Kailahun District wants MOMS to work in all areas.  Empowering women changes lives.
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A peanut-sized baby snuggles with Mamie Jebbeh in Daru.  August 2013. 
Buffy Price helps teach the Helping Babies Breathe class in Daru. 

District Medical Officer asks MOMS to "train everywhere"

MOMS is poised to work in all the main clinics in the Kaialhun District.  The District Medical Officer (DMO) and the Nursing Sister both told us that they want MOMS to "train everywhere in Kailahun!"  They specifically asked that we teach our next class near the capital of the District in the Luawa Chiefdom.  We gladly said YES!

When MOMS first went to Sierra Leone, the Kailahun District had the worst maternal and neonatal mortality rates in the country.  In the 2012 report from the government, the Kaialhun District had the best mortality rates!  Ministry of Health officials searched for the reasons for the change.  Clinic staff, village chiefs, and the women themselves said, "MOMS TBAs make the difference.  You need MOMS TBAs everywhere."  The District Health Management Team (DHMT) agrees.

It has taken time to built trust - that we will return, that we are respectful, that we don't create dependence, that our model really does work.  But the DMO's request shows that MOMS has proven our commitment, cooperation, and competence. 

Part of this trust and approval is shown in the DHMT's request for us to train the clinic staff on the Helping Babies Breathe program.  They want us to reach as many clinics and staff as we can.  In the August trip, I trained seven Maternal/Child Healthcare Aides, six student nurses who were almost finished with their practica, and seven MOMS' TBAs how to resuscitate a newborn using a bag-and-mask.  We had trained the TBAs in Pellie on this skill six years ago.  But some of the MCH Aides and student nurses had never even seen the device. 

So, once each year, we will train a group of "MOMS TBAs" (traditional birth attendants) in the Kailahun District.  Once a year, we'll teach in a different area.  We'll continue with our plans to train teams of trainers who will continue to share MOMS model even more widely.  We will hold a "MOMS TBA Jamboree" where we can conduct continuing education and the women can share ideas and celebrate their sisterhood.

How will we make this all happen?

We need your help, obviously.  This is all big - bigger than Chris and I and the Board.  This takes effort - and we are willing to do the work.

We need money.  A teaching trip costs less than $10,000.

With this, we can train 30-35 women to provide sound maternity care and act as change agents.  They get a micro-grant so they can support themselves and help the neediest women in the village.  We check in with previous groups and conduct continuing education classes with them.

So for about $300 per learner, we save lives and create a vital group of skilled women who improve the lives of everyone in the area.  Not a bad investment at all.

We also need a few good volunteers.  We'd like one or two per trip.  Volunteers need not be midwives, nurses, or doctors, but need to be experienced in teaching without lecture!
Above, you see Emily Kritzler coaching one of the Ngolahun TBAs in palpating a woman's belly to confirm the baby's position and estimate its gestational age and size.  In our training, we spend a few days in the local clinic to provide clinical experience to apply what we've been teaching.

Empowering women makes a difference

In Ngolahun, Jeneba Battie is a changed woman

The women of Ngolahun provide a terrific example of empowerment in their move from victim to victor. We have in Jeneba Battie a woman who is wise, but lacked any sense of her own strength and ability. 

In a refugee camp during the brutal, 10-year civil war, she and a few friends committed to finding some way to care for the women in her hometown.  When this small group returned to Ngolahun after the war, they had to first rebuild the village.  Most of it had been burned, and their lives were seared, as well, with awful memories.  There had been a day when 150 people were killed by rebels; the next day, the villagers dug a mass grave to bury their murdered friends and relatives.  How do you recover from that?

Here are some excerpts from their initial proposal to MOMS for a maternal/child clinic, made just after the war.
A-Gii-Amue was founded by us five women after completing a three months course in child birth, Ante-Natal, and Post-Natal Health Care Service in camps in Kenema in 2004. Upon our repatriation, we organized ourselves and formed our group. 

The sole goal of forming this organization was to bring together the resources, efforts, knowledge, and skills of our women-folks to end our suffering and gain access to safe childbirth and primary health care which once existed before the ten years rebel war.

Our Organisation works in a largely low income group of women who are largely illiterate.  On the social plane, we live in a male-dominated social milieu, where women are slowly being recognized in society.  After the general election of 2007 our area is politically stable.  Government has done very little about Health Care Delivery Services in our locality.  Our problem of getting access to Primary Health Care still stands huge.

And now for the rest of the story....

In 2009, MOMS was asked to help build the clinic, when The New Field Foundation funded the project.  MOMS' role was to oversee the work and dispense the funds.  Well, some of you remember that this happened when donations to MOMS fell catastrophically - to the point where we considered closing our doors. 

We managed to hang on, by begging for your help, and kept working with these women.  We sent messages to them in whatever ways we could, to encourage them and tell them we cared.

Then, in January of 2012, we checked on the clinic and found the main building in place.  We took many pictures, and offered some suggestions and a lot of encouragement.  In August, 2012, we visited again, and found the compound almost complete, but the people were getting discouraged.  We spent time with them, brainstormed ideas, and talked to some other agencies about providing help.  We agreed to return in February, 2013, to teach the women.  So we took a team (Emily Kritzler, Lisa Varnes-Epstein, Chris, and me) to teach 30 women to be "MOMS TBAs."

In June after the training, Jitta attended the Grand Opening of the clinic.  Here is an excerpt from her report:
The TBAs leader Jeneba Battie also spoke.  She said MOMS training has made them bold and taken fear from them in speaking in public.  Now as MOMS TBAs, they can stand to speak in every public meeting.  Before this time, they have been timid and shy in addressing crowds. They also expressed their love and appreciation to MOMS for making good out of them.
Now, I don't think MOMS "made good out of them."  We told them that we see them as experienced, smart, and dedicated, and these qualities would lead them to success.  We provided knowledge and the chance to reflect on how this knowledge merged with their experience.  We gave them a chance to demonstrate how good they are.

Then, on this last trip in August, I talked with Jeneba.  On our first morning in Ngolahun, I was sitting on the verandah, nursing a cup of coffee, when Jeneba walked up.  I said, "Ah, Auntie Jeneba, bi-yeh-yi?"  She said, "I slept well, thank you."  I was really surprised - I'd never heard her speak English before.

She laughed at me, and said, "I don't speak English, but I try!"  Then she said to Jitta in Mende.  "MOMS taught me to have confidence, so now I do many things that I was afraid to try."

Yes, we have in Jeneba a woman who has survived, and is committed to doing good - to end the suffering and provide access to maternity care.  MOMS didn't create that commitment.  MOMS provided knowledge, and, in Jitta's words:
I told them “knowledge is power” and as long as they follow the knowledge and skills gained from the MOMS training, there is no mountain that will stand before them they cannot move.
Here, you can see Jitta translating the module on women's anatomy and physiology in Jokibu.  She draws comparisons to goats, because the women are familiar with their bodies from butchering them. 

Jitta's background as a rural village girl and as a nurse is an invaluable asset to MOMS work.  She connects readily with the women, and they respect and trust her.  Many who have listened to her translate for us describe her as a genius.  We think so, too!
Jitta has grown from village girl to professional woman

Jitta herself is another study in empowerment.  We met her in 2006.  She seemed very young but street-smart beyond belief.  She presented herself as a girl from a rural village, who'd spent much of her life running from rebels and trying to take care of herself and younger sisters.

Today, she is a self-assured woman in her early 30's.  She has a position of responsibility with MOMS, which gives her entree into the offices of senior officials in the Ministry of Health.  She is a nurse who competently treats the sick and wounded in her community.  She is an educator who effectively transmits knowledge that is completely beyond the learners' imaginations.

Jitta recently said, "I was sitting in Dr. Bome's office, and I realized, 'This is my job - this is what I do.  I explain things to doctors.  I tell officials what to do and why.  I am not a little girl!' "  We applauded this insight.  Yes, she is not a little girl.  She is a woman who speaks authoritatively for an international non-governmental organization to people in power.  She is not only our daughter and employee, she is a respected colleague.

So much more to say, but...

This trip was wonderful in all the most important ways.  Seeing for myself the differences we've triggered is humbling.  Hearing the women plan how to teach others life-saving techniques is exciting.  Talking with friends, reconnecting so easily, is so delightful.

Yet there were hard things, too.  We saw the hopelessness that stems from extreme poverty.  We saw a baby born in the clinic we built die just a few hours later.  We struggled with mundane hardships - mosquito bites, bad beds, dirty latrines.

I would never exchange these trips for anything else.  The hardships and the rewards are both part of a whole that moves me toward joy. 

In reflecting on this trip, I have an overwhelming awareness of "This works, it works, it really works!"  Women are surviving.  Babies are thriving.  Girls are eating and growing strong.  Families are healthy and prosperous. 

It works!

So thank you for reading and helping.  Without you, it wouldn't work.  We aren't doing this all by ourselves.  Your gifts, your prayers, your time are all essential. 

The women send you their greetings and deepest thanks for giving to them, praying for them, and just knowing about them.

Please contact me.  Please give. 

Take care,

Trish Ross

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