We focus on improvements to midwifery in Chad.
Initially we focussed on improvements to poor conditions in the maternity units of the two district hospitals of the capital of Chad, N’djemena. Lack of reliable water was a problem, so we funded borehole, water tower and tank systems. At night, lighting was by candles so we donated portable solar lamps. We also provided some supplies of life-saving drugs such as Magnesium Sulphate, an effective treatment for eclampsia, which were not available in Chad. One SBIC achievement was to have this compound added to the list of imported drugs to the Central Pharmacy.
Since 2007 we have enabled simple delivery kits, provided by Birthing Kit Foundation Australia www.birthingkitfoundation.org.au to be delivered free of charge to the district hospitals, one for each mother. This has improved hygiene and conditions. The gloves, swabs and cord ties are valued when such simple resources are often absent.
We began to realise that, although these practical interventions made a valuable short-term difference, the most sustainable way to improve outcomes for the women of Chad, was support the midwives.
There are only 220 trained midwives in Chad and currently ( 2014) 9 trainers in the main state training school. A recent paper commmissioned for AMREF * concluded that the most effective strategy to reduce Chad’s maternal mortality ( currently estimated to be the 2nd. highest in the world after Afghanistan )* would be to increase the number of midwives and improve the quality of midwifery. This requires government legislation to make midwifery a regulated profession.
When the Nurses Association of Jamaica, UK became affiliated to SBIC, skilled British midwives were able to offer their experience to Chad’s midwives. In 2009 we began to work with the Chadian midwifery trainers, helping to improve practice in the real-life conditions of the crowded delivery rooms, which lack many basic resources we in the UK take for granted. British midwives have made several visits since then to support Chadian trainers with their “Action Plan” to evaluate practice in all the hospitals in N’Djamena where women give birth.
The most recent visit to Chad took place in March 2013. Two midwives from the UK, Mary Kitson and Rebekkah Frick, with Ann Pettitt SBIC chair as interpreter, spent 6 days working alongside Chadian midwifery trainers, observing real-life practice in all the hospitals where women have their babies, in the capital, N’Djamena. As in previous visits, there was a lot of discussion about problems and how to overcome them . Each visit ends with workshops where midwives from all over N’Djamena meet, discuss, learn from each other and compare experiences with their UK counterparts. Midwives working in the UK learn a lot from the resourcefulness of the Chadian midwives. The experience is enriching and stimulating for everyone.
Good midwifery saves mothers’ and babies’ lives. Midwifery in Chad has low status and is not even accredited as a profession. By supporting the Chad Midwives Association we encourage them to develop into a profession which sets and regulates standards there.
* AMREF – African Medical and Research Foundation.
* Unicef – Chad statistics