Community Voices: Florence Ojaara
Traditional Birth Attendant (TBA)

Translating was Hariet Nsuburga, Health Educator in Mukono District and a District-Based Trainer (DBT) for Theta. Interviewer, Dr. Caitlin Mullin.

C:  How did you become a traditional birth attendant?
Hariet translating:  It began with the grandmother of her father. But she is saying she mostly got it from her auntie.  She was staying with the aunt who was also practicing. So when she got married, she started doing the same thing.  Initially she was taken to be trained by a goverrnment organization which came in and took people from the various areas to be trained.  So that is how it began, it came up through the family.

T: When mothers come here for prenatal care, that is usually where she passes on the information .  She shows them her certification concerning the new program that has come in.  She has referal forms here, she can write a referral to the local health center for HIV testing.  She also has a record book where she records mothers who come here for consultation and the names of mothers whose babies she delivers.  In the month of December, she had 13 deliveries. Many of them were girls. In this month she has delivered 7 so far, 1 boy and 6 girls.
C: What prompts you to refer some of these mothers to the health facility?
T: She says when a mother comes in who has never given birth she just refers.  If a mother comes in with a history of bleeding a lot, she refers.  If a mother comes in with some of the signs and symptoms of HIV/AIDS, she also refers her to be tested and to get more treatment at the health facility. Or, if one comes in who is anemic, that one she can’t handle.  Those are some of the conditions she doesn’t handle here.

C: How have you benefited from the Theta training?
T: She has benefited a lot in the Theta training program.   She didn’t know before the conditions she could not treat in her clinic, but she learned them from the Theta training.  She also learned the importance of hygene in the home, and how to prepare and store her herbs.  She learned as well how to grow herbs around the home and now she has an herbal garden.  And, in the deliveries in the past, especially when they were handling normal deliveries, they would do the milking of the cord.  But these days it is very dangerous. In the era of HIV/AIDs you don’t have to milk the cord of the mother because there could be transmission of HIV from the mother to the bab, so she has come to learn about that as well.  Also she has learned to use only one sissor or razor blade to prevent cross-infection.
C:  Who has just come into the room?
T: The girl is one of her clients, she has come for the antenatal clinic.
C: Is this first?
T:  Yes, it is her first pregnancy

She gives herbs to the pregnant girl.  Florence pours the herbs into a bag and gives them to the girl as she gives her directions on usage.  She should mix these herbs with vaseline and apply them around her waist.

C: What are some of the challenges Ojaara faces?
T: These girls who come, they don’t reveal that the pregnancy is the first one.  They hide it knowing that she doesn’t handle first time mothers so they don’t tell the truth.  Another problem she normally faces is that some of the mothers get severe malaria, others have severe bleeding during the delivery and transportation is a problem for them, taking them to the hospital.  The drugs she gives facilitates the easy dilation of the cervix so that the cervix expands freely and the baby passes through quickly. 
C: When does her client expect to deliver?
T: in February, next month, so she is due any time.
Rose: How does the community feel about your work?
T: The community feels very proud of her, they come to her. This morning many of them gathered here.  They have tried her and they are very proud of the work she is doing.  People come from some distance, not just in the area here.

As we leave the tiny clinic Ojaara stops in front of her bamboo structure for drying herbs to show Rose a tray of herbs from her garden that she has dried in clay.

Rose translating (pointing to a tray of herbs): So, if you want to stop headaches, fevers, lack of appetite, lack of strength, you have to take this.  She gets those herbs, puts them together, preserves them in clay, and especially gives them to young girls .