Hawa Shami, 29, travelled over 15 kilometres from Kawanula Village in Machinga District to deliver her first three children at St Luke’s Hospital in Malosa, Zomba.
“It’s a costly life-threatening trip. It makes us poorer and costs lives,” says the woman who ironically lives 300 metres away from Chamba Health Centre.
Lack of a maternity wing at the nearest health facility made safe motherhood challenging for women who cannot afford motorcycle trips to the Anglican Church’s hospital, which cost K18 000 per person.
“We cannot afford food and other basics while waiting to give birth at St Lukes,” says Shami.
Many women only made the trip when labour pains kicked in, making childbearing a life and death experience.
“Chamba Health Centre only provided services that pregnant women need before giving birth,” says Shami. “Twice, I gave birth on the roadside without the help of trained caregivers. For the third-born, I arrived at the hospital on time after a painful journey. I thank God I am alive.”
In 2019, Margret Joseph, 26, did not have money for transport to St Luke’s Hospital.
“I spent hours looking for a free ride. Water broke on the road,” recalls the mother of two. “Sadly, we couldn’t cruise as I was in pain.”
The costly hospital trips push poor women to give birth at home, contrary to national policies and community bylaws that require every child to be born in clinical settings with the help of skilled caregivers.
The community regulations prescribe a K20 000 fine for every offender.
However, the community lobbied Machinga District Council to introduce safe motherhood services at Chamba Health Centre.
World Vision Malawi supported a citizen action group that facilitated dialogue between underserved communities and service providers to improve healthcare, education, child protection and livelihoods.
The volunteers’ leader, Kadzuwa Kang’oma, recalls meetings with district council officials and Machinga South legislator Grant Ndecha to discuss the gap in safe motherhood.
He says: “Pregnant women were enduring long travels due to lack of maternity wing at Chamba Health Centre.
“During the meetings, we asked duty bearers why our women were walking over 15km when government policy says no one should travel more than five kilometres to access quality healthcare.”
By comparing government’s commitments with the grim reality on the ground, the local activists convinced the council to construct the maternity wing using Constituency Development Fund.
Each village provided bricks, sand and stones for the block while World Vision provided life-saving equipment.
Around 9pm on April 8 this year, Shami safely delivered Chimwemwe, her fourth child.
Senior Chief Chamba named “the first-born of Chamba Maternity Wing” Chimwemwe in celebration of the dawn of safe motherhood services.
“Childbearing was a near-death experience for mothers because of the long walks. All that is history,” says the community leader.
Shami speaks of a soothing childbearing experience: “The health centre is just a four-minute walk from home, so I wasn’t worried about long walks. I had peace of mind while saved money for other basics.”
Machinga District Council director of health and social services Dr Jones Chise says this is “a huge relief” to healthcare workers and 48 000 Malawians who depend on Chamba Health Centre.
World Vision advocacy and safeguarding manager Lizzie Lombe says the Christian organisation is committed to empowering communities to demand improved services for the good of children.
