Our Twins Came Pre-Term

Tears and Triumphs Through The Muhami’s Journey with their sons

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Sam: I am a 43 year old Auditor working for the National Treasury. Mercy, 38 years and I have been married since December 11, 2004. We have four children; Dennis who is 10, Cynthia, and then the twins Alex and Felix. We experienced no challenges in our first two pregnancies. I attended pre-natal clinics with Mercy and even went to the labour ward for the birth of our second child Cynthia. When Mercy fell pregnant a third time, we thought it would be as easy. At the 7 weeks clinic, we were told that it was one baby, but the sixth month scan revealed that she was carrying twin boys. It was then that we started attending Gynaecologist Dr. Kagema’s clinic. We saw him twice or thrice before Mercy went into premature labour at 7 months. He was the one who prepared us for the possibility that the babies would be born early, and administered an injection that was intended to strengthen the lungs of the baby. We were to go for another but Mercy went into labour.

Mercy: I have never smoked, drunk alcohol, I had no issues with blood pressure and my husband is very supportive and nonviolent. When I was young, I had asked God that when it was time to name my father, He would allow me to have twins so I could name him and my eldest brother at the same time. This was before I got married. I was there for ecstatic when a scan revealed that I would be having twin boys.  My father had died while we were still young, and my eldest brother, who is about 20 years older than I, had taken us through school. I never missed a day of school due to fees.

I started experiencing a pain on my right side, and the doctor said my small frame was being taxed by the twins within me. We had been to Dr. Kagema’s on June 22, 2013. He had told me that everything was progressing well with my pregnancy. So when I started having cramps the next day from around 10am, Sam and I were convinced it was not labour. We finally decided to go to hospital at 4pm. I had dilated 7cms already and had they delayed more, I would have had the twins naturally. I was in theatre at 10pm when I delivered them. Actually I opted for it since the babies were so tiny and I did not want to loose either of them through the birth process. They scored high during the birth, they cried well and Alex weighed 1650 grams while Felix weighed 1480 grams. They actually brought them to me soon after birth for a short while before I was wheeled to the ward and then to nursery. The next day, I was in a lot of pain from the operated area so I was not able to see them. Sam however came and told me they were well. I had no reason not to believe him. I was to find out later that Felix was admitted straight into the ICU. He reduced to less than 1000 grames and Alex to 1200grams. Neither of them were able to feed.

Sam: When I first visited them I was informed that the children were very sick. I was also advised not to share this information with my wife since she was still in extreme pain from the operation the previous day.

Mercy: The next day, however, I felt I needed to see them. I steeled myself against the pain, and walked the distance to the nursery. I was told that they were in the ICU as they were critically ill. They took me to see Felix first. I was horrified. He was tiny, and in respiratory distress, each breath lifted him off the bed. I fainted. I did not see Alex that day. The resuscitated me and took me to the ward. I wept and was not able to talk to my visitors. I didn’t think I would ever be able to look at my babies again. After some hours I gathered courage and went and saw Alex. He was helpless and in an incubator. I was advised to express milk, and I tried but could not since I was stressed up. I looked at the other mothers in there. They seemed to have their act together, and easily expressed, and fed their children.

Sam: They prescribed and administered Surfactant for the development of the lungs. It normally costs Kshs, 60,000 for a 10 ml bottle of which they only use 7ml. We asked the staff to keep the remainder for a parent who was not able to afford it for their child.  I would visit daily. The children were on I.V.s. Mercy is strong, and would diligently express milk for them as they were not able to suckle on their own. Preterm babies, cannot like other babies, suckle, breath and swallow simultaneously and risk chocking or even dying if they try. She would divide the expressed milk between the children according to the doctors recommendations. They started with 1 ml each through N.G. tubes.

Mercy: They would feed after every three hours. I had to go to the nursery despite the fact that my wound had not yet healed. To check if they had digested the milk we would stick a syringe into the N.G. tubes, and pull it back. If something was drawn from the child it would mean that they were not digesting well. Alex despite being the bigger of the two was admitted into ICU on his fourth day as he had lost weight due to his inability to digest food.

They need also to make smaller diapers for preterms. The smallest pampers almost covered their entire bodies. Huggies had a smaller one that fitted better but was still way too big.

Sam: The back and forth between the ward and the ICU every three hours was depressing for my strong wife. The doctors tested the babies’ blood constantly to see if infections had set in, in order to treat these.

IMG_3128.JPGMercy: KNH has about one nurse to 50 babies so we have to be involved. I would wake up and go clean my babies from that day. I forgot about my wound and have no idea to-date exactly when it healed. They had administered Surfactant to Felix and he was breathing more normally now. Since he was in ICU, the nurses would clean him but I still was the one to feed him. Alex on the other hand had not been able to digest food for four days, and was admitted into the ICU as well. After two weeks, a Professor recommended that he be taken to theatre the next day and be put on a central line. I was depressed. He was the bigger baby, and the one on whom I had hope and now he was scheduled for theatre.  I talked to another mother about this and she discouraged me saying that most babies died during the process of this procedure. I wept again. I made three calls to my brother, to my cousin and to my friend and didn’t say anything just cried and disconnected.  I then called my Aunt Nancy who is a nurse. She came to see me. She told me that God was able to do a miracle if I prayed. I asked God not to allow the operation but to heal Alex. I did not sleep that night but talked to God about Alex.

The next morning I determined to feed Alex which was not procedural before surgery. The nurses tried to stop me but the doctor finally allowed me to exercise my faith. I began with 2ml, then 5ml, and then 7ml. By the next morning he was taking and digesting all of 10mls. The doctor was amazed and in short, he did not go to theatre. He was fed and eventually put on 600gms. Putting on even 100gms for a pre-term baby is a miracle. I was also Kangarooing Alex, he was jaundiced and was also put under blue light.

Both my babies needed transfusions and my husband and brothers in law had donated blood for them. Bureaucracy made it sometimes complicated for them to be transfused. I remember one day just going mad and going to the nurses station when I discovered that they had not been. I made a scene and they ended up giving them the blood.

IMG_3041.JPGAfter a week Felix was discharged from ICU. One day I was feeding him in the nursery and the nurses came and asked for him. He was throwing his hands and feet. One nurse shouted something like ‘Apnea’. I did not know what that meant. I went back to the nursery after 3 hours and found so many doctors around him. One of them was telling the others that he hoped I would not walk in when I did. My baby was purple. I was shocked. I called my husband, my pastor and my cousin who is an elder. I would call, cry and disconnect. I run to the nurses room and hid under a bed. I cried bitterly calling out to God. He heard me. The now late Nurse Judy came for me. She simply said “Mercy, toka chini ya kitanda. Mtoto ameamka.” Felix was in ICU attached to a machine. His SPO2 – flow of oxygen was almost 100. This was a good sign. He was doing fine. My cousin had been at a Gospel outreach Pastor’s forum when I called. He interrupted his colleagues and they prayed for me without knowing what was the matter.

After this I could go the ICU and find the readings at 70, but as I stood there, they would rise steadily to 100. One mother noticed this and asked if I practised magic, I told her it was simply the power of prayer. I prayed a lot. I sang, and I cried.

One day my friend Grace’ baby who had been stronger than mine died. Not just hers, but three babies around Felix. I was not able to feed him that day. The other mothers were holding me and crying and calling me. Every three hours, a baby would die. They were taken to the Sluice Room. When we came in for feeding we knew whose it was by either checking into that room first or if a nurse called a mother aside to sit with them.

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I cried a lot during my time in hospital. I was known as ‘mama wa kulia, na kuomba na kuimba’. One time our couples’ fellowship – Precious Couples visited me. The women just came and cried with me. The nurses were shocked at this. The next day one of them pulled me aside and on confirming I was Christian, read to me from Philippians 4:6-7 “Do not be anxious for anything, but in everything, by prayer and petition, with thanksgiving, make your requests known to God. And the peace of God which surpasses all understanding, will guard your hearts and minds through Christ Jesus.” My now late mother coincidentally visited me at this time, on the insistence of my brothers who were concerned that I could not stop crying. She was 78 years then, a mother of 10 children. She told me that Kikuyu customs did not allow for tears to fall on nursing breasts. I don’t think this is true but it worked – I never cried after this; well not as much anyway.  My brothers have never let me forget this.

After this, whenever I was with my babies, I would talk to them telling them that they would survive their beginnings. I would create time between the feeding schedules that lasted one hour for each child to do KMC. My husband was only able to support me in this when the babies came home for hygiene reasons.  I was vigilant about accessing my babies to what they needed to survive.

Before we were discharged, the doctors ensured that the twins were able to suckle. Finally August 9, 2013 came round. I was called by a doctor and told I could go home. I was ecstatic. I just wanted to be home and sleep on a mattress. We were sleeping in the Mothers Mess where we shared beds or mattress on the floor by now. I just wanted to sleep in my own bed.  I could hardly wait for my husband, my sister Purity and my friend Nancy to get there.

Sam: I paid for most of the general drugs and test while NHIF paid about Kshs 500,000/ to cover their time in hospital. We are not rich but have never lacked for anything. God provides. For instance they were able to use Huggies throughout.

We had chosen Kenyatta National Hospital for the delivery because we had faith in the doctors there, and that the hospital was more than adequately equipped for any eventuality. It proved a good choice but I also think we also played a role; parents must follow the instructions of medical personnel. Upon their discharge for instance, the nurses demanded total hygiene on and around the children. Their room had to be disinfected and the nursing cups washed and handled only by my wife and myself. They were to have no visitors initially as their immunity was low. This was really hard to effect.

Mercy: I would plead with Sam sometimes to allow friends and relatives to see the children. Some came from really far away to see them but he was firm; especially when Felix got an infection two weeks later, and we had to be readmitted for a week. Some people took real offence.

When Felix got sick two weeks later and we had to go back, I was devastated. I refused to pack but somehow when we got to hospital, our things were all packed. He was put in the isolation room, diagnosed with mild pneumonia. Shortly afterwards another baby was brought in diagnosed with menegitis. I cried then but was told the kind of menegitis this baby had was not infectious. I was concerned also about Alex. How would he feed without me? Sam and the nurses assured me that Sam would be able to handle Alex. Still they would fight over the milk I expressed.

Sam: When one twin gets sick at this stage both are admitted along with their mother, so it gets really costly. The sick that is not sick gets exposed to infections and may end up unwell too. To avoid this, I requested to keep Alex with me, and signed him out into my custody. This meant I had to be at KNH thrice daily to get breast milk for him; at 6am, lunch time and evening. The milk needed to be warm. One time, I was flagged down by a police man for over-speeding at night. Alex had been crying and I had his milk. I told the police man to take my car and allow me to get food to my two month old son whose mother was in hospital. The policeman had compassion on me and released me. Sometimes the nurses in hospital wanted to keep the expressed milk for Felix, as he was their priority. We would literally tug over this.  Alex on the other hand would through fits throughout the night.

Mercy: Felix was discharged a week later, and thankfully the twins have never been admitted since.

Sam: We were grateful for the care of Drs. Miriam Karanja, Kihara, and Opondo of KNH, but met and have been seeing Dr Ngugi Maina at Kasarani’s Josma Medical Center. Since we were afraid of infections and hardly took the twins out in the sun, Felix got rickets at 7 months. Thankfully these were treated. He had to go through physiotherapy  and at some point had straps on his legs. He just begun walking on May 20, this year at the age of 3. Alex had started at 14 months and experienced normal milestones. We learnt from our doctors to never measure our children against the achievements of another child, not even each other.

Mercy: Felix also spoke later, and is now learning to form sentences.

Sam: The twins are both poor feeders. Mercy, who is a qualified accountant, has stayed indoors voluntarily since 2013. We try to feed them as many times as possible. They have even been on appetizers from time to time. One would wake up at night and then wake the others. We started taking shifts sleeping so we could face the next day.

IMG_3045.JPGThey are fraternal twins. They love being together but fight a lot too. Alex who is older is domineering and manipulative. He is also friendly and remembers faces and names of those he meets. Felix is a worshipper. He loves dance and music. He persistent, determined, focused and strong willed. He is a fighter. Alex fluctuates in his weight whereas Felix keeps the weight he has gained.

We keep two house girls; remember the two older ones are still babies themselves. We had our househelp Cugu who has been with us for 9 years, but needed a new one so we could handle especially the mornings. Initially for the first two months we did not sleep. Our other children understood why we gave most attention to the twins. Mercy’s elder sister Purity was really supportive and lived with us for 9 months.

Mercy: It was hard for Robert and Cynthia initially with me being away for two months in hospital with the babies, and their father trying to cope between home, office and hospital. He would bring them to the hospital to see me from time to time.

Sam: I have a very understanding boss who is also a parent. Understanding my challenges, he would allow me to work on flex time. I needed to be available for all hospital visits and emergencies.

Mercy: Back at home a week later, we were now even more paranoid about infections.  We would not take them out of the house. Felix developed Rickets. We found a good nutritionist and were given some powder from the UN called Prampinot I think, and another medicine.

Until they were three years, my life has been a whirlwind. I had physiotherapy with Felix and would cry when they massaged him. He finally began walking at the age of three and is now stringing words together to form a sentence. I can now think about engaging in income generation outside the house.

Sam: We have actually been able to get away twice on our own without the children. For three days each time. It is important for me that my wife is happy and rested.

Mercy: Sam has supported me throughout this journey. We are grateful to God, to the staff at KNH, to our siblings , our pastors, and the very many visitors who came and who sometimes did not get to see me. I was touched by the plight of many of the mothers of preterms. Some were married but were never visited by their husbands. Some of their husbands would encourage them to abandon their babies there – hence the presence of so many KNH babies. Some mothers loose all their babies, like one who remains childless as all her three babies have been preterm. One time a mother stole her own child out of ICU presumably to go throw it away.

On the children’s first birthday we went back to celebrate with the mothers then at the nursery. We had noticed in our time there that they had a shortage of heaters so we gifted them with a few, and brought cake for the nurses. It really encouraged the mothers there to see Alex and Felix. I remembered while there I had wished that I could have a mother come back and just say “Mimi nilikua hapa and these are my babies”.

Pre-term children can survive and thrive. I know one who is now studying at JKUAT, and one who was born in KNH at 900grams and is now a doctor there. Once they overcome, they perform well and are like other children. As a parent, the words you say over your children stick to them. Be careful therefore. Never give up on them – even when the doctors do.

Sam: In the last three years, we have lost four people who stood with us during this ordeal. My father, my eldest sister who even lived with us for a while, My mother and my mum- in law. Its been difficult but we know to be strong. My late mother in law told us at the very beginning that she knew the boys would be well enough to visit her fun and she could see them in her mind’s eye running around. This prophesy has come to pass, many times.

vipslit@yahoo.ca

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Keratoconus: Esther Thairu’s Story

As told to Vip Ogola by Esther, her father Stephen Thairu and their good Samaritan Mr. Kamal Sanghani

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Esther: I was young, 2 years old. I had eye trouble and started going to hospital for eye drops. I could see maybe, 30 centimeters and my eyes would pain. The doctors told me it was treatable. It reached a point where I was told I would go in for an operation. I was not afraid even when I saw the razors. I thought it would be painful but it wasn’t. I was anaesthetized and I woke up seeing better. I was in hospital for four days, three of those with my eyes bandaged.

Stephen: Esther was born in Loitokitok. She started having problems with her eyes at the age of two years. She would wake up and find her eyes clogged shut with pus. This happened annually between April and August and we suspected it had something to do with the cold weather. We took her to the district hospital there and she was told she had allergies that would resolve themselves by the time she was eight years old. She was given medication for this.

Esther Thairu.JPGEsther: I do very well in school. I am now 13 years old, and apart from academics, I play football.

Stephen: We moved to Githurai and Esther joined Mercies Academy where she is currently in Standard 6, having dropped back a year due to her medical challenges. Since she was a bright student she caught the attention of her teachers. Teacher Teresia noticed her problems with her eyes and advised us to change to Lions Hospital in Loresho. In the initial year of her treatment, they kept changing drugs. Her right eye was in terrible shape and needed urgent surgery. The left one was also in bad shape. The cost of surgery would be Kshs 350,000/ and they were not taking NHIF. I was confused. I was advised to take her to KNH due to the more manageable costs. On examining her, they concluded that her eyes were badly off. They only perform surgeries once as year so they referred her back to Lions for more urgent attention. We found that the costs there would be the same. I talked to my employer who suggested that we sell my father’s land to offset the costs. She talked to Mr. Kamal Sanghani of the Rotary club about my case and they referred us to Dr. S.P. Amin. We had to wait until he was available.

Kamal: Dr. Amin is in the Board of Lions. He was my contact. I would talk to him and then talk to Stephen. The doctors of Lions are good friends of mine. My family agreed that we would sponsor Esther. We did not know her then, and we have since sponsored three others.  One of the Rotarians told me about her. It took time but Stephen was both patient and persistent keeping me on my toes. Initially it was difficult to get a Cornea. We did not loose home. My mother insisted pushed me from the home front. Since we were working on a tight budget, we agreed that she goes to Lions four or five times. She is a bright student so we wanted to see her excel. There were so many issues and at one point I almost lost my temper with the hospital. Finally we received a Cornea for her from India.

Stephen: They started with her right eye. Then after two months they did Cross linking. She was in a private ward at the hospital and was the only child admitted there at that time.

Esther: I did not go to school. I was told not to by the doctor as it was possible to play a bad game and hurt my eyes. I also needed to avoid dust. I stayed home with Mum and really missed Shule.

Stephen: We had to go to hospital every Saturday after for check-up as she was on medication.

Esther: They would change my specks, I think twice between the first and second operations.

Stephen: They needed to do this to adapt to her strengthening eyesight.

Esther: After I did my first operation, Mr. Francis Mwangi my teacher at my school, Mercies School in Guthurai 44, put me to sit in front of the class. He then moved me to the back of the class to see if I had improved after two week. I had. Fellow students were also supportive in helping me catch up with them, especially Peter Mutuku. I am in Standard 6.

Stephen: She is supposed to be in standard 7 but she lost a lot of time that year and was not able to do her exams.

Esther: My grades are good. I get 350+. At the cross linking the doctors told me that I would go through pain for the night. I stayed indoors for three days with Mum. I am the first of three children and the only daughter of my parents. My mother sells vegetables and my father digs for a living. They gave me eye-drops to put after every two hours.  I was told I could go to school after a week. This was in March 2015. Since that time I have only had my specs changed once. I am in no pain and I can see relatively well.

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Behold The Man

The Man is betrayed by his friend in the inner circle; and his friends scatter because of the menacing cloud of enemies that surround Him; one of His friends stands his ground a while, and takes out his sword to inflict injury on one of His enemies, but The Man, stays his hand, and performs First-Aid on His enemy, in a way that would be envy of the best cosmetic/reconstructive/plastic surgeons of this century.
The friend who stood up for him, who follows stealthily somewhere within his crowd of enemies, will a few hours later deny ever knowing him. The accusations against The Man are flimsy at best, ridiculous, false, but not one of the ones He so powerfully blessed is brave enough to stand up for Him. So they take away His name, tarnish His reputation, and He will not defend Himself. The slander against Him, kills Him literally. And yet His enemy is given no reprieve, for God rises to now cloud and shake the world, to open and spill out the contents of graves, and to tear at religious barriers that kept His people estranged from Him. Three days later, The Man walks – no longer dead. And God lifts Him up, and seats Him on a Throne before which both His friends and enemies must stand at some point in eternity. For The Man, on earth robbed of His Name, Heaven bestows A Name, The Name at which all knees buckle either in Loving Faith or in Terror.
 
Let Heaven name you for the name the earth has taken from you for your loving service for God. God is Worthy!
 
“Kite ne kit Nyasaye nyaka e chakruok,
to ne ok otuere ni nyaka osik marom gi Nyasaye,
to notimore gima nono,
Nokawo kit misumba,
mi odok dhano mana ka wan,
kendo konenore ka dhano kamano,
to nobolore, kendo no winjo wach nyaka tho,
mana tho mar msalaba!
 
Mano eomiyo Nyasaye ne Omiye duong’ ahinya e polo,
kendo Omiye Nying’ moloyo nying’ duto.
Kamano gik moko duto manie polo
gi manie piny kon manie bwo piny,
Omi Nying Yesu duong’,
kendo ji duto mondo ohul ni
Yesu Kristo e Ruoth,
Mondo Nyasaye Wuoro Bende Oyud Duong’.”
Jo-Filipi 2:6-11 (Philippians 2:6-11)

From Traditional Birth Attendant to Birth Companion – Jane Mukuyi’s Story

Jane Mukuyi4.JPG“My Grandmother was a ‘Mkunga wa Nyumbani’ in Chepkaka where I grew up,” begins the elegant 66 year old mother of four. “Of my many siblings I was closest to her. From the time I was 12 years old, I would assist her perform her vocation. She would send me for things while I watched her deliver women of their children. When I got married at the age of 21, and moved to a nearby location, I too, started practicing. My grandmother’s reputation had preceded me and they assumed rightly that I was likewise gifted and inclined.”

Jane was a nursery school teacher. She, however, gladly volunteered her services helping women through pregnancy and the delivery of their children. “When a woman, in the places where my husband and I lived, suspected that she was pregnant, she would seek me out for some sort of clinic. I would wake up at around 6am to find them waiting outside my house, most of them not having even washed their faces. They wanted me to touch their bellies and let them know the progress of their babies. They would come for me to massage them with oil, or just because they had woken up from an uncomfortable night. Many came in as many times as thrice a week during their pregnancies. In the latter parts, I would massage them to ensure the baby was presenting well. I have since learnt that this could mess things up for the baby and the mother.” She says sadly.

“When a woman went into labour, depending on our agreement and her condition, I would either go to her house or she would come to mine. In mine they would deliver in the kitchen. In theirs, it depended how many rooms they had. The idea was that men could not be part of the process. If there was only one house, they would make themselves scarce.” She remembers.

“If one of my women was due, I would prepare a herbal concoction to rub her down with during labour. The woman would get down her knees, legs apart. She was not supposed to have had a bath before labour. I would guide her to push down the baby. Twice there were complications that led to the babies coming out leg first, but thankfully I successfully managed all such cases without a single fatality. I never delivered a child that was in breach. In a normal situation, I would wait for the head of the baby to present, then using my thumb nail, cut her down there to allow the baby to come out. Once the baby was out, we would use one of the mother’s garments, normally a dirty one, to cover it. We would cut the cord using the bark of a sugar-cane. The woman had to stay indoors for three days. She would not bath. She would use an item of clothing that she had worn to get to the Mkunga’s house to catch her flow. It was all very dirty and unhygienic, and yet I knew no other way. Some of the children I helped birth are now married or even in university. I know of five that died before the age of three years.”

Nine years ago, Jane was one of the TBAs that the Ministry of Health reached out to, in response to a WHO policy, to train in emergency child birth and transform into Birth Companions. Until then, she had never met or known of any other TBA except her grandmother. “That is when I realised that we were conveyors of ill health and not of life as I had previously thought.”

abraham-wanyonyi1Behavior Change Communications Coordinator Abraham Wanyonyi of Save the Children elaborates on this. “More than 50% of unskilled deliveries are conducted by TBAs. They have gravely impacted on the Ministry of Health and their partners’, GlaxoSmithKline and Save the Children – Kenya’s attempts to get women to deliver in hospitals under sanitized conditions. They can therefore not be ignored in our efforts. The National  Health Policy 2007 – 2012 provides that they stop providing deliveries and accompany expectant mothers to health facilities. This was just a statement, and there was nothing to support it in terms of making this a reality.” This is where the partners came in. They use the training curriculum adapted from AMREF’s Linda Afya Mama Na Mtoto to reorient them on their roles, give them a small reimbursement towards transport, and have monthly meetings with them.” He says.

“For many of them this is a calling. I remember that when HIV became widespread many TBAs in Western and Nyanza provinces were wiped out by it. You can imagine the hygiene issues, the infections, I mean many health facilities are still struggling with hygiene control. These challenges are more than doubled in a poor old woman’s house.” Abraham laments.

Jane is now an unrelenting firebrand with regard to getting women to attend clinic and deliver in health centers. From being the one sought out to offer clinics, she now accompanies those who do, and seeks out those who are resistant sometimes to the point of having interventions that involve the husband or the chief to get the women to go. “They are tough but I am tougher. I go with them for their initial clinic, then for the fourth of the five mandatory times, and then for delivery. I will ride with the woman on the bodaboda ambulance, and will only deliver if there is a roadside emergency. Otherwise, I go with her to the health center, and stand by her taking care of her needs throughout labour. I act as the link between her and the health facility staff on how far she has gone, and also alert them if I sense there is trouble. I will also accompany her back for post-natal clinic.”

Nurse Violet Nyongesa.JPG58 year old Nurse Violet Nyongesa, of the Bunyala Sub-County Hospital dons the Birth Companion Apron in solidarity with Jane for this interview. She describes the Birth Companion’s role throughout the maternity journey as crucial but thankless in terms of remuneration. “With all they do, we are not even able to offer them a cup of tea. They have really helped raise the number of women giving birth in health centers from 30 to about 100 in a month. We are normally understaffed, with about three nurses on duty at any on given time. When they come in with the mothers in labour, they stay with them. They get them water to shower, clean them after delivery and give them clean linen. They are also usually much better able to communicate with the women than we are. They are really part of the team.” She speaks softly. “I know it is better for a woman to deliver at a health center, despite the challenges we face, because of the sterile environment and because we are able to deal faster with any challenges during the process. The baby is also kept warm. When a child does not cry at birth, we are able to resuscitate them. It is also easier to register a child who has been born in a health center as opposed to at home.”

Jane now makes a living from her farm and also receives support from her four grown children of whom she is very proud. “The training that the partners have given us have earned us renewed respect within the community. The uniforms they have provided makes us stand out in a good way. We are also involved in Table Banking. I love that I am now helping give life the healthy way.” Concludes a smiling Jane.

vipslit@yahoo.ca

Why Women Preferred Being Delivered by Traditional Birth Attendants, By Abraham Wanyonyi, Behavior Change Communications Coordinator and Communications Point Person in Save the Children Kenya, Bungoma Office

  • Facilities often understaffed and have little attention during labour whereas with a TBA it’s just the woman. She receives a lot of tender loving care, the backrubs and encouragement.
  • The language often used by the TBA is gentle as compared to that used by the overworked, little appreciated Health worker.
  • Men who find health facilities crowded have access to their wives during labour to support them.
  • Socialisation, everyone in your family has been delivered by a traditional birth attendants, its difficult for women to start a new trend especially at her in-laws.
  • The TBAs are part of the community. With Devolution in particular people may prefer to be attended to by someone from their own communities than a well-trained ‘outsider.’
  • Distance to the health centers make it preferable for women to walk into the TBAs house during labour.
  • People feel safer with older, and more experienced women.
  • Perceived high cost of delivery even in public hospitals whereas TBAs are compensated with what you have. A leso, a chicken etc.

Story and photos by NaMeD Afrika Studios, Kenya

First Published on The Standard Newspaper’s Wednesday Life Pullout, September 28, 2016

http://www.standardmedia.co.ke/lifestyle/article/2000217596/no-more-giving-birth-at-home-for-women-in-kenya

 

Abbygail Mwanduka’s Battle with Migraines

javagraduation-007About a month ago I had an attack while crossing the streets, I had to stop right there in the middle of oncoming traffic. It’s bad. You cannot move. You are not afraid of anything else, as the headache becomes everything. I almost did not come today, because I had a crisis last night, but my mother prayed for me all night. Recently the headaches have been frequent and intense, since I have no way of procuring treatment and medication without medical cover. I require approximately Kshs 10,000/ every time I visit the doctor to cover consultation and medication. My current source of income cannot support that.

I first had a seizure in 2003 while in primary school in Mtitu Wandei. I thank God that my father had a medical cover for us, so I was treated at either Pandya or Aga Khan Mombasa, I cannot really recall which. My mother would ensure that I had my medication and things remained relatively stable. When I joined High School, I would have a seizure maybe once or twice annually. However, things went terribly wrong when my O-Level results were released. I had failed. I was devastated and my father was very angry and disappointed. I am my parents’ first female child and they naturally want to see me doing well. My results had found me recovering from an appendicitis surgery. My mother suggested I go back to school to try again to better my results. I was admitted, this time at a school in Machakos, in form three with a fresh surgical wound. Subsequently, I spent approximately one and a half of those two additional years in high school, away being attended to medically in Mombasa. My final exams also found me out and I was brought in from hospital to do my examinations.

I failed again. Dad was livid. My medical alone had cost them approximately 5 million in my High School days. I attempted suicide by taking all my Migraine medication. I slipped into a comma that lasted a week. I was diagnosed as being in Psychological trauma, stress. My father and I went through a week of counselling at Mombasa Hospital. He mostly avoided me before and after this time, addressing me through my mother.

My mum suggested that I take a certificate course in IT. I joined the Kenya Polytechnic and moved to Nairobi to live with my Aunt in Kariobangi. I would sometimes faint in the house while with her. After my certificate course, which I now passed, my parents took me to Catholic University of East Africa to pursue a Diploma in IT. My dad was much friendlier. My self-esteem which had been really low, was boosted by his approval and my marks. During the six months that I was at the University, I only sought medical attention twice, for unrelated conditions. I did very well in my examinations.

I needed to go in for an evaluation at Aga Khan Hospital in Parklands. Up till this time, I had not had a particular doctor I was seeing. It was here that I met Dr. Sylvia Mbugua. It was she that finally diagnosed me with Migraines. She recommended an MRI and noticed the number of seizures that I had experienced. She also noted my mental distress. She managed me well. She recommended a tripartite medication that took into consideration and cancelled out the negative side effects, including possible barrenness, that could have resulted with me just taking one form of medication. She also warned me against taking Betapin which for me had the effects of making me high, in the way alcohol would and another drug Rizatriptan that induced suicidal thoughts. She recommended lifestyle changes in terms of diet and exercise which included drinking a lot of water. I could not drink especially wine, and not smoke. Manipulation of my hair into various styles affects me so I keep it short. Since I am no longer a student, and my current employer is new and does not offer medical cover I have been without medication between April and September. I now live alone with my sister in Nairobi, and enjoy my work. I hope that I can be able to go back to school, mainly so I can again have access to my father’s medical insurance which covers me as long as I am a student. I also pray that I can find Dr. Sylvia again so that she can continue to walk with me through this. She left Aga Khan hospital. I now mostly try to manage the Migraine attacks through my lifestyle.

vipslit@yahoo.ca

photos and words by: NaMeD Afrika Studios

First published in The Sunday Standard’s Sunday Magazine – September 25, 2016

Dance with me.

PULSE Volunteer Partnership

Imagine you are a teenage girl or a boy, you are young, smart, beautiful, talented. You aspire to play, laugh, create, perform, achieve. Yet, you live in an informal settlement or a slum area in Nairobi. The streets where you live are not safe. You need to do an extra effort to get a decent education, school fees, stationary, textbooks. You don’t have easy access to … things, things that a teenage kid in a developed country would take for granted. So you need to work harder to… just to be able to be a normal kid. Except that you are not, you are exceptional.

I met this exceptional boy. I met this exceptional girl. A whole group actually. They call themselves Thunder Squad. They live in distant areas in Nairobi, Tassia, Embakasi. They are young, talented, passionate. They are a team of sixteen kids, aged between 14 and 25, majority of them are at high school level. Four children are aged…

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Conquering High Blood Pressure with God’s Intervention

img_9679I am 39 years old. I was diagnosed with High Blood Pressure by a doctor at the Webuye District Hospital.

It began one morning with a terrible headache, accompanied by intolerance to any kind of sound. All sound manifested as noise and I resisted the impulse to bang my head against hard surfaces. I was with my husband and he rushed me to hospital. They decided to check my blood pressure and it was at 210/110. The nurse who checked me, was uneasy about the result and she called in another nurse, who repeated the test. They had a hushed conversation between then and then the initial nurse left the room to come back minutes later with a doctor in her tail. He connected his machine and repeated the test and said to them “there is nothing wrong with your machine. The test is accurate.” He put a pill under my tongue, then one of the nurses injected me with what we were told was valium. It was now about 2pm in the afternoon.

They suggested admission but I resisted as my youngest child was 2 years old and needed me. I did not have a house help. I agreed however to come in daily for assessment and medication. My book was full of ‘patient refused admission’. They put me on Inderal for my blood pressure, Lasix to drain excess water in my system, and Ponstan Forte for the headache. Ponstan cost 300 shillings per tablet then. I don’t know if that was the real price or the chemist, to which we went to purchase my medication, was trying to exploit us. But the price was one of two reasons that helped me decide not to purchase it. The other was Dr. Ken’s advice. He was my husband’s close friend and a medical doctor. Dr. Ken talked to me about the dangers of addiction to pain medication, especially strong ones like the ones the hospital had prescribed for me.

I was asked by the hospital staff, after this and on subsequent attacks, about my family’s medical history. My maternal grandfather suffered a stroke just before I was born and was paralyzed by it on his left side. He too resisted medication. He was very fond of me. He lived 15 years after the stroke and then passed on. On my first attack a nurse heartlessly said to me that that was where I was headed. I rejected that heritage. One of my sisters also bleeds heavily during her pregnancies and suffers the swelling of her eyes. I also went through something similar during my last pregnancy, where I woke up once or twice to find my bedding soaked in blood. I did not seek medical attention for it, and my daughter was born healthy in September of 2011 by the grace of God. I was also asked if there was anything that would cause me undue stress. I told them even living in a police line was not a stress factor for me. I had a relatively good life.

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One time I had an attack in the night when my husband was away on duty. We were still living in a police camp at that time, a fact I thank God for. My children were able to run to a neighbour’s house, my husband’s colleague named Koech, and he rushed me to hospital. My head was aching badly, and when they checked my pressure, it was extremely high. They tried to get me to agree to admission, but three of my four children were unwell and on medication. I had no help at home and my husband’s work hours could not be changed to fit into their prescribed schedules. I could not leave my children alone.

I was lucky again, Dr. Ken was at hand to cover for me. He told the doctor attending to me that he knew me, and that I would be faithful in taking my medication and also attending a daily clinic. They again injected me with valium to help with the pain, and put a pill under my tongue. I was later to find out that this pill is called Propranolol. Koech took me home. My pressure was still very high the next morning but the hospital did not detain me. I eventually stabilised. I remained on Inderal and Lasix for the next two years. The headaches seldom came, but when they did, I took Panadol.

In 2005, my husband was transferred to Malindi and because there were some challenges with regard to accommodation, and I also wanted my children to have some stability with regard to their education, I opted to go live with my mother in Kisumu. My mother is a Clinician so she monitored my blood pressure and made sure I took my medication. One April afternoon, I noticed that there was a crusade happening at a hall in Mamboleo, just opposite my mother’s clinic. I asked my mother to take my blood pressure, as I was going over to be healed. I was so tired of medication. She took it and it was high. I went over to the meeting which was being run by Pastor Muliri and Bishop Mark Kegohe. The Bishop announced that there was a healing grace. He called on those with various illnesses that were able to believe God for healing to get up. We were asked to lay our hands on the general area in which we sought healing. I didn’t put my hands on any part of my body. I just spoke to God from my heart; I told him blood was all over my body and so I could not touch a specific part. I asked Him to go to the place where the problem lay and restore it as He had intended for it to work at my creation. I was calm. I went home and my mother measured my blood pressure and it had gone down significantly.

I have never taken any medication since that day, 11years ago, and my BP has remained relatively stable. In terms of diet, my husband loves beef so we have to eat it daily, to the point where one of my sons cannot stand it. I also went off salt for about a year. A few times, I have had a terrible headache that necessitated my going to hospital, and it was during one of those times that I met Dr. Lusi. But I am generally well, all glory to God. I have come to believe that the only thing that can beat science is faith in God.

vipslit@yahoo.ca

Photos by Nash of NaMeD Afrika Studios

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First Published in The Standard’s Sunday Magazine on September 4, 2016

http://sde.co.ke/article/2000215045/i-shouldn-t-be-alive-my-battle-with-high-blood-pressure

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