2016-11-10

                                                                                                                                                                                                     A new mother rests with her baby at a PWRDF-funded health centre in Mozambique. The baby was born unresponsive, but was resuscitated at the health centre. Photo: Zaida Bastos                                                                                                                                                                                                                                                                                                                                               In Mozambique, not all health centres have electricity, and light can be hard to come by when night sets in. Unfortunately, however, the nighttime is when most babies are born. This means staff have to do what they can to provide light, as Zaida Bastos, director of the development partnership program at The Primate’s World Relief and Development Fund (PWRDF), saw first-hand during a trip to the impoverished East African country this summer.

Bastos says that at one clinic she met a nurse who depended on the light from her cell phone during nighttime labours. The nurse—who, she said, delivered an average of 198 babies a month—would hold the phone between her teeth so that her hands would be free.

Two countries away, in Rwanda, a working light bulb can mean the difference between life and death, says Joel Mubiligi, deputy chief medical officer at Partners in Health, a non-governmental organization and PWRDF partner that runs a hospital and other facilities in the country. Mubiligi says he once had to transfer a woman in labour to a hospital—a two-hour drive away—for a Caesarean section because the light bulbs in the clinic where he was working had burned out.

“It was very dangerous for the mother and her baby,” he says. “Really, you cannot imagine the difference that having equipment in a facility can make.”

But from ambulances in Burundi to “solar suitcases”—portable solar power units—in Mozambique, much-needed equipment is flowing into East African clinics as a result of money provided since earlier this year by PWRDF and the government of Canada, attendees at the agency’s annual national gathering in Toronto heard last week. Other PWRDF funds are allowing health centres to train and pay much-needed staff.

PWRDF’s board met with representatives from Canadian Anglican dioceses, plus members of the PWRDF Youth Council, from November 2-6. On November 4, information sessions on PWRDF’s maternal, newborn and child health program (MNCH) were offered by Bastos, Mubiligi and Sophie Matte, senior program officer with Village Health Works, PWRDF’s partner with the program in Burundi.

Announced last summer and implemented beginning in April of this year, the initiative is a five-year joint program with Global Affairs Canada (formerly known as Foreign Affairs, Trade and Development Canada) focusing on maternal and child health in 350 villages in Burundi, Mozambique, Rwanda and Tanzania. The project has a total budget of $20.5 million, $2.79 million of it to come from PWRDF and the rest from Global Affairs Canada. PWRDF received a boost this October with a $500,000 contribution from the diocese of Toronto, most of which will go toward helping PWRDF pay its share of the program.

Funds from the program, Matte said, have already allowed Village Health Works to dramatically expand its services in Burundi. They’ve enabled the organization to ramp up its team of community health care workers from 98 at the start of 2016 to 150 as of October; next year, this figure is expected to reach 200, she said. Village Health Works will also significantly increase the number of doctors and nurses at its clinic, she added.

With funds from MNCH, Matte said, the organization has recently purchased two new ambulances—vital for helping expectant mothers avoid having to climb steep hills to get to the clinic, she said. It is also planning, among other things, to build a nutrition centre to train farmers to grow a wider variety of crops, and teach techniques for better nutrition. Village Health Works has also purchased two HIV diagnostic machines; one is the first of its kind in all of southern Burundi; the other is one of only four of its kind in the entire country, she said.

“This partnership is really going to help us increase all our activities related to maternal and newborn child care,” Matte said.

Meanwhile, she added, Village Health Works is currently fundraising to build “an incredibly huge hospital” near its current facility, which will, among other things, train medical students.

Mubiligi said Partners in Health was looking forward to continuing to improve both the quality of services provided by the nurses at its centres in Rwanda, and its equipment. In particular, he said, the organization is working on improving the quality of the lives of the babies it delivers. While Partners in Health has helped reduce infant mortality in Rwanda, many of the babies whose lives it has saved are born with health problems. Their mothers are often in poor health—they will arrive at health centres malnourished, for example. So along with running health centres, Partners in Health also aims to promote better nutrition by offering training on growing crops and seeds and using farming equipment. And it also has been working at providing training for pediatric development clinics to improve these babies’ quality of life. All together, 19 health centres will be provided with equipment and training to help children born with health problems, he said. PWRDF’s MNCH program, he said, now provides Partners in Health Rwanda with roughly a quarter of its annual budget.

Joel Mubiligi, deputy chief medical officer at Partners in Health, a PWRDF partner in Burundi, gives a presentation at PWRDF’s national gathering in Toronto November 4. Photo: Tali Folkins

Bastos said she witnessed one particularly dramatic birth while visiting a health centre in Mozambique. The birth happened, she said, while she was helping install a solar suitcase at the centre. A young woman had gone into labour and the baby had started to emerge, but became stuck because his mother was too exhausted to push, she said. When the baby finally came fully out, he was blue and unresponsive.

“I could see in the faces of the mother, the nurse and the grandmother that they had given up,” Bastos said. “It was like, that’s it.”

But Bastos remembered that the man helping the health centre staff install solar panels on the roof was also a trained pediatrician. She called for him, and he set to work trying to resuscitate the baby.

“He worked for 40 minutes trying to resuscitate the baby…and at the end of the 40 minutes, that was an eternity, finally the baby began to breathe and a little cry came, and we were all exulting,” she said. By the time they left, the baby seemed normal and was being nursed by his mother, she said.

Bastos was in Mozambique in July and August, accompanied by Richard Librock, external funding program manager at PWRDF, to install the solar suitcases and train staff on their use. The suitcases, designed by an American non-profit organization, are specially made for providing solar energy to health centres in parts of the world where access to electricity is difficult. They are equipped with a battery, charger, lamps and Doppler monitor, a device for picking up the heartbeat of fetuses in the womb.

Note: A correction has been made to this story. The total budget for the maternal, newborn and child health program is $20.5 million, and the contribution in October from the diocese of Toronto will not trigger new funds from Global Affairs Canada.

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