Recent statistics show that every day in Western Kenya, 380 young girls become pregnant, more often than not, unwanted pregnancies. Half of these pregnancies end up in abortion. Because of the fear of being frowned at, 60 of the abortions are usually unsafe, which are performed by backstreet quacks and untrained personnel, and this leaves 7 young, unwed teenage mothers dead from pregnancy related causes. It goes without saying that these women engage in unprotected sex, which exposes them to the danger of contracting STDs and STIs, which include HIV/AIDS. Because of the stereotyping in my community, these young women shy away from attending antenatal clinic, since being a small community, chances are that the nurses at the clinic know of the circumstances surrounding the women’s pregnancies thus automatically become party to the discriminating parties, which is very humiliating. It is usually easier for them to deal with traditional birth attendants, and midwives, who are ill equipped to attend to the expectant mothers, let alone advise them on how to take care of themselves and the unborn baby to term. These traditional midwives, who usually accept payment for their services in kind, i.e. foodstuff and other goods and services, in place of money, have their work cut out for them, as the most they do is give the expectant mother a tummy massage and announce a clean bill of health. It may sound weird, but the midwives who are in most cases very old women, even identify and administer concoctions to their patients “to help the baby grow strong in the womb.” They also offer the same promising an easy, painless birth. It is not uncommon therefore, for these old women to be called upon, as soon as their charges are in labour. It is unfortunate that to these attendants, what matters is their payment for the service of delivering a new life, never mind that the expectant mother could be suffering a bout of false labour. There have been many instances where traditional midwives force their patients to give birth, before their time, using some very crude means. Some of them have been known to instruct the expectant mother to sit upright on the floor, while they sit on her back, exerting as much pressure as they can, while urging the mother to push the baby out of the womb, which often leads to the death of mother and child! Most such cases create an increase in maternal mortality, which could have been prevented in hospital. At the time of birth, it seldom matters whether they have clean instruments to administer the birthing process, meaning that while checking for the dilation of the cervix, it is not uncommon for them to use their bare hands, and when they wash them before use, they seldom use soap. This means that both mother and child are usually at risk of contracting diseases from the midwife’s hands. It becomes worse if the mother is HIV+, as the baby, who would have been born negative in hospital with proper medical care, ends up contracting the virus from the mother. It is also hard to deal with a situation where the mother develops complications at birth, since rather than admit failure, these midwives continue offering unorthodox advice, like administering their mysterious concoctions to the patient, until it becomes hopeless, and by the time they agree to seek medical attention, it is usually too late, to save the mother, baby, or both. At the Centre for Disadvantaged Girls, Kenya, we are lobbying for these traditional midwives to be incorporated in mainstream hospital as Community Health Workers, and be trained in proper birth attendance. It all comes down to education, which is never too late to acquire, since they also need classes on hygiene, cleanliness and the use of proper gadgets for their work like gloves, scissors and clean water. We also have a Program at the Centre, which identifies expectant couples and offer off the record counseling on pregnancy, the advantages of attending prenatal clinic, eating right, getting tested for HIV and even how to prepare for the coming life. We usually insist on having both the mother and father -to-be for these sessions, even in cases where they are no longer together. We hope that our new government will not only keep its campaign promise to make maternity fees in all public hospitals a thing of the past, but also make it mandatory, thus pass it into law, that all expectant mothers to give birth in hospital. Prevention sure is better than cure!

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I was happy to read that you are integrating the midwifes into your program as in spite of their lack of training, they will always be considered essential to childbirth. To help them develop proper skills in childbirth will mean fewer deaths and healthier babies. Keep up the amazing work in your centre.

It is sentiments like yours that keep us going, at the Centre. We are working with a local District Hospital, whose nurses avail themselves to offer the much needed training, albeit small scale, to our midwives. At least they now know a thing or two about hygiene, the birth process and even offering counselling when there is great need for mothers to deliver in hospital. All the best,

Phionah Musumba Founder/Executive Director Malkia Foundation & Centre for Disadvantaged Girls, Kenya P.O Box 9461 - 00300, Nairobi, Kenya Facebook: Phionah Musumba Twitter: @KenyaGals LinkedIn: Phionah Musumba Skype: phionah.anguzuzu.musumba

Hi Phy,

As per usual, you deliver such important information with so much passion. I enjoy reading about your cause because it is similar to mine, just a different disease. The work your centre does is an inspiration. May God grant you all the strength to continue.

Warmes regards

Lortoria McDonald

Twitter: New website coming soon!

Hey, Lortoria, Thank you very much for always taking the time to not only read, but also comment on my posts. It is very encouraging, makes it all worthwhile. I love doing whatever I can for the community, because herein lie my future generations' legacy, and I mean to ensure that they inherit a sound, healthy, informed and educated one. I appreciate your prayers, I really do, and pray for the same and more for you, to realize all your dreams. All the best,

Phionah Musumba Founder/Executive Director Malkia Foundation & Centre for Disadvantaged Girls, Kenya P.O Box 9461 - 00300, Nairobi, Kenya Facebook: Phionah Musumba Twitter: @KenyaGals LinkedIn: Phionah Musumba Skype: phionah.anguzuzu.musumba

Yes, in small communities the chances of being ostracized is much higher and this leads to undesirable effects. As you have explained, unwanted pregnancies are taken to untrained 'health' personal to be terminated. While many of us believe child out of wedlock as not acceptable, what we have to realize is that it happens. And it will happen. The society needs to have some mechanism to give them protection and the needed support.

So yes. well done on your efforts.

Wish you all the best, Aminah

Salaam Aminah

You keep on boosting my confidence and morale. I believe we are all human beings with needs and feelings just like the next person. At the Centre for Disadvantaged Girls, we emphasize on upholding and maintaining the dignity of our charges because we believe it is seldom their fault, that a woman would find herself pregnant, and in cases where it could be, it is not always intentional. Some of these young women are usually victims of rape. We understand what they are going through. All the best,

Phionah Musumba Founder/Executive Director Malkia Foundation & Centre for Disadvantaged Girls, Kenya P.O Box 9461 - 00300, Nairobi, Kenya Facebook: Phionah Musumba Twitter: @KenyaGals LinkedIn: Phionah Musumba Skype: phionah.anguzuzu.musumba