Maureen Harris volunteers in West Timor
Associate Professor of Midwifery, Doctor Mo Harris, joined a group of volunteer doctors to work in Kefamenanu Hospital, West Timor. The birth of a baby should be a joyous occasion, but for an unacceptably high number of families in West Timor, where the maternal death rate is about 350 per 100,000 births, it is one of great sorrow (in Australia the maternal death rate is 5 per 100,000 births). A substantial proportion of West Timorese women live with a legacy of reproductive ill-health, which accounts for 33% of total diseases in women. Neonatal and infant death rates are also very high.
Improving the quality and delivery of maternal and neonatal health care services is a global priority. There is a strong desire on the part of Dr Hartono, the Director of Kefamenanu Hospital, to develop sustainable multidisciplinary education, clinical guidelines and quality monitoring systems. Volunteer clinicians work side by side with local doctors, nurses and midwives to provide education sessions, bedside teaching and practical training.
Mo explains: “When we arrived at the hospital we were greeted by crowds of smiling people. Many had walked for several days to attend the outpatient clinics. Despite the long wait, there was never a complaint. Diagnosis work up is a challenge and requires excellent clinical acumen as laboratory and medical imaging facilities are limited.”
“The locals were intensely curious when we visited their village. About 30% of women birth their babies at home, without the care of a skilled attendant. In rural areas in particular, traditional healers attend to women in labour. Anaemia and malaria are common and in this weakened state women succumb more readily to childbirth complications. The most common cause of maternal death is haemorrhaging and infection. After the birth of the baby, some women observe the ritual of ‘roasting’ where mother and baby are isolated in the traditional home, rugged up and exposed to excessive heat and smoke for 30 days. This is believed to speed recovery, replace blood loss and return body shape. Unfortunately, burns, respiratory complications and overheating are common consequences of this practice.”
Mo spent three days in the maternity pavilion working with midwives, women and their families. The room where women give birth had three trolleys in it, separated only by a small curtain. However, there was no apparent need or desire for privacy. The women in the room would comfort one another during labour, taking turns with back rubs, providing companionship and comfort, ensuring that the mother was never alone.
Midwives are the cornerstone of maternity care in West Timor and they strive to do the best they can under difficult circumstances. They are hugely motivated, enthusiastic and committed to improving their knowledge and skills, to ultimately benefit all women and their families.
Mo’s short time in West Timor was a humbling experience and she hopes to return later this year to contribute to the efforts of the midwives, nurses and doctors in providing a safe and emotionally satisfying birth experience for women and their families.
