Midwife and Send Hope Not Flowers partner Sara David shares her emotional experiences from her most recent trip to PNG.
I stood in the centre of the village feeling overwhelmed.
I’d just arrived in the remote village of Yamen with my Living Child team of volunteers the day before, only expecting to train 36 carefully selected Village Birth Attendants [VBAs] so that they could be trainers in their villages.
I had carefully selected the VBAs from villages scattered across the Keram catchment area and their names had been called out over the short-wave radio a few weeks earlier. I had chosen women who had come to several sessions of training over the five years I’d been travelling to this area and had shown leadership potential. There were way more than 36 women before me now.
Men had travelled with groups of women coming for ‘Living Child Training’. Community leaders, elders, women I hadn’t seen or met before. I was overwhelmed. What was I going to say to them?
I had specifically planned a smaller training session so that we could more effectively spend time with the women and give more detailed instruction, supervise them and provide feedback in a more personal way.
My heart always breaks when I know that people have travelled a far way to come and see me or come for training. Some had walked for more than a day, or paddled in a canoe for many hours to make it to Yamen for training. I stood quietly in the middle of the village and thought deep and hard.
In the quietness of my thoughts I heard a still small voice say, “organise a community workshop”.
Of course! I’ll ask the community to divide up into their geographical areas and respond to some questions, that way we can get some feedback about how they’re feeling about what we’ve been doing in the community over the past five years.
Julie, one of our PNG volunteers from Perth, explained to the community what we were proposing. There was a lot of interest and soon our small hauswin (shaded pergola made from local bush materials) was surrounded by men, women and children from all over the Keram area. They divided into groups depending on their locality: The Upper Keram River is known as Keram White, Middle river is Keram Black and lower river is Keram Grass. Each area had about 15 villages represented.
A question was given, the groups retreated to discuss it and write down some responses, then they all gathered together again to share responses. The questions were:
What good things are happening in your village regarding health, for the past five years, since Living Child has been giving training?
What are the not so good things/problems in your village that you feel need attention?
What solutions do you have for these problems?
The groups went off to discuss the first question. I stood back nervously and thought, “They are going to have nothing but complaints. There is still so much to do so I bet they have very little positive feedback”.
It’s easy to see why I felt like that. The health problems are overwhelming. I had just spent a week in the small riverside town of Angoram which is meant to have a District Hospital to receive referrals for the whole District.
Currently, at the hospital, women are giving birth in a disused laundry on a concrete floor with little-to-no medical care. Our team of volunteer midwives provided maternal and newborn in-service training for 16 Community Health Workers. They had not had training for over 20 years. One female Community Health Worker, with tears streaming down her face, told us that after so many years of facing many maternal deaths she had been on the verge of walking away from her job at the hospital just before we came.
She had felt so overwhelmed by the needs of women, and was not properly trained to help them. After our training she said she now had hope and felt inspired to provide a quality service to women again. The smile on her face was contagious.
I don’t blame her for wanting to walk away. I could not do what these frontline health workers do day after day. No facilities, no equipment, little medicine, insufficient supervision.
But back to the village. If there were no services in the towns, what hope was there for women in the villages? What was the community response going to be about the “good things happening in their villages?”
The first group got up to share their responses. “Since Living Child Training for the past five years we have had no maternal deaths in our village.”
What?! Did I hear that correctly? I asked them to repeat the statement. Tears filled my eyes. I could not believe it. No deaths of mothers since Living Child started giving training in 2012. That is incredible. There was more good news.
“Since Living Child has given us clean birth kits we are seeing fewer mothers and babies with infections after birth.”
“Since Living Child training, there are less problems at delivery because we recognise the danger signs and send mothers for help early. We do not delay.”
“Since Living Child introduced the [contraceptive] implant we are noticing that our mothers are happier. They do not have a baby in the belly, a baby on the hip and a toddler at their feet. They are enjoying the family more.”
The tears were flowing now. Group after group came up and shared the same revelations. Men and women shared. I don’t have the statistics to prove this. I do have their stories though. And they will stay with me forever.
In five years a community has turned around from the brink of despair at the number of mothers dying, to now having hope and a future where mothers are not only surviving pregnancy and childbirth, but thriving because they are not always pregnant.
Village Birth Attendants are growing in confidence because they are seeing that their simple village health promotion sessions and support and care at birth is saving lives. They are empowered and proud of what they are doing in their communities.
That afternoon we had to ask the women to choose 36 representatives that they wanted to attend the training. We explained that these women were to be the trainers of others and so they needed to be trustworthy and faithful volunteers.
I felt so sad as some women were turned away who I had got to know over the years. But thankfully they understood why. They came up to me and said “Wanbel” which means “we are one spirit, we understand”. I was so grateful to them for understanding.
Three women who I had never seen before came up to me. They had travelled from a neighbouring area because they had heard about Living Child training. They had had three maternal deaths during the year so far and were desperate for education. I let them stay.
As I went to sleep that night in the house the village people had built specifically for Living Child volunteers, I was reminded of the fact that the most important things we have done is respond to the need as identified by the women in the community.
They asked for training for the Village Birth Attendants and so for five years we’ve faithfully travelled out to this very remote part of the world to support, encourage and equip the women with simple training which will help save lives. They asked for access to family planning as a priority and we managed to find a way to get contraceptive implants to them. The community recognised this and loved us for it. Even though I felt what we offered was so little, to them it was so much.