Editor’s Note: This article was written before the pandemic. Since then, we have implemented COVID-19 prevention measures, like social distancing and limiting the size of gatherings, across all our programs. This means that we have had to temporarily pause Maternity Open Days, with a commitment to resume them as soon as safely possible.
Hezron Salamba Matumusi’s wife had to go to work during the first ever Maternity Open Day held in their village of Vikunga in Western Kenya. So, Hezron went in her stead. He sat amongst fellow community members under a vinyl canopy that weakened the equatorial sun beating down upon the public clinic’s lawn. Listening intently for hours, Hezron dedicated his entire day to learning about maternal and infant healthcare.
First, community health volunteers in bright blue vests sang catchy songs with lyrics about best practices for prenatal, delivery, and postpartum care. In one verse, the chorus members chanted, “It’s important for pregnant women to go to health facilities.” As they ululated and thrust their arms in and out of a tight circle, the lead singer intoned, “They should go at least four times.”
Next, community volunteers acted out educational skits, in surprisingly naturalistic and comedic scenes. The audience burst into laughter even as they absorbed key health messages: always sleep under a bed net to prevent malaria; give birth in health facilities instead of at home; if possible, initiate breastfeeding within one hour of birth. A Q&A session provided community members the opportunity to ask professionally trained health workers about whatever they wanted to know. They asked questions ranging from how to best communicate with an emotionally distant, pregnant spouse (write a note), to whether health services are free of charge at Vikunga clinic (they are).
A tour of the maternity ward
As the day’s final activity, women took a guided tour of the clinic’s maternity ward. They crowded into every inch of the room, which had been inaugurated one year before. Nurse Joyce Imbahala Makanji showed off the modern equipment and facilities. She reiterated that all services are free, from ambulance rides to postpartum pads. She also assured the women that the clinic would not discard mothers’ placentas. This misinformation had kept women away in the past, since tradition dictates that families bury the placenta on their homestead.
For Hezron, this is personal
While the tour was going on, Hezron stayed behind with the other men, conversing about all that he had learned. The subject of maternal healthcare is deeply personal for him. A 49-year-old father of six, he lost his fifth child to stillbirth in 2013. He believes that the baby boy might have been saved had he taken his wife to the hospital right when she started to have unusual abdominal pains. Instead, they waited until his wife went into pre-term labor, by which point the baby had already died in the womb.
During labor, his wife nearly died from complications. Thankfully, she returned to health, but the experience permanently marked the couple. “When we lost the child, we were very sad,” Hezron said, simply but emotionally.
Though their previous four children (now 24, 22, 21, and 12 years old) had been delivered at home by traditional birth attendants without incident, the couple’s more recent ordeal taught them that there were safer options. During their sixth pregnancy, there was no question that Hezron’s wife would go to the hospital to give birth. This time, the delivery went smoothly, and the baby, now five, was healthy.
Knowledge is power
“When you know something, it’s easier for you to make a decision,” Hezron said, unwittingly echoing the aphorism, “Knowledge is power.” Hezron wants other members of the community to have that power. He believes that Maternity Open Day offered the opportunity to gain it.
“You know, many women put their faith in traditional birth attendants, but now their eyes have been opened,” he said. “From what I can see, they have learned that it’s important to visit a clinic.”
Information and reassurance for Marther
Indeed, many of the women who attended the event confirmed Hezron’s observation. Marther Masinde Shikuri Ayoti, a heavily pregnant woman with a nearly two year-old daughter in tow, said, “I have learned that when you’re pregnant it’s good to visit the clinic consistently. If you go, you will know how the baby is positioned in the womb. You will be given medicine to prevent malaria. If the baby has a problem, they will help you.”
During the maternity ward tour, Marther asked the nurse what would happen if a woman was in the early stages of labor during the clinic’s off hours. The nurse reassured Marther that she would be taken by ambulance to the 24-hour hospital nearby. Marther was also impressed by the clinic’s facilities. Her first delivery had been in a Nairobi hospital. She didn’t expect a clinic in a small village like Vikunga to be just as clean and well-equipped as one in a big city. “I’ve now seen that the maternity clinic is good,” she said. “It’s nicer than the one in Nairobi. I am happy about it. If I feel any [pregnancy-related] pain, I will come here.”
Raising awareness about available services
A few people were surprised to learn that the maternity ward was open and that its services were free. Maternity Open Day, an event sponsored by Helen Keller and Action Against Hunger as part of a Global Affairs Canada-funded program to strengthen health systems in five counties in Kenya, served as much to raise awareness about the clinic’s existence as to educate people about maternal healthcare. Nurse Makanji pointed out that while the clinic is on-target in terms of the quality of care provided to women, it had not been reaching its goals in terms of the number of women served. After Maternity Open Day, however, Makanji was optimistic. “We now expect more mothers to come to the facility,” she said. “We expect more deliveries of healthy babies.”
And if we are blessed with another child, I will encourage [my wife] to go to this clinic.”Hezron Salamba Matumusi
With evangelists like Hezron committed to spreading the word, we at Helen Keller and Action Against Hunger are optimistic, too. “What I will tell the people who are listening to me is that they should not ignore things,” he said. “They should take heed of information like what was given here, and when such events are held they should attend.”
“When I go home I will tell my wife what I learned here,” he continued. “And if we are blessed with another child, I will encourage her to go to this clinic.”
[All photos and video are Helen Keller Intl/Ruth Fertig except for the final photo, which is Helen Keller IntI/Nyaribo Mochoni.]
Take a look at Vikunga’s 2019 Maternity Open Day [filmed before the pandemic]:
Systems Enhancement for Transformative Health
Maternity Open Day is a product of the Systems Enhancement for Transformative Health (SETH) project. It is implemented by Action Against Hunger and Helen Keller Intl with the financial support of Global Affairs Canada. This project focuses on maternal, newborn and child health and nutrition.
Read about another SETH program here.
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