Wampembe, Tanzania—Wampembe Health Center is an extremely remote health center in western Tanzania, four hours by car from the nearest district hospital on the worst road I have ever seen—100 km of dirt, stones, hills and ruts. The nearest health center that offers basic emergency obstetric and newborn care (BEmONC) is six hours away by boat. Not a single phone company provides service here. And the lorry that travels twice a week from the village to town takes much longer than the four-hour land cruiser trip that brought me here.
If a woman in labor has complications before 3:30 p.m., Wampembe Health Center can radio for an ambulance. It will take four hours for the ambulance to arrive, and another four hours for it to return to the district hospital on that same rutted road. In short, any woman with a complication during labor out here is basically out of luck. That’s why strengthening emergency obstetric capacity in underserved health facilities is vital—and why nurse-midwife Adelina Kizzila works hard to save lives at Wampembe.
Wampembe Health Center is one of 26 health facilities in Rukwa and Mwanza regions, where Jhpiego is working with the Ministry of Health and Social Welfare to reduce maternal and newborn deaths. This initiative is part of the Mothers and Infants, Safe, Healthy and Alive (MAISHA) Program, funded by the United States Agency for International Development, and the Wazazi na Mwana Program, funded by the Canadian International Development Agency, and implemented in partnership with Plan International and Africare.
The Jhpiego-led MAISHA Program is equipping health providers with competency-based training and necessary equipment and supplies for BEmONC. For the Wazazi na Mwana Program, Jhpiego and partners will go a step further by equipping health providers at Wampembe and three other health facilities with comprehensive emergency obstetric and newborn care (CEmONC), which includes surgical services, such as delivery by cesarean section, and blood transfusions, in addition to BEmONC services.
The clinical officer in-charge at Wapembe Health Center, Anglibert Kapembwa, is a true BEmONC champion. Throughout my visit, he often repeated to our group that “BEmONC saves lives!” One afternoon, he pointed out the only woman in the postnatal ward, Ashura Baraka, 25, who had given birth to her fourth child the night before, a baby girl named Upendo. Her previous three children were delivered at the same facility with no problems.
After delivery, the new mother received a shot of oxytocin, a normal practice to prevent bleeding after birth. Soon after, however, nurse-midwife Kizzila discovered that Baraka had a retained placenta and began to bleed. Kizzila shouted for help. Flora Mwananjela, the facility nurse midwife in-charge, came to Kizzila’s aid, guiding her step by step to manually remove the placenta and give the mother an additional oxytocin injection, thus managing the postpartum hemorrhage.
Thankfully, both providers had been trained on BEmONC under MAISHA some months before. Nurse-midwife Mwananjela told me of the importance of teamwork that she and Kizzila learned through their training. They had to communicate during emergencies and help each other manage problems—which is exactly what they did. As a result, baby Upendo was healthy and going home with her mother.
While retracing my way back on one of the toughest roads to travel so far, I kept thinking of the hundreds of pregnant women in underserved communities who do not have access to basic lifesaving care. I kept thinking of Anglibert Kapembwa, Adelina Kizzila and Flora Mwananjela at Wampembe, thankful for their commitment and proud of their dedication to women and families. I thought of all the other health providers at MAISHA-supported health centers. They are making a difference. Through their work and improved skills and attitudes, hundreds of mothers and newborns will be saved.
I shared my profound joy in an e-mail to Jhpiego program staff in Dar es Salaam, “Good news from Rukwa. Good morning, everyone. You saved a mother’s life this week.”