First Impressions

More than two years passed. I maintained contact with Tarek through e-mails. I was fascinated, moved, sad, amazed and many times brought to tears, a whole host of emotions each time I read of his work in Lilongwe.

I logged on to Joanne´s blog (http://www.babycatching.blogspot.com/) and started to feel somehow involved and knew that I must go, I had to see for myself. Joanne is an American midwife who has been working in Malawi for several years, she writes a wonderfully descriptive blog emotively telling of the women and the babies in her care.

And so it was that in October/November 2007 Lucas and I went to visit.

It was an incredible experience landing at Lilongwe airport. I was in Africa... at last!

Tarek and his lovely daughter Lara welcomed us. We stayed for a month in their house. We felt good, we felt at home. We met many kind people who contributed to this and we are grateful. We took time to safari, to see the beauty, the wildness, the bareness, the poverty, the colour, the smell, to see and to feel Africa.

I remember my first visit to the hospital. Actually I was not suprised by what I saw... deeply affected but not suprised. I had either been well prepared by Tarek and my emails with Joanne or it was what I had been imagining for so many years.

The conditions in the maternity unit were poor, poorer than you could possibly imagine.

Shortage of materiales, basic cleaning products, medication, but above all shortage of trained staff. The midwives worked hard, cared for the women and babies as best they could in difficult, no, almost impossible circumstances. None of the ease and luxury that we take for granted. Women rolled around and sweated , called for loved ones and endured pain, finally pushing out their babies and bringing them to their breasts crying and healthy- at least for now and they were the lucky ones.

I think what struck me hard and more so due to the type of working environment to which I am accostumed in Acuario, was to see all the women laid out on beds. Uncomfortable iron framed beds, so closely placed as not to allow intimacy nor privacy, even if the old dirty curtains, that were more not present than present, had been pulled around them. I was attending birth in Spain naturally, vertically, with freedom of movement, of choice... the way they do it in Africa ...or so I thought... and here I was in Africa and women were obediently lying down throughout labour and birth because that was what was expected of them, that was the way you did it in hospital. It was not considered better or worse, more or less comfortable, more or less safe, it was what you did.

The short time I was able to spend working alongside the midwives in Bwaila left me deeply affected. I was received with kindness and respect. It was diificult to communicate with the women, I tried to learn a few words of their native language and a few spoke English. I relied on the other midwives to translate for me and did the best I could... I wanted them to get up, get off the bed but of course they received me with caution, with distrust. Women all over Malawi were giving birth naturally, instinctivly, in the villages, in huts, attended by birth attendants not always midwives and not always well attended, accompanied by other women. But here in the hospital women lay down, on their own and didn´t move.

It took me a while to work out how to control cross infection with the few materiales available. To protect the woman and to protect myself... I take for granted plenty of gloves, hand washing facilities and sterilised every thing and here I was moving from one bed to the next, one birth followed by another, frantically trying to achieve... not sterility, this was impossible, but some reasonable level of cleanliness.

So I returned to Spain. Different. How could one not be different after what I had seen ?