’Many pregnant women’ll die if TBA is banned’
Tell us a little about this profession?In most of the TBA homes there are ante-natal care units and semi clinics attached to them where women are attended to. For instance, at my facility on Okon Ene Street in Calabar South and many other homes, there are trained nurses and doctors that visit us regularly to […]
Tell us a little about this profession?
In most of the TBA homes there are ante-natal care units and semi clinics attached to them where women are attended to. For instance, at my facility on Okon Ene Street in Calabar South and many other homes, there are trained nurses and doctors that visit us regularly to attend to the pregnant women, do immunization and check their health.
How do you handle cases that require surgical operation?
For CS (Ceasarian Section) cases we have medical experts that attend to them immediately. As at now I am trying to ensure that every woman that cannot easily deliver is quickly taken to a hospital. Now that government hospitals don’t attend to us, we have an ‘angel’ doctor’ who attend to pregnant women. By angel doctor, I mean that he is a doctor with a gold heart. He does not reject women who do not have money for CS, for example. He will save life first and then ask you to go and look for the money.
Are you saying TBAs no longer use crude methods to deliver pregnant women?
I assume that by ‘crude’ you are referring to the old, native ways of child delivery where leaves and other practices are used. We no longer use those things again. We have trained and are still training our TBAs not to continue with those old practices for safety reasons.
Are you implying that the TBAs that used leaves and such things no longer exist?
They still exist. We are still trying to stop them. That’s why we are regularly organising training for them. We strongly solicit for government intervention to train them. The TBAs that are giving us headache are those ones that did not attend school at all. But I am certain that with time it is going to be a thing of the past.
What is the level of patronage?
There is good patronage. Pregnant women flock to TBAs because they are given better and friendly attention. At my facility as much as 30 to 35 women come in regularly in a given month.
Their number triples each time when government hospitals are on strike. Last week, we had several of them whom we sent to the General Hospital but the nurses had to return them. And we delivered their babies safely.
What type of women patronise TBAs, educated or illiterates?
Both of them.
Are they not scared?
They are not. They visit us to see what we do. They take time to see the way we operate. They visit our post-natal ward, labour room; they even enquire about the equipment we use during delivery, and in cases of emergency.
Are you implying that all TBAs have medical equipment?
No! Those that operate in their churches only have small side rooms without the required equipment. But we are trying to stop that because it is not good enough to take care of the mother and baby.
In case of complication, how do you handle it if you are not able to reach a doctor?
We don’t keep them to become worse. As soon as a pregnant woman comes in with labour, the signs will all be there. When this happens an experienced TBA does not need to wait. She will know whether her BP needs to be checked, whether she needs to be fed before delivery or whether her condition requires a surgeon or gynecologist immediately.
Have you had a situation where you lost both mother and baby during delivery?
I have never had such a case. We refer all bad cases to the hospital immediately.
What do trained hospital midwives think of TBAs?
I am not afraid to say it loudly that their relationship with the TBAs is extremely bad.
What do you mean?
We normally refer bad cases to the hospitals, we have situations where the nurses in particular, not doctors who are often helpful, would become aggressive and refuse to let us see doctors. They themselves will not attend to us either. If you see the way TBAs are treated at government hospitals you will pity us. Even when the woman in labour is taken there in good condition – that is, in a situation where the woman can still tell her story yet the nurses will not attend to them. At least, in such a case, the poor woman should be admitted because she can recall what happened to her.
Is it because nurses are aggressive to pregnant women that they flock to you?
So many run back to us due to the poor and aggressive treatment meted out to them by medical personnel in government hospitals. But we do strongly encourage women to register at hospitals in case of emergency. And truly, they attend ante-natal in some of these hospitals. But when they flock back to us we do ask them why they don’t go there and deliver their babies, they would sigh and say the way hospital midwives ill-treat them, insult and abandon them they cannot stand it. There is the case of a particular woman who said even though she was admitted in the hospital yet no nurse or doctor attended to her and she had to deliver her three children all alone. Some say whilst in labour with the pains of delivery, they would scream for nurses to help, but the nurses would rather shout at them.
Are you saying TBAs don’t mete out this kind of unfriendly treatment to women in labour?
How can we treat women who are in labour pains in such a God forsaken manner? During this time women in labour can behave wildly because they are in terrible pains. Midwives ought to be patient with them; they need to be understanding and friendly, not to become hostile and abusive. Women in labour need encouragement.
Why do you think government officials frown at TBAs?
Perhaps it is because of the poor practise by few TBAs. For instance, I was at a General Hospital one day and a very bad case was brought from a TBA that was not registered with us. She was not known, never attended any of our trainings. Anyhow, we rallied around to save the woman. She was afraid to register with us because she thought government will begin to collect tax from her. But we are out to block such TBAs.
How do you intend to get government cooperation and recognition?
For now since the government says we the TBAs should not operate, there is nothing we can do. But it appears that their minds towards TBAs is softening. TBAs are being trained frequently by LACA, NGOs like Development Options, local government councils, and medical personnel. This is because government has noticed that despite their warning many more women are patronising TBAs.
If government succeeds in stopping TBAs what will happen?
They will have succeeded in killing and harming many more women. Government should not forcibly stop TBAs. They should rather train and co-opt them. When government hospitals are on strike it is the TBAs that have come to the rescue. There are thousand and one cases of women that come to us everyday. Government would then be taking a wrong decision to ban TBAs. TBAs are very useful and helpful to the public.
Your own facility might be ‘medically equipped’. How about others?
We regularly visit other TBA facilities with a view to checking and encouraging them to update their equipment. We have shown them what medical equipment to use and how to use them. We have warned them not to deliver women again on the floor so that women and their babies don’t get infections. We have shown them the pattern of bed to use.
Do TBAs charge?
That’s the problem we have. Women would complain that they don’t have the N4000 or so to pay. As simple and cheap as gloves and tissue paper, women would lament that they don’t have money. But when they get to hospitals and are slammed with fees ranging from N50,000 to N70,000 they easily raise that.
So TBAs don’t make money?
We don’t. But the educated ones do appreciate us. They would be surprised at our low charges compared with the very high amount they are charged in hospitals. Seeing our effort they are often willing to appreciate us.
Do you see any risks in the practices of TBAs?
Even in conventional practices there are risks during child delivery. It is risky both in the hospital and in traditional delivery homes. That is why I am pleading with women to come in and train TBAs even though we have trained and shown TBAs the possible danger signs to expect during labour and the urgent things they must do.