This month as we celebrate 10 Years of Shanti Uganda, we would like to share the incredible journey of Sister Josephine, our Head Midwife. Her career in midwifery has spanned four decades and has transformed into a legacy of care for mothers in Uganda within her own family. Two of her sons, Peter and Kimuli, are nurses. They became nurses after their mother shared the story of their grandmother’s death. Her son Joseph is a social worker, and her last born, Grace, is currently in midwifery school. We asked Sister Josephine what motivated her to become a midwife, and she recounted the story of her mother which led her into this inevitable and rewarding life’s calling.
Tell me about your journey to becoming a midwife?
When I was 6 years old, my mom had taken me to primary school, Primary 2. I remember mom taking me to school, it’s the first thing I remember from that time. The second thing I remember was my mom calling me to bring her a mat into her coffee plantation and to leave her there alone, in the morning time around 8. But unfortunately, by 8pm, I didn’t know she had passed away. From there, the lady lost her life. She had APH, antepartum hemorrhage, the placenta was lying in the lower region of the pelvis. So while she was giving birth, my relatives could see blood coming, but they didn’t realize she was losing blood. They thought the baby was coming. So by the time they went for a vehicle to take her to the hospital, it was too late. We were very young, it was so strange to see people crying, we didn’t know what had taken place.
What came next?
So as I was growing up I started asking what killed my mom. I tried to find out, but people would not narrate the story. They didn’t want to scare me. But when I grew up, people started talking to me, saying that your mom was giving birth to one of your sisters, that she was bleeding through labor. So that inspired me to go and find out, and so it was so many people who were dying in labor.
When I went to nursing school I learned about the maternal mortality rate, and at that time it was 606 per 100,000 dying in live births. It was really too much. Those were the figures I was finding when I was joining nursing. It is now 336 per 100,000 live births. The community didn’t know anything about the complications of labor. The mothers in law. They were so ignorant. They didn’t want to take those mothers who were pregnant to the hospital. So when I grew up I said, “No, I must become a midwife to help my community, keep them from dying, and health educate them.” So I married, and my husband came from another district, but I knew I had to come and practice at home. I had to come back home to fulfill my reason for becoming a midwife.
Sister Josephine finished midwifery school in 1982 and has worked in several local institutions since, from neighboring hospitals to the District Health Office.
With all of this experience, what made you want to join Shanti Uganda?
Shanti came on board in the district after realizing Ugandan mothers are dying in big numbers. They came on board to work together with Ugandans, they wanted to lower the number of mothers dying. So it is a community that came with the mission to save mothers from dying. So I realized that those were the right people that I could join so that we work together towards reducing mothers’ deaths.
What makes Shanti Uganda different from other hospitals or clinics mothers where could seek services?
Health workers at Shanti work as a team and they provide their services in a holistic manner whereby they respect their clients. They are kind. They have a helping attitude. The community is often commenting about the kindness, the goodness, the approach, the respect. We are proud of that.
What also makes us unique is that we follow up on our mothers with four visits after birth, and by so doing we are helping the community. We are saving mothers and babies from complications, and the mothers are then referred to one of the hospitals around. And you can’t find this in any other hospital.
Our services are almost free, right away from the little money from booking, the rest of the services are free. Right from family planning, immunizations, postpartum care, community outreaches, school programs, they are all free to the community. We offer prenatal yoga, which is never found in any other hospital, and mothers are always bringing us feedback that those who practice these exercises are having shorter labor, it’s less painful, and they go into labor with little stress because those yoga exercises reduced some of their stress. And when mothers come to Shanti and find an environment where people are happy, people are healthy, they find the labor less painful. They find they are helpful, they are loved. So this makes Shanti unique compared to other facilities.
Tell me about a surprising birth experience you had:
I was once on my way to Kampala, and I saw a lady get into the vehicle with a wet dress. I saw a man come in with her, and I knew this woman was in labor. They were on their way to Mulago Hospital. I told the man to buy supplies, a long plastic sheet, gloves, a razor blade. By the time we reached Bombo, the lady started screaming and I thought my goodness, she’s going to deliver in this vehicle. We drove two kilometers and I saw the baby’s head coming out. I yelled “STOP THE VEHICLE.” I helped her deliver the baby in the back of the vehicle. I even used the bands of the gloves to cut the umbilical cord. I went to palpate the uterus, and it was very large, indicating a second baby, can you imagine? I sat alone with that lady in the back of the vehicle, while the others sat elsewhere. I told the driver to take us to find a clinic on the road, we found one in Kawempe, we didn’t have any more supplies ourselves. They ran out with the stretcher, and I carried the first baby in, she delivered the second in that clinic.
The others in the vehicle said [about Sister Josephine] this lady is very courageous. The lady was not showing she was in labor, but I saw her dress was wet. Otherwise, another midwife might have kept quiet, said it’s not my business. But because I have a helping heart, I came with the directions, buy this, do this, maybe it was God who was helping me to be courageous to be able to ask the man to get the supplies, and bravery from my midwifery.
Helping other people in pain is really something good, and it makes me feel good. That’s why I’m a Head Midwife, but I would always find myself in the labor suite assisting the younger midwives, even yesterday the cord was cut, and it slipped off from the placenta, it was still inside. The junior midwife said she wanted long gloves to go inside, but I said let me apply my skills and it came out nicely.
What do you think about the new Birth House expansion?
I’m happy, very happy about it, I can’t wait to see it ready, and I hope when it’s ready we are going to have a busy clinic, we are going to have busy delivery, a busy antenatal clinic, the numbers are going to increase. When the clients see another expansion, we are going to have many mothers coming, seeing the place has become bigger than what it is now. We are expecting increased numbers of all the services. The space where we are operating until now is very small, that has been the challenge, so when we grow, our service delivery is going to improve, and our counseling is going to be very effective.
The level of quality care at our Birth House simply would not be possible without the expertise and passion of this phenomenal lady. We are blessed to have her as a guiding light in our decisions, and as an inspiration in our work every single day. Thank you, Sister Josephine.