Traditional Midwives Try Modern Ways

Akai Lokiridi Vivien waits outside the Eliye Springs Dispensary to see a nurse of the Eliye Springs Dispensary, Turkana, Kenya, Jan 13 2013. Vivien plans on having her fifth child with the help of a nurse. (Jessica Stallone)

Akai Lokiridi Vivien waits for a nurse outside the Eliye Springs Dispensary. (Jessica Stallone)

By Nicole Bansen

TURKANA, Kenya – Akai Lokiridi Vivien waited for the nurse in the dusty Eliye Springs Dispensary, rubbing her pregnant belly and describing the modern way she hopes to give birth: no spear cutting the umbilical cord, no root teas.

Each of her four deliveries had been assisted by a nurse, making her an exception among Turkana mothers, who largely rely on traditional “birth attendants” or midwives.

“I would never want another person to deliver my baby,” she said. “But I know the nurse has studied medicine and I would let him help.”

Vivien plans to have her next child the “Western way,” using medication to help with labor pains and a nurse to help with delivery – tasks that would typically be done in Turkana by a midwife using herbal mixtures.

The modern practice means that when she delivers her child, it will be done on a clean mat in her hut. She won’t have her umbilical cord cut with a spear or sharpened knife, and she won’t drink ground-up roots from an esekon tree to subdue her labor pains, customs specific to the Turkana people.

Health officials in Kenya say mothers who choose to deliver with midwives put themselves, their babies and the midwives at risk. According to Thomas Nasilo, a nurse at Lodwar District Hospital, after labor women can suffer from blood loss, retained placentas and post-partum hemorrhages.

“I just don’t understand why the mothers would do this when they know they need professional help,” said Nasilo.

As for the babies, during delivery they are at risk of inhaling secretions, catching bacterial infections and contracting illnesses through contact with the mother’s blood. This can be especially dangerous for babies born to mothers who are HIV-positive. UNICEF estimates that more than 1 million people live with HIV in Kenya. At 7 percent of the population, that is almost seven times the global numbers. Midwives are at risk of contracting HIV from the mother if they have an open cut on their hands while delivering a baby.

A preventative measure typical of the “Western method” is covering the hands with latex gloves, which could protect the baby, the mother and the birth attendants from these hazards.

Dr. Craig Lehmann, dean of the School of Health Technology and Management at Stony Brook University, who has done extensive medical work in the Turkana region, believes the only way to preserve the traditions of the unique Turkana culture, while removing the dangers and risks of infection, is by educating traditional birth attendants.

[The birth attendant] is the spokesperson, so she has their trust,” said Lehmann. “Simple hygiene is something really simple to teach. It’s a matter of getting them the appropriate material. It’s a challenge but it doesn’t mean it can’t be done.”

Ellen Lomoru, a traditional birth attendant who, after being trained by Western doctors, now takes precautions when helping women in labor, kneeled on a worn burlap sack as she positioned her plastic-clad hands low to the ground to demonstrate her new, more hygienic way of delivering children.

In 2005, Lomoru was invited to go to Kakuma, Lokichar and Locho to learn the newer, safer way of delivering children. After a few weeks of training, she gained a better understanding of the importance of proper hygiene.

Lomoru said that since her training, she has successfully delivered an average of 10 babies a month. Before learning to take precautions, she said, she sometimes felt feverish after a delivery, and that no longer happens.

Now, when she delivers children, she wraps her hands in plastic, asks the mothers to kneel on a plastic sack, and cloaks the newborn in washed clothes. She also washes all her instruments before and after use.

“I am happy to help because it’s a talent,” Lomoru said with a smile that deepened the wrinkles on her aged face. “Young women are too afraid of delivering a baby. They think they can’t help.”

By combining the old methods with the new, Lomoru is providing a way for women like Vivien to get all the benefits of a safe delivery through traditional Turkana ways.

“A good healthy baby is God’s gift,” said Vivien. “It is a blessing in Turkana.”