Sister, sister

Joyce Safe and Kathlyn Ababio, regional representatives of the African continent, attended last week's Regional Conference of the Americas hosted by the Trinidad and Tobago Association of Midwives (TTAM) in collaboration with the International Confederation of Midwives (ICM), at the Trinidad Hilton, under the auspices of the Pan American Health Organisation. The theme “Midwifery in the Americas — Yesterday, Today and Tomorrow” was interesting enough to bring roughly 400 participants from 25 countries and 60 presenters from 15 countries to our shores.

As representatives of the African region, Kathlyn and Joyce were attending meetings of the ICM’s executive committee which were being held in tandem with the first Regional Conference, comprising Canada, the United States of America, Latin and Central America and the Caribbean, to be organised in this part of the world by the TTAM, which from all reports had done “a fantastic job.” The two African midwives became firm friends while serving three two-year terms of office as regional representatives, even though they live thousands of miles apart; Joyce in Tanzania is the representative for the east and Kathlyn of Ghana represents the west. They will both demit office at the 2005 International Conference in Australia because the constitution permits only six consecutive years in office.

Joyce, past president of and advisor to the Tanzania Midwives Association, does not practice midwifery, but works with the government as Chief Nursing Officer at the Ministry of Health headquarters. After completing her training as a nurse/midwife in Tanzania in 1968, she obtained an Advanced Diploma in Nursing Education at Nairobi University, joined the civil service and today travels all over her vast country, home to about 33 million people, to supervise those who see that government policy is carried out at regional and district level.

While many people in Trinidad and Tobago pay little or scant attention to midwives in today’s world, Joyce is sure that “midwifery is there as long as there are women of all ages; we take care of women of the reproductive age; and still have women in general who come for matters of reproductive health. It is not a dying profession because as long as women are delivering, how can it. Women become pregnant and need assistance. In Tanzania, there are a lot of government health centres and dispensaries at community level which need midwives; also there are district and regional hospitals; and consultant hospitals.” As Chief Nursing Officer, Joyce is responsible for the policies regarding nursing and midwifery services in the country.

This was her first visit to Trinidad and Tobago and she had been looking forward to coming here “because I have met nurses coming from Trinidad, in workshops and seminars and I was really eager to come and see Trinidad and Tobago, so I thank the Lord I now know what it looks like... at least Trinidad.” Kathlyn, national president of the Ghana Registered Midwives Association (GRMA), did her nurses training in Accra, Ghana; midwifery training at Queen Charlotte’s Maternity Hospital in London; and both a midwifery teachers’ diploma and Certificate of Proficiency in neo-natal paediatrics at Birmingham Maternity Hospital. Kathlyn inherited her mother's 12-bed clinic and is in private practice, but is also a master trainer for Safe Motherhood Programmes in Ghana. Through the GRMA, she is involved in policy for the nation, and writing of guidelines and protocol of midwifery for the 350 odd private maternity homes in the mostly rural areas of Ghana.

However, the government also has hospitals, health centres and clinics in the community and one of Ghana’s major policy decisions in the field of health that ensured the dramatic reduction of maternal and infant morbidity and mortality rates was the establishment of the Maternity Hospital in Korle-Bu in 1926 and the initiation of the District Midwifery Programme in the early 1930s. From this positive policy environment, the GRMA was formed in 1935 by a group of private midwives as a forum for sharing experiences on a regular basis, and with the acceptance of the association into the International Confederation of Midwives in 1954, the GRMA opened up to both public and private midwives. This resulted in private midwives now being found throughout the country, but mainly in rural and under-served areas, earning the trust of the communities they serve.