Wednesday, May 11, 2011

Baby boom!!

There was a baby boom in the first month of the house being open! Considering about 20-30 births happened on average in the village in previous years, it's pretty amazing that FIVE babies were born in the first month! Four of them were delivered in the home, and the fifth was successfully referred to the Royal Victoria Teaching Hospital in Banjul for a caesarian section. All ten moms and babies are doing well, and the TBA has already requested more clean delivery kits from Babucaar, the community health nurse!

I went for two visits to Penyem before leaving the Gambia last week. Ebrima and I visited three of the newborns and their families (adorable!) during my first visit. Since the opening of the house, Penyem has welcomed Ousainou Nyassi, Ebrima Bojang (named after our very own Ebrima!), Sulayman Bah, Sainabou Touray and Salieu Sonko, who was delivered via caesarian in Banjul.

There is a running joke in the village that this year is the year of the male child (4 boys and only one girl so far!). The women and I contend that it's still early and the girl child may make a comeback yet!










The second visit was to say goodbye - for now - to the women, Ebrima's family, Babucaar and everyone in the village who has been involved in the project. It was pretty emotional. I'm so proud of what we have acheived together, and really look forward to coming back for a visit to see how the house, the village and the birthing house babies are getting on!













Tuesday, April 5, 2011

Publicity on both sides of the pond...

Here is the link to a CBC interview my mom and I did after the opening of the birthing house, and the article that was published in the Daily Observer, one of Gambia's main newspapers. Enjoy!

http://www.cbc.ca/ottawamorning/2011/03/22/birthing-house-opens-in-west-africa/


Monday, April 4, 2011

Introducing Ousainou Nyassi

Here are photos of Ousainou Nyassi and his proud mom Lala, as well as the TBA and some of the grandmothers. Aren't they gorgeous?








We gave them a bag of rice and two containers of cooking oil as a celebratory contribution towards the naming ceremony!




Wednesday, March 23, 2011

The first birth!!!!!!

The first baby was born in the birthing house today!! Everyone is ecstatic, and it's happened so soon after the opening! A baby boy was born to the Nyassi family (i.e. a relative of Ebrima's)...!!! He will be named in one week's time at his naming ceremony. The delivery, attended by Nima Colley, went really well and mother and baby returned to visit their family compound about an hour after the birth.

I spoke with Sanna on the phone this evening and he said everyone in Penyem was thrilled, and that the women were dancing and celebrating around the outside of the home. There are several other women in the village who are due soon and it's expected that someone else will join little baby Nyassi very soon!!! Photos will hopefully be coming shortly of mother and baby... the birthing house trailblazers!

Monday, March 21, 2011

The grand opening... a joyous occasion!

We had the grand opening for the birthing house this past Saturday. It was such a celebration!!

I arrived early in the morning as we had a few last minute touches to pull together. We mounted the sign on the wall outside, made the beds with the beautiful sheets and pillow cases that were made in Brikama, checked that the clean delivery kits were inside the house and had it cleaned out one last time. Then Sanna (one of our 'go to' guys in the village for this project) had village boys raise the Gambian flag on either side of the house, and prepared the ribbon across the front entrance (which was actually four separate ribbons in the Gambian flag colours).

I met the grandmothers under the shade of a big mango tree near the house, and we walked around it together. It was amazing to see their reactions with all of the details and finishing touches pulled together. There were lots of hugs... they are just awesome!








Festivities started mid-day when women gathered to prepare the food (delicious meat benachin). They were joined by friends and a group of drummers from neighbouring villages, and dancing began under the mid-day sun in the daycare compound next to where the food was being prepared. Yes... I did join in. Just a little bit. :-)

More guests from the coast started to arrive just in time for lunch at 3 pm, and what a treat! It was delicious. My staff, friends and I ate in the school. Afterwards, Ebrima and I were interviewed by a reporter from one of the Gambian newspapers, The Observer, and then started gearing up for the opening program with the master of ceremonies, Sidi.






I was blown away by the number of people who had gathered for the opening program in the clearing right next to the house. There were hundreds of people, both from Penyem and beyond, who came to listen to the speeches and celebrate the opening of the house. Ebrima and I were surprised by matching batik outfits (my mom received a third one in absentia) from the women of the village and changed into them right before the program.

The alkalo (village chief) gave the initial welcome to the guests. He is a fantastic speaker. His key message was: this house is yours. Take care of it like you take care of your children. It was very moving. The imam then gave a welcoming prayer and made a blessing on the house. Next up... us!

Ebrima and I did a joint speech, giving the guests the background on the project: both the fundraising powerhouse in Canada and the work on the ground to build the house starting last fall. We were both a little nervous and I felt overwhelmed - in a good way - when I first began addressing everyone present. I thought it was fitting that we spoke together, as we have worked side by side here since the project began. Ebrima ended our speech with a huge thank you to my mom and all of the donors in Canada, and everyone burst into applause. They are so grateful for the support their dream has received from people on the other side of the world.




Bubacaar Jallow, the fantastic community health nurse responsible for Penyem, spoke next. He emphasized local ownership of the home, and encouraged all women present to manage it with pride. He also emphasized the men's role in safe births, and pre- and ante-natal care. His main message was that children are the future and Gambia's development depends on their health and education. Finally, he discussed the birth and death registers and how thrilled he was that they were included in the birthing house project. The information they collect is vital.

Next, his colleagues from the Regional Health Team spoke. Juma Jallow and Alhagie Sankary also emphasized the tremendous impact a clean, safe, private and confidential space for deliveries will have on the women of Penyem. They also underscored the place of the birthing house in the Gambian health system, noting that government can not do it all, and that this is a wonderful example of 'bottom up' development: the village had an idea and made it happen. This wasn't a development project imposed on them by government or a donor.

The traditional birth attendant, Nima Colley, and her assistant, Jainaba Sanyang, spoke next, followed by the Lady President of the women's association, Fatou Saidy. All three women expressed gratitude for the house and invited women from neighbouring villages to come and use it for their births. How generous of them! The house can be used and benefit women beyond the borders of Penyem.

Finally, the chairman of the village development committee (VDC), Ansu Kujabi, spoke and emphasized good maintenance of the house. With the opening, responsibility for maintenance of the home has transferred over to the VDC and it was clear from all of the speeches that the villagers of Penyem really do 'own' the house.

All of the speeches were translated into both English and Jola, and of course there were lots of dancing breaks.





Ebrima and I were then presented with certificates from the alkalo, and two of my friends accepted certificates on behalf of my mom and the donors in Canada. Then Bubacaar handed over the birth and death registers for Penyem to the alkalo. He will be coordinating the handover of the registers for the remaining 12 villages this week.






The sun was starting to set at this point, and we all made our way to the front of the house for the official ribbon cutting, which was done by a local government representative who honoured us with his presence. After the ribbon was cut, the guests stormed through the front doors and there was a tremendous amount of excitement as people toured the house. I can't believe how many people could fit in the house at once! The women were dancing and signing, and everyone was really impressed with the facilities, including the standard and the attention to detail. They loved the art work on the walls (my mom's students sent photographs with a birth theme, and we had them framed and mounted on the walls). It was... simply awesome.








In the dark, I planted the commemorative tree (it's an avocado tree, which people here call 'pear') and that marked the end of the opening, which really is the beginning of a new chapter for the women - and men, and children - of Penyem.

Meanwhile... on the other side of the pond, my parents and family friends had a celebration of their own, and stayed connected during the opening thanks to my friends Katie and John, who braved the bad internet connection to send a typed play-by-play of the ceremony to them over Skype.

It feels pretty great to have pulled this off... with and for the people of Penyem. I concluded my speech with: this house is for all of you, for every woman in the village. And you deserve it. It would not have happened without the generosity of so many people in Canada and my parents consistent, quiet cheerleading and fundraising. Abaraka, abaraka, abaraka (thank you, thank you, thank you) to everyone who has supported the project. Now we can kick back a little bit and wait for the first births to grace the house!!




(And we are still collecting donations for the 'sustainability' fund for the house. Just get in touch if you are interested.)

Monday, March 7, 2011

Less than two weeks till the opening!





"Ifamai fama"... means, loosely, 'I miss you and it's been awhile' in Jola. I heard this a lot when I visited Penyem last week. I missed everyone too. The house looks fantastic! Here are some photos:





Ebrima and I had a very serendipitous meeting two weeks ago with a paediatrician and midwife who work in the Gambia with Maternal & Childhealth Advocacy International (http://www.mcai.org.uk/). They wanted to meet with us to talk about oxygen for ambulances in the Gambia. It turns out they have also recently sent a big shipment of clean delivery kits to the Gambia that are being distributed through the Maternal and Child Health Unit at the Ministry of Health. And... we've got some for the birthing house! What a relief... we were really struggling to find kits or the components of kits anywhere else we were referred in country and thought we may have to order from overseas.

We owe another huge thank you to the Jammeh Foundation for Peace hospital. They donated all three hospital beds to the house. They rely often on donations, which makes their donation to us all the more touching.

We're sending out invite letters this week for the grand opening!! It's taking place on Saturday, March 19th. Whoo hoooo! Here is the program for the day:

10 am - cooking and traditional Jola dancing begins
2 pm - lunch
4 pm - official grand opening ceremony

The ceremony will include: speeches from the project managers (Ebrima and I), the village alkalo, traditional birth attendant and village health worker, the women's association, the community health nurse and representatives from different Ministry of Health units. There will be an opening prayer and we will plant a commemorative tree. We will also be handing out the birth and death registers to representatives from the 13 villages in Babucaar's catchment area. Finally, guests can tour the house.

We can't wait.

Thursday, December 9, 2010

The details... coming together!

We've had quite a busy month trying to pull everything together. The house itself just has a few tiny touches left (painting the exterior compound wall, fixing the tiling, painting the ceiling and mounting the water tank outside).

Ebrima and I met with the community health nurse who lives in a neighbouring village and is responsible for village health outreach in Penyem and twelve other villages in his area. His name is Babucaar Jallow and he is the main link between Penyem's village health worker (VHW) and the regional health team (RHT) which coordinates health programming.

Babucaar has trained traditional birth attendants (TBAs) and has lots of experience and good ideas. One idea we are helping with is creating printed birth and death registers for each of the 13 villages Babucaar is responsible for. It's an important step in determining village birth rates, recording causes of maternal and neonatal mortality (when known), etc. Penyem has a birth register but not all of the surrounding villages do, and they don't all capture the same information. We are printing registers for his catchment area that record standard information for births and deaths in the village. It's quite an important step in capturing the right data, and Babucaar will do a training session with all of the village health workers with the new registers once we've handed them over. They are at the printers right now and will be ready to pick up on Tuesday! Here is what they capture:

Inside pages, birth register


Inside pages, death register


We also met with the regional health team to get their feedback on the project, and to discuss training for a second TBA from Penyem. It's very important to us that the birthing house be integrated into the existing health system as much as possible. Babucaar has offered to come and do some training on clean management practices for the women who will be responsible for the house, and we are hoping representatives from the regional health team will be able to attend the opening as well.

Last weekend Ebrima and I visited Penyem on Saturday. We met with the women to discuss the program for the opening, and their thoughts on training a second TBA for the village. The current TBA is quite experienced, but also getting older and from a sustainability point of view we would like to support the training of a second younger TBA who can then be mentored by the current TBA. The discussion went really well. The grandmothers are all really looking forward to the opening - as are we! - and discussed the need to engage the men in the village as well in supporting the birthing house and the women who will manage it.








We are on the hunt for hospital beds for the house. We are hoping a donation will come through from a hospital here. We've also asked a local contractor to be on standby to make metal-framed beds for us if the donation doesn't come through. I was an unsuccessful bidder at the American Embassy auction this weekend; I bid on some filing cabinets to store the delivery supplies in the house, but was outbid by the guy standing next to me!

We did lots more errands this weekend, including buying solar lights for the house from d.light (http://www.dlightdesign.com/home_global.php). Here's Ebou with our new lights:



Buying solar lamps for the birthing house!

We still need to pick up our stock of clean delivery supplies from the local pharmacy, which includes antiseptic soap and disinfectant, razors, cord ligatures and gloves. The TBA has a small kit with her own supplies that will be kept in the house, and we are buying a stove and gas tank to boil water for her metal delivery supplies.

Clean delivery practices go a long way in reducing infections acquired during delivery. I've had the chance to learn a fair bit about clean delivery through this project. The World Health Organisation's six principles for clean delivery are:

  1. clean hands
  2. clean perineum
  3. nothing unclean introduced to the vagina
  4. clean delivery surface
  5. clean cord-cutting instrument
  6. clean cord care (including cord ties and cutting surface)

PATH (http://www.path.org/) has great resources on clean delivery kits, including this guide which we have referred to along with Babucaar and the TBA's guidance to ensure the house is properly equipped for clean delivery: http://www.path.org/files/MCHN_BDKG.pdf. Considering that almost 70% of Gambian women still deliver at home, these clean delivery practices can reduce the chances of infection that are responsible for 15% of maternal deaths worldwide every year (120 000 of the 600 000 who die in childbirth every year, according to the WHO).

We still have a few more errands to do, including buying the pear tree we are going to plant during the opening, and coordinating the beds (either donated or made). I need to find a nice big red ribbon for the launch, and we are also having a sign made for the outside of the house when the official opening date is set.

We have been planning for next weekend (December 18th, 2010), but there has recently been a death in the village, and the villagers are also concerned about having enough time to harvest their rice crops. So they are currently discussing whether we should go ahead with the opening next weekend, or wait for a little while. Either way, everyone is looking forward to the launch!! We have recruited the MRC's public relations officer as well to help us publicize the event with the local media! And I know that CBC is interested in doing a follow up interview when we are ready to open.

Stay tuned for another update!!