Midwife with a difference

The world this Monday marked a population boom of 7 billion. Malawi’s own 7th billionth baby was born in Mangochi. But what does such a population growth mean for the people who play a central role in helping bring forth such beings? Sam Chibaya spoke to a nurse/ midwife Charity Salima based in Area 23 in Lilongwe on the challenges of rapid population growth.

The world is celebrating the seventh billion child. As a midwife, what is your reaction?

This is rapid population growth and as a result, we are forced to continue competing for the same limited resources that used to be there when the population was smaller.  We are overstretching the resources. For example, despite the population rise, we are still sharing the same land, nurses and doctors. Government is even being stretched to cater for extra people. This is not alright.

 

You are running a community clinic, how many children do you deliver in a day?

I deliver at least five to six children on a daily basis.

 

Do you empower the women to be in control when it comes to child bearing?

I always talk of family planning methods.  I tell them that a woman is not supposed to have a baby by accident but by choice. Time has come when people should ask themselves “do I need this number of children?”

Present times are unlike the past when culturally we believed that the more children, the more wealth you have, or children are there to continue with the clan name. These days having more children is a maternal burden as the mother is restricted in participating in development activities.

 

What are some of the common challenges?

Although there is family planning, still people are giving birth because culturally we say children have to be there in order to continue with the clan name and to help the parents.

 

Is there a way of making giving birth easier?

Giving birth is a process and like any process, it has to be done in a normal way.

Some women are said to take medicine, particularly herbs, to induce labour. Is this advisable?

It is not advisable because labour as a process has a time that it is supposed to last. Now if one tries to induce labour, it means she is supporting an abnormal process. Sometimes, this leads to a woman developing stress which can lead to ruptured uterus where the baby can suffocate and make delivery complicated. Labour cannot be normalised by inducing it. There is no short cut in delivery, let it follow its normal course. If we try to follow short cuts, it means we are endangering both the woman and the baby.

 

What about taking pain killers?

They are advisable depending on prescriptions from the physician and the need.

What would you advise on the number of children one can have?

It is up to a family to make the decision. I only offer pieces of advice and reason that when we consider the resources vis-à-vis the rapid population growth, the women or parents have to consider having a number of children they will manage to support.

For example, they have to be able to pay for their school fees or support them with their daily needs. Don’t forget that we run extended families and this makes our responsibility bigger. Now with the HIV/Aids pandemic, we are also forced to take care of the orphans. In all this we are competing for the same scarce resources. So the parents have to really consider this when deciding on a number of children. The motto is children by choice and not by chance.

 

Has nursing/midwifery always been your dream?

Yes, it has always been my passion. That is why I have been a midwife since long time back. I will die while a nurse and I want to be remembered like that.

 

Having spent over 20 years in the career, what passion do you have for the job?

It’s my passion and it is being renewed every day. Nursing is a career where we make a pledge. As citizens, we should not think of what the government is going to do for us. We should think of how I am going to contribute to my country, government, community, neighbour, to this mother and this baby. That should be the thinking.

 

Why did you choose to open a clinic after retiring from the private sector?

I have lived in Area 23 for over 10 years and as a nurse/midwife and I used to see the problems women faced especially when they were about to give birth. Because from here to Kawale (Health Centre) it’s a distance, from here to Kang’oma (Health Centre) it’s a distance as well as from here to Bwaila (Maternity Hospital ) its far. Now you can imagine what these women had to face when they were about to give birth at night. That’s why many women were delivering at home, where accidents may happen and the child or the mother lost in the process.

But as a nurse and a woman from this area I wanted to leave a legacy for the people of my area. MDGs 4, 5, 6, are areas that we as Malawians need to assist government in achieving.

 

How do you manage maternal deaths?

As a nurse, you should have ears that can listen, a nose that can smell and eyes that can see. As midwives, we also have safe motherhood programme obstetric management protocols which I follow and I refer cases to larger hospitals. I also ensure that I upgrade myself.

Have you made any sacrifices in your career?

Most of the activities in nursing are a sacrifice. There are times when one is not supposed to be on duty but is forced to work during that time. We are even forced to sacrifice ourselves. We are there for somebody more than ourselves.

 

Usually, women are scared of their first pregnancy. When they enter the maternity ward, how do you help them?

The first timers in pregnancy are afraid because everything seems new to them. The first thing we have to do is to wear a smile and then give words of encouragement. I greet and tell her that it is going to be fine and she should be free to ask any question she has.

Can you explain the meaning of “nursing is a calling”?

Nursing is a calling because one has to give equal care to everyone irrespective of race, tribe, and colour. We give care to a person in his or her capacity as a human being. We also don’t look at the remuneration and benefits. We work to render support. Nursing is even recorded in the Bible, there were nurses there. So nursing is a calling as we are also required to make a nursing pledge and sing a nursing song where we pledge to be dedicated to our work. In the song we ask the Holy Spirit to come down so that the mothers should be saved.

Are you married?

Yes, I am married to Mr. Salima. He is supportive, and he has really helped me a lot. Family members too have been very helpful; they support me in everyday work. For example, my husband or family member is able to escort me to the clinic at odd hours. And my husband, when I am stressed would say “this is your job and it happens.”

 

How many children do you have?

I have three children, one male and two females. They are all working. My first daughter Naile studied humanities, the second born Matilda did computer engineering and the last Andrew graduated in education. And I also have a grandson, Mwanjiwa (meaning Beloved) who wishes  to become  a medical doctor.

He says

he   wants

to   continue with my work  when I die.

 

Where did you grow up and attain your education?

I grew up in Blantyre where my father comes from and I also spent sometime in Nkhata Bay, that’s my mother’s home district by the way. I did all my education right here in Malawi. But I have been to countries like Denmark , US, Zimbabwe and UK for on the job training.

 

How did your parents help prepare you for the career?

I am a nurse because of my mother. She was passionate, loving and kind. She used to keep and care for children from other homes.  She encouraged me greatly and would usually say “you can be a good nurse.” I said if my mother was saying I could be a good nurse why don’t I become one. My interest grew a lot while I was in Standard Three. I had zeal for being a nurse.

 

Also when walking along the hospital corridors and seeing nurses smile, my passion would be fired up. I was also encouraged to be a nurse when I saw a mother thanking a doctor for healing her baby. That touched my heart. Again I was also encouraged by my aunt Mrs. N. Masantche who is a nurse at Queen Elizabeth Central Hospital. Since then my zeal is being renewed everyday.

 

What clothes and food do you love?

I like the nursing uniform because it helps identify me as a nurse. When I am off duty I like to wear blue. In terms of food, I like a cup of tea with milk, nsima with roasted chambo fish and any type of vegetables. I encourage fellow nurses to stick to our profession because it is a calling.