Activity Updates

In July we admitted 24 babies, this is the most admission we have ever had in a single month. 17 of these babies are orphans including 2 sets of twins.  Nurses are currently following 233 babies and 21 women.  Nurses visited 216 babies and women this month and distributed 587 tins of formula.

Baby Care Story. Everything went smoothly with Hajira’s fourth pregnancy. She experienced the regular fatigue and discomforts but she still managed to keep up with her other four children, even the twins. Thankfully the delivery was also uneventful, her daughter was born on May 19th and after 24hrs, Hajira took her new baby home to introduce her to the family.  Initially, everything continued well her baby was an eager feeder, she produced plenty of milk and she watched her daughter grow and change day by day. In mid-June Hajira felt the familiar symptoms of malaria – severe pain in her back and joints – and went to the hospital. She was treated for malaria and seemed to recover but then one week later she developed a cough. When she returned to the hospital, she was treated for asthma, but this time there was no improvement. Hajira died on July 5th.  Hajira did not have any pre-existing lung condition and though no one will ever know for certain it is possible that she may have died from Covid. Her family was immediately referred to Joyful Motherhood for continued support of her infant. 

As always we depend on your support to provide quality care to our beneficiaries, and with such a large increase in admissions our resources are stretched more than usual. Please consider making a donation in honor of Hajira.

We appreciate your generosity.

In June we enrolled 6 infants, including 3 orphans and 3 babies without access to breast milk. Two of the mothers of orphans died from postpartum hemorrhage and the third died from unknown causes (they were 20, 21, and 25 years old).   Three postpartum women were enrolled, each suffered severe postpartum infections which ultimately led to total hysterectomies (they were 17, 19 and 30 years old). Nurses visited 148 babies and women in their homes. 589 tins of formula were distributed.

Mother Care Admission. Zione knew she would deliver her baby by c-section, her first two children were born by c-section and the safest option for her would be another c-section.  When her labor started she presented to the hospital and clinicians delivered her son again by c-section.  She returned home with her baby three days later. About a week later she noticed drainage from the wound and returned to the hospital. Her wound was reopened, and they found that her uterus was necrotic. She had a total hysterectomy.  Despite her severe illness and close brush with death, Zione recovered well and continues to breastfeed.  Joyful Motherhood nurses will continue to follow her at home until her recovery is complete.

Baby Care Admission.  Georgina was 21 years old and excited about having her first baby.  The midwives advised her to await labor on the grounds of the District Hospital (as opposed to at home or at a health clinic) so that she might access emergency obstetric care if necessary.  At the end of her pregnancy, she packed a bag and traveled to the District Hospital.  She waited two weeks before her labor started.  Her daughter was born on March 20th healthy and screaming but Georgina bled profusely.  Midwives stopped the bleeding but the following day it was clear that her condition was poor and she would need a transfusion.  She was transferred to the Regional Hospital but before any additional action was taken, Georgina died.  Her family assumed care for her newborn, struggling to feed and provide for her.  This month they were finally directed to Joyful Motherhood and we will continue to follow the family, provide home-based nursing care, formula and later porridge for the baby until age two.

Donate to support Georgina’s daughter and nursing visits to Zione.

In May 8 babies were enrolled, including 7 orphans and 1 baby whose mother is admitted due to postpartum psychosis.  Mothers of the orphans died from:  seizure disorder (diagnosed in childhood), tuberculosis, 3 from severe anemia and an unknown illness, a respiratory illness, and an unknown illness.

This month we lost two babies.  Jennix was a twin whose health was strong during his first year but over the past several months he struggled with abdominal issues and this month he developed pneumonia.  He died in hospital.  Chifuniro was an orphan still receiving formula he developed a fever and respiratory illness in the village, he died before his family made it to the hospital.

Three women were admitted in May.  We are currently following 234 infants and 23 women.  140 visits to infants and women were made and 546 tins of formula were distributed to babies in need of formula. 

Mother Care Admission Story.  19-year-old Annie had a long labor and after 24hrs in hospital her baby boy was delivered by c-section on April 11th.  The baby developed a fever the following day and was admitted to the nursery (there is no NICU and only babies needing support are admitted to the nursery). Annie was discharged after two days but stayed on the hospital grounds waiting for her baby to recover.  On the fifth day after delivery, she experienced severe abdominal pain and began vomiting. She was transferred to the Regional Hospital and when the doctors opened her abdomen (11 days after delivery), they found that her uterus had ruptured during the delivery and it was also completely necrotic.  They did a complete hysterectomy and admitted her to the ICU.  She was discharged this month but is not producing any breast milk. Joyful Motherhood will continue to provide at home nursing care for both Annie and her son.

In April we admitted 11 babies (10 orphans, which included one set of twins) and one baby without breast milk.  The 9 mothers died from: 5 from postpartum hemorrhage, 3 from unknown causes and 1 from postpartum sepsis.

We are following 233 babies and 21 women. Nurses conducted 155 visits to babies and women in their communities this month. 477 tins of formula were distributed.

We lost baby Matness this month to a case of severe malaria. The baby girl developed a fever and died within 48hrs, despite care in the hospital.

Mother Care Admission. 22 year-old Martha started labor on March 28th, three days later she had not progressed and midwives noticed that the baby was experiencing distress.  From an outlying maternity clinic she was transferred to the District Hospital for a c-second.  Once she arrived, her baby boy was promptly delivered by c-section and they were discharged three days later.  On April 8th, Martha returned to the hospital, she felt dizzy, her abdomen was swollen, she was feverish and nauseous.  The clinicians opened her wound and found a severe infection, the purulent fluid was drained and she received a blood transfusion.  Martha was discharged home on April 20th.  She was enrolled in the Mother Care program by Joyful Motherhood nurses and they will visit her six times at home to check on her wound and to assess the progress of her healing.

Baby Care Admission. When 18-year-old Laina progressed into her third trimester of pregnancy, midwives at her clinic told her to wait for her labor to start at the hospital.  As a first-time mother they knew it would be safer for her to labor close to a hospital where emergency obstetric services including an operating room would be available.  Even though her belly appeared to be the size of a complete pregnancy, she was only 34 weeks when her labor started and Laina went directly to the District Hospital.  She had an ultrasound in early labor and was told that she was expecting twins.  The baby boys delivered without complication even though her second baby came out bottom first.  Then immediately following their birth Laina began to bleed profusely.  Thankfully the midwives were able to stop the bleeding and stabilize Laina.  Laina and her babies were discharged the following day.   At home, even with the support of her mother, the first days were very difficult and then her condition seemed to worsen rather than improve.  After a week at home her family took her back to the District Hospital.  Clinicians who admitted her knew that she was suffering from severe anemia and they admitted her but she did not receive a blood transfusion.  Finally, thirteen days after the birth a transfusion was ordered.   Blood was available but they did not have a blood transfusion set. Two days later, previously healthy 18-year-old girl died leaving orphaning her twin boys.  She died because there was no blood transfusion set at a District Hospital, where she had gone following the advice of her midwives specifically so she would have access to expedient emergency obstetric care.

In March 6 babies were enrolled including 4 orphans and 2 babies without access to breast milk.  (The four infants lost their mothers to postpartum hemorrhage, sepsis, possible cardiac myopathy, and gastrointestinal illness.  So many times when a woman dies in Malawi the actual cause is never identified which compounds the tragedy, this is the case with the story of Violet below. 

This month we lost baby Prisca, she was a 22-month-old triplet.  She developed pneumonia and was admitted to the hospital.  After three days in hospital, she died. 

This month 2 women were enrolled in the Mother Care program (one had experienced a severe postpartum infection and the other was suffering from severe anemia). 

Nurses are currently following 23 women and 241 babies.  This month they made 187 visits to women and infants in their homes.  560 tins of formula were distributed.

Baby Admission Story. Violet was only 21 and pregnant for the first time.  She attended her prenatal care visits but we are not sure how far along she was when she became sick.  At some point in her third trimester, she contracted a severe diarrheal illness and sought care at the district hospital.  She was given medications and sent home but nine days later she returned to the hospital feeling worse.  At that time they admitted her and she received a blood transfusion.  She continued to deteriorate and three days later her baby boy was delivered by c-section.  Violet died the following day, October 28th.  Violet’s family did everything possible to care for her surviving baby, they sought donations for formula, sold items to purchase formula, fed him watery porridge when formula was not available.  Finally in March Violet’s family learned about Joyful Motherhood and brought her baby for enrollment. 

Violet was a healthy young woman. The loss of her life is not only emotionally devastating for her family, the loss of her life also has financial implications.  First her family lost a productive adult who was actively contributing to the overall well-being of the family and second, after her death her family used scarce resources to care for her orphaned infant.  The loss of a single woman of reproductive age sinks a family deeper into poverty.  The tragedy of her death is compounded by the fact that her family will never really know why she died.  It is hard to imagine losing a loved one and not understanding the cause.  This is terrible for any family, and certainly this is also terrible for the clinicians who cared for her and even the Ministry of Health. The clinicians who treated her do not have the diagnostic tools to determine the true cause of her illness and cause of death.  Therefore, the ability to improve practice and prevent similar deaths in the future remains limited.   

We at African Mothers Health Initiative and Joyful Motherhood, are intervening and addressing a small part of a large problem.  We are now supporting Violet’s family as they care for her son in his first years of life.  Our goal is to see him through early childhood and ensure that his family has the knowledge and support needed to protect his health. We know the efforts, funds and support spent on these fragile newborns are worthwhile and life-saving.  Still, it is important to remain aware of the greater context, the complexity and interconnectedness of maternal and child health.

During the month of February we admitted 6 infants (5 orphans, and 1 baby without breast milk). Nurses visited 155 infants and distributed 550 tins of formula. We currently have 237 babies and 22 women in our care.

Baby Admission Stories.

(1) Twenty-year-old Alice’s first pregnancy ended in a normal delivery on September 25th.  Her small healthy girl went home with her two days after the birth.  Alice has flat nipples and her 5lb baby could not open her mouth wide enough to latch well.  Alice was determined to breastfeed, but the improper latch created pain.  Over the first week the pain worsened, sores developed on her nipples, the sores opened and bled with each feed.  Still, Alice knew there was no alternative to breastfeeding; her family could not afford to sustain a baby on formula; her daughter’s survival depended on her milk, so she continued.  Nursing did not go well.  Alice’s baby lost weight, neither she nor her daughter could adequately extract the milk from her breasts.  Her breasts swelled and hardened, they were exquisitely tender and she developed a fever.  Infections in the milk ducts grew into abscesses, which eventually ruptured through the skin of her breasts.  She returned to the hospital where midwives cleaned the wounds and taught her to hand express her milk, but the pain did not improve. 

Alice did not sleep. Her baby cried constantly from hunger. The unremitting pain and sight of bleeding breasts caused physical and emotional trauma. Her family continued to seek support.  As time went on Alice’s milk dried up and she became increasingly despondent.  In early February Alice was admitted to a psychiatric ward and her baby was taken by a family member to the hospital.  The nurse who met them in the hospital directed the relative to seek support with Joyful Motherhood.  JM nurses enrolled the baby and began instructing the relative in how to prepare and provide formula. Slowly, as her body healed, Alice’s mind also began to improve.  Quality postpartum care is necessary for all women. It is not often than we recognize the link between nursing care, lactation support, and accessibility of formula to maternal well-being and infant survival.  But, these elements should be included in discussions of maternal and infant health. Sometimes seemingly simple issues have life changing consequences.  

(2) Lolita lived in a community just outside Malawi’s capital city.  She was 21 and healthy.  On February 18^th she started feeling contractions and her family took her to the closest health center.  Midwives there checked her cervix and told her she was still in early labor, they instructed her to return home and come back once the contractions were stronger.  Lolita continued to contract through the night.  The contractions continued the following day, but she feared the nurses would again turn her away, so rather than return to the health center, she went to a prayer service with her family.  Much to everyone’s surprise her baby girl was born during the service.  Those around her immediately began to seek transportation to take her to the health center, but before they were able to move her, Lolita hemorrhaged and died.  Our dear secretary, Trust Kachala, happens to be a neighbor to the family and she was the one who told them to come and seek help from Joyful Motherhood.

We enrolled 14 babies in January! 3 sets of triplets, 4 orphans, and 1 baby whose mother had no breast milk. This month nurses visited 160 babies, 580 tins of formula were distributed and 261 women and infants remain in our care.

Baby Admission Story. Anna already had four children and she hoped that the fifth would be the last.  With five pregnancies she was considered a grand multigravida and all the midwives she saw during her pregnancy reminded her that her delivery might be difficult. She was told again and again that she would need to deliver at a health facility, with a skilled birth attendant.  Anna’s belly grew quickly and on August 2nd she arrived at the health center planning to stay through her delivery.  [Health centers are staffed with midwives, but do not have facilities necessary to handle true obstetric emergencies.] Finally, on September 21st Anna’s contractions started.  The midwife who met her that day at the health center told Anna that she was in labor with twins and encouraged her to  quickly make her way to a larger hospital with an operating room.  That same day, soon after arriving at Nkoma Hospital, Anna quickly delivered two babies.  Thirty minutes passed and rather than the placenta, Anna delivered a third baby.  The babies were premature but Anna was attentive and breastfed as frequently as possible.  Unfortunately, Anna could not keep up with the needs of her three infants and their health began to deteriorate.  Anna’s family could not afford supplemental formula and so a nurse at Nkoma Hospital posted a plea for support on Facebook.  Joyful Motherhood nurses saw the post and enrolled Anna and her babies. The nurses will continue to support Anna with her breastfeeding an provide enough formula to ensure that Tiyamike, Tiyanjane and Tikondane all thrive.

In December nurses admitted 4 infants (2 babies of mothers with severe mental health issues, 1 orphan, and 1 baby whose mother was not producing breast milk). Baby Stella, who was enrolled in program along with her twin last month, died this month following one hospitalisation for diarrhea and a second visit to the Health Center for malaria. Nurses also admitted one postpartum woman who experienced a severe infection. Nurses visited 165 women and infants and distributed 640 tins of formula.

Baby Admission Story. JS is 16.  She has struggled off and on with seizures for most of her life.  At times they are better controlled, at other times, no matter how many pills she swallows, the seizures keep coming.  As a result of the frequent seizures over many years, JS is developmentally delayed.   Earlier in the year someone identified JS as an easy target.  He attacked her, raped her, impregnated her and – as it was later discovered – infected her with HIV.  Thankfully she was able to communicate the identity of her attacker, and he is currently imprisoned.  But for her, there is no return to life before the attack.  JS will struggle with the psychological and physical effects of this trauma for her personal eternity.  This December JS gave birth to a 3lb baby boy.  She had no desire to see, hold or feed the baby and so her relative took in the baby and brought him to Joyful Motherhood.  After delivery JS’s health deteriorated again and she is suffering from uncontrolled seizures. 

This is a story with multiple layers of tragedy.  At times the problems which lead a family to our doorstep, eclipse all the aid we can possibly offer.  Our team cannot heal JS.  We cannot heal her family.  Our team will continue to bear witness, to listen, to validate, and encourage. Our nurses will support JS’s relative as she cares for and raises the baby.  It takes immense courage to remain present and attentive in the face of such deep suffering, but it is important.  We know from experience that giving someone a set of eyes to lock into, or a hand to steady them, is often in itself enough to save a life. Please donate to support our work.