September 2020 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 9th 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.