White Ribbon Alliance and George Nkhoma
Meet George Nkhoma
My name is George Nkhoma and I work as a nurse and midwife in the rural district of Chitipa in Malawi. I am proud of the work that I do saving the lives of mothers and children in my community, and it is because of my work with WRA Malawi that I have been able to take my advocacy for maternal and newborn health to the world’s stage. I went to the United Nations General Assembly in New York City as a White Ribbon Alliance Citizen Representative, an experience that changed my life.
“Midwife by Choice, Not by Chance”
I grew up as a house boy, not knowing my real family. After searching for my roots, I learned that my mother died while giving birth to me. I gave up my plans to become an engineer in order to become a midwife so that I could save others the incredible pain of growing up without a mother. My friends laughed when I told them, but I did not mind. There is nothing more important to me than saving mothers’ lives.
I’m proud to call myself a midwife, especially a midwife from Malawi. Malawian midwives are among the most passionate and hard-working midwives in the world. In my District of Chitipa, most health centers operate with just one midwife per facility. It is shocking how much our profession is understaffed.
According to a 2016 survey by White Ribbon Alliance for Safe Motherhood Malawi, the country has only 3,233 bedside midwives serving a population of over 15 million.
I know the realities of working in an understaffed and overworked field. We often work several 24-hour shifts for days in a row without a break. Recent government cuts have left midwives and patients without food. Our pay, the equivalent of US$250 a month for those with advanced degrees like myself, doesn’t cover our basic living expenses, so many midwives also have to farm or run small shops. We do not have the most basic supplies like sterile gloves; we lack fuel which can mean working in the dark or by the flashlight on a cell phone.
The result of these working conditions is that women in our maternity wards give birth untended while midwives, often the only health worker on shift, rush between one life-threatening emergency and another.
I’m proud to call myself a midwife, and I’m proud to call myself a supporter of White Ribbon Alliance. I know that it is by raising awareness of the realities of midwives in Malawi and around the world that lives can be saved. The recent, groundbreaking publication by World Health Organization, the International Confederation of Midwives, and WRA of Midwives’ Voices, Midwives’ Realities highlights the very real challenges faced by midwives, and the real changes which can be made to improve the lives of these maternal health advocates.
White Ribbon Alliance unites citizens like you and me to demand the right to a safe birth for every woman, everywhere.
Respectful Maternity Care Saves Lives
Respectful Maternity Care (RMC) is not an alien subject to midwifery profession. To begin with, every pre-service midwifery training emphasizes the fact that “the patient is the boss” to every midwife. From the word go, you are told that without a patient, there is no midwife and no midwifery. This entails the kind of treatment the patient deserves, treatment full of respect and dignity, as anyone would do for his or her boss. That’s the core of RMC in midwifery. Every midwife is taught principles of ethics and professionalism, and that cements the respect-based approach a midwife should show towards mothers and guardians.
Just some of the reasons why RMC is important…
1. RMC creates service demand from women and the community at large.
2. RMC promotes good health seeking behavior in societies with little or none.
3. RMC prevents trauma, physical and psychological to patients and guardians.
4. RMC promotes job satisfaction for midwives and all skilled birth attendants.
5. RMC promotes health outcomes for mothers, newborns and guardians.
6. RMC promotes and maintains the midwifery profession through positive imaging.
Sadly, the situation turns out differently when midwives go into practice. RMC becomes difficult at times to implement and issues of disrespect, malice and physical abuse are reported from patient and midwife. That is why I want to tell every midwife and every patient about RMC, because the overall goal is to promote well-being for mothers and their babies.
I love mothers and newborns, I love midwives, and I love the work WRA does to support midwives around the world.
Self-Care for Maternal Health
A lot of people have asked me recently about how self-care for maternal and newborn health relates to my work as a midwife in Malawi.
Self-care gives you an understanding of what you should do — and when — for your health. Self-care promotes health behaviors and addresses cultural practices that deter a woman from seeking medical care. The woman should be empowered to know when to seek health care, what health care she needs, and what she should expect from the health care provider.
The incredible thing about self-care is that it also has a ripple effect throughout the village, because once one woman understands her own needs, she is able to tell her friends, who tell their friends, and so on, until everyone knows how best to care for themselves and their babies.
Examples of Self-Care
- Following a healthy lifestyle when pregnant, including having a balanced diet, a good standard of hygiene and taking regular exercise.
- Taking iron supplements, if necessary.
- Soon to be mothers knowing that they are entitled to quality care offered by trained health workers.
- Understanding the difference between what is “normal” and when to seek emergency care.
- Learning how to breastfeed and look after a new baby.
- Being part of a mothers group — talking and learning from others’ experiences.
Self-care is a game changer in community health, and I am proud to be involved in spreading this important health knowledge through my work with White Ribbon Alliance.
The United Nations and Me
I have written of my experience working with White Ribbon Alliance from the joy of my heart, and every word signifies the outpouring of the expressions of my heart. It is a great pleasure for me to be associated with White Ribbon Alliance for Safe Motherhood. This big family is a dream place to belong to. The beginning was humble; little did I know that small things can burst into such big heights.
I was surprised, amazed, thrilled and filled with disbelief when I was told in September 2016 that I’d be going to the United Nations as a Citizen Representative for the White Ribbon Alliance. Honestly, I never thought I would ever step foot in America, so being told I was going to New York City was hard to imagine. And, what I was able to accomplish there for mothers and children was a real dream come true.
At the UN, I was able to…
- Share my life story in front of the world’s maternal health leaders at The Partnership for Maternal, Newborn and Child Health’s brunch meeting.
- Speak out for midwives everywhere as part of the panel at the launch of The Lancet’s — one of the world’s most highly revered medical journals — Maternal Health Series.
- Tell the American Academy of Pediatrics to support midwives and midwifery training across the globe.
- Advocate for mothers and babies everywhere by meeting global leaders face to face at the United Nations headquarters.
Working with everyone here at WRA has made me into the best midwife I could be, and the chance to share my story with the world as a WRA Citizen Representative has empowered me in ways I never thought possible.
WRA will always be on my heart, lips and mind. And, after having the opportunity to speak at the United Nations, my commitment to mothers, newborns and midwifery is enhanced more than ever before. I envisage a midwifery ambassador in me at a global level, not very far from now.
I wish you all well, and may GOD bless you all abundantly.
Thank you for reading my story, and all of my best wishes,
George Nkhoma, White Ribbon Alliance Malawi
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