Meet the … traditional birth attendants

The car drops us in the internal yard of Bumula health facility. Sitting at the back seat and chatting with my colleague, my mind is somewhere else, so I’m surprised to see a big group of middle aged women sitting on a sloping meadow, below some trees. They are expecting us. I hesitate to get out of the car, as the group approaches us. What now? Formal greetings in order? But to everyone’s suprise, instead of waiting for formal introductions, one of the women starts singing, the rest follow. They start dancing. I’m dumbfounded. I get out of the car, my camera is on. Asking for permission? I’ll do that later, can’t miss the moment. The singing, the dancing create unique atmosphere in seconds. One solo voice, then the whole group and again and again, they dance in circle, come towards me, move back… (I hope you see the video), the shrieking they say is a special way to welcome really special guests. Yes, we do feel special!

Video

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They are the traditional birth attendants.

Women without medical skills, who provide what normally would be classified as “medical” services to mums, giving birth in their homes, and not in health facilities, across the whole country. In Kenya, with more than 50% of underage population, with high birth rate, with high poverty, high distance to health facilities that are not well equipped and understaffed in many cases, one can easily understand the profound role of these women in local communities. In some interviews we have taken at Save the Children, women quote they had 8 deliveries, 7 of which at home, therefore 7 attended by traditional birth attendants (TBAs) … And yet, these are women whose role has been largely denied by local and international health authorities, because of being untrained, unskillful, unsafe. So, you would ask, what do we do here?

In one of its many interventions as part of the Health Signature Program in Bungoma*, Save the Children work through local community health volunteers to recruit and convert TBAs to … birth companions, who actually encourage mums to go to the health facilities not just for delivery, but also for regular checkups before and after giving birth. As an organization focused on behavioral change in communities, Save the Children have realized they cannot ignore these so important local influencers and the stories we hear are proof of that.

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They dance and sing and laugh, and I have the chance to take many photos. Then we all sit under the trees, and wait for the senior nurse to join us for the meeting to start. Time passes by, the nurse is late, she’s busy attending a delivery. Finally she comes, wearing the same uniform as the TBAs. “These are my sisters,” she says. “They are proud to wear the uniform I’m wearing, this way they feel they are part of this institution. They are my girls.” The women smile. The nurse is late, because she just helped a young girl, 17 years old, to give birth, the granddaughter of one of the TBAs, as it turns out. “She just brought her here earlier today”. The meeting starts. We hear a lot of personal stories. They share how they persuade mothers. How sometimes it’s only them accompanying the women to the hospital, while men stay at home. How they work during any part of the day, and night. They stay with the mums, they encourage them to eat, to start breastfeeding, bring them back home. Each one is a story you hear with your heart.

Birth rate in the facility has gone up, in many of the cases it’s with the involvement of the TBAs. The sister is really proud of her girls, of the work done. We go to see the granddaughter, the young girl who just gave birth. There was some complication during delivery. Girl is exhausted. But she’s well attended to, and baby is feeling well, trying to suckle. Few years back, before Save the Children’s intervention, this girl would have probably given birth at home, the complication could have been fatal to the baby. This is the moment when I think.. one saved life.

*I am proud to say that GSK is the main donor for the Signature Program in Bungoma, which runs many interventions, converting TBAs to birth companions being one of them.