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Babies by Candlelight

By Kimberly Burge
July 2009

Florence Chakulya has lost count of the number of babies she’s helped bring into the world. But she does know that she has delivered more babies by candlelight or kerosene lamp than with the electricity on.

The only midwife at the Chalimbana Health Center in rural Kampekete, Zambia—about an hour’s drive over bumpy roads from the capital city, Lusaka—Chakulya sees more than a hundred women and babies during the three weeks each month the clinic is open. The clinic’s generator is not terribly reliable. So she has become very adept at candlelight deliveries.

Chakulya tries to see each woman four times during her pregnancy. Exams are fairly basic—there are no ultrasound machines in Chalimbana. She monitors the mother’s blood pressure and the baby’s heartbeat.

For each woman, this midwife also administers an HIV test. If the mother-to-be tests positive, Chakulya can give her Nevirapine, a drug that helps to prevent transmission of the HIV virus from a mother to her baby during delivery. The supply of Nevirapine that Chalimbana receives is paid for in part through funding by a U.S. foreign assistance program, PEPFAR (the President’s Emergency Plan for AIDS Relief).

Watch the video here to see a digital story of writer Kimberly Burge’s visit with Florence Chakulya and the women of Kampekete, Zambia.

Preventing mother-to-child transmission is a high priority of PEPFAR. In 2007, through PEPFAR funding, some 31,600 HIV-infected pregnant women received drugs to prevent transmission of the virus, meaning that approximately 6,000 infant infections were averted. Bread for the World members have advocated for funding for PEPFAR since it was launched in 2003.

If a woman tests positive for HIV, Chakulya encourages her to bring her husband back to the clinic at her next visit so he may also be tested. Some do, but not all.

Edith Zambo is typical of the women she sees. Twenty-five years old, Zambo was pregnant with her third child. She had an 8-year-old and a 6-year-old at home. Zambo had already tested negative for HIV. After her exam in her eighth month of pregnancy, Chakulya gave Zambo some iron supplements.

“Most of the women have anemia,” the midwife said.

If a woman makes it to the clinic to give birth, Chakulya tries to keep her for at least one day to monitor both her and the baby. But that depends on how many women arrive at one time. The delivery room has three beds. If more than three are in labor, the mothers-to-be are doubled up in one bed.

A group of volunteer doctors from the United States recently visited Chalimbana to teach Chakulya how to resuscitate babies who are “born blue,” with breathing difficulties. For the training, she invited some traditional birth attendants, women who deliver babies at homes in surrounding villages. Since so many women must walk many miles to the clinic, they often can’t make it there when they are in labor. So Chakulya does her best to accommodate for the realities of life in rural Zambia.

“We’re handcuffed here, with our limited supplies and no doctor, no other midwives. We still use boiling water to sterilize medical instruments,” she said. “We appreciate what we have. But we still must improvise so much.” (Field Focus)

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