Races Lost

Calla Lily - Series 2 - 01“Mami, have you seen the body the neighbors have been staring out since morning?” Shukri greeted me one afternoon in March. “People are saying he committed suicide, but others think he was killed.” I was tired. It was 4 pm in the afternoon. We had just gotten home after a shoot and several interviews, and I just wanted something to eat and a place to retire and worry about whether or not this article would be published, how I would manage food and rent and how to keep the landlord and his caretaker from calling me – without sinning. But I put on my sandals and went back out. I walked the about 100 meters to where a police truck was now parked, and several uniformed and un-uniformed officers were milling about. One of them, a lady greeted me, with a hug. I remembered her from a child’s right issue that had taken us to the Post recently. She, her colleague and I had accompanied the minor to hospital in the dead of the night, for first aid before we surrendered her to their care.

“What’s going on?” I asked.

Ina kaa huyu muyu amejinyonga.” She said pointing towards the unfinished tinned accommodation a few feet from where I was. “Si ukuje uone kama ni mutu unajua?” She wanted me to go see if was someone I knew. Sleep had been difficult in coming so I declined her offer thankfully when her colleague asked if I had a bed-sheet I no longer needed in my house. They needed it to carry the body into the waiting car. I scooted as fast as my 100 kgs could carry me back to my house and came back about five minutes later. By this time, curious neighbors were gathering around the scene but the officers kept them away but insisted I go see the man. “You never know.” Said one.

He was unknown to me, and from the identity card found in his back pocket, just a few months older than my son. My heart broke as I looked at his peaceful, oddly frozen face, with a neat cut – presumably from a rope, across his adam’s apple. The brain is merciful, because I cannot remember much more, except that his body sounded embalmed as it hit the back of the police car. One other item was found on his person – a medical card indicating that he had just had his first doze of ARVs. I went home and prayed for those he loved, and those that loved him…and for those I love, and those that love me…that none would ever feel so alone that they would choose to end their lives. That there would always be someone that cared.

So today afternoon, Leroy rushes into my bedroom just as am about to get into prayer and bible study. Our neighbor needed us urgently. Either a thief or a snake. I again left the house wondering how I was going to be useful in either situation. But again, it seemed as though my feet had two brains of their own. I found my neighbor handling the issue of the snake – I didn’t even want to see it. She insisted I go check on the thief. He husband was already there, with one other man. I went hoping to convince them to take the alleged thief to the police post, as opposed to killing him in my other neighbors’ plot. The young man had stolen some metal building materials, some things that looked like old chimneys, and a set of nearly rusty sufurias. Ok, this was going to be serious since my neighbors had had their water piping materials stolen and another apparently a gate or something. I asked God again, what my role was there. I noticed that the men were uncomfortable talking to the young man in my presence and at one point my neighbor’s husband closed the gate between me and them and then descended on the young man with slaps. I called him out and talked to him calmly, about what would be the right thing to do. He went back in, and came out shortly after and went back to his plot, to deal with the snake issue.

Before he left, he had called the owner of the paraphernalia, and continued to interrogate the man loudly. Another man had joined them. He knew the young man, in fact, he described him as a hard working builder that he had hired from time to time. The young man changed his initial story that he had been hired to pick the wares up, to the truth, that he was hungry, that his house in the Soweto Slums had been locked and that he had not been able to find any work to do in the past week. He said he had never stolen before and loudly begged for mercy. My heart broke.

Then came the owner of the paraphernalia with a friend and a rock. I asked him not to kill the man. He ignored me and rushed in. He came up about three minutes later, sweating, and shared his frustration. He had been robbed too many times, he lost his gate, all his clothes from the line, he was tired and this guy would pay for it. Other men came to see what was going on, and the interesting thing is that they stood afar, not willing to get involved. They commented on the affair, “that is hunger, that is hunger.” They should not kill him, they should discipline him and then let him go. I prayed, God why are you allowing me here? I do not want to witness this man dying. I called the owner of the paraphernalia, he was my neighbor. I asked him to just check, the man may be innocent…to take him to the post and check out the story about someone else sending the man for this things. He said it was alright. He went in and then asked the man to carry the things he had stolen back into his compound. He had by this time, confiscated the man’s identity card. The man carried the things into the compound and then dashed out. He ran, he ran, he ran…he run into two women, and told them he was running from a mob that wanted to kill him. I don’t think anyone, not even the one who he had robbed was sad he got away. In fact they locked up and went back to their days as though nothing had happened.

I looked around at the men and women as they dispersed…I saw their pain, and their perspective of this particular situation. It spoke of things that united us all – the hunger, homelessness, the pain, the fatigue…the despair. We go through the motions of living, hoping that someone, God mainly, would decode the language of the stream of our unshed tears, and free us. If we could all run…run, run away…it would be understood. God was in that place. He is everywhere, but in this place…about 75 meters from where the body had been found a few weeks ago, God had come and dispensed His Justice.

vipslit@yahoo.ca

“Moreover as for me, far be it from me that I should sin against Jehovah in ceasing to pray for you” 1 Samuel 12:23

Perfect Stains

IMG_20170515_142112.jpgI have sensed in my spirit God leading me to wear my yellow Buobou with the pink and blue flowers, that I had not worn in a long time, since I woke up this morning. As ironed it, I noticed that it had stains, that in that light and given that it was a faint coloured garment, looked like faded blood stains. I wondered at this, because I wash my cloths carefully after every wear. It was otherwise clean. I tossed it into the place where I keep laundry making a note to deal with the stains as soon as I was done ironing. I went to the suitcase where I keep my clothes to make a choice about another outfit but sensed The Spirit of God speaking to, and nudging me: “So what if it is stained? It is what I want you to wear today. Don’t you think I knew that it was stained before I commissioned it for this day? I considered all about it, including those stains and knew that your wearing it in obedience would make it beautiful in My Eyes.” I got it immediately: He was talking about more than the dress.

Vip, tell them, tell them that I have said – ‘So what if she is stained? I have commissioned her for My Highest Purposes. I have taken into consideration that she is stained and that her stains are unhidden before the eyes of heaven and the earth; that I will be the beauty that drapes Myself as a Mantle about her. But she must not focus on her stains to give up, but on me to raise her to the peak of greatness to which I have called her. As she rise, her stains are obvious to all, and My Mantle about her will be obvious to all too. For her glory is Mine, and I have given Mine to her. Rest – enter rest.’”

I am calmed, deeply so, as I write this. I can enter rest from my strivings, – beautified by the word of God. Shalom.
vipslit@yahoo.ca

John 15:3 “You are Already clean BECAUSE of the word I have spoken to you.
Revelations 19:11-16 “I saw heaven standing open and there before me was a white horse, whose Rider is called Faithful and True. With justice He judges and makes war. His eyes are like blazing fire, and on His Head are many crowns. He has a name written on Him that no one knows but He Himself. He is DRESSED IN A ROBE DIPPED IN BLOOD, and His Name is THE WORD OF GOD. The armies of heaven were following Him, riding in fine linen, white and clean. Coming from His Mouth is a sharp sword with which to strike down the nations. He will rule them with an iron sceptre. He treads the winepress of the fury of the wrath of God Almighty. On His Robe and on His Thigh He has this Name written:
KING OF kings and LORD of lords

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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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

 

The Boda-Boda Saint Named Gordy

gordy-and-the-12-bodaboda-men-of-bunyala2The man arrives at the health center late into the night. He is helped by a community health volunteer, and between them, they support a wailing pregnant woman. All of them are wet, and bloody. A nurse takes the man’s place and supports the woman to the labor ward while the man gets someone to sign a little book and then leaves into the night. He is back two hours later, in different clothes, equally wet, equally bloody, this time he is holding a baby in one arm, while supporting a tired woman with his other. The nurses rush towards him and relieve him. They know him well. He is here almost every night. He is not staff, he is a perpetual good Samaritan.

gordy-with-baby-hildaWe traveled to Bumula sub-county, Bumula village to find out from the 34 year old married father of three Godwin Simiyu Wanyonyi (Gordy) just why he does what he does. Many men would probably rather walk through fire, than be with a woman, for any period of time, who was in labor, especially in the latter stages, even when it is their wife or close relative. But in Bungoma County we met, not just one, but 13 of 23 men with a different perspective. And just in case you are thinking that Bungoma County has hoarded Gynecologists, you are wrong. These are ordinary men, Boda-Boda riders with a calling that leads them to choose to be around pregnant women in labor, to support them by taking them, free of charge, to a health center for medically assisted deliveries.

“I don’t know why, but most women give birth at night,” begins this hero in Kiswahili. “Some nights I get as many as three urgent calls. I respond to all. Many of them are in advanced stages of labor and this for me means that we sit on blood and water all the way to the health center. Sometimes we make it. Sometimes the baby comes on the way to hospital, and I never shy away from the challenge of helping out. Most times the lady is accompanied by a Birth Companion, a Community Health worker, her mother in law or a female relative. Sometimes, like last week, it’s just the two of us.”

Even in the best of times, the rush to hospital when in labour is, to say the least, uncomfortable for most women with the ever present risk of losing the mother or child to the journey. This is even more challenging in the counties outside the capital. In some places, women are ferried on the back of Lorries transporting quarry stones in attempts to save their lives and those of their soon to be born babies. gordy-taking-a-woman-into-healthcareBernard Mare, a Transport Officer with the Ministry of Health Bungoma explains “Many places in the County are inaccessible to regular ambulances due to climatic and infrastructural challenges. Many homes are at least 5kms from the nearest health centers and can only be accessed through footpaths, sometimes mountainous like in the Mount Elgon areas. When it rains, and it is night, family and community members here either use makeshift stretchers with blankets to carry women either  to the centers or to a waiting Bodaboda at more level places. Some are brought in on wheelbarrows. Bodabodas, though considered dangerous by most, is the way most people get anywhere these parts of the country, so it makes sense to encourage their use, with caution of cause.”

“I have been a Boda-Boda man for 9 years, and whenever I see someone sick, I help  them – for free. I think this is what built my regard in this area, but I didn’t know just how much until the election. In June last year, the sub-chiefs angordwinnounced in the markets and in the villages around that they were looking for a Bodaboda man to help the villagers get to hospital, especially in the night. They, the Government, GlaxoSmithKline and Save the Children, had laid out about ten requirements that this man needed to have.  He was to be dependable, a man whose phone was never off, with a volunteer spirit, not a drunkard or criminal, someone who would best represent the community. I had a funeral on the day the election was to take place so I went” Says Gordy.

“The requirements were deliberately stringent. With the challenges in the area, including security, we needed mature men, with good reputations, with valid Riders’ licences, Insurance and a log book showing that they owned the bike they were riding.” Explains Felix Makasanda a Community Development Officer with the Boresha Programme that rose up to respond to Gordy’s initiative.

“When we were just about to bury, I got a call from one of the community health volunteers who knew me well. They told me to hurry back to the market and try my luck. There were about 60 riders who had responded to the call. Some had been campaigning and had come with their supporters. When I walked in, their morale dropped, and one or two asked me what I was doing there. The short of it, is that most of my competitors became my supporters. At the end of it, the community shortlisted five of us, and I got the most votes,” smiles Gordy. At least, Gordy could now fuel his bike on his mercy errands and have a something left to care for his family.

gordy-with-his-wife-janet2“It’s not easy,” his beautiful wife Janet Nafula contributes. “Many of the women get pregnant in the food season and give birth in the drought season. Sometimes these calls come in at night. As a human being of cause there are times I feel bad, but I have learnt to wake him up and release him, with a prayer. The night holds many issues. I am proud of what he does. Sometimes it rains, and in those nights, he could get as many as three calls. Which means I get to wash more clothes, but I do not mind it. I know he is out saving lives, and I trust him totally. He has never been one with a wandering eye, so that does not even worry me,” she says playfully. “He is a responsible father and husband. We have never slept hungry, he has bought and built on this plot, my children are all I school by God’s grace, the last being in a private school. He has helped set me up in a small hotel business where I have 4 employees, and where he comes in to help from time to time. We also farm goats, chicken, maize and beans, which is where we started off.”

How do they get to know his number? “My mobile number is like a hotline around here. The Chiefs announce it during funerals, in churches, at the hospital during clinics and at meetings. Former traditional birth attendants as well as community health volunteers have it.” Gordy explains. beneficiary-1-mildred-simiyu-with-baby-hildaOne of his beneficiaries Mildred Nanjala Simiyu, not a relative of his, who had her baby in March this year shares how on the day she went into labour, they had no way of getting to the hospital. The young mother of three, had walked to the health centers in the company of her loving mother in law for the first two births. This time though, it was raining, dark, and the path to her home in Bonambobi village in Bumula is full of twists and turns and narrows to barely passable footpaths closer to home. It is about two and a half kilometers from Gordy’s. She had challenges with pregnancy related hypertension. Her mother in law had heard about a BodaBoda Ambulance that transport’s people to hospital for free. “I was surprised by how fast he responded. He rode fast, it was just the two of us that night. My mother in law had to stay back to care for the other children. He saved my life and that of my baby Hilda. If it was not for him, I would have died in the process of trying to have the baby here. She kept presenting her chin first.”

beneficiary-2-jessica-wamalwa-with-baby-prosperJessica Wamalwa had a similar experience. She got Gordy’s number from a neighbor at around 11pm in the night. It was a rainy night. “I was overwhelmed. He was gentle and encouraging. He would ride at the pace that was comfortable for me, but would not stop when I asked him to. He said it was important to get me to hospital. Sometimes he would use one arm to hold me steady on my back. We rode also with my mother in law. By God’s grace I had baby Prosper at 3am.”

Gordy confesses that there have been some challenges. The weather, the roads especially on rainy nights, his susceptibility to frequent bouts to malaria and pneumonia. The lack of proper riding and safety gear is also a challenge for him. “I wish also that they would train us in basic first aid so that we could be more useful in cases where the babies come before we get to the health centers. I have so far, in the past years, had four women give birth when I was taking them to hospital.” gordys-colleague-pastor-wilfred-sifuna-otunga-1The other Riders agree with him on these challenges. Pastor Wilfred Otunga who has been doing this work for 20 years due to his love for children says “There is also said to be a ghost rider who terrorizes road users. Many who have seen it describe it as a jacket riding a bodaboda. I have never met it. I believe God has been with me. Many of us have also met with thugs and thankfully none of us has lost their bikes.” Lack of clarity on the role they are playing, by police on patrol was previously a challenge, but since their partners gave them branded reflector jackets with government and partner logos and branded as Ambulance.

Gordy’s twelve colleagues are grateful to him for his perseverance, and good example that impacted all of them to do the work they do. They also appreciate the assistance that has come as a result of their love for their communities. Like Gordy, many have bought land and built their simple homes on them. Some are educating children at all levels including at the University. They have also initiated businesses for their wives in which they work when they are not on the road. Most importantly, it has enamored them to the communities that chose them for this noble work and are committed to supporting them. They echo Gordy’s sentiments as he concludes our day, “I am convinced I was born to do this. I am grateful for the help I have received from the partners, but I did it before and I will do it long after they leave.”

vipslit@yahoo.ca

 

What They Said

Mildred – Gordy is the kind of person who reacts urgently to every call. If it was not for that, I would have died in labor. He is helping the women here, they will not have their children at home unless they do not have Gordy’s number. The number of deaths of mothers has also reduced significantly. I have his number and would recommend him to any woman in labor.

Jessica – Gordy’s work is meaningful. I don’t think my neighbor would have helped me without transport.  I had seen his number on display during clinic. But on that day, I got it from the community health volunteer who is my neighbour called Martin.

dr-brian-inima-moh-bunyala-subcounty-hospital

Dr. Brian Inima

Dr. Brian Inima – MOH Bumula Sub-County: The BodaBoda Ambulances have increased greatly the number of hospital deliveries.

transport-officer-moh-bungoma-county-bernard-mareBernard Mare –Transport Officer MOH Bungom: Gordy has a lot of passion for the work he does.  He has a big heart.

img_0031Dr. John Papaya – Coordinator of Community Health Services, Bungoma County: Gordy has a lot of humanity. No man would otherwise volunteer to do the work he is doing.

Photos and Stories by NaMeD Afrika Studios – (Nashon David Dwoya and Vip Ogola)

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

http://sde.co.ke/article/2000214893/birth-by-boda-boda-bumula-riders-who-provide-free-emergency-transport-to-women-in-labour

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