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Former RW reporter Craig Tower has a new mission in Mali

A Malian proverb says that a woman in labor has one foot on earth, and one foot in the grave. The proverb is all too true: a woman in Mali has a 1 in 15 lifetime chance of dying from childbearing complications. Many women die because there are no doctors, nurses, or highly trained midwives rural villages. In villages, where most Malians live, auxiliary midwives, or matrones, provide the vast majority of maternal health care. For most Malian women, matrones are first and only health care provider they will ever see. Mali Midwives facilitates continuing education opportunities for rural matrones in Mali.

I worked with matrones in rural Koutiala, Mali first as a Peace Corps volunteer (1994-1996), and later as a midwife and researcher (2003-2004). Unfortunately, Mali's health system is overwhelmed. Matrones attends 60% of all birth that involve a formally trained health worker. Yet, matrones fall at the bottom of the medical hierarchy. This leaves matrones to face enormous responsibility with few resources.

Matrones I worked with shared their pride and frustrations in caring for women and newborns under difficult conditions. Without exception, matrones pleaded for opportunities to update their skills and knowledge. Matrones understand that women and children depend on them for their survival.

Here are some examples of what matrones said that moved us to help them:

…because the system has changed on the local level, everything has collapsed. You work in order to get some benefits from it but… we are not receiving our salary anymore. I have been working now for eight months without salary. That is a very serious problem we're going through.

I strongly believe that I cannot go on strike because of the deep love people of this community have for me. I also had the same feeling toward them. These people love me so much that even if I take a trip on my vacation or leave town and a woman in labor comes to my house, she doesn't want to go to the another village to give birth… They refuse to go there and go back to their village. They say if Fatime is not here, we are not going to go anywhere else... This is an expression of love people have for me. That is why I cannot go on strike. Sometimes when I am sick, I ask the trainee to tell people coming to the maternity that I'm sick. Despite this information they get, some people come to my house begging me to go see their wives. They tell me, Fatime, if you're not that matrone who is taking care of my wife's delivery, I am not at ease. So please do everything you can to come see my wife. All these expressions of trust show me that we get along. Because of all these considerations people have for me, even if I'm going through all kinds of difficulties, I force myself to go to work. Even if I spend a whole year without getting a salary, I will work for the sake of my people. I have to forget about my own troubles to take care of my people.

Okay. I have dealt with some very difficult deliveries. These kinds of deliveries are very hard for me. I don't even know what to do. So I don't take any risk. I tell her people that we have to take her to Koutiala (the closest city with a hospital). I also have some stillborn babies. A woman delivers without any problem but the baby is stillborn. I really don't understand that. Some women deliver. After the delivery I do everything I can to resuscitate the baby but I fail. That bothers me also. Another problem I face is that some women have a very difficult delivery. You can see that they are complete. You can even see the baby's head but the lady in labor cannot push. That is another aspect that I do not understand.

I remember my last retraining took place in '92. Since that date we have not done any other retraining. Therefore we are not improving. Sometimes learn through your own practice on the job. But if we could have some retraining that would help us to have better results. If we could have some new tools that would make some positive changes in our way of working. Unfortunately, we do not have new tools.

Mali Midwives seeks the support of the public to continue their work. You can find out more on their Mali Midwives' Facebook page. Checks payable to The Village Project, Inc. with Mali Midwives written in the memo section can be sent to Mali Midwives c/o Nicole Warren, 1355 W. Hood Ave. Chicago, IL 60660.

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