When our eldest daughter was 7,
the other three were aged 5, 3, and 1 respectively.
For holidays, we would usually
pile in the car and set off for a week’s camping on the Continent. Long car
journeys, (and preparing for them), therefore, were seminars in applied child
psychology:
“No, it’s not an ugly plastic
rucksack I found in the park, (with nothing wrong with it except a broken zip,
by the way), it’s a special magic fairy suitcase I borrowed from a princess!”
“Look! Dolly and Teddy are going
for a wee before we set off! Does anyone else want to squeeze out a wee?”
“Eat up your food so you don’t
get hungry on the way. Dry bread is a special treat! Who can eat theirs
first?”
“Look! Dolly and Teddy are
throwing up on the roadside before we set off. Does anyone else want to get
car-sick before they even get in their seats?” …
“No, not you, mummy…”
“Right! Who would like to have
the special snuggly seat in the boot with all the luggage?” …
“No, not you, mummy…”
Etc.
However, once the journey is
under way, the real psychological deal-breaker is the management of the deadly
phrase, “Are we nearly there yet?” As plaintive as a baby’s cry; as irritating
as Kim Yong Un’s haircut; and as impossible to ignore as a bevy of bickering
tom-cats being struck by a falling piano. Yet ignore it you must, for the sake
of your sanity. (Unless, of course, the questioner is the driver, your saintly
relative by marriage, after she notices that her navigator has been asleep
since Milton Keynes).
Yes, long journeys then were a real
mission, full of the unexpected, and, what was worse, the expected.
However, what I failed to
appreciate in those days of discovering that we should have turned right at
France, is this: any number of factors might prevent you from spending a week
in Marais-Isolé de Mouches, but almost all of them wreak their negative effect before
the journey starts. By the time your car engine coughs into life, reaching the
destination is almost guaranteed. Sooner or later. Often later. But
nevertheless you arrive. It may be that you are not nearly-there-yet when you realise
after driving fifty miles that you left teddy on the doorstep, but you know
that, eventually, you are going to be.
And so it is that I am delighted
to report that the EMBRACE-Tushikamane journey, after two years of careful
planning, is finally about to begin. I wanted to say that it has been a tough
two years, but, in reality, it hasn’t.
We needed first to decide how exactly
we were going to tackle the awful maternal and child mortality in the rural areas
served by hospitals such as Berega. You three regular blog- readers will remember that I
went there for a couple of months in 2013, in the naïve hope of influencing the
deaths in childbirth by improving the maternity services. It transpired that
seven out of eight deaths occurred in the community, due to tantalisingly remediable
causes such as lack of transport when needing a caesarean; having no money for any
health intervention; lack of antibiotics in septicaemia; ruptured uterus from
taking traditional medicine; lack of early recognition of blood pressure and therefore death from eclampsia; bleeding to death for lack of a simple injection to
deliver the placenta, etc, etc.
This litany of awfulness would
have been overwhelming had it not been for the pioneering work of Prof. Anthony
Costello, Mikey Rosato, and the team at UCL, London. Anthony is the Director of
Global Health, and he and his colleagues were only too well aware that
charitable interventions in utterly resource-poor settings often produced only
dependency and transient benefit. They therefore devised and fine-tuned a
mechanism for getting each small community to participate in determining its
own destiny, beginning with setting up women’s groups. Success followed
success, and eventually their methodology became official WHO policy:
A charity was set up to
perpetuate the aims – ‘Women and Children First’ – and at the same time as the
system produced huge success in Malawi, under the leadership of Florida Banda:
http://www.maimwana.org/
https://vimeo.com/15751446
Fortunately for
EMBRACE-Tushikamane, we have had enormous support from Mikey Rosato at W&C
First, from Florida Banda in Malawi, and from Prof. Costello himself ...
... reprising his supporting role of
forty-six years ago, when he played Scrooge to my Cratchit in the school play:
“A must-see triumph! *****!”
(Blackheath Herald).
“Wood brought tears to my eyes!”
(Belmont Hill Spectator).
“I brought tears to Wood’s eyes!”
(My mum, when I then failed my exams).
(Note the black stuff on top of
my head, by the way. One day I woke up and it was gone.)
Countless other happy coincidences, (if coincidences they be), have created the circumstances for the successful
start of the journey:
- the good will of the hospital hierarchy and the leaders of the community;
- the drive and determination of Prof. Arri Coomarasamy at the University of Birmingham and the charity Ammalife, in housing the project, finding it support;
- the provision for Helen Williams to centre her PhD thesis on the project;
- the help of ‘Hands4Africa’ in mapping the roads;
- the support of the Diocese of Worcester and the charity Mission Morogoro being ready to respond to at least some of the needs which will be articulated by the women’s groups;
- the generosity of many of you supporters, in providing for the financial costs thus far;
- the free provision of materials, advice and technical support from Mikey Rosato at W&C First;
- and finally the creation of partnership with key individuals such as Dr Godfrey Mbaruku at the Ifakara Health Institute1, and Prof Senga Pemba at the Tanzanian Training Centre for International Health2, who hope to use our project as a pilot for spreading the programme more widely in Tanzania.
However, none of this journey preparation would have
been of any use without a driver, and the driver needs to be in the car, not
5000 miles away in the UK. What a delight to report then, that Dr. Greg Kabadi
will be taking on local leadership of the project.
Greg is Tanzanian, with 15 years of
experience in project management of community-based maternal health programmes.
Indeed his PhD was closely linked to the work we are doing, and he is
passionate about reducing maternal death in rural Tanzania. He is a public
health and African community project management specialist rather than a medic, and that actually suits our purpose better.
He will
begin his association with us by seeing how this work has already achieved a
major impact in a similar setting. At the beginning
of July he will be visiting the Malawi team and villages, and will get first-hand
experience of how the process works and of what it can achieve.
Some time in the autumn, when all is ready, he and I and Helen Williams will
visit Berega and Tunguli, to meet the key people. We will finalise recruitment
of staff, finding local champions of women’s issues to begin to help the women
of the villages find their voice.
And so, finally, we begin.
“Are we nearly there yet?”
Of course we are nearly there! We
have set off.
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