Editor’s note: A version of this article was originally published in Stories of Mothers Saved, an initiative organized jointly by the White Ribbon Alliance for Safe Motherhood and the United Nations Population Fund. The collection recognizes women who have lived to tell their stories — who did not die needlessly in pregnancy or childbirth — due to a key action taken by her, her family, the community, a health worker, a political leader or others. ChildFund was one of a group of dynamic organizations whose stories are included in the collection. Julia White was also invited to blog about her participation in the Stories of Mothers Saved project.
“It takes a village….” These words spring to mind when relating the story of Maïmouna from the isolated village of Dobour in Thiès, Senegal, West Africa.
A 45-year-old mother who has lived through 14 pregnancies and currently has 10 living children, Maïmouna almost lost her life giving birth to her most recent son, Seydou. Today, looking at his healthy round face and toothless grin, you would never guess what his mother went through to bring him into this world.
A quiet woman who is used to the hard life of living without electricity, running water or modern amenities, she is not a complainer and is used to continuing her chores while pregnant.
But those close to her recognized immediately that her last pregnancy was not like the others. “My wife Maïmouna was sick and very tired because of her age,” says 56-year-old Mamadou Diouf. “I was very worried, and that is why I gave her so much support. The children believed their mother was going to die.”
Luckily for Maïmouna, her story did not end with a sense of helplessness in the face of reproductive health problems. Thanks to the community mobilization, training and supervision efforts of the USAID-funded and ChildFund International-led Community Health Project (Programme Santé, Santé Communautaire), she had easy access to a community health hut run by volunteer community health agents. The project works hand-in-hand with the health districts in Senegal, such as the Health District of Popenguine.
Concerned about her health, Maïmouna spoke with the trained community health worker and traditional birth attendant, Madjiguène Ciss. Ciss immediately took note of Maïmouna’s mention of repeated and intense vomiting, weakness and dizziness, recognizing the risk factors related to her age and the number of past pregnancies.
“I knew that if I did not do anything, she could die or have some other serious complications,” says Ciss, who decided to refer Maïmouna to the government Health Post in Kirène.
But instead of leaving Maïmouna to navigate the clinical system herself, Ciss’s training and experience taught her that it would be much better to stay with the patient throughout the referrals. Ciss also knew that without her emotional support, Maïmouna would be too afraid to complete her referral appointments alone.
So she stayed by Maïïmouna’s side throughout the pregnancy, accompanying her for each referral appointment outside the Dobour Health Hut. Every time, Ciss took the initiative to work with Maïmouna’s husband and the community to organize the necessary transportation to the health post and to accompany Maïmouna.
When Maïmouna went into labor, she was referred from the health hut to the Kirène Health Post and the Popenguine Health Center and, ultimately, to the Thiès Regional Hospital where she gave birth.
Ciss also made sure that Maïmouna attended her village’s Pregnant Women’s Solidarity Circle that is organized regularly as part of the Community Health Project (PSSC). The Solidarity Circle gives pregnant women in the village a chance to openly discuss their pregnancy and their concerns with a group of other pregnant women and a trained traditional birth attendant.
Madjiguène wanted Maïmouna to learn from her participation in the circle to and to recognize danger signs during pregnancy and the family planning options available that help women to plan and take control of their fertility.
Fighting back tears, Maïmouna says, “If it had not been for my husband, the health hut, Madjiguène Ciss and the Kirène doctor, I would not be here today speaking with you. And, today, if I were not here, my children would suffer and have difficulties related to their education, their health and their life. The circle is also very important; it teaches us how we can take care of ourselves and our health. And thanks to that I am here today to care for my children.”
Maïmouna’s story highlights the importance of a community structure that stands by women and their families before, during and after pregnancy to help them understand reproductive health, danger signs and how to take action.
ChildFund also works to forge the links that are necessary between the community and government-run clinical structures. In this case, it was Ciss, the community health worker, who was the critical link in the system that ensured continuity in Maïmouna’s care and treatment from the community level up through the clinical levels.
The holistic approach to reproductive health starts with the community: “It takes a village”… to save a mother.