Abim nurses offer child care beyond the maternity ward

Trainee midwife Hilda Azireyo checks on an infant during a home visit near Kalongo hospital in Abim District. photos by Edgar.R.Batte.  

By Edgar. R.Batte
Posted 


Monday, December 14  

2015 at 

02:00

In Summary

Midwives in Abim are still faithfully observing the practice of offering new mothers postnatal care beyond the ward. Edgar. R.Batte visited with them.

When a mother gives birth to a baby, she needs all the care and attention she can get. At St Mary’s Midwifery Training School, located within Kalongo Hospital, midwives have been taught to give this and more.
Under the domiciliary care, the health workers follow up mothers in their home setting, after they give birth.

How it works
Kalongo is a rural area, about 160 kilometres north east of Gulu Town.
Sister Carmel Abwot, the principal of St Mary’s Midwifery Training School in Kalongo hospital, says the hospital does not have the necessary human resource because it does not have enough financial resources to attract health workers to work there.

Their solution, she explains, partly lies in training students with a more hands-on approach. A visit to the facility proves that students achieve more than mere academics. They are passionate to help mothers and babies.
Hilda Azireyo, a diploma student, at the school exemplifies domiciliary care. A day after she helped deliver a mother, Florence Akulu, she follows her up at home.

The home visit
She introduces herself to Akulu’s aunt before she is led into the hut where Akulu is breastfeeding her baby. Azireyo then asks Akulu to pass on the baby for examination.
The baby, Angelina Gift Odongo, is then examined from head to toe. The trainee midwife checks the top of her head, then the eyes, umbilical cord, the temperature and heartbeat.

“There are things which are done within an hour after a baby is born. I have to ensure that the umbilical cord is properly taken care of and the mother has to breastfeed the baby within an hour of delivery,” she explains.
Then after monitoring the mother and baby for an hour in the labour room, Azireyo says that the two are taken to the postnatal ward for continued monitoring.

When the mother is discharged from hospital, the health workers continue visiting her at home to ensure that mother and child are healthy and are maintaining good hygiene standards. She also teaches the first-time mother how to clean the baby.
Akulu, the new mother is receiving care at her aunt’s place, which is close to the hospital. While Azireyo cleans the baby, she reminds the new mother to take the baby back to the hospital at six weeks for additional immunisation.

Important health tips
“I have to teach her how to take care of the baby’s umbilical cord. She needs to keep cleaning until it dries,” the student midwife says.
The mother is also given reproductive health advice on Family Planning (FP) practices, and the need to observe some time before she can engage in sexual intercourse with the husband or partner. Azireyo explains to her that this will allow her birth canal heal properly.

Occasionally, the trainee midwife asks the young mother to be open with her in case she feels any discomfort or complications so that she can receive proper care.
Akulu is one of the few lucky mothers to benefit from domiciliary care because she has an aunt residing near the hospital. Otherwise, it is challenging to offer domiciliary care to mothers who live far away from the hospital.

History of care
Azireyo’s supervisor, Sister Teddy Terry Abor, explains that domiciliary care is a programme that started in 1980, in Kalongo and Kanungu districts.
Incidentally, it was in the same year that Sister Abor, qualified as a nurse. She says that in the early days of domiciliary care, nurses would go to mothers’ homes and inspect them to find out if they had facilities such as a pit latrine and dust pit for waste disposal.
Generally, they wanted to make sure that when the mother was discharged from the hospital, they would return to an environment where mothers and babies would not pick diseases.

“When we went to carry out domiciliary care, it was a chance for us to give communities health education. Through community interactions, locals would also ask questions that we would answer or refer to other health workers,” Sister Abor adds.
The 58-year-old veteran midwife says domiciliary care last seven days after the mother gives birth. Traditionally, trainees have played a big role because they spend more time with the mother, under occasional but close supervision from senior midwives.

A keen trainee
Sister Abor commends Hilda Azireyo for her keenness and passion. “She is a good student, very committed. She respects her work. When she doesn’t know something, she asks. When she graduates, she will save lives,” Abor says of her protégé.
Azireyo first trained as an enrolled comprehensive nurse at Arua School of Comprehensive Nursing. On completion of the course, she felt she needed to do something more specific.
The district health office of Adjumani, recommended her for a course at St Mary’s Midwifery Training School where she is already proving herself.

“I needed a profession that would enable me deal directly with my patients. I chose midwifery because it allows me to do that. It is only under complex situations that I call on a doctor,” she explains.
The 27-year-old student comes from a family of four children. Her late father was a district inspector of schools in Moyo. Her mother is a tailor. She plans to enrol for a Bachelor’s degree in reproductive health.