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

Kangaroo Mother Care Saved Baby Winnie

IMG_9851Phyllis Wanja Kariuki

Age: Early 30s

In her own words:

I lost my first pregnancy at 15 weeks. I had 20150303_183406begun bleeding, and doctor in Mandera, where I worked as a Logistics officer with Save the Children, Kenya, recommended two weeks bed-rest. I came back home to Nairobi and all went well. The day before my scheduled return to Mandera, my friend and I went shopping. I started feeling funny, like cramps and remembered that the doctor had permitted me to take regular painkillers for this, so I took a Panadol. I did not expect that there would be any adverse effects, and it helped. At night however, I woke up to the same cramps, intense pain. When I went to the toilet, some water came out. I did not understand what to make of this, as it was my first pregnancy. I was rushed to Nairobi hospital, and on getting there, they discovered that the amniotic fluid had leaked out. Their prognosis was not good. They suggested a termination of the pregnancy as it had only a 90% chance of being viable. I resisted this and sought a second opinion. I went to Aga Khan hospital. I was given the same story. The doctors there meet and make sure that by the time they are giving you your report, they have tested you, they have discussed it together and allow you to make the final decision based on their thorough analysis of the your case. I had stayed for so many hours, and since this was my second stop, I felt I had no other choice but concede.

It was a horrible experience. They started with the treatment, and I was discharged and moved on with my life. After six months I conceived again, and I still had issues. I started bleeding at 8 weeks. This time I was more cautious, and able to see the warning signs. I went to the nearest clinic, St. Bakita in Utawala, and was injected with Buscopan. They suggested I go for a scan.  I went home and the next morning went to Agakhan for the scan. I was frightened of loosing my child. During the scan, the doctors were discussing the point of bleeding around a certain spot. But there was another spot and when I asked what that was, I was told it was another baby. I understood them the magnitude of what I was carrying and how careful I needed to be. After the scan at the ER, I was referred to Dr. Obura, a Gynaecologist. He looked at the results and gave me hope.  He gave me medication to strengthen the wall of my uterus, and advised me to avoid strain.

At around 18 weeks I started spotting again, but this was not serious.  Both at home and in the field in Mandera, I took very good care of myself. Mandera was less strenuous for me as I only had short distances to walk, and we are basically taken care of. I did not have to cook or do anything for myself. I stayed there for six weeks and then came back for R&R. At the airstrip, the flight attendant asked me how far along I was. She alerted me to the fact that I could not travel in a small aircraft beyond that point, and I understood that to mean that I would now be working from Nairobi. I worked for one more month before I started swelling. One of my colleagues, Eric Muthiani adviced me to have my blood pressure checked to rule it out as a cause for the swelling. My pressure was normally but now my feet begun to swell as well. It was during clinic test. I was to do a HCG test to determine my glucose level. It takes time, but they advised I change the clinic date as it was too late in the day. But I wanted to understand what was causing the swelling. The doctor insisted on a urine test. I had to do it twice for them to determine what the problem was. The doctor told me that my urine had a lot of protein in it, and suggested for additional tests to determine the functionality of my kidneys. This came out normal. They connected me to someone closer to home who would monitor my blood pressure daily, as they had noticed that it was fluctuating. I was to call the hospital daily to give them the readings.

This was on a Friday, but on Saturday, I was planning on going shopping for baby clothes so I did not go to check my pressure. I went in on Sunday, it turned out high. It read 170/100mmhg. The doctor recommended I go home and rest. I rested, and went back for another reading in the evening, this was even higher after then rest. I know High Blood Pressure is serious, but had no reference for people having it around me, and therefore did not see it endangering the pregnancies. The doctor recommended that I go into hospital immediately. I went home, got ready and then went to hospital. I was alarmed to find a team waiting for me on my arrival at the hospital. I was feeling fine, and wondered why they found this reception necessary. The scan showed that the blood was not flowing into the second baby as it should. I was admitted, but even then I thought it would just be for a night. At around 1am the doctor came to check on me and informed me that they would have to do an emergency Caesarian Section if my blood pressure did not go down. I had no idea that HBP could lead to one giving birth to pre-terms.

In the morning, a group of four doctors, took me to radiology for a scan. They sat around me and studied me. They told me they needed to do the emergency CS, in order to save my life and try save the lives of my babies. I therefore signed the consent and the CS was done at 3pm that day. This was on February 2, 2015. Everything went well. They did a spinal epidural, where I can see what is going on. They did a good job, they engaged me a lot. I heard my babies cry and I was excited. I was not able to see them immediately as they needed to be taken into the ICU, as they were a bit small. My daughter was 790grams and my son was 970grams. My son was a bit bigger. Everything was completed and I was taken to the ward. I wanted to go see my babies but I was not allowed then. It was too early, I was still numb. I saw my babies the following day.

It’s quite bad when you are in the ward, can hear other babies crying and you don’t have yours. You deal with a lot at that point, even the bills. I went to see the babies on February 3rd, around mid-day. I remember the nurses telling me that I needed breast milk, even if it was just two drops. Imagine there is no way I can be able to stimulate…you need the baby to stimulate it to produce milk. The nurse told me to be strong, calm down, focus on the babies, and try to express. There are other liquids they give the babies for feeding. I tried to express and nothing was coming out. By evening I had two drops and the staff was quite encouraging. The biggest trauma was when I saw the babies and how tiny they were, and wondered when they would ever grow to the size of the other newborns in the ward. I remember my daughter was the size of the 300mm soda bottle, she could be held in a hand. A nurse advised me to be strong and to take every single day at it comes. Her words remained with me through my darkest times.

The reality of the bills started hitting me. My insurance had been exhausted and my family began counselling me towards moving to a cheaper hospital. I was spending about Kshs 50,000 per baby per day in the ICU. On the 4th the doctor attending to the babies came to the ward. I sensed that something was wrong. The previous night, my son Jaden had been transfused. She started with the positive, telling me that my daughter Winnie was doing well, but the boy was struggling. I did not want to hear anymore. I told her to take me to them. She got somebody to take me to them in the ICU. I found them trying to resuscitate him. They did this while I watched. I told them to do all they could, within their power to make sure he was well. A male doctor assured me that they were. They kept encouraging me that girl was doing well. Unfortunately Jaden passed him while we were looking at each other. I felt like he was telling me ‘mum do something’ or ‘you are going to be okay just take care of my sister.’ Everything was done. I cried a lot. But I turned to the girl, and prayed to God ‘God I am going to walk out of this hospital with this one, and I know you can make it happen.’ I kept telling my close friend and colleague Jane the same. She was there for me through it all. I told her I was sure God would answer my prayer to the affirmative.

20150203_214802I did not want to mourn a lot because I needed to be strong for the girl. I had no choice. I remember the nurses counselling me and telling me, “this one was not yours, let go.” I could not let go the first day. It could hit me and I could cry, and then remember that this one was not mine but I had one surviving. I also remembered that the first time I came to this hospital, I had left without a baby, this time I had a chance to leave with one. I gave it all my energy, I did everything possible to get enough milk. I did not want stress to be a reason for not having milk for my baby. We paid a fee for the hospital to take care of my son’s remains as I did not have the energy to handle it. The hospital recommended some counselling, but most times I cannot and help me move on during dark times. I stayed for a while as they needed to monitor my pressure, but I was doing well. I was discharged on the 6th of February.

The bills were also increasing but my colleague encouraged me to focus on the baby as the money would somehow come.  Miraculously everyday passed. When I was told to give a deposit of Kshs 600,000. I borrowed this. I did not care where it came from as long as I could save a life. The credit office kept calling me and one day I went there and just told them “you are ladies like me, and am sure some of you are even mothers. You call me every time. I know you are doing your job, but at some point try and engage someone. My baby is in these wards, meaning I have not running away. Meaning I cannot run away. At this time my baby was in ICU. She stayed there for two weeks, and luckily she was doing well. She had the oxygen tubes from the 2nd to the 7th then they removed them because she was able to breath on her own and her oxygen saturation was normal. We moved out of ICU to the normal HDU ward. She had a oxygen desaturation, so she was put back on oxygen. I remembered the nurses words about living a moment at a time. She had also told me about how much pre-term babies were affected by movement. Moving mine from 1st to 2nd floor had had this effect.

Proffesor Aketch, told me that they would put the baby on medication to strengthen the lungs, and this caused the sugars to rise up to 21 and its supposed to be between 6 and 8. It really stressed me. I tried to get information for myself, from Google. The pain of seeing my child on injections, tubes and the thought of them having to put down her sugars. I cried a lot, it was very painful to watch.

I started doing Kangaroo at 800grams while she was still at the ICU. She was very tiny. I remember the feeling of putting her against my chest, how nice it felt. It was the first time I was touching my baby and she was calm. Every time I was doing Kangaroo I was happy and not tense. I could sense how happy she was as she could pray. Whenever I arrived in the hospital in the morning, she would play as though she sense I was there. I would do at least two hours daily. I would split this between morning and evening. I sometimes extended depending on how available the baby was in between procedures. The nurses used to encourage us and I used to Google the importance of Kangaroo MotherCare. It improves oxygen saturation, helps in weight gain which was very important for me since I needed my baby to gain weight, and also the bonding thing. These three are the three things that made me keep at it. It really motivated me.

There is this powder they normally mix with the milk call suffactor that helps them to gain weight. Winnie’s body rejected this, so they needed to lower the quantity they put. She got an infection after getting it. Imagine this was her chance for boosting weight gain. I could look at other babies, and though we were told not to compare our babies. I was jealous. They had their own problems but not those challenging weight gain like mine. I never lost hope. I even encouraged others. We had a group and I was considered the experienced. We had a room and we would chat and I discovered that others had problems that made mine. For instance one lady told us how her cousin had triplets and stayed in hospital three weeks and then they suddenly died, one by one. This really challenged me, as I still had a baby. Every time I remember that situation I remember her. I realised how blessed I was. There were others who were crying, and I needed to motivate myself to care for my baby. These helped me get stronger daily.

It was my job to wake up in the morning like I was going to work, get to the hospital, express milk as I could not kangaroo with the milk as it would leak, and then kangaroo. The fact that our babies could not breast feed by themselves, they were too tiny for it. For Aga Khan, until the baby is 1800grams they are still kept in an incubator. After that they are put in a cot. The first time when I saw my baby in cloths it was really happy, it was exciting. I would tell the other mothers “am nearing the door”. In her first two months Winnie went through several lung treatments and two blood transfusions. I did Kangaroo for two months and increased the hours. I could do several 1 and a half hours sessions. I used to cry a lot when I had to leave her especially when she was under treatment. She went through two transfusions. These were the worst since I connected the death of my son with the transfusion he had undergone the night before he developed breathing complications that led to his death. From Google I learnt that transfusions sometimes cause complications in pre-terms.

Some of effects of Kangaroo on Winnie Wakanyi is that she is very close to me, she is alsoIMG_9869.JPG friendly and independent. She is still small bodywise though she weighs 8.3kilos, but this does not discourage me. I knew this would happen. The nurses taught us that when we went to the clinic and were asked the age of my baby…even now when I tell them that she is 1 year 5 months, I see the shock in their faces. I don’t explain unless I feel it’s necessary. One time a nurse responded by asking me if my child was picky about food. She is doing very well, I make sure that I don’t miss clinic. She has never been put on a special diet on her hope. She is now walking on her own and is really fast. I remember the nurses telling us to never compare our children’s milestones with another child’s. The pace does not really matter as long as they get there. As long as everything else is normal, they are good. For pre-terms, don’t mix yourself with pressures from outsides, its her time. If its kangaroo, her time is her time.

vipslit@yahoo.ca

Photography: Nash of NaMeD Afrika Studios and from Family Files

First published on the Sunday Magazine, Sunday Standard, August 21, 2016 (shorter version)

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