Where midwives thrive in spite of maternity fee waiver

By FRANCIS ONTOMWA

Mumias, Kenya: Helena Oteo, 23, drags her swollen dusty feet as she weaves her way towards the home of Mama Rukia Odinga. She has covered almost three kilometres, but she is not ready to give up, the back pain notwithstanding. Hellena is in her fourth month of pregnancy.

For Mama Rukia, 85, it is a happy day as she is sure of earning some money from her first visitor. She is a popular traditional midwife and a firm favourite of many.

We arrive at Mama Rukia’s at mid-morning in the remote village of Emasanga in Mumias. We find her in her hut readying herself, after news reached her that one of her clients was on the way.

“I cannot underestimate any situation, I have attended to Helena many times since she became pregnant and although this is just her fourth month, I must be ready, I have dealt with similar situations before,” remarks Rukia, gazing to the distance from her stool.

She has delivered many women in the hut which is used as the delivery room. There is just a single mangy and moth-eaten bed. A torn blue mosquito net hangs from the rooftop; it is heavy with dust. The hut is usually filled with joy and excitement once Rukia announces the safe arrival of a baby. Today, however, there is an eerie silence. Things get overwhelming, she says, when more than one client arrives.

“Sometimes I just don’t sleep; things get sticky when I get more than one client, a few days ago I handled three cases in a single night, and when they come, they line up one after the other,” observes the elderly woman.

Tools for exercise

Before she starts her assignments, her master table needs to have all tools ready — gloves, a razor for incision, cotton threads for stitching, a plastic pipe to listen to the baby movements and traditional herbs, just in case of bleeding.

This is Hellena’s second pregnancy. The midwife took care of her during the first and even this one, she will.

“I stay far away from the hospital. From experience, I know how labour pains can be taxing, at least Mama Rukia is nearer and I will not hesitate to come here since she is blessed with the skills and I always feel safe in her hands,” says Hellena.

“Mama Rukia midwived the birth of all the children we find in this homestead,” she tells us. In fact, the elderly woman birthed her five children at home without anyone’s support.

“I never called anyone to help me and all those around me know that, I would hold a banana trunk and push hard, these skills were taught to me by my late mother,” she notes.

She admits pregnant women to her small hut, places them on the bed and the first treat is usually a massage on the belly. Afterwards, she applies some traditional concoctions on the belly and with tender grasps underbelly the woman is made to push the baby.

“Sometimes I have been forced to do some little incision on my patient to ensure the baby is out. This is a minor surgery and afterwards I do the stitching, with the use of some special herbs, bleeding is greatly controlled,” she explains.

She cannot remember an instance when her procedures have gone wrong  — all have succeeded, she says.

Birth fee

“All mothers whom I have attended to have had successful births, this is my calling and God always does it for me,” she tells us. She attends to her clients at a small fee, usually between Sh600 and Sh800. Interestingly, she sometimes fails to get her deserved share of cash. She laments that most people short-change her after getting her services.

“What is Sh800? That’s all I ask from my clients not really as pay but as a token of appreciation, but what do they do? They deliver safely and run away! But this has not dampened my spirits I still do what I do best, I am a vessel to do that which is good,” asserts Mama Rukia.

In keeping with promises made by the Jubilee Alliance in the run up to the last General Election, the Government abolished maternity charges in public health facilities. This notwithstanding, traditional midwives still have a field day.

Dangers of midwives

Hakeem Bakunda is a medical practitioner in Kakamega town. “There are a host of factors that goad many to seek the services of traditional midwives, sometimes it has to do with distances from health facilities, sometimes poverty or even ignorance,” says Dr Bakunda.

He adds: “The dangers and risks that these midwives, mothers and infants put themselves to are bounty, in this age of HIV infections, there is need to encourage mothers to visit medical facilities when giving birth.”

“It is so worrying that the message of free maternity services has not reached Kenyans, I am saddened by the fact that these midwives use crude tools to even conduct surgical incisions, that is dangerous,” says Dr Bakunda.