Since my last post about the Aberdeen Women’s Centre in August, I have visited the centre twice. On both occasions I was struck by the impression that this was an oasis in the midst of a busy community, where calm and order rule. Entry into the compound is strictly controlled by security guards and the areas between building are swept free from debris and rubbish – on my second visit, a group of workers were carefully scrubbing out the drain from the compound to the road. Even though it is located near some very deprived communities, the centre aims, and succeeds, in setting and maintaining high standards of hygiene and care and they are recognised as a centre of excellence.
The maternity wing provides ante natal care and a delivery suite for mothers from the poorest homes. An active policy is implemented to ensure that only those who cannot afford care elsewhere, are looked after here. In the past, women queued outside the centre for a ticket to be seen, but many sold the tickets on to others. Staff were then sent into the community to find women who are approximately 5 months pregnant and give them tickets to attend, but once again some more affluent patients presented themselves. Now, digital photographs are taken when the ticket is issued and matched to the women arriving for treatment.
Women attending check ups wait on the covered verandah and here they receive healthcare/nutritional,family planning and birthing advice, as they wait, in the form of dance, song and colourful charts. Their vital signs are taken inside by the midwives and passed to resident doctors if there is cause for concern. The delivery suite has three delivery cubicles. Women prefer to stay active while in labour and are encouraged to walk around. They are often seen hanging on to the railings outside. The unit has one resuscitation/examination table for newborns, but it is not uncommon for two babies to be on it at once, during busy periods (or in the fairly common incidence of twins). Staff do their utmost, with very limited resources, to do whatever they can for mother and baby and in most instances, with great success. Two senior Kenyan midwives supervise and train local midwives. We asked what pain relief was available and didn’t quite expect the answer: paracetamol! We also sympathised with Karen, the Director of the Centre, as she lives directly above the delivery suite – so her sleep is not always like that of a baby!
The unit has only 8 beds, so mothers are encouraged to leave as soon as they are ready. This is usually within the day. Babies tend to be small for dates as a result of their mother’s poor nutrition. All mothers breastfeed – they really have no economic choice. They would not be able to afford the equipment required, let alone the milk products, or necessarily have access to sufficient clean water to mix them.
Once discharged, mothers have access to the paediatric clinic which is on the other side of the compound. It’s run by two visiting UK doctors, who may have thought their NHS workload was heavy, until they were confronted with up to 120 patients a day here. The waiting room is heaving with parents and small children, even after they have been triaged and the most sick sent to the local hospital. They have to queue the evening before to get a ticket to attend the clinic, which is the only way to limit the numbers each day.
These two departments have been added to the original work of the centre which is fistula surgery. This happens in the central area where three wards are built around a courtyard. As I described before, young girls, pregnant too soon, often have great difficulty giving birth. Prolonged labour results in danger to both mother and baby. They are often taken first to traditional healers before, belatedly being taken to a hospital or clinic for medical intervention. At this stage it is probably too late to save the baby and the mother is damaged during delivery. Afterwards these girls are shunned, or treated very badly, in their community as they are incontinent and may also have a condition called drop foot as the result of nerve damage.
Aberdeen Women’s Centre has set up a free telephone number, sponsored by Airtel, on which anyone can call to report the whereabouts of a fistula sufferer or to get help. Unfortunately this line is abused by prank callers, but the patient operators are there when the genuine calls come through. The Centre also sends staff up country to spread the word about its work and look for cases. It can take some persuading to get a girl and or her relatives to agree to travel to Freetown for the operation. The girls who return in good health are the best ambassadors.
We met the seamstress who makes the new outfits given to each of the girls when they are ready to return to their communities. Most Wednesdays and Fridays the girls celebrate with a ‘Gladi gladi’ ceremony, the good fortune of those who are ready to leave. For some girls their stay is quite short, for others it is months before they are even strong enough for the operation. While in the Centre they have daily education sessions to help their literacy, numeracy and craft skills. The selection of crafts for sale was vastly reduced after the visit from International Women’s Club and a few days later an official party from DFID.
The ladies of the International Women’s Club followed up their tour of the Centre with a little pampering for some of the girls – painting their nails with some donated polish.
It is clear that the success of the Centre is down to the dedication of the staff, both local and from overseas, and, of course, generous funding from the Gloag Foundation. The aim is for the Centre to be self sustaining with sufficient trained local staff to continue and expand its work. The recent addition of a Family Planning Clinic supported by UNFPA means additional work, but also further outreach into community health issues.
It is heartening in a country with so many problems to see a project with such positive outcomes and it deserves all the support it can get.