have the facilities to conduct c-sections. By the time she was transferred to the District Hospital, it was too late. Her uterus had ruptured, her baby had died, she was bleeding internally. Loveness lost her baby and her uterus and almost lost her life. At the time of discharge, Loveness was weak and depressed. Joyful Motherhood nurses will visit her at home over the next couple of months, but she is just starting a long road to recovery.
Many times when policy makers, academics, aid organizations, etc. consider maternal mortality and strategize ways to improve statistics the emphasis is placed on receiving prenatal care and delivering within facilities. However, the vast majority of the women we care for, or whose orphan babies are enrolled in our programs, have followed the “rules.” They attended prenatal visits. They made their way to health facilities for delivery. But in the end, they were not protected from excessive suffering or loss. As an organization we stand with the victims, who are often invisible to the larger system. Our support is focused directly on them.
If you would like to support our work, please DONATE.
This month 11 infants were enrolled in our program, including 6 orphans, 1 set of twin orphans, 2 babies of women admitted to the ICU, and 1 baby whose mother is not producing any breast milk.
Baby Admission Story. Thirty-five-year-old Rachel had two children and was pregnant for the third time. She attended her prenatal visits and when contractions started, she went to Bwaila District Hospital. Only after Joshua was born, did Rachel learn that she had been carrying twins. As the second twin settled into her pelvis he had his arm over his head, unfortunately no one noticed until it was too late. The birth became complicated. Due to a prolonged period of hypoxia during the birth, Joshua’s twin was distressed at birth and he died several hours later. Rachel took Joshua home on November 14th. She breastfed Joshua for two weeks but then she developed a significant cardiac arrhythmia and returned to Bwaila. There she was diagnosed with pre-eclampsia and cardiomyopathy. Her milk supply diminished as her condition worsened. Rachel needed heart surgery, but there is no place where this is done in Malawi. With nothing more to offer her, clinicians discharged Rachel. She died on January 27th.
Rachel’s mother works at Bwaila District Hospital where Rachel delivered and where she learned her daughter had a terminal condition. The office of our local partner, Joyful Motherhood, is located at the same hospital. Rachel’s mother had escorted other grandmothers carrying their orphan grandchildren to our door. Her knowledge of the Hospital did not spare her the trauma of losing her own child, but she knew where to seek help for her grandson.
Mother Care. The mother who was enrolled this month, is only 19. Her labor with her first child was hard and long. It ended with a cesarean section and a stillborn. Days later she developed an infection in the wound, which led to a total hysterectomy. Our nurses will visit her at home as she recovers physically and emotionally over the next couple months.
Please consider a monthly donation HERE to support our work.