A story of waiting mothers shelters in Zimbabwe.
Having a child in Australia is not a particularly dangerous business. Our health system swings into action from the moment a woman presents herself to a doctor and confirms a pregnancy. Ante natal check-ups are organised, the couple inform hospitals and prepare things at home ready to leave when the baby is due to be born. Women in rural areas of Australia with more than 100kms to the hospital might stay at the hospital or a friend’s place beforehand but otherwise for urban or rural mothers, it’s a case of knowing when it’s time as per training in ante-natal classes and hopping in the car to the hospital with their partner, friend or relative. A distance of 10-20 kms from the hospital in either circumstance would seem to an easy circumstance. But not in Zimbabwe or other places around the world.
In the village of Irisville in Matabeleland South, in southern Zimbabwe, people like Sibusi Siwe Ndlovu have a more difficult time. Until recently, women in Sibusi’s area were an average of 32 kms away from the District Hospital or clinic. There was no car to hop into. It’s a case of walking or perhaps getting a ride in a donkey-drawn open cart on dirt roads. For many women that meant not getting to the hospital on time or even if they did, they would face complications from tiredness and jolting of the baby. There was no guarantee of a doctor at the hospital but hopefully a midwife was there or a nurse.
Things have changed in Irisville. Sibusi is part of a community that has been working with the Australian Aid funded Matabeleland South Integrated Health and Livelihoods Project. The project staff have been working with representatives from the local community as well as the Department of Health, especially the staff of the clinic in Irisville. They have been working together to construct a ‘waiting mothers shelter’ in the grounds of the clinic compound. In these parts of Zimbabwe, waiting mothers shelters are a solution to the problem of access to adequate health care for pregnant women. Firstly, they are a place where pregnant women can stay until their baby is due to be born and so they don’t have to risk the walk or cart ride immediately before birth – it’s like a hostel. Secondly, there are facilities for the women to wash themselves, to cook meals and to wait with other women. Thirdly, they are next to immediate care and can be moved to a birthing room in the clinic nearby quickly.
Don’t get the wrong impression – it is no paradise. These are basic concrete rooms with a mattress, a bed if lucky. Often the toilets are a drop latrine 20-30 metres away. There may be water but there is only one option of cold water. There is no electricity so you bring your own candles. If you want to eat, you have to bring your own food. If you want to cook, you must collect your own firewood and utensils. The government don’t have the resources to provide this kind of infrastructure and so it is up to communities to do so. People here are not rich and they have never had the resources to build these kinds of buildings. It is usually foreign aid, in this case ANCP funding from DFAT, or assistance from some form of NGO that enables these structures.
In Irisville, the local community were at a point where they realised something significant needed to happen for their womenfolk. There were too many incidents of women or children dying at childbirth. The offer of assistance was just the catalyst they were looking for. Community leaders organised villagers to collect local resources like sand, wood and labour. The building is built to a standard design supplied by the Ministry of Health. World Vision provided cement and roofing. The water is not actually piped in and still has to be collected from the stand pump 20m away. There is electricity coming into the compound but it is not connected yet. But the building is usable.
Sibusi is one of 18 women who have used the building to prepare for the birth of their children. She gave birth to a baby boy, Unathi Moyo and both are doing well. She is grateful that now the clinic is within 10kms of her home. Her husband was able to come to ante-natal training with her, a relatively new thing for men in this area, and to see the mothers shelter. He was able to assist in preparing food to bring to the clinic for her and to come and visit regularly. Sibusi was also helped by the very active village health worker (VHW), Lizina Myamamdi. Lizina has been active in getting women together to talk about preparing for child birth, to presenting training to women and men and to help community leaders understand what is needed to help pregnant women prepare and be looked after. She has been active in coordinating welcome packs for women giving birth; a parcel of soap, clothing and other needs. Lizina wants to see not only the water and electricity connected but she also wants the community committees to establish a vegetable garden that can help supply food to the women staying in the shelter. She even dreams of connecting a television set with reception relayed from the nurse’s homes nearby.
The community committee have been supportive. Many of the committee are also pastors of churches and they have been encouraging their congregations to learn about the needs of pregnant women, for the men to be supportive of their wives and to participate in the workload of construction. They have been particularly thankful, one pastor breaking into local poetry and dance to thank World Vision and Australian Aid during our visit.
It is not just the physical structure that has brought change to this part of Irisville. What has been just as significant has been an attitudinal change. The Chairman of the community committee said that they were so grateful for the generosity of the assistance as it meant so much to them. He said that “as you gave to us, so we now want to give”. This catalytic effect of assistance has meant that one person in the community has offered to pay one year’s supply of electricity and another has offered to pay for one year’s supply of the diesel that will drive a pump to haul water into the shelter. They also have visions of supplying a fridge and obtaining a smokeless stove to cut down on wood required for cooking. This is the stuff of offering hope and fulfilment to a community.