African Mothers Health Initiative

Providing care for critically ill mothers and vulnerable infants in Malawi.

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Stories

What does your heroine look like?

Every month we hear tragic stories of young women who die shortly after childbirth and of women who lose their babies and/or their uteruses in the course of their labor and delivery experiences.  But, we also hear stories of incredible sacrifice, strength and resilience.  The women who are enrolled in programs sponsored by AMHI are heroines.  They take on the care of fragile newborn orphans and believe in the possibility of their survival even when those around them do not. Before they find us, many of them keep fragile babies alive by selling their own meagre food stores to buy a few tins of formula. Others overcome incredible personal losses – their health, their child, their relationship – and bravely move forward rediscovering hope and purpose. They are our heroines and here are some of their faces…

Who is your heroine? Have you told her? Consider making a donation in her honor to support these women HERE.

One Story.

This story was recorded as part of a focus group, transcribed, and translated in 2021

I had a difficult delivery with my fourth born and needed a c-section. After I returned home my stomach began to swell. One day I returned to the doctor and told him that I was experiencing chest pain. He said not to worry, he would prescribe some medication and that I would feel better. But, I knew I was very sick, so I refused. I said, “Doctor, I live very far away. Please help me while I am here. It will be difficult for me to find money to come again.” He said ok and ordered an x-ray.  He told me they saw something in my uterus and that I should pay K15,000 ($20) to get my uterus cleaned. I said I did not have that kind of money. If it meant dying, I should just die. He said, “You will not die, we will call for an ambulance to take you to the Regional Hospital.”  I arrived at the Hospital and was there three days before they took me for surgery. My stomach was so swollen. They did not suture the wound and I did not eat for a whole month. I stayed in the hospital for two months. They would just clean the wound. My baby was also in the hospital on a different ward, he was receiving formula but was malnourished. At one point while I was there, a nurse from Joyful Motherhood [AMHI’s sister org] gave me a card and told me to call once I was discharged. Finally, after the two months, I returned to the smaller hospital near my home where they partially sutured the wound and then discharged me. 

When I returned home to my elderly grandma, I told her, “I am not producing milk, I am eating but there is no milk.” We did not know what to do. I said, “If you have K100 ($0.12) please, let’s call the one on this card and maybe they can help.” My grandma did not have K100. I had no money and my husband had sold all the maize [the staple food in Malawi] we had in the home to cover the costs of our hospitalization. In those days, my baby cried a lot, I had no breast milk and so I was just giving him porridge. He was three months old and very malnourished.  One day my neighbor heard the baby crying and came by and asked me what we should do, I told her about the card and she told me to call the number using her phone.  I talked to them and they said, “We have heard you.  Please do not give water or porridge to the child, your child will live.”  I wondered if the child would really live, the way he was crying, but they assured me that they would come. They came the next morning. At that time, both my baby and I were sickly and malnourished. People in my area thought we had been discharged home to die. The Joyful Motherhood nurses gave us a thermos, 7 tins of formula, they also gave me a pack of soy flour to use to make porridge. I started eating that porridge the same day. After that, people started saying that I was looking like myself again. Life was returning to me. The next month when they came and weighed the baby, they noted that the weight had improved. I kept giving the baby the milk and the health improved, I also received soy flour and I was better.   

Joyful Motherhood has helped me a lot in my household. When they discharged me from their program, they gave me K10,000 ($12) and said I should start a business. My neighbor kept the money for me initially and I found odd jobs – like washing laundry – to earn a little more. Then I rented a small a garden and cultivated it. I harvested ten 50kg bags of maize. There is no hunger in my home now. Joyful Motherhood nurses helped to improve my home, they taught me how to care for my children, they encouraged me, they taught me many things. I thought we would die; there was no food in my home, Joyful Motherhood restored hope in my home. My home is no longer the same. I am thankful to Joyful Motherhood. Please continue this work.

January in Malawi

I’ve always found colors to be more vibrant in Malawi, particularly in rural areas. As we drive away from town, I touch my face to see if the effect is from my glasses, but I am wearing none. Perhaps it is the humidity or a horizon where earth touches sky and buildings rise from the fabric of the land.  Red earth births red bricks, which are topped with thatch and the occasional tin roof reflects sun and sky.  Along the road, a string of kiosks, simple thatched shelters, their hand-painted signs distinguishing one from its neighbors.  “Dine Fine.” This morning a young woman peers into a pot and stirs in her roadside café.  The rains are late, but they have arrived, and from a distance the damp earth seems to bear its first fruit – bright colors are grouped together among the tilled rows.  Men and women – mostly women – in vibrant prints, bend at 90-degree angles with hoes raised then thrusting downward.   A landscape of sienna and green against a blue-purple sky.  Six bunches of bright green lettuce stand alone in the open window frame of a small teal-painted village store.  A woman’s red skirt catches my eye from where she stands in a field of black soil.  Men herd cattle and swat at two bulls whose flaring tempers blind them to their surroundings. As they butt heads one suddenly shoves the other into the road.  Our driver swerves in time and chuckles.  The beguiling beauty leads your mind’s focus away from the poverty.  This is a season of hunger.  Food stores are low and without irrigation all hopes rise upwards, coalescing in the heavy clouds. Perhaps hope alone becomes heavy, each thought a particle drawing in moisture and culminating in the thunderous precipitation.

Today we visit five homes, six orphans, and their aunts and grandmothers who care for them.  Down a dirt road we stop in a rural trading center.  (Trading centers are areas along a main road – some paved many not – with a few shops and sometimes electricity.)  The first home is set back a few feet from the road in a cluster of buildings.  We enter and sit on a grass mat.  The only other items within the 6 x 8ft room are the items for the baby that we previously provided (a thermos for clean water, a bucket to keep the cup and spoon, and a tin of formula).  Through an open doorway, I see into the other room in the house.  It is no larger than the room we are in.  I see stacked bags in the shadows, likely containing the family’s clothing and food.  Like the homes of all of those in our programs, there is no running water here, no toilet, no kitchen. The woman who joins us on the mat and unwraps a baby from her back is the grandmother.  She looks no older than 40.  The baby, now four-months old, was the first born of her 18-year-old daughter who died in childbirth.  The young grandmother has three school-age children who are not in school because she has no money for school fees.  Her husband died last May, and she now rents this tiny house, earning money by washing clothes.  Nurse Verina chats with the grandmother, asking about their situation and the baby’s health. Verina’s energy is warm and the grandmother’s receptive.  Verina assesses the baby and gives more formula. The grandmother expresses her gratitude, and then we leave.   

Next we visit Chikondi.  He weighed just under 3lbs at birth.  His mother and twin brother died during the birth and his grandmother was so fearful that he would die in her care that she begged Verina to take him.  Verina says that in the early days, they would have the same conversation at each visit and she would have to repeatedly assure the grandmother that she was capable and that we would support her.  Today he is 19-months old. He is walking, and his grandmother playfully tells Chikondi that his grandmother Verina is here to see him.

We visit Chisomo whose grandmother meets us in another trading center.  Verina says the house is very far away so they only occasional visit in the home.  Chisomo is eight months old, she is still taking some formula but should be eating food at home as well.  Her hair is thin and Verina asks what they ate before leaving today.  Chisomo’s grandmother says there no food in the house and asks for K200 ($0.25) to buy a little.  Verina checks Chisomo’s inner eyelids, notices she is a bit pale and asks if there is a mosquito net in the home.  (Malaria is a major cause of childhood anemia in malaria-endemic countries.)  The grandmother says there is not.  Mosquito nets are often distributed for free at health centers, but frequently they wear out before next distribution date.  I hand the grandmother money for food and for a net.  Verina gives them formula and porridge and we leave.

We visit Julie who is being cared for by her father and paternal grandmother and then Ganizani and his grandmother.   Our day ends on the front porch of an aunt with her beautiful twin nephews.  What is clear at the end of the long day is that we are not coming close to solving all the problems of the families in our programs.  But, we are ensuring the survival of their most vulnerable members.  Care is provided with deep compassion and respect.  And when hope is reignited, its natural companions, joy and gratitude follow.

Material Donations Needed

For those of you who like to give items, we have a couple specific needs (thermoses and graduated beakers) and an organization (www.MalawiProject.org) which is generously donating shipping to Malawi. Please note the shipping address on the wish list and clearly ship to African Mothers Health Initiative. Donations received by the end of the month will be sent to Malawi.

Why thermoses and beakers? About a third of the babies enrolled in our program at any one time are orphans and they need formula to survive. The homes of our beneficiaries are basic and families live well below the poverty line. Many households cannot afford soap. Most of the homes do not have running water. Some homes do not have easy access to potable water. Most guardians must walk to either a borehole or a stream to fetch water, carry it back. The women then use firewood – also gathered by hand – boil the water, then finally use this clean water to prepare formula. Because the clean water costs so much in labor and is also absolutely necessary to ensure the baby’s health, we want them to have a place to store the water (thermos). We also discourage the use of bottles and sippy cups because they are difficult to clean. Rims on bottles and small holes in sippy cups easily accumulate bacteria which leads to diarrheal illness. Thus, we supply each family with a graduated beaker that they can use to safely and accurately use to prepare formula.

If you would like to send a thermos or beaker to a baby in Malawi, please visit our Amazon wish list here and ship it to: African Mothers Health Initiative 2421 Golfside Dr. Lebanon, IN 46052-8176.

(If you regularly make purchases from Amazon and would like Amazon to donate to us, please use https://smile.amazon.com and select African Mothers Health Initiative as your supported charity.)

Survivors of Traumatic Births

When Rhoda showed up with a small bump of a belly for prenatal care at a rural clinic, the midwives told her that she would need to deliver at the District Maternity Hospital.  She was only sixteen and they foresaw a difficult birth.  It would be risky to attempt to deliver her in a facility that had minimal capacity to offer emergency obstetric care and no capacity to conduct a cesarean section.  They reminded her each visit and when her labor started on October 23rd, she made her way to Bwaila (the District Hospital).  The labor was indeed hard. With no pain medication, Rhoda suffered the onslaught of her contractions without progress.  Finally in the afternoon of the follow day she delivered a baby boy by cesarean. Her son had experienced a great deal of stress during the labor and his condition was poor, rather than stay with his mother he was sent to the nursery, where he would receive oxygen and share a warmer with one or two other babies. On the 25th Rhoda’s abdomen was painfully distended and nurses observed green discharge oozing from the wound.  She and her baby were transferred to the Regional Hospital for additional treatment.  On the 26th, clinicians reopened the wound and her abdomen was irrigated.  She did not improve.  Nor did her son.  On November 4th she had a total hysterectomy – uterus, ovaries, hope of future children gone.  On the same day, her baby died.  She was discharged home on November 11th. 

Statistically, Rhoda is a success.  She is not counted among the many African women who die in childbirth. Rhoda is a survivor. But, when we focus in on her story and the struggles she will endure from this point forward, we can only count it as a tragedy.  There are so many more women like Rhoda on the continent who struggle to go on after traumatic births, which leave them both physically and emotionally wounded. Join us to support the re-empowerment of Rhoda and women like her and to bring attention to their lives. Donate Now

Innocent

Angela was a healthy 23-year-old, pregnant with her second baby. The midwife notes and lab results in her prenatal booklet foretold an uneventful labor and delivery. When her contractions started, Angela arrived at the health clinic with the trepidation that is universal among laboring women, but she reassured herself. This was not her first. This time her confidence tempered the fear. A few hours past midnight on May 10th, her son was born. She named him Innocent. Innocent and his mother headed home on the 12th. Over the following days, Angela began to feel sick. A new cough developed then worsened until the fits caused her to vomit. Her family took her back to the clinic. A sputum sample was taken and sent to check for tuberculosis. She had a chest x-ray. She died. There is no record of the results of the tests, there was no further investigation. Her devastated family was left with a newborn and many questions that will never be answered.

Angela’s family was referred to Joyful Motherhood by neighbors and our nurses have been providing support over the past three months. The picture above is of Innocent at three months on his grandmother’s lap. He is doing well and we will continue to provide support until he turns two. His grandmother, though still grieving the loss of her daughter, is relieved that she now has support to ensure that her grandson will survive his infancy.

This work is only possible when you partner with us. Please consider a recurring monthly donation. HERE

In Elizabeth’s Words

Elizabeth is one of the nurses who works for Joyful Motherhood. I asked her to tell us about her work and this is what she said…..

I enjoy my job because of the care we provide. After enrolling babies we follow up with them in their homes. One interesting thing I have noticed is that when we enroll clients at the office, they act as though they understand everything we tell them; maybe they feel uncomfortable or intimidated because it is within the hospital. But, when we go to them in their homes, they feel free. They ask questions. They ask for clarification about what they did not understand. And, over the period that we continue to visit, we see the children growing well. We are happy and the families are happy.

With regard to the mothers, we feel also happy because we know we are doing a lot for them. The picture above is a mother we enrolled last week. The mother had a c-section but was very sick afterwards and was hospitalized for two months. Her milk dried, her husband abandoned her, and she had no one rely on. The other women and families in the hospital were actually contributing money so that she could buy formula for her baby. One of the our nurses found her at the hospital and enrolled her in our program; she was greatly relieved. She was finally discharged last week and taken by ambulance all the way to her village, one hour away. Her neighbor called us when she arrived to let us know that she had been discharged and told us that the child had no formula. We went immediately and were saddened to see that the baby was just crying. They didn’t have anything to feed the baby so they were just mixing sugar and water for feeds. I brought formula, prepared it and fed the baby. I checked on the mother’s wound, which is healing well. They were so happy with the care received.

I love my job. When you work in a clinic as a nurse, you just give the prescribed medicine, you do not follow the patients. You do not know if they understood your instructions, or if they have what they need to care for their family member, you may never see them again. But, here we see our patients in their homes monthly and we know that what we are doing is indeed benefiting many.

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