Ugandan midwife speaks to current health needs in Sub-Saharan Africa

Sabine Clappaert – WNN Features

Ugandan midwife Esther Madudu in the field
Ugandan midwife Esther Madudu listens to the heartbeat of an child in the womb as she assists a mother in the field. Image: SUAMC - Stand Up for African Mothers Campaign

(WNN) Deauville, FRANCE : “I came here to stand up for the voiceless mothers of Africa,” says thirty-one-year-old Ugandan nurse midwife and woman’s advocate Esther Madudu at Global Meeting 2011 of the Women’s Forum for Economy and Society in Deauville, France. She begins with murmured conversations dying down to hear her speak. “When people ask me: ‘What can we do to help you do your job?’ I answer: I need more of me. Every year, more than 200,000 women in Sub-Saharan Africa die during pregnancy or childbirth, just because medical care was too expensive or difficult to reach.”

The facts in much of Uganda and Sub-Saharan Africa present a harsh reality: only 28% of all health centres have the required supplies and equipment to offer basic emergency obstetric care, while 32% of hospitals in the districts have the supplies, equipment and staff to offer patients caesarean sections.

Madudu knows the dusty plains of the Soroti district in eastern Uganda like the back of her hand. She has lived there all her life. She has walked its trails and knows what the vast distances of Africa mean to the reality of its inhabitants. “I was eleven when I saw a woman deliver her baby next to the road,” she says.

The incident made a huge impression on the young girl, who decided to become a midwife. “I wanted to save mothers and babies,” she adds.

Saving mothers and babies is proving more than a full-time job for Esther, who now lives next to the local hospital, in a house she shares with three other families. Esther works as one of two midwives that attend to pregnant women throughout the region.

Getting up every morning at 5:30 Esther prepares breakfast for herself and her two young children. She then also prepares their lunch and dinner. “I don’t have time to come back home during the day so I prepare everything before I go to work,” she outlines.

Some days are busier than others and on the really busy ones, Esther can see up to forty women in a day. “And you know that more babies are born at night, so I have to be ready all the time,” she outlines.

But things are looking up: the hospital now has a doctor and Esther has heard rumors of an ambulance.

“Recognizing the importance of the role of midwives in improving maternal health, the professional scope of midwives has been expanded to include responsibilities that were previously reserved for medical doctors,” said Uganda’s Makerere University Institute of Public Health in 1999. “The administration of intravenous fluids, prescription of antibiotics, manual removal of the placenta and use of manual vacuum aspiration machines in post-abortion management are some of the new responsibilities that have been transferred to midwives,” continued the Institute of Public Health.

Conditions for much of Uganda’s medical facilities is basic at best. “Everything you take for granted in western hospitals, we don’t have,” says Madudu. “No electricity, no running water. It’s hard to encourage a woman to push with a mobile phone clenched between your teeth to cast some light (in the room),” she adds.

In the glaring stage lights of an assembled international press, Esther sits (at the Global Meeting 2011 conference), surrounded by other dignitaries.  She sits calmly; her hands folded neatly in her lap; her eyes scanning the audience from behind plain wire-rimed glasses. Swathed in a sunny orange sarong her face is framed by a turban, with a ‘cheeky bow.’ Madudu looks like a beautiful exotic peacock here among the demure grey of the Western European delegation.

Everyone on the panel speaks; of the need to educate local communities; of the urgency in building decent medical facilities; of the hardships they have witnessed on their trips to Africa.

When Esther is handed the microphone her voice booms confidently through the darkened hall.

“The only medicine we have to give women is ‘Verbacane’,” says Esther explaining the practice for Uganda’s nurse midwives of providing emotional reassurance to a client by talking to and physically soothing her. While women living in remote rural areas are used to having little access to health care or medicines, they are also the ones who are often at risk of dying from complications in childbirth.

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