How I Became “Woke” to Global Health Inequities
On a bumpy road, moving at 80 kilometers per hour in the back of the Land Cruiser, head wrap tied maybe a little too tight…that’s how I dressed when I was going to Solwezi, locally known as Solwezi Mabanga. Solwezi is the dustiest town in Zambia, and you have to drive with your headlights and hazards constantly on to avoid being hit by a truck. I had just begun my job as a Regional Management Information Systems Officer (fancy jargon for for “data person”) at the Society for Family Health, and this was my first field visit. I was super excited to finally get out there and see people on the ground. As a “newbie,” I learned quickly that field visits actually entail sleeping in lousy lodges to save on per diem and learning how to navigate and eat whatever is available.
We started off for a clinic at a Zambia National Service (ZNS) site about 40 kilometers from Solwezi town. The drive from Solwezi to the facility was smooth because the road leads to a mine that has tarred and maintained the road. Upon our arrival to a housing complex for ZNS staff, we were greeted warmly by the community health volunteers who had traveled for miles, awaiting the medicines, supplies, and performance allowances that we had come to deliver. I decided to take a tour of the facility and the first thing I noticed was how small the house — now clinic — was. It lacked proper tables and chairs, the two small bedrooms had been turned into wards with only two single beds each. Due to the lack of space the clinic had turned the bathroom, which had a small bathtub, into a storage room for a mix of stationary, broken chairs, and dishes. While walking past the toilet I saw someone sitting on the toilet, initially assumed he had simply forgotten to close the door, then I saw him writing some notes on a table he had pulled to the toilet. The toilet covered with a wooden plank and the small desk were converted into an office for anybody who needs to write up notes. They had a separate toilet and shower outside for staff and patients to use.
The clinic was divided into two sections: one house for the Out-Patient Department and the other house for the maternity wing. The maternity wing only had about four beds and concrete floors smeared with red polish. When I entered the maternity area, where the door was wide open, I found a half-naked heavily pregnant woman lying on the bed, moaning in a low tone. I apologized and informed her that I was not aware that anyone in the ward. She smiled, and then I asked her if she had been attended to, and she informed me that the nurse had been there two hours earlier.
While I was talking to her, some of the male community workers were coming in and out of the ward to access a storage room. I informed them that they were supposed to use another entrance and keep the door closed to respect her privacy. I proceeded to find the nurse and asked if she was going to check on the pregnant woman who seemed to be in pain, the nurse informed me that the woman had come to the clinic thinking she had malaria, but was actually in the early stages of labor. Her husband had gone back to their home to pick up the baby clothes and other utensils; in Zambia, a pregnant woman is required to bring all of the things her baby needs, including a cord clamp and razor blade to cut the umbilical cord to the hospital. The nurse then informed me that she had to go to town to run an errand, and hoped the woman would be ready to give birth when she returned. She said one of the nurse’s aids, Irene*, was available to cover for her.
The nurse had only been gone for 15 minutes when Irene came dashing out of the maternity wing to find me and asked if I could follow her because the woman was in active labor about to give birth and she needed my assistance. I panicked when I told her I had no medical experience and had never helped deliver a baby before, and she gave me a speech about how God created women to give birth and we have been doing it for years. We rushed to the ward my hands trembling and by the time we were by the woman we could already see the baby’s head. Irene shouted for me to grab an object for her, and I yelled that I didn’t know what it was. She described it, I got it, and she proceeded to tell the woman to push. The woman started to say she had no energy, and after Irene questioned the woman she found out that she hadn’t eaten anything that day. I remembered that I had some drinks in the car, so I ran outside fast as I could, grabbed one, and took it to the woman. As soon as she drank it, the baby came out. For the first few seconds, the baby didn’t cry. My heart stopped for a bit and I felt tears running down my face. Irene used a little utensil to suck out mucus from the baby’s mouth, and a couple of manual pumps later, the baby finally cried. We all smiled and laughed with joy.
“I knew someone had to do something to help this facility and the many others like it. I knew then that I wanted to dedicate my life to make sure people not only had access to healthcare, but access to good healthcare.”
Since the woman’s husband had not yet returned with the baby clothes, and the clinic had no materials to wrap the baby in, Irene suggested that we use an old dirty curtain, that looked like a mop in the meantime. My heart broke when I thought about this baby coming into the world and being wrapped in a mop. I searched the room and found the soft paper they used for male circumcision during surgery. We wrapped the baby in it, and then put the old curtain on the outside. The new mum cleaned herself up, and then she laid on the bed next to the baby and attempted to breastfeed.
“I am now part of a global community of young leaders who believe that access to quality healthcare is a human right for all. We will keep fighting to transform broken health systems until health equity is a reality for all people, everywhere.”
In that instant, even though I knew most clinics and facilities in my country lacked supplies and space, I was heartbroken seeing that baby come into the world and have to be wrapped in a mop, while other parents cannot decide which cute outfit they want their babies to wear. I knew someone had to do something to help this facility and the many others like it. It was this event that made me decide that I wanted to dedicate my life to make sure people not only had access to healthcare, but access to good healthcare. No baby should be born in circumstances that can be prevented, whether that means something as little as having a blanket to be wrapped in, or as serious as being free from disease like HIV/AIDS.
Shortly after this experience, I joined Global Health Corps as a fellow at Planned Parenthood Association of Zambia. I am now part of a global community of young leaders who believe that access to quality healthcare is a human right for all. We will keep fighting to transform broken health systems until health equity is a reality for all people, everywhere. I work extra hard everyday and contribute to bettering health systems so that every child should survive and be born in a decent hospital with qualified medical personnel and facilities.
Jessica Mayenda is a 2017–2018 Global Health Corps fellow at Planned Parenthood of Zambia.
