As I've mentioned, I will, providing all is politically stable and enough resources can be gathered, be going to Madagascar in September.
I am now a member of Taratra Reny Sy Zaza, which means "Shining Light, Mothers and Children". This group was founded by the traditional midwives, mothers, and young women of Mahatsinjo, Madagascar, whose mission is to promote women and children's health in that region.
Karen Samonds, family physician Deborah Golberg, midwife Sarah Hunter and I (doula Lesley Everest) will be going to Madagascar to do an educational exchange with the midwives there, as well as hopefully with the doctors who work from the Tsinjoarivo hospital 15 km away from the area we will be staying.
The intent of this trip is to give the midwives some basic equipment (they have nothing), some training in preventing and dealing with complications in the childbearing year, as well as trying to improve conditions in the hospital (which is an 8 hour walk away). Karen sent me some photos of the Tsinjaorivo hospital, and there is basically a slab in the middle of a "delivery"room (and that's it), and a couple of recovery cots. A few basic pieces of equipment, medications, and some training could do wonders in lowering the rates of newborn and maternal death in this region.
This will not be a case of "helicopter medicine", where we Western folks sweep in haughtily, telling everyone they're doing it all wrong, dumping a limited supply of equipment without proper instructions, and then take off with a "good luck". These workshops will be conducted with the utmost respect for the tradition and vast amount of experience the midwives have. The Taratra midwives who are good friends of Karen, who has spent many months per year in Madagascar out of the last 10 years of her life, told her these workshops are something they want. And we are fascinated to learn of how they deal with complications in birth. As a doula, I am really excited to learn about the massage techniques they use to treat infertility, and am curious about how they support a mother in a long birth. Karen told me their approach to birth is very much like that of a doula.
Some of the areas Karen and the midwives have identified as being useful to focus on are:
1) Contraception and STD prevention. Many of these women have more children than they want, and really want to know how to prevent conception. They were not aware that there are more fertile times in the cycle than others. Also, condoms were not something known before. Men tend to have multiple partners, so STDs are an issue. Male and female condoms will be huge on our list of things to bring or have donated and shipped.
2) Nutrition throughout the childbearing year. Malnutrition is a huge issue for the women of Mahatsinjo. They have many children, do not have an adequate diet, work extremely hard, thus often don't have the strength to cope with things such as lots of blood loss in labour. Pre-eclampsia is very common. The diet consists of rice, manioc, and other really starchy things. Some fruits and vegetables are available, but it is not known by the women what can provide better nutrition. Also, smoking and drinking rum are habits that are common, and not known to be harmful to a developing fetus. Vitamin A deficiency is a huge problem. Donations for prenatal vitamins for women and children are being arranged, as well as a workshop in prenatal nutrition.
3) Equipment and skills. As I mentioned, midwifery skills are very basic, and there is no equipment. We're coming up with a list of things that will help the midwives do their jobs more easily, as well as things that will be helpful to equip the small hospital. A hanging scale for babies, tape measures, fetoscopes, blood pressure cuffs, stethoscopes, suturing equipment, drugs to control bleeding, etc. are part of the list, and we are hoping to get all of these things donated and sent over, or to raise the funds to buy them. The doctor and midwife on the team will do trainings to enhance the skills of the midwives and hopefully doctors in this region (Advanced Life Support Obstetrics). Teaching basic neonatal resuscitation procedures as well will most likely reduce the rate of neonatal mortality considerably. There are some books also on the list of necessities that will help provide information to a reader who perhaps doesn't actually read, but learns from pictures.
4) Breastfeeding and infant nutrition. Karen told us that the women there are not aware that colostrum is extremely valuable to the health of the newborn. Breast milk is not seen as the amazing nutrition we know it to be. When Karen arrived in Madagascar with her first child, the women could not believe that a baby could be so chubby and hale with exclusive breastfeeding. Coffee is given to infants in order to "give them strength". Low birth weight and diarrhoea are common causes of infant death in this region. We are hoping basic information about the nutritional and immunological benefits of breastfeeding will go a long way in preventing the extremely high rate of illness and death in young children.
Other topics will arise as we do more planning, but these are the basic things we have been discussing.
What we need is to raise funds! I am putting this out there in the hopes that it will get passed on and the word will get out. Any sponsorship, donation, funding, volunteering of time to help fund raise, etc. will be a blessing. Karen has gotten funding from the African Women's Development Fund, but it is not enough to have the team or the equipment that will make the best of our time in Mahatsinjo. We are asking for help! Information about the Sadabe organization (which was founded by Karen and her husband Mitch, and seeks to find a better and more effective coexistence for Madagascar's humans and its wildlife) and Teratra Reny Sy Zaza can be found at http://www.sadabe.org/ You also have the opportunity to make donations on that site, or you can contact me at firstname.lastname@example.org I will be putting something on my site for donations soon as well on http://www.motherwit.ca/ We are also thinking of holding a silent auction, so donations of products or services are welcome as well.
You have the opportunity to make a profound difference in the lives of these women and children by helping us provide the empowerment they are asking for to develop their knowledge and skills in caring for themselves and their community. You will be honoured on the Sadabe website as a friend and supporter.
Please pass this on and help us make this trip a reality!
Thank you, and have a wonderful weekend