Isolation is a term the inhabitants of Kucwiny sub-county in Nebbi District are well too familiar with. Here, medical facilities are few and far between, and if you are lucky enough to access one, your new worry is the cost of healthcare.
For pregnant mothers, the situation is worse. Newborn care facilities are only available in high volume hospital level facilities, which in Kucwiny, is a far-fetched idea. Lower-level health centres in this area offer maternity services to the bare minimum; give birth, go home. When faced with pre-term labour, things screech to a halt. Will the baby survive? How exactly?
Laurine, the Village Health Team coordinator for this area met Vivian Masende in August 2021 during a household visit conducting Pre-Natal Care follow-up in Gotmoyo Village. Vivian had gone into early labour and was escorted to Kucwiny Health Centre III where she delivered premature twins. Odongo and Opio were born at 1.5 and 1.9 kgs respectively. The family was discharged from the health centre after only 48 hours, with very little knowledge and no assistance to the parents on taking care of pre-term babies.
Before their discharge, with the help of the midwife who assisted Vivian’s delivery, Laurine introduced the family to Kangaroo Mother Care, a method of care of pre-term infants that involves skin-to-skin contact, heavy swaddling in cold weather, exclusive breastfeeding, and minimal agitation of the infants. She has subsequently visited them at home to track the babies’ progress and provide consistent training to the parents.
KMC is considered equivalent to conventional care (incubators), in terms of safety and thermal protection, and contributes to the humanization of neonatal care and to better bonding between mother and baby in any setting, even where technology and adequate care are available. By training birth attendants and VHTs, ACHAP Afya has proven that KMC can be successfully conducted at home, hereby challenging the belief that in the absence of technology and skilled healthcare, the survival rate of pre-term babies is slim to none.
Vivian’s husband, Oyirwoth Patrick is a teacher by profession. He was the sole breadwinner for the family until the COVID-19 pandemic necessitated strict lockdowns in Uganda and schools went into indefinite closure. Having lost his paying work, he has had to find casual work around Kucwiny to provide for his family, especially for Vivian’s growing nutritional needs as she is exclusively breastfeeding their two sons.
“I work extra hard to find food, and sometimes even forage from the bush to keep my family fed, and not once have we gone hungry,” he says.
Being more present at home, Patrick has been Vivian’s pillar throughout their journey of parenthood. In a culture where taking care of children is viewed as a woman’s job, Patrick challenges gender norms by being a hands-on parent, especially with providing skin-to-skin contact for his sons to allow Vivian to eat and rest, and reduce any stress on her that could adversely affect her breastmilk production.
By following the KMC guidelines religiously, and supporting each other, Vivian and Patrick now boast of a healthy, happy family. Their babies, Odongo and Opio, are now two months old and weigh 3.0 and 3.5 kgs respectively. They are a living testament to the fact that KMC works, and at home no less.
“I am very happy for the support ACHAP Afya has given to see that my children stay alive and healthy; before this I had never seen health workers visiting homes, so now I see that they really care about us, and this gives me the courage to continue working to provide for my family,” says a beaming Patrick.