Reproductive & Child Health, Nangwa, Tanzania

Services for children are a key aspect of the health centre at Nangwa, Tanzania, a small village near the foot of Mount Hanang, which at 3,418 meters, is the country's fourth-highest peak.

The Ministry of Health in Tanzania uses the term "Reproductive Child Health Clinics" (RCHC). For our team at Nangwa, this means covering many miles by jeep each week in addition to the clinics held at the base.

There is a weekly child welfare clinic for under-fives and weekly antenatal care. There are four outreach stations, each of which is visited monthly, providing RCHC services to children and pregnant women. There is also a weekly postnatal clinic at the base and a monthly clinic for 2-5 year-old children.

There can be bigger problems. Sister Catherine Fallon told us about Hawa, who had no living child.

"Hawa was in her early twenties. She lived with her husband, Mohammed, in a village of her Barabaig tribe.

"Already Hawa had been through three pregnancies. Each time she delivered a stillborn infant after a very difficult labour. Not only did Hawa suffer terrible grief but everyone in her village was very sad because the Barabaig people love children. They value the gift of new life very highly.

"When Hawa became pregnant for the fourth time, someone told Mohammed that if he brought his wife to our health centre at Nangwa, we would help. Together, the young couple set out and trekked the forty-three kilometres on foot. Hawa was already eight and a half months pregnant.

"'Just tell us what we have to do', Mohammed said to us. 'Whatever it is, whatever it takes, we will do what you say because all we want is a living child.' Sister Mary examined Hawa and found she had a condition known as cephalo-pelvic disproportion. She explained to them that Hawa could not deliver a baby in the normal way. She would need a Caesarean operation. That would mean going to hospital, and it would mean paying for the operation.

The Sisters tell us:

"We knew it was too late in Hawa's pregnancy for her to return to her village. With their cultural beliefs it was a difficult thing for them: to leave a woman alone with strangers, to allow her to go to hospital, and to have an operation to deliver a baby.

"But Mohammed had said he would do whatever we advised and he trusted us. Ours is not a bedded health centre, but they agreed that we should find accommodation for Hawa with a woman in Nangwa village, while Mohammed would return home on foot and sell some cattle to get money to pay for the operation."

Sister Mary Friel (below right) wrote a letter to the doctor-in-charge at Dareda Hospital, which is an hour and a half away from Nangwa by bus. It is a hospital where MMMs are well known. We founded this hospital back in 1948 and it is now run by the Diocese of Mbulu. As soon as the Sisters could arrange transport for Hawa, she was brought to Dareda and admitted. When Mohammed returned he was shown where to get the bus that would take him to Dareda. Anxiously, he set off to wait there with his wife.

Very soon after that, Sister Mary had some business to do in Arusha, and stopped off at Dareda Hospital en route to deliver a message. She decided to go and enquire about Hawa. To her great surprise, she found the happy young mother already sitting up in bed, feeding her beautiful infant son.

Where was Mohammed? As soon as he knew that Hawa and the baby were all right, he had taken the bus back to Nangwa, then walked the forty-three kilometres to his village to get his father. They walked back again all the way to the road to get the bus to Dareda so that the old man could see for himself the place where his healthy little grandson was born!

Before Hawa was discharged from Dareda, Sister Mary was doing a mother and child clinic near Hawa's village. As soon as the landrover appeared, all the women ran up to her, clapping and dancing, with joy all over their faces, announcing to her the good news, "Hawa has a child and it is alive!"