Josephine Murekezi is the President of the Rwanda Association of Midwives and has been in the midwifery field for 31 years. For the last ten years, she has been training young midwives. The 49-year-old talked to Women Today’s Sharon Kantengwa about her experience as a midwife and the state of midwifery in Rwanda.
What has your experience in midwifery been like?
Personally, I have not had a mother or child mortality incident in my career as a midwife. I have helped treat so many delivery complications that would have resulted in death of mother or child. Those are good memories and it is a bad experience to see someone lose her baby. It is always an interesting experience to see a mother happy after receiving her baby in her hands. The only problem is during labour. It is the pain that they endure; but in the long run when she comes out with a baby, she is very happy. Being a competent midwife requires commitment, skills and experience.
Mid wives are known to be harsh towards mothers while giving birth, what do you have to say about that?
I think that is a generalisation. Most of the people think that every birth attendant is a midwife. I cannot deny that some midwives are harsh but that is on an individual basis. Some are polite and have so many mothers appreciating their services.
What does it take to be a midwife?
Anyone willing to contribute to the health sector should be compassionate, trustworthy and kind. When you help someone out of danger, it gives you joy. It is, however, different from other medics. There are mothers with health risks and those without but you cannot predict until the mother has delivered. The general medical practitioners need to go deeper and know all those complications that the mother is likely to get. Midwifery is something that someone can learn. Good skills can help a mother deliver without any complications as long as you are in a hospital. All mothers should deliver in safe hands.
What is the difference between traditional birth attendants and midwives?
We no longer use the traditional birth attendants. We use the health care workers, because traditional birth attendants may not know midwifery skills, which is why we prefer the health care workers to the traditional health care attendants. It is much easier to help deliver a baby, but the complications that kill a mother are not because the baby is not out of the womb. The baby can come out but the mother might sustain complications that the traditional birth attendant may not manage, like severe bleeding or high blood pressure that is common for women at the child bearing age. Their places of birth are not always clean yet infection is a killer disease that is common. Traditional birth attendants cannot detect this fast.
Do you think midwifery has changed over the years?
There has been a big improvement in midwifery over the years. The services are much better than it is now. The mortality rate has decreased. In the past, people used to think that child birth was all about helping the baby out of the womb without considering the complications that the mothers would get. Now people are more aware of what midwifery entails.
What is the state of teenage pregnancy in Rwanda?
There are many cases of teenage pregnancies, especially in schools, but I think we just need more sensitisation in secondary schools and families. We used to have teenage clinics where we would sensitise girls in schools on the dangers of teenage pregnancy. This, however, needs more effort. We need to talk to them and avoid the stigma.
Why do you think there has been shortage of midwives in this country?
It is because we are not training enough midwives but it is beyond our control. There are some rules and regulations that we have to follow. I think that the government has done enough because it’s a process. Only that at times, those who are trained are not employed, which is where a big number is. If these trained midwives were employed, then we would have a bigger number of midwives at the district level.
How have you been coping with this?
The government of Rwanda has done a commendable job in improving midwifery in this country. In 1994, we didn’t have any midwives. In 1995, we had a few training outside the country; while in 1997 we had the first school of midwives that is the Kigali Health Institute. They trained a few midwives and ten years later, we had five schools opening their doors. Now we have many midwives and we hope that in the near future, we will have many more midwives.
Name: Josephine Murekezi
Education background: Diploma obtained in Uganda, and Masters Degree in Midwifery obtained at the University of Aberdeen (Scotland).
Career background: Has been a midwife since 1985. She has ten years experience in management, and is currently the President of Rwanda Association of Midwives.
Place of Work: King Faisal Hospital
Advice: Mothers should go to health facilities for primary health care. Midwives should be kind to pregnant mothers and help them in any way possible. The life of these mothers and their babies is in their hands.