Activity Updates

This month nurses enrolled 12 babies (5 orphans (including a set of twins), a set of triplets, 1 baby whose mom is in the ICU, and 3 infants whose moms are not producing any breastmilk). One mother was enrolled due to severe infection. Nurses visited 213 women and babies and delivered 589 tins of formula. There was one death this month – Stefano was a 10-month-old triplet, he was hospitalized for a diarrheal illness and died during his hospitalization.

Baby Admission Story. At 33 years old, Chamjira, was pregnant for the fifth time, this time with twins.  She attended her prenatal visits, but after birthing four healthy babies, she felt calm about the delivery.  Chamjira lived in a rural area.  Her home, that of her parents, and those of her siblings sat huddled together on a bare well-swept patch of land.  Around the homes were the fields which sustained the family through the year.  And, within sight of their homes were others of community members. Though the fields sat empty in September, they still required work – hoeing, tilling, preparations for the planting season.  Halfway through her pregnancy Chamjira had stopped participating in the hard labor. She stayed near the homes, where the work was also plentiful but less physically grueling. 

On September 9^th Chamjira was alone in the house when her labor started.  The contractions came on strong and fast.  There was no way for her to walk out to find or call for help.  No one had a phone.  Chamjira was focused.  The babies came quickly, a daughter then a son.  She picked them up and cradled them in her arms.  She pushed to birth the placenta, but instead of the placenta there was only blood, so much blood.  Chamjira tried to focus on her babies; the feel of their bodies against hers.  She focused on keeping them warm, but the bleeding continued, and she started to drift in and out of consciousness. 

Her mother walked through the door at 10am.  She found Chamjira there in the pool of her blood, gasping her last breaths, but still holding her babies.  Screaming, Chamjira’s mother ran to get help, and within a few minutes a small group gathered, but it was too late for Chamjira. The women cried with her mother, but told her to quickly take the babies to seek help, they would stay, clean Chamjira’s body, the house, and keep vigil until she returned.   Everyone knew that without a mother, the chance of the twins surviving depended completely on finding help to purchase formula.  If help were unavailable the babies would surely follow their mother in death within days.  

With tears clouding her vision Chamjira’s mother bravely took up the assignment to save the two fragile lives that remained.  Within an hour she arrived with the babies at the nearest health center.  There midwives examined and weighed the babies (a healthy girl and boy of 4lbs 13oz and 6lbs 6oz) and referred the grandmother to Joyful Motherhood for support.  Filled with grief, embattled by anguish, fear and hope she continued her journey.  A few hours later, with two hungry newborns in her arms, she crossed the threshold of Joyful Motherhood. (Chamjira’s mother is pictured above with babies Maureen and Moffat on the day they were enrolled.)

Mother Care Admission Story. AM is 21 years old.  Though she had always felt healthy, she tested positive for HIV in her pregnancy.  The diagnosis was devastating and it took time for her to assimilate the information, but the midwives gave her hope.  She took medicine every day to reduce her baby’s risk of contracting the virus from her.  She did everything she was supposed to – going to her prenatal visits, taking iron supplements, anti-malarials, and the anti-virals.  She made it to nine months before labor started. 

She knew labor would be hard, but she never anticipated the impossible. The contractions tore through her, one after another, but her baby did not drop into her pelvis.  She felt the baby was not correctly positioned inside. She cried to the midwives in desperation and after three days of labor she was sent from the health center to a neighboring hospital where she could deliver her baby by c-section.  Thankfully, her baby boy tolerated the prolonged labor and was born alert and healthy on July 4th. 

Mom and baby stayed in the hospital; AM convalescing and learning to breastfeed.  (HIV positive women may transmit the virus to their babies via breast milk. But, the risk of the baby contracting and dying from HIV is lower than a risk of a baby dying from starvation or diarrheal illness when a family cannot afford to purchase formula. For this reason, the World Health Organization continues to recommend that HIV positive women breast feed their babies for one year.)  After three days nurses noticed that AM’s abdomen was swelling and the wound reopening.  AM received antibiotics and rather than closing the wound, nurses assessed it, cleaned it, and changed the dressings daily while it slowly healed from the inside out.  Finally on September 25th, AM’s wound was healed sufficiently that she and her baby were discharged from the hospital and told to follow up at the health center for the remainder of her wound care.  Joyful Motherhood nurses met and visited her during her hospital stay and will also continue to visit her in her home over the next several months to ensure her complete recovery.

• 10 babies were enrolled (5 orphans, 1 set of triplets, and 2 babies of moms with no breast milk)
• 2 women were enrolled
• Nurses visited 190 babies and women
• 1 baby (a triplet) died from malaria

Baby Admission Story. Lufeyo was the second child of Mwaiwawo.  Mom and baby made it through delivery and returned home just one day later. Initially everything seemed to be going well. Lufeyo was an eager nurser and Mwaiwawo produced plenty of milk.  But then, after two weeks, Mwaiwawo began to feel that something was not right.  She found it difficult to articulate the exact problem, she thought perhaps it was related to her episiotomy which was still painful.  She returned to the hospital where nurses checked her wound and sent her home again. A few days later her discomfort and anxiety increased.  Filled with fear she told her family that the right side of her body was heavy and limp, minutes later she lost consciousness and began to convulse.  Her family rushed her back to the hospital, but Mwaiwawo died before she received any treatment.  Nurses referred her family to Joyful Motherhood to assist with the care of her newborn.

Mother Admission Story. At 35 Lexa was pregnant for the third time.  As her belly grew, she anxiously considered her pregnancy and tried to keep the hope locked tight inside her chest.  Her peers all had three to five children, some old enough to help with farming and cooking.  Her first born was now 12, but his brother who was born two years later died at age three from hydrocephalus.  During those three years the entire family suffered along with him.  They watched him regress physically, first losing the ability to walk and crawl, then even to sit and smile.  At first the clinicians told her that he would be fine, but then when his head began to grow and his gaze became vapid, they told her it was too late.  Life continued with a sour edge;  she learned to live with loss and fight expectation, but then she became pregnant. 

Labor started on August 18^th. Lexa initially went to the local public maternity clinic, but the midwives kept sending her out to walk and told her she was not ready to deliver.  She fought with herself, wavering between doubt and trust of the clinical staff. The following day she decided to seek help at a mission hospital, hoping there the care would be more expedient.  They allowed her to labor until that afternoon when midwives determined that she would not be able to give birth normally.  Her perfect baby girl was born via c-section, stillborn. Lexa’s heart broke.  She lay in the postpartum ward silently grieving her child, waiting to be allowed to leave, trying not to see all the other newly delivered moms nursing their babies all around her.  Everything hurt.  She thought all consuming pain was just what woman feel after they are cut open and their dead babies removed, but then she noticed pus oozing from the surgical wound.  She was sent to the regional hospital five days after the c-section.  There they opened her up again and removed her uterus and her ovaries.  Joyful Motherhood nurses met her at the referral hospital as she was recovering from her second surgery.  They will not be able to fill the void, but they will visit her at home, support her physical recovery, hear her and be present for her grief, and help with a small project to add a bit more financial security to her home.

In July 5 babies were enrolled into our program (3 orphaned infants, 1 baby with a mother in ICU, and 1 baby whose mother was not producing breast milk). One woman with severe anemia was enrolled in our mother care program. Malawian nurses visited 216 woman and infants in their homes. 614 tins of formula were distributed. In partnership with Joyful Motherhood, AMHI is currently supporting the care of 234 women and infants.

Baby Admission Story. Lyness and her family did not have much, but they had enough to get through each day.  They rented a basic home in a community on the outskirts of Lilongwe. The house lacked indoor plumbing, but the water spigot and a pit latrine sat steps from their door.  The house was also close to a clinic and an outdoor market.  Lyness took pride in keeping the home tidy and the dirt yard swept free of footprints.  Her husband left each morning to seek different jobs in Lilongwe to support them. When there was not enough money to buy fish or beans, Lyness’ husband would tell her to take another serving of nsmia (cooked maiz that has been processed to remove husks).  The nsima filled her belly, which seemed to grow day by day, and she was easily sated.  Lyness felt well.  Her baby kicked powerfully from within.  She went for her prenatal visits at the recommended intervals and the midwives told her to expect the baby in July.  Days filled with caring for her toddler and the home slid quickly into months. 

On June 3rd, her contractions started.  She arrived at the clinic, progressed quickly, and delivered a premature baby girl, weighing 4.5lbs.  With a small baby, the delivery was quick this time. But this time, the placenta was difficult to remove.  Even once it was out, Lyness continued to bleed, and the midwives sent her to the regional referral hospital. There clinicians placed an IV, removed the pieces of retained placenta, and stopped the bleeding.  She stayed in the hospital until June 12th. At that point, clinicians determined that she was stable and discharged her home with her baby. Lyness managed to breastfeed her baby girl, but she kept waiting to feel better.  The exhaustion consumed her, and the cold stayed in her bones.  Her head hut. Her chest hurt. Her legs hurt.  On June 29th she died at home.  She was 22 years young.  Midwives in the clinic near their home told her family about Joyful Motherhood.

Many women in Malawi begin labor anemic and malnourished.  Most families do not eat three daily meals, and many make up for a lack of food rich in protein, fat and vitamins with extra nsmia.  Nsmia is the staple food of Malawi, but has minimal nutritional content.  Because many women suffer from chronic anemia, their bodies learn to cope with incredibly low levels of iron.  Blood loss occurs with every delivery (typically 250-500ml), and even normal blood loss in a severely anemic woman can push her over the edge and cause cardiac failure. 

First, it is likely that Lyness began labor already anemic.  The second problem was the delay.  Fortunately, Lyness lived close to town and motorized transport to the referral hospital was accessible. (If she had been in a village or outlying health center, she likely would have died along the way.)  Even so, if she was bleeding heavily, it is possible that she lost another liter of blood during the transport.  Finally, hospitals and blood banks in Malawi, never have sufficient blood products; it is rare for a single individual to receive more than a pint or two regardless of their condition.  The little that exists must be shared by all.  Lyness likely needed more blood and she was discharged too soon. 

The first contact between Joyful Motherhood and clients always follows a tragedy.  When matched with an orphan our goal is to ensure the well-being of that child.  When matched with a mother after a difficult delivery, our goal is to ensure that she recovers to care for herself and her family.  Joyful Motherhood will accompany Lyness’ family through the next chapter, ensuring that they feel supported and that her baby girl thrives. Ensure the future of this work by donating HERE

In June nurses admitted 11 babies (4 orphans, 1 set of triplets, 3 babies whose mothers did not produce breast milk, and 1 baby whose mother developed postpartum psychosis). The mother suffering from postpartum psychosis was also admitted into our program. Our team visited 227 babies and critically ill postpartum women. Nurses distributed 635 tins of formula to babies without access to breast milk.

Baby Admission Story. Emma had three children.  Life had been challenging, but her children were healthy and her youngest was ten when she learned of her new pregnancy. At 37 she was considered unusually old for a baby.  Thankfully, the pregnancy was uneventful and according to hospital notes, the delivery was also. Emma delivered a healthy six pound baby girl on June 7th. Emma named her Happiness; life was complete.  Three days after the birth, mom and baby returned home.  Before the hospital bag was even unpacked, Emma started complaining of headaches, chest pain, and dizziness.  Family convinced her to turn around and return to the hospital.  At the District Hospital, they checked her blood type and her blood pressure, which was very low. No one bothered to check to see if she was anemic or to evaluate for an infection.  She was referred to the Regional Hospital and admitted to a high acuity ward.  It seems there was no additional treatment and she died there on June 14th. Her family was referred to Joyful Motherhood for the support of her surviving infant.  This is the tragic story of another preventable death that produced four more orphans

Mother Admission Story. At 20 Betty was bright and dynamic. She became pregnant unexpectedly and as her belly grew, a mix of curiosity, excitement, and anxiety grew with it.  On June 19th she began to feel pain in her belly and went to the labor ward at the district hospital.  Midwives there determined that she was not yet in labor and sent her home to continuing waiting.  The following day she began hallucinating and was taken to a mission hospital where her baby boy was delivered by c-section.  The hallucinations deepened and darkened; she seemed lost to her family and had no capacity to connect or care for the fragile being she had just brought into the world.  Betty was hospitalized briefly and nurses referred her family to Joyful Motherhood for additional support for the entire family.

Please consider making a donation by clicking HERE to help support our work of caring for babies and women like Happiness and Betty.

In May nurses admitted 8 infants (3 orphans (includes a set of twins), 3 babies whose mothers were not producing breast milk, and 2 babies of critically ill mothers). One postpartum woman with a severe infection was admitted. Nurses visited a total of 221 mothers and infants over the course of the month and 558 tins of formula were distributed.

Baby Admission Story. Twin boys Chimwemwe and Chisomo were admitted this month into our program.  Their mother was pregnant for the first time and attended her prenatal care clinic at the recommended intervals.  Her rapidly enlarging belly signaled to the midwives that she was carrying twins and at 34 weeks she was sent to a rural hospital for an ultrasound.  (Most women do not receive even a single ultrasound during their pregnancies.) Then, as is commonly done for high risk women, she was instructed to stay on the hospital grounds and await the delivery there. 

[Few hospitals have adequate facilities to accommodate these pregnant women.  Most often, women sleep in a room packed with mattresses – some on frames, some on the floor.  Each woman’s small bag or cloth bulging with personal items sits at the head of her mattress.  In some hospitals women are offered two basic meals of beans and rice or nsima daily; others will need to purchase food, cook, or wait for their relatives to bring meals.  There is generally a communal toilet/shower for both pregnant and recently delivered women.]

After a bit more than a week her labor started.  Staff at the rural hospital referred her to Kamuzu Central Hospital (the regional referral hospital) and there she delivered two premature boys.  The babies were taken to the nursery to receive oxygen and initially their young mother hovered attentively over them.  But, when she told a nurse that she was feeling dizzy, she was sent back to the labor ward.  Before any further evaluation or intervention, she died.  Her family was told that there was a shortage of blood and so she did not receive a needed transfusion.  Family members were referred to Joyful Motherhood to support them in caring for the twins.

Almost half of the infants admitted into our program lost their mothers moments to days after their births.  The death of a mother is an event which puts the life of her newborn in imminent danger.  And tragically, so many of these deaths might have been prevented.  The stories told by grieving mothers, sisters, and husbands often include a similar series of events. (1) Chimwemwe and Chisomo’s mother suffered from no pre-exiting health condition.  (2) She followed medical advice – attending her prenatal care visits, waiting at a hospital to deliver (rather than risking delivery in a village hours away from potentially life-saving care).  And, in her case, her delivery actually occurred in THE maternity referral hospital for the Central Region of Malawi; arguably one of the “safest” places to deliver in the country.  (3) Tragically, even at the best hospital in the country, a death which should have been prevented was not.  The chance of twin orphans dying prior to their first birthday in sub-Saharan African may be as high as 80%.  Thankfully, with Joyful Motherhood, they now have more than a 96% chance of reaching their first birthday, but they will reach that milestone without ever knowing their mother’s embrace.

Please consider supporting our work in Malawi by making a donation today. Donate here.

In April Joyful Motherhood nurses admitted 5 babies (including, four orphans (two were a set of twins), and one baby whose mother was not producing breast milk). Two women were admitted into the program due to severe postpartum infections. The team visited 215 women and babies in their communities and 558 tins of formula were distributed.

Baby Admission Story. Twenty-one year old Farao’s pregnancy was uneventful.  The months passed quickly this time, as she now had a toddler to care for.  Farao lived close to town in a bustling area which had its own maternity clinic, but her aunt worked at Bwaila, the District maternity hospital and they felt Bwaila would be a better safer place to deliver.  Farao delivered there on April 19^th.  Her baby boy was healthy, the labor uncomplicated, and they were discharged the following day.  Five days later she started feeling sick. Complaining of diarrhea, her family took her to the local clinic.  From there she was referred (meaning she was told to go, her family would have to arrange transportation) to the regional maternity hospital.  She died before they started the 30min trip. She was buried on April 25^th. Her son turned one week old on the 26^th.  Her family will never know what caused her death.  Because it was less than a week after delivery it was likely related to her hospital experience; possibly an infection picked up during delivery.  Likely preventable. Another young woman gone and another baby orphaned.  Her aunt is pictured above with her baby Moses.

Mother Admission Story. Three years ago Memory delivered her daughter without any complications.  Now as an experienced mom at age 25 the labor with her son was long and difficult.  After 24 hours in labor he was born by c-section and after three days they were both considered stable enough to return home.  Two days later Memory noticed fluid draining from the surgical wound, she returned to the hospital, she was given antibiotics and sent home.   When she arrived home, with her pills still untouched in a small paper bag, the wound ruptured.  She returned to the hospital and from there was referred to the regional hospital. Clinicians opened her abdomen and washed out a significant amount of purulent matter.  Her wound was left open and dressed daily. At some point it was discovered that she was severely anemic and that she had been bleeding internally.  She returned to surgery for a third time and received three pints of blood. Joyful Motherhood nurses met her in the hospital, enrolled her and once she was discharged started their home visits.

In March 11 babies were enrolled for support in our program (including 3 orphans, 3 sets of triplets, 1 baby with hydrocephalus, and 1 baby whose mother was not producing breast milk). Two sick women were enrolled. Nurses visited 194 babies and 23 sick women after delivery. Nurses distributed 595 tins of formula. (Formula is provided to sustain life. It is for babies without access to breast milk and for mothers of triplets, to supplement their milk.)

Baby Admission Story. The triplets above are Success, Shepherd, and Stella. Even though Maggie attended her prenatal care clinic as recommended, she was unaware that three babies grew and tumbled within her. (Few mothers receive ultrasounds during pregnancy, so multiple births are generally surprises.) On March 14th Maggie delivered a small baby girl. Her tiny daughter was followed by a boy and then by another daughter. The babies are all less than 4.5lbs and will grow best if kept skin-to-skin against the chest of someone who loves them for as many hours per day as possible. Their parents and grandparents will supply the 24*7 care. Nurses from Joyful Motherhood will visit regularly to support, assess, and provide supplemental formula and porridge down the road, if necessary.

Mother Admission Story. Nineteen year old Seba attended prenatal care at a rural clinic near her home during her pregnancy. On March 14th her labor started and she was taken to the hospital. After 24hours without progress she delivered her baby boy by c-section. Three days later, both returned home in stable condition. She expected to feel pain and so she tried not to complain. She kept stoically silent for one week until she could no longer bear the fire in her swelling abdomen. She was taken back to the hospital and then transferred to the regional maternity hospital where a severe infection was diagnosed. Surgeons opened her abdomen and washed her insides with saline, but three days later she had not improved. She was diagnosed with a systemic infection. She was given antibiotics and a blood transfusion and then discharged home still weak and pale. Seba is one of many patients discharged early in an attempt to decongest the wards as Covid starts to take hold in Malawi. Though all healthcare workers are at risk, the care provided by Joyful Motherhood to women like Seba is more critical now than ever.

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In February, seven babies were enrolled in our program (6 of whom were orphaned as newborns). Nurses are currently following 215 babies. One hundred and eighty five of those babies received home visits during the month of February.

Sifra, pictured above with her paternal grandmother, is one of our new babies this month. Sifra’s mother was pregnant for the third time and carefully observed the recommendations made to ensure she and her baby remained healthy. She attended her prenatal visits. And, because her home was far from the hospital, she moved onto the hospital grounds two weeks before her due date to await her labor. On November 10th she delivered a healthy baby girl and returned home the following day. Rather than regaining her strength quickly as she had following previous births, her health deteriorated. She went to a nearby health clinic and from there she was referred to the district maternity hospital. There was no clear diagnosis but she received a blood transfusion at one point. On January 8th, she died. Sifra’s paternal grandmother had been with them when her mother died and she started searching for assistance for her new granddaughter. Eventually she was referred to Joyful Motherhood.

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