Interviews with MCHAs recorded as part of the IHLFS Final Evaluation Report (December 2012)
Anita Kamara, MCHA – Modia PHU
I have not attended the Kambia Appeal training this year because I am alone here in the health centre, so I cannot leave the centre for a week-long training workshop. In 2011, I did have Kambia Appeal training for a week. It was very useful and educative. The training covered resuscitation, safe delivery and hand washing.
I am able to put this training into practice in the PHU. We have resuscitation kits [photographed above] and delivery kits supplied by the Kambia Appeal, and I use them in the PHU. I have been working in Modia for nearly 4 years. I have no problems here because I have a good relationship with the local community.
I had 7 deliveries in November, and there have been no maternal deaths. I do make referrals to the district hospital. For example, for excessive bleeding and eclampsia I call the ambulance and it always comes. The training from the Kambia Appeal has allowed me to deal with more cases at the PHU and I feel more confident doing my work, but I need more training as there is always more to learn.
There were a few language problems with the UK trainers, but not many. We were taught in small groups, which means we can pay more attention. I have used the infant resuscitation kits several times. We have 566 Under 5s in the PHU catchment area, and the total population is 3,197.
Rebecca Samura – MCHA, Sella Kafta PHU
I have been an MCHA for 3 years. I was not called for the 2012 training, but I last attended Kambia Appeal training in May 2011. They taught us about delivery and resuscitation. I have been able to use this in my job here. All our deliveries here are successful, including twin deliveries. Every month someone comes from the hospital to collect the PHU health statistics, taking information from the attendance registers. I now need refresher training again on using the resuscitation kits provided by the UK.
We need to teach TBAs to bring women to the PHU to deliver, because many women do not come for our help.
Case Study – Sella Kafta PHU: Ruptured Uterus
A recent patient, a pregnant woman, had been with a TBA for two days. The TBA brought her to the PHU along with her ten relatives. She came at 6.30am. She had complained of abdominal pain, a full bladder and could not pass urine. I tried to help her with a catheter, but she still could not pass urine. I identified that she had a ruptured uterus, so I called the ambulance and she was taken to Kambia District Hospital where she had a c-section. This woman came to the PHU too late. The TBA should have brought her to me sooner. This is a very common problem in Kambia.
This patient story was verified by inspection of the referral note and entry in Maternity Ward Register at the Kambia District Hospital.
Abioseh Bangura – MCHA, Katherie PHU
I attended the Kambia Appeal training in November 2012. They gave me a certificate at the end of the workshop. They taught us how to stop and control bleeding of pregnant women. I used this when a woman came to my PHU who had many pregnancies. The training was very helpful. I can now manage breech birth and resuscitation of adults and babies. We were given a resuscitation kit and a delivery kit. This is my fourth year at Katherie PHU. The catchment population is 3,364. We have not had any maternal deaths since I have been here, and this is due to the training I have received. The TBAs were here this morning, but now they are out harvesting their rice.
Isatu Koroma – MCHA, Tawuya PHU
I have been here at this PHU for 2 years. I have taken part in the IHLFS training twice – in 2011 and November 2012. I have never had a maternal death or an infant death. On the IHLFS training Dr David taught us about family planning, labour and delivery, resuscitation, sutures, hand washing, breech presentation, normal delivery. I have had 8 deliveries in November.
Yes I have been able to put the training into practice, but most of the time we have normal deliveries. For a breech delivery I know that I should be “hands off” and when the head is stuck they showed us how to manipulate the head, but when the baby comes out I know that I should be “hands off” until the body appears. If we have a difficult case we refer to Kambia District Hospital. Difficult cases are teenagers, breech delivery if discovered during the ANC, multiple pregnancies. We identify the at risk cases during the ANC and I refer to Kambia District Hospital with a referral letter. In 2013 I will record the referrals that I make to Kambia District Hospital, this is not a government initiative, it is just something that I have chosen to do, I think it is a good idea. We have about 20 women coming for the ANC, but it depends month by month. TBAs bring the women to the PHU. I have a TBA who is based here, and I have 20 TBAs in total. I have a catchment area of 22 villages. The total population is 4,712.
Interviews recorded December 2012