Safer Together: A Malawi Midwife’s Story
Conflicting feelings of compassion, empathy and fear plague Malawi midwife, struggling to provide respectful maternity care amidst the COVID-19 pandemic
Luseshelo Simwinga is a nurse and midwife working at Queen Elizabeth Central Hospital (QECH), in Blantyre city, Malawi. She shared her experiences as midwife providing care in the period of COVID-19 with Hester Nyasulu, Executive Director of White Ribbon Alliance for Safe Motherhood Malawi, as part of the Safer Together: Respectful Maternity Care and COVID-19 campaign.
There has been a certain type of discrimination against health workers using public transport from when Malawi confirmed the first COVID 19 case. People are not comfortable sitting close to a nurse for fear of contracting COVID-19, as they assume nurses have the virus because they take care of patients. For me, I experienced a discriminatory look when I boarded a public transport and am noticing that some of friends and relatives are not visiting me as frequently as they used to.
In the past weeks my facility did not have adequate Personal Protective Equipment (PPEs) for healthworkers but at the same time, we were supposed to be providing quality respectful and dignified maternity care to our clients. Personally, I had a lot of fears when providing care to my clients, especially when they would cough or sneeze without covering their mouth, as I was not putting on any type of protective wear. My work became very stressful, especially when going home, thinking that I might have contracted the virus. I felt that it was not safe for me to visit my father, who is old, and my young niece, people that are so dear to me at moment.
I felt stuck between a rock and a hard surface, with feelings of compassion, empathy and extreme fear. I’m obliged to provide quality and respectful maternity care to my patients but at the same time, I did not have adequate equipment to protect myself. I quoted my pledge of service that states, “the health of my patients will be my first consideration,” then questioned how I was to provide quality care if I were to get infected and ill. This created emotions of fear, hurt and burnout.
In trying to achieve the Safer Together campaign goal that “all providers, women and families are aware of their rights and responsibilities within the health care system, and those rights are respected, protected and fulfilled during the pandemic,” I have put on a badge with the words “respect is a choice” on it. I put on this badge before every duty shift as I explain to my colleagues that they have to choose respect and provide respectful care to all pregnant women, fellow midwives and doctors regardless of their current mood, social standing, religious or economic background. I further tell them how important respectful care is to pregnant women, that it can help improve maternal and neonatal health indicators, because women who receive respectful and dignified care are more likely to come back to the hospital to get skilled care at their next delivery, or whenever they or their neonates have any danger signs or a secondary obstetrics emergency.
The health facility where I work in is now fully back in operation after the health workers conducted a sit-in over several days to demand the Ministry of Health provide PPEs. With the PPEs now available, I am able to provide my services more comfortably and with limited fears.
The Malawi government should set their priorities right and provide adequate PPE for all health workers, regardless of the level of health service provision they are working. Also, messages about COVID-19 prevention and psychosocial support should be provided using proper channels of communication and a language understandable by all Malawians. Finally, health workers working in COVID-19 isolation sites should be given adequate risk allowances and necessary counselling and support services for them and their families.