Stories

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.

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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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With limited testing capability, 33 cases of Covid-19 have been identified in Malawi and three deaths have been attributed to the virus. An injunction to stay the original lockdown order by the President has been extended to April 29th. Fear of hunger and related civil unrest continue to eclipse fears of Covid. And, the goal of a lockdown in Malawi is being debated; there is no possibility of flattening “the curve” sufficiently to ensure that the health care system care would be able to cope with cases.

In this world, where everything is changing day by day – and where it seems everything is at stake – Joyful Motherhood staff continue to visit clients in their communities, supporting families with fragile babies as well as women convalescing after difficult deliveries. In the above picture are nurses Verina (left) and Nitta (right) and our driver (Mr. Ritchie).

On March 23rd there were no confirmed Covid-19 cases in Malawi but President Peter Mutharika, declared a national disaster and closed all schools and universities. As of yesterday there were 16 confirmed cases of Covid-19 in Malawi and two deaths. In response, the President issued a three week lockdown order, scheduled to begin Saturday, April 18th at midnight.

Anxiety runs high. People are afraid, not so much of Covid-19, but of the order’s impact. The health care system, in normal times, functions at a skeletal level. There will be no high acuity care for Covid-19 patients, only supplemental oxygen and basic nursing care. Hospitalization for those with Covid-19 is part of a containment strategy, not much more. But, with an extreme shortage of beds, even this function will not be sustainable for long. On a normal day at the regional hospital in the capital city, patients are seen on mattresses outside on the verandas due to limited space. Now, in order to decrease congestion of the wards, patients who are still fragile but deemed stable are being sent home. The concern is that fragile patients will be discharged prematurely and deteriorate at home while others with deadly but treatable conditions, like malaria, will not be able to access care. Recently delivered women are also being sent home as quickly as possible following their deliveries. Many not have any additional care or visits. It is possible that women may experience more severe postpartum infections due to an inability for prompt diagnosis and treatment in the early postpartum period.

Access to transportation may become a life threatening issue. The poor and working class use minibuses as their primary means of transportation. These converted privately owned minivans are ubiquitous in the developing world. Rows of seats are positioned as close as possible, so that the vehicles typically accommodate 21-22people when full. (This means that someone like me at 5’5″ will have my knees pressed into the seat in front of me and my hips pressed against those of the passengers to my right and left.) It remains unclear whether there will be provisions made for minibuses. If they are not allowed to run, hospital staff will have trouble presenting for work and patients with malaria or other acute conditions will struggle to access care. If they are allowed to run, people fear that they will help spread Covid-19.

People fear hunger. Most people survive day by day. The urban poor depend on small trading and the rural poor depend on the sale of their agricultural goods. All of this demands daily movement, daily connections, daily contact. The risk related to Corona virus is high but in a country where the per capita GDP is just over $1/day, in the majority of homes, there is little held in reserve.

Joyful Motherhood nurses are strategizing on how to continue serving our clients in this rapidly changing environment. They are educating about prevention, spacing out visits, and making more phone calls, but for the most vulnerable they must continue to visit and assess and bring food. At this time with the world entering a deep recession (at best), the effects are magnified in countries like Malawi, and exponentiated, in the homes of the extremely impoverished. For many of those we serve, our assistance helps individuals survive.

We know that regardless of where you sit as you read this, it is likely that your home has also been touched, directly or indirectly, by this pandemic. Still, we continue to rely on your generosity. We know that through the experience of our personal hardship we grow compassion, and we appreciate your collaborative support to care for those who need it most. Donate here

The opportunities available today for young women in the US and Europe vastly outnumber those available to their grandmothers and perhaps even to their mothers. While racing towards the future we are acutely aware of persistent inequalities and many of us actively work to address them. Today is a day to celebrate the fruits our journey thus far, the momentum we continue to build, and the sisterhood between us.

As we do this, let us also remember women who work hard with very little, striving for the survival and education of their children. Let us remember that women continue to lose their lives daily in pursuit of the basic joy of motherhood. And, let us stand with them as well. Support AMHI

Six year old Mercy came by our office last week just to say hello. Mercy’s mother died moments after her birth and Joyful Motherhood nurses visited her and her grandmother for the first two years of her life. Nurses provided formula, porridge, health education, and lots of encouragement. We are thrilled to see Mercy beautiful and thriving. This is what it is all about!

Miracle was born prematurely. Her mother suffered eclamptic seizures, and though she survived, she had a long slow recover and remained permanently impaired. Miracle was enrolled in March 2018 (see the full story and earlier picture) and with support from our nurses and the loving care of her family, she has thrived.