Because of the low levels of literacy among traditional midwives, most of the training takes place in the form of easy-to-remember songs and skits.
At the women and War photography exhibition, the caption for the photo above reads “graduates of the Trained Traditional Midwife course proudly display their certificates of achievement and their colourful delivery buckets”.
It was the colourful buckets that caught my eye and made me instantly wonder ‘as beautifully colourful as they are, what’s a delivery bucket?!’ I decided to investigate the story behind the picture…
Fifth from the right hand side is Kaibeh Kollie, she has a purple bucket perched on her head and clutches her certificate to her chest. During the 14 year civil war, from 1989 to 2003, Lofa county, where Kaibeh is from, in the North West of Liberia was one of the hardest hit areas, most of its people fled.
Kaibeh returned to her village after many years of exile, “I ran away and went to Guinea and stayed for seven years. Then UNHCR came and asked who wanted to go home. We came back and stayed for one week and the war hit us again.” She and her family then endured another three years of internal displacement, moving from village to village and hiding in the forests. She lost all that she owned, “I lost everything, but I have my life” says Kaibeh.
There was very little infrastructure remaining, roads, schools and hospitals had been destroyed. Not all health centres were operational and those that remained were often understaffed and inaccessible. Women remained particular vulnerable to the post conflict problems confronting all Liberians. Access to basic reproductive healthcare was a struggle.
The Red Cross, in coordination with the Ministry of Health, initiated the training of Traditional Midwives, who frequently oversee pregnancies in rural areas where there are no professional midwives.
The photograph of Kabeih and her fellow graduates is currently on display at the Powerscourt Gallery, Dublin 2, as part of the Women and War exhibition. This exhibition is open to the public and will run until June 30th 2013, entry is free of charge. This moving and challenging collection portrays the many ways in which women have experienced war over the last two decades
Video | Safe delivery: traditional birth attendants in Liberia
Kaibeh was selected by her village to follow the six month training programme.
“The Traditional Midwives are chosen by the community. They are volunteers, who are respected. Traditional midwives play a vital role in the community. So they are very important people and that’s why it is good for the community itself to choose the people.” says Eunice Ekeno, from the Red Cross.
Kaibeh started assisting births 60 years ago. Like most tradition midwives she initially acquired her skills by watching others, “I learned from my mother when we were living here. When the birth attendants were helping a mother give birth they would call and we would help. This is the way I learned until my mother dies and then I started to do the same. I was working without knowing my limits. As long as a woman was in labour, I tried to deliver at all cost.”
Kaibeh walked several hours to and from every one of the training sessions. She has had no formal education; most of the women in the programme are illiterate.
“We use songs and drama to teach them because they cannot read or write. So we teach them in song and drama, they remember when they are at home. Any problem they see they will think about the song and what the song means and they will be able to handle it or know what to do or if to refer the case .” says Beneta Kessely, a Red Cross trained midwife.
Each graduate is given a delivery bucket stocked with all she needs to achieve clean deliveries. The women regularly return to the health facilities for advice and to replenish the supplies of birthing materials. This also allows for important information to be exchanged about the health of her community.
The role of the traditional birth attendant goes far beyond following a normal pregnancy and delivery. She also gives post-natal care to the mother and her newborn and key information to the community on nutrition, vaccination, malaria, family planning and hygiene.
Kaibeh, “It is good because now we understand our limits. We should not force ourselves to manage difficult births. I’ve learned to work for both mother and child. The training has opened my eyes. Now, when we are helping to deliver, both the mother and the child can live.”