INFANCY: ORPHANS

DIANA'S STORY:
Supporting orphans—and preventing maternal deaths—in Malawi.

Diana's mother died in childbirth. Abwenzi Pa Za Umoyo (APZU), PIH's sister organization in Malawi, is working to make sure Diana will not face the same struggle as her mother.

“If you want to understand what APZU has done,” said Veronica Kanyenda, a nurse at Neno District Hospital in Malawi, “you should know the story of the baby Diana.” She pointed out a small child sitting on a young woman’s lap in the shade of the health center’s metal roof. 

Veronica, affectionately called masiteni (mother) by junior staff, first met Diana the day after her birth. Diana’s mother, Madalitso, was just 15 years old. Afraid to tell anyone of her pregnancy, she hid it, and delivered Diana behind her home. She suffered a post-partum hemorrhage—heavy bleeding that usually requires emergency medical care. Her family and neighbors administered traditional medicines, but Madalitso died at home, leaving Diana an orphan. 

Wondering how she would feed and support the tiny baby, Diana’s young aunt brought her to Neno District Hospital, where staff from the Ministry of Health and APZU provided the newborn with medical care and gave her family infant formula, clothes, and the on-going social support of a community health worker. 

“Without APZU, Diana would have been another statistic,” said Veronica. “She would have been an orphan in a family that lacked the means to support her. She would have died."

However, Veronica acknowledges that the best way to ensure that other girls like Diana have a chance to grow up healthy is to ensure that their mothers survive to care for them. The tragic fate of Diana’s mother is commonplace in Malawi. Malawi’s maternal mortality rate—a measure of deaths from pregnancy-related causes—is among the highest for all developing countries at one maternal deaths for every 148 live births.

The average woman in Malawi has five children, and almost half of these children are delivered at home. Home deliveries in rural Malawi are risky. When complications requiring emergency obstetric care—such as Caesarean sections—occur, health facilities may be hours or even a day’s journey away.

To prevent maternal deaths, APZU employs a community-based model that supports women in their reproductive health choices and links them to a strong clinic- and hospital-based women’s health program. The maternal health program focuses on prenatal care (as is standard in most public health programs) and on emergency obstetric care. Other program priorities include providing access to transport to a facility for women in labor, skilled attendants to perform deliveries, and blood and surgical services for when complications occur.

When Veronica first met Diana, she knew APZU could help because of the Program on Social and Economic Rights (POSER), which enabled her to provide social support as well as clinical care.  POSER embodies PIH’s efforts to treat not just the symptoms of disease but the extreme poverty that causes illness by providing the poorest patients with support such as food, transportation, jobs and agricultural supplies. Since Diana’s birth, the POSER team has routinely supplied her family with baby formula, food, fertilizer, soap, and charcoal to cook with. 

“APZU saved this child’s life,” Veronica said. Today, she is a lively young girl who plays with her cousins and chatters with her neighbors.

Working closely with the government of Malawi—in particular new President Joyce Banda's Safe Motherhood Initiative, Veronica and her APZU colleagues hope that Diana will never face her mother’s fate. And the day may come when Veronica will no longer have to tell the story of a small child orphaned because her mother died during childbirth.

Learn more about PIH's work in Malawi.