African Mothers Health Initiative

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

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maternal health

March 2022

Twenty-one babies were enrolled this month (10 orphans, 5 babies whose mothers are admitted in the ICU, 1 baby whose mother is not producing milk, 1 set of orphaned twins, 2 babies of mothers with severe mental health illness, 1 one baby whose mother left her with the grandmother). Two women were enrolled, both of whom lost their uterus due to birth complications – they are 19 and 20. Nurses conducted 190 visits to mom and babies this month.

Baby Care Story. Hannah’s mother was diagnosed with breast cancer and started chemotherapy but when she unexpectedly became pregnant at 40, she stopped her treatment. She delivered Hannah prematurely. Hannah weighed just over three pounds at birth, but she quickly put on weight with her mother’s breast milk. After two months her mother’s health began to deteriorate at a precipitous rate, and she returned to the cancer treatment center to resume her chemo. Hannah’s grandmother brought Hannah to us, requesting assistance with formula and nursing support.

Mother Care Story. Loveness was just 20 and pregnant with her first baby. Her labor was long and hard. She headed to health center when her labor started and was watched by the clinicians there. But,health centers do not have the facilities to conduct c-sections. By the time she was transferred to the District Hospital, it was too late. Her uterus had ruptured, her baby had died, she was bleeding internally. Loveness lost her baby and her uterus and almost lost her life. At the time of discharge, Loveness was weak and depressed. Joyful Motherhood nurses will visit her at home over the next couple of months, but she is just starting a long road to recovery.

Many times when policy makers, academics, aid organizations, etc. consider maternal mortality and strategize ways to improve statistics the emphasis is placed on receiving prenatal care and delivering within facilities. However, the vast majority of the women we care for, or whose orphan babies are enrolled in our programs, have followed the “rules.” They attended prenatal visits. They made their way to health facilities for delivery. But in the end, they were not protected from excessive suffering or loss. As an organization we stand with the victims, who are often invisible to the larger system. Our support is focused directly on them.

If you would like to support our work, please DONATE.

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.

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.

September 2021

10 babies were enrolled (7 orphans and 3 whose mother critically ill in hospital). 147 babies were visited and 6 discharged. 243 babies are being followed

2 mothers were enrolled and one discharged. 23 women are being followed

Mother Care Story. 19-year-oldRhoda was healthy and had a normal pregnancy.  When her labor started she went to the nearest health center.  Labor was long and painful and did not progress.  After 24hours she was referred to the District hospital for a c-section.  At the time of the c-section her baby was already deceased.  She stayed in the hospital, with her cramping empty wound and empty arms listening to the crys of newborns around her for two days and then was discharged.  After spending just two days at home she noticed her abdomen beginning to swell and returned to the District hospital.  From there she was sent to the Regional hospital.  She began vomiting blood and seizing.  She was taken back to the operating room and a total hysterectomy was done – uterus, ovaries, baby gone.  On the medical ward her condition failed to improve and she was diagnosed with covid and then placed on isolation.  Rhoda is young and after several weeks her health was stable enough to discharge her but the emotional scars are deep.  Nurses will follow her not only to check on the visible wounds but also to counsel and encourage her as she begins to address the other invisible wounds that remain.

Baby Care Story. 19-year-old Dorothy went to her regular prenatal appointment toward the end of her pregnancy and diagnosed with pre-eclampsia.  Her legs were swollen and her blood pressure was quite high.  Within a few days her labor started on it’s own and she delivered a healthy baby boy.  Dorothy began to hemorrhage and was referred to Salima District Hospital.  There she received a transfusion of two units, but her blood loss had been significant and she died soon after.  Dorothy’s husband heard about our work through someone in his community and his mother arrived with the baby in arms.

August 2021

In August 19 babies were enrolled in the Baby Care Program. Of the 19, 13 of these babies were orphans, 2 babies with cerebral palsy and unable to breastfeed, 2 babies with mothers were unable to lactate, and one set of twins whose mother was not producing enough milk to sustain them both. Nurses visited 155 infants and 21 women.

Two women were enrolled in the Mother Care program.  One experienced sepsis and a difficult recovery, and the other mother had a severe postpartum infection which led to a complete hysterectomy. Both of their babies survived birth.

240 babies are currently being followed, 23 women are being followed.

Baby Admission Story. Chisomo’s mother became sick during her last trimester.  She developed a cough and a terrible headache that was unrelenting.  When she arrived at the hospital, nurses diagnosed her with high blood pressure and admitted her.  In an effort of self-preservation four days later, her body delivered Chisomo one month early.  She remained hospitalized for observation for an additional six days and then was discharged home.  Within two weeks, her condition deteriorated.  She died on her way back to the hospital.  No one knows the true cause of her death.  Covid? Pre-eclampsia? Severe anemia? Sepsis?  All these are possibilities.  What is known is that a previously healthy 39-year-old woman died on July 31st.  And with her death, her daughter Chisomo’s survival was also imperiled.   Thankfully Chisomo’s family was guided to Joyful Motherhood by someone who came to pay her respect at the funeral. Our nurses will continue to follow and support Chisomo over the next two years.

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

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