A Midwife and Teacher
Midwife Gaudiosa Mugyabuso Tibaijuka is leading Jhpiego’s efforts to help Tanzania provide skilled emergency care to pregnant women, mothers and newborns. With more than 30 years of experience, Tiba has delivered babies, helped prepare the next generation of midwives and now works in conjunction with the Ministry of Health to educate Tanzanian health workers in essential maternal and newborn care. That includes antenatal care, infection prevention, active management of third stage of labor, exclusive breastfeeding and postnatal care. As part of her duties, Tiba, 57, is working to make sure that health facilities in Tanzania and Zanzibar adopt the national standards for emergency obstetric and newborn care, and infection prevention and control. Even though Tiba spends a lot of her time helping strengthen health services, nothing pleases her more than to see “a confident, happy, breastfeeding mother waiting to be discharged home.” Don’t be surprised if you are walking with Tiba in Tanzania and a woman shouts out her name to let the world know she helped save her life or respectfully calls, “Oh my teacher!”
An Afghan Midwife Strikes Out on Her Own
From the time she took her first job as a midwife at a hospital in Herat, Afghanistan, Mozhgan Mohammadzai took great pride in helping women who previously gave birth without a skilled birth attendant at their side. Living in a rented room near the Gulran District Hospital, the 2005 graduate of the Health Science Institute of Herat spent two years filling a void in a place where there were previously no female physicians or midwives.
“Working with women and saving mothers’ lives gave me a special feeling, which I never felt before, and made me more confident that I made the right decision to become a midwife,” says Mozhgan, who estimates she has assisted with more than 1,000 deliveries.
After her two years in Gulran, she went to work for the Afghan Midwives Association (AMA) as a provincial representative, and joined the staff of the regional maternity hospital in Herat City as the head midwife.
Since 2009, Mozhgan, whose family includes many women who are physicians and teachers, has worked as a program officer with Jhpiego’s midwifery education program in Kabul. Convincing her relatives to allow her to move far from home was not easy—it remains culturally unacceptable for a young woman to strike out on her own. But she says it was worth the struggle: “I’m proud of my profession and it feels good working for mothers and midwives through Jhpiego and the AMA.”
Dr. Johnson Is Mr. Midwife
Peter Johnson is proud to be called a midwife. As a man in a predominately woman’s profession, he is often asked whether he shouldn’t be referred to as a “mid-husband.” His response is always quick and to the point. Midwife, in Old English, literally means “with-woman” and he is passionate about his role working with women before birth, through labor, at their deliveries and between their pregnancies. As a nursing student, Peter had no interest in women’s health and resisted opportunities to learn about the role of midwives. Some years later he found himself alone in the middle of the night supporting a woman through a long labor. It was during that night that Peter realized his life would be spent as a midwife.
Twenty-seven years later, Peter has served in a variety of roles such as an Air Force midwife in rural North Dakota, a midwifery educator supporting students through distance learning and an international public health professional helping prepare a State of the World Midwifery Report.
Peter loves his current work at Jhpiego because “it supports the development of quality midwifery education and practice in places where midwives are most needed by women and their families.This job is extremely challenging, deeply satisfying and always humbling. I learn something every day.”
In Her Mother’s Footsteps
Midwife Asmuyeni Muchtar, of Jhpiego’s Indonesia office, is living her mother’s dream. A midwife since 1977, Yeni was encouraged to join the profession by her mother, who passed the exam for midwifery school but never had the chance to attend because of her marriage. Yeni had a dream too—to become a teacher. With her mother’s support and encouragement, Yeni became a midwife and teacher of English. When not at work with Jhpiego, she serves as a weekend lecturer at a midwifery college in Jakarta. A midwifery advisor for Jhpiego since 1999, Yeni is now part of the U.S. Agency for International Development’s Maternal and Child Health Integrated Program (MCHIP) team. MCHIP is working to educate midwives in Indonesia in essential maternal and newborn care, newborn resuscitation and other skills to keep pregnant women healthy and give birth safely.
She is so well-respected among her peers that when a senior midwifery colleague was due to give birth, she chose Yeni to be with her. The woman delivered a healthy baby girl. “She gave the baby a part of my name. I will never forget this,” says Yeni.
Another woman Yeni won’t forget was a patient at a health facility in East Kutai, where Jhpiego was working in 2009. The woman had a prolapsed uterus. She needed to go to the hospital but her family didn’t have the money to transport her to the hospital, which was four hours away. Yeni intervened with a supervisor saying, “Are we just waiting for her to die?” With help from local officials, the woman was taken to the hospital, where she eventually recovered. She is a happy mother of three children today.
An Advocate for Healthy Rwandan Families
A nurse-midwife since 1994, Gloriose Abayisenga has a song in heart. When a delegation of Jhpiego officials visited a Rwandan village last summer, the local women greeted them with a song proclaiming the importance of healthy motherhood. Abayisenga had written the tune to reinforce for Rwandans the need to access health care services before and after birth. Through Abayisenga’s work for Jhpiego, the area around the village of Nemba has seen an increase in the rate of births attended by a trained health care worker. “I am so pleased that more and more women are delivering with a skilled provider by their side,” she says.
As the maternal and newborn health coordinator for Jhpiego in Rwanda, Gloriose, 36, is carrying on the work she began in maternity wards and nursing school classrooms as a younger woman. She is educating community health care workers and health care providers in prenatal care, emergency obstetric care and kangaroo care, a family-centered approach to nurturing and caring for premature babies. Gloriose is also involved in an innovative program for male circumcision services that uses Jhpiego-trained nurse-midwives to do procedures usually performed by doctors.
But her primary focus is promoting health strategies and practices that will reduce maternal and newborn deaths. “The most rewarding part of my job is seeing the large number of health providers (we train) become competent in different procedures that can help save mothers and newborns, leading to healthier Rwandan families,” she says.
A Young Girl’s Dream Profession
As a girl in Ethiopia, Berhane Fekade knew what she wanted to be when she grew up: a nurse. After earning a coveted spot in the nursing school, Berhane got the chance to become a midwifery student. A practicing midwife for a decade now, Berhane is Jhpiego’s maternal and newborn health advisor in Ethiopia. She helps train health providers in basic emergency obstetric and newborn care, offers supportive supervision at health facilities and promotes Ethiopia’s goal of improving maternal and newborn services. Berhane, 30, remains passionate about accompanying a woman on her journey of giving birth. “Once the labor ends, witnessing the mother forget all of her pain and suffering and become gloriously happy, trying her best to feed her tiny baby, holding so gently and staring into its eyes with her tearful eyes, is the most inspiring thing to me,” she says.
Helping Afghan Midwives Organize
When the Afghan Midwives Association meets this year, more than 400 of its nearly 2,000 members are likely to attend. At the inaugural meeting of the group, 16 midwives showed up and Sheena Currie was among them. That was back in 2004 and Currie’s work helping establish a strong midwifery program in Afghanistan is but one of the many accomplishments in this 53-year-old midwife’s career. A native of Scotland, she trained as a nurse and then a midwife and stayed in the profession: “Being with women on the day of birth is just the best job.” Today, you will find her in maternity wards and health clinics in Tanzania, Ethiopia and elsewhere across the developing world. Recently named Senior Maternal Health Advisor for USAID’s flagship Maternal and Child Health Integrated Program (MCHIP), Sheena is helping lead an effort among health providers to improve caring behaviors toward mothers during the birthing process and ensure evidence-based practices are integrated and implemented in country programs. “This is an exciting time for midwifery and midwives with increasing recognition of the key role they can play in improving maternal and newborn health,” says Sheena. “With strong political commitment, as experienced in Afghanistan, midwifery can flourish in any country, regardless of its socio-economic status or structural development.”
Effecting Change as a Midwife and Program Manager
As a new nursing school graduate, Hannah Gibson got a little advice from a tutor that helped launch her career in international health—if she wanted to work in the developing world, she would need an additional degree. Hannah chose midwifery: “After I graduated, I found myself loving being a midwife. I loved providing one-to-one care to women, caring for them in labor and then seeing them at home as they adjusted to their newborn.” Before long, Hannah was heading for her first overseas assignment, achieving a goal she has had since she was a precocious 8-year-old.
Her work as a volunteer clinical midwifery tutor in Pakistan proved to be “one of my most challenging roles—persuading doctors that midwives could in fact deliver babies!” Hannah says. While working in Sierra Leone, where maternal mortality is the highest in the world, she confronted cases where “a lifesaving cesarean section would be refused unless money had passed hands.” Hannah decided that she personally could better effect change to benefit all women if she implemented and managed programs designed to improve health care on a national and local level in developing countries.
Today, she serves as Jhpiego’s Ethiopia Country Director. “While I miss the ‘hands on’ midwifery, I still get tremendous satisfaction from knowing that our program efforts are visibly improving the quality of midwifery education and improving the services that women and their babies need,” she says.
Full Complement of Skills
Nurse, midwife, public health educator and maternal health program specialist, Alemnesh Tekleberhan has been working in the field for 21 years. She has worked in health clinics and a government hospital, taught nursing and midwifery students in college, managed maternal and newborn health programs, and now serves as Jhpiego’s maternal, newborn and child health team leader in Ethiopia.
In this position, she works closely with Ethiopia’s Ministry of Health, Regional Health Bureaus, UN agencies and other donors and partners on strengthening maternal, newborn and child health services. She also provides technical support to the midwifery schools and the national midwifery association to improve the standard of midwifery education and profession.
“As a midwife, what makes me happy is being able to share life-changing moments with a woman—what it is like to be pregnant, her concerns and fears for herself and her baby, expectations for the birth and its outcome, and the joy and happiness after giving birth safely,” says Alemnesh. “In many developing countries, including Ethiopia, being pregnant is not just a matter of having a baby—it is a matter of life and death, for the woman and her baby. Because of this I am grateful I am a midwife, and that I have contributed to saving many lives of women through my clinical practice. As I work on programs, I know I have contributed to producing tomorrow’s generation of competent midwives.”