Activity Updates

January 2019 Activity Update

In January….

• 11 babies were enrolled including, three orphans, one baby with a mother in the ICU, one baby of a woman with severe psychosis, two sets of twins, and two babies whose mothers were not producing breast milk.
• 7 women were enrolled including, three for a ruptured uterus with subsequent hysterectomy and four for severe abdominal infections following their deliveries.
• Nurses visited 170 women and babies.

Mother Care Admission Story. At 18 Chimwemwe was pregnant for the second time. Her first child died as an infant and with that loss ever present in her mind she was praying for a healthy strong baby this time. She began laboring on December 22nd and reported to her health center. Two days later midwives determined that the baby was too big and sent her to the district hospital where a c-section would be possible. Chimwemwe delivered a healthy baby boy by c-section that same day. She was overjoyed with her baby but the pain from her surgery only increased over the following days. Clinicians at the district hospital noticed the deterioration of her health and sent her to the region’s high risk maternity hospital. There she underwent an exploratory laparotomy, they drained a half liter of pus, inserted a drain and started her on antibiotics. On January 12th she appeared greatly improved, the drain was removed and she was sent home. Joyful Motherhood nurses started their visits.

Baby Care Admission Story. 22 year old Monica had a normal healthy pregnancy, she delivered her baby boy in the hospital. After his birth she began to hemorrhage, the bleeding was not stopped in time and the requested blood products were not available. Monica died quickly. Her mother left the hospital with a grandson, one tin of formula and her 22 year-old daughter’s body. She was referred to Joyful Motherhood for continued support.

December 2018 Activity Update

This December….

– 10 babies were enrolled in our program, including three orphaned newborns, one set of triplets, one baby with multiple congenital anomalies, one baby who was abandoned in a public space, one baby’s whose mother was not producing breast milk, and one baby whose mother was on chemotherapy.

– 7 women were enrolled including five with ruptured uteruses and subsequent hysterectomies, and two with severe infections following c-sections and subsequent.

– Nurses visited 138 women and babies

Baby Care Admission Story.
Mary was pregnant with her fifth child when she tested positive for HIV. She attended prenatal clinic and was able to receive anti-retrovirals to lower her viral load and decrease the risk of transmitted the disease to her baby. She went into labor a bit earlier than expected but delivered a healthy five and a half pound baby boy. Mary’s health seemed stable but she had developed a sore on her leg which, despite herself care, only seemed to get worse. The midwives who attended her delivery determined that the wound was severe enough to refer her to the regional hospital. There clinicians biopsied the wound and diagnosed her with cancer. Mary soon began chemotherapy but was forced to stop breastfeeding. At this point Mary and her baby boy were referred to Joyful Motherhood.

The World Health Organization recommends that HIV positive women exclusively breastfeed their babies to six months. WHO recommends anti-retrovirals during pregnancy and breastfeeding to decrease the risk of transmission. The risk of death from malnutrition or diarrheal illness for a young baby in Malawi outweighs the risk of HIV transmission from his mother. Formula is used as an absolute last resort, for babies who do not have access to the breast milk their need to sustain their lives.

Joyful Motherhood nurses are visiting Mary and her baby, providing formula, monitoring his health, growth and development and providing health education to Mary.

Mother Care Admission Story.
Sakina felt some early painful contractions on October 15th. She was a healthy 17 years old, expecting her first baby. Her mother accompanied her that day to the nearby health center to ensure that she labored under that watchful eyes of trained midwives. Soon after their arrival Sakina began seizing. She had developed eclampsia. Sakina was transferred to the district maternity hospital for high risk management.

Pre-eclampsia is a life-threatening disease of pregnancy. Even in 2019 our knowledge of pre-eclampsia is incompleted. We know risk factors but cannot predict who will be affected. When a woman suddenly develops high blood pressures and has protein in her urine she is diagnosed with pre-eclampsia. Delivery is the only cure. In the US a woman with pre-eclampsia is monitored carefully and delivered as soon as possible. In Malawi these early signs are often missed. There is often not much time between their onset and the quick acceleration of the disease. Pre-eclampsia may affect all the major organ systems and ultimately lead to death. Seizures indicate an advanced disease process (eclampsia).

On October 30th Sakina finally delivered a six pound baby boy. She was critically ill but clinicians believed she was well enough to go home and discharged her on November 4th. Sakina’s body was struggling to heal from the eclampsia and the c-section and she did not produce any breast milk. Her mother anxiously and loving tended Sakina and the baby, she saw them both struggling, but how could she leave Sakina to seek help for her grandson? She feared Sakina would deteriorate if left alone and where would she even go to get milk. Within one week Sakina’s baby boy wasted away and died. On November 11th Sakina’s mother could wait no more, she decided that to save Sakina, they would go to a mission hospital. She would have to pay for care but she would worry about that later. At the mission hospital doctors diagnosed Sakina with a severe infection and referred her to the region’s high risk maternity hospital. There Sakina was diagnosed with severe peritonitis and a necrotic uterus. On November 12th 17-year-old Sakina was taken to the operating room and underwent a total hysterectomy. Weak and critically ill Sakina stayed in the hospital for over a week. On November 20th when it was noted that her condition was not improving, she returned to surgery. Her wound was reopened more purulent material was washed from her abdomen, four drains were placed. For the next month she stayed in the hospital, her wound slowly healing. On January 4th Sakina complained of leaking urine and a fistula was noted. She was referred to the fistula center where she was taught about dressing changes and discharged home on January 6th. She was still leaking urine but would have to wait until her body was strong and healthy enough to undergo the first repair surgery.

Joyful Motherhood nurses first met Sakina while at the high risk maternity hospital. They followed her after discharge and will continue to visit her, monitoring her health and offering emotional support to her family until she returns for her fistula surgery.

November 2018 Activity Update

In the month of November…

– 9 babies were admitted, including one set of triplets, 4 newborns with critically ill mothers in the ICU, 1 premature baby with a sick mom, and 1 baby whose mother’s milk had dried up completely

– 7 women were admitted, 3 with a recent history of ruptured uterus and hysterectomy, 1 with eclampsia, 2 with severe anemia, and 1 with a severe infection and vaginal fistula

– Nurses visited a total of 136 women and babies

Mother Care Admission Story

Domisa was expecting her third baby. She had two normal deliveries but her third labor was long and difficult, she was ultimately referred from her health center to the district hospital where she was delivered by c-section. Three days later, when she should have returned home with her newborn son, nurses noticed pus oozing from her surgical wound. She returned to the operating table and found that the first surgery was done incorrectly, a lip of her uterus had been sutured to her bladder. At that point the infection was so severe that they removed her uterus, her bladder was damaged in two places and a fistula. Her wound was left open to continue to drain. A month after her labor started she was sent from the first district hospital to a fistula center to await surgery for fistula repair. Joyful Motherhood nurses met her in early November and continued to follow her and her baby once she was discharged home.

Baby Care Admission Story

Joyce was pregnant for the 6th time, she attended her prenatal visits as recommended at the clinic closest to her home. Her belly swelled quickly and about one month before the time she expected to deliver, she started contracting and felt a small pop followed by slowly leaking fluid. She made her way to the district maternity hospital and soon delivered four live but small babies vaginally. She was admitted to the kangaroo ward with her four newborns but within the first week her last baby boy died (the probable cause would be infection contracted from the hospital). She was then referred to Joyful Motherhood. Joyful Motherhood nurses have been visiting Joyce at home and supporting her in the care of her babies since November.

October 2018 Activity Report

In October 2018….

  • 8 babies were enrolled, including 4 orphans, 1 set of triplets, and one newborn whose mother was critically ill.
  • 6 recently delivered moms were enrolled (their birth experiences include: eclampsia, pulmonary edema, ruptured uterus, and severe infection)
  • Nurses conducted 149 visits to beneficiaries.

A Woman’s Story.  Lonely Harold was enrolled in October.  She was 20 years old and pregnant with her first baby.  She started labor at home and then made her way to a health center. When it became clear that the labor was not progressing, she was sent to the district’s maternity referral hospital.  At some point her baby girl died inside of her, but it was not until after her c-section that she learned that she would not return home with a baby at her breast.  While still in the operating room, Lonely experienced a heart attack and required resuscitation, her lungs filled with fluid and she was sent to recover in the ICU.  Twenty days later she was discharged home without her baby.

A Baby’s Story.  Tikhale was 23 years old.  Her first baby was a stillbirth.  Her second labor was difficult and finally, on October 10th, resulted in a c-section.  Her newborn daughter was distressed and needed resuscitation but they were both discharged home in stable condition after a few days.  Several days later Tikhale returned complaining of stomach pain, she was hospitalized and given a transfusion.  She stayed in the hospital for two weeks and died there.  The woman who took in her baby, named her Memory and was referred to Joyful Motherhood for support.

 

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.

August 2018 Activity Update

In the month of August, 10 infants and 4 women were enrolled in our programs.

Of the 10 babies, 5 were orphans, the mother of 1 was critically ill in the ICU, the mother of another prematurely stopped producing breast milk, and the remaining 3 were underweight.  Nurses visited 144 babies this month and are currently following a total of 245 babies.  Seventy-five babies are on formula and 230 tins were distributed.

Of the women admitted, one had eclampsia, two had severe infections, and one experienced a ruptured uterus. Twenty-three home visits were made this month to sick women.

Here are a couple stories:

Baby care story: Jean was 19years old and having her first baby.  On July 15th she began to bleed spontaneously.  Luckily she made it to the hospital in time for an emergency C-section.  Her baby boy cried as he was lifted from her body; he was a strong healthy baby weighing 5.5lbs.  Soon after the surgery, mother and baby were deemed stable and transferred to the postpartum ward where they would remain for the next several days.  On July 18th Jean complained of heart palpitations.  In the capital city, in the district hospital, in the ward, Jean died before a nurse responded to her complaint.  Jean’s death tragically illustrates the inadequacy of the health care system.  She may have died from an infection or from internal bleeding or something else.  No one will ever know why she died at 19.  Her son will never again feel her warmth, taste her milk, or hear her voice.  Nurses directed her relative to the office of Joyful Motherhood, located on the same campus as the hospital, and they were admitted to our program.

Mother care story: On 21st August, 2018 Juliet started convulsing.  Staff at the rural hospital where she was, started her on medication to try to stop her seizures then transferred her to the referral hospital in the capital city.  When she arrived her baby was delivered by C-section. The baby took his first breaths but did not cry.  On August 26th her baby died. On August 28th, Juliet was discharged home to her village.

Each of the remaining 12 admissions for the month of August has an equally heart-rending story.  For many, these stories include the death of a baby or a mother.  These tragedies indelibly mark the lives of family members left behind. However, they (the sister or mother of the woman who gave birth) make a conscious decision to continue forward and care of the vulnerable survivor.  They do this at great personal cost. And, thanks to you, those who find their way to Joyful Motherhood are granted the necessary support to multiply their efforts.  Sacrifice + support = hope…. and later joy.

July 2018 Activity Update

  • 17 Babies were admitted in July.  The mothers of 13 of these babies died just after their births.  The mothers of 4 of these babies are not producing any milk, including 1 set of premature twins.
  • Nurses visited 155 babies
  • 70 of the 248 babies currently in our care are receiving formula, 250 tins of formula were distributed.
  • 4 sick women were enrolled this month and 20 women received visits from nurses

July Admission Stories

Anna went into labor with her 4th baby on June 22nd.  After a long day of painful contractions and no progress, she delivered a 9lb4oz baby boy by c-section.  Mom and baby seemed healthy and were discharged home four days later.  On June 26th Anna complained of a headache and started seizing.   She quickly deteriorated and died at home on the same day.  Baby Lyson and his aunt (pictured above) were referred to Joyful Motherhood to receive assistance.

22 year old Oliveta was well throughout her first pregnancy.  The hospital was far from her village home and so, like many Malawian women, when labor started she stayed in her village and delivered her baby girl at home.  Unfortunately she began to bleed after delivering her daughter.  Those with her were unable to stop the bleeding and there was no quick way to transport her to the hospital.  Her life slipped away within minutes making her tiny 4lb daughter an orphan.  Her relatives brought the baby to the health center seeking help and were referred to Joyful Motherhood.

17 year old Mphatso came to the health center on June 6th for her regular prenatal visit.  This was her first pregnancy and she wanted to make sure her baby was growing well.  While at the health center she fell to the floor and started seizing, that same day she was transferred to the referral hospital and a c-section was done.  Her premature baby weighed only 4lbs.  Nine days later she developed a distended abdomen and an exploratory laparotomy found a severe infection. At that time they did a total hysterectomy.  On June 29th her wound was found to be severely infected. Finally on July 12th, still weak and on anti-hypertensive drugs, she was discharged home.

These are a few of the difficult stories from July.  The need is immense but with our combined compassion, hope, and resources we can support these women and families through their most difficult moments and see them through to the other side.

June 2018 Activity Update

  • This month 9 babies were enrolled, all of whom are orphans.
  • Nurses visited 140 babies during this month.
  • A total of 241 enrolled babies are currently enrolled.
  • 300 tins of formula were distributed to infants without access to breastmilk.
  • One well loved 7-month old girl died of malaria.
  • 6 postpartum women were enrolled this month (1 with severe anemia, 2 with eclampsia, and 2 with a history of ruptured uterus and hysterectomy)
  • We are following 28 women.

Lofina Kingsely was enrolled in our program at three months when her mother suddenly stopped producing breast milk.  With the supplemental formula and home visits, Lofina was growing into a healthy toddler.  On May 1st she became violently ill. She was diagnosed with malaria and treated at the local health center.  When there was no improvement in her condition, Lofina was transferred to the district hospital.  Tragically, despite additional treatment, Lofina died from malaria on May 3rd.

Charity Malota was one of our new baby admissions in June.  Charity’s 18-year old mother attended regular prenatal care and went to the hospital when she felt labor pains increase take hold and increase in intensity.  Charity, a small but healthy baby boy was born on 25 February. And after a few days, mother and son were discharged home in good health.  On June 11th Charity’s mother complained of a severe headache and went to lie down.  Providers presumed that Charity had cerebral malaria, within an hour his mother had died.  Relatives who knew about Joyful Motherhood escorted the guardian and baby to our office.  It is our mission to ensure that despite the tragedy this little life continues to grown and thrive.

Annie Yakobo is a 22 year old who was admitted this month. The delivery of her second child was difficult and she ended up with a c-section.  Several days later her abdomen became very swollen and pus started leaking from the incision.  When she was returned to theatre they found her uterus was already necrotic and the clinicians proceeded with a total hysterectomy.  Annie is alive but still very weak, she was discharged home to a very poor environment, and will need to continue to administer to her wound for sometime.  Her baby girl’s life is at risk, simply because her mother is ill.  Joyful Motherhood will be present to help see them through this difficult time.