Zambia: We Have Donated Bicycles and Emergency Carts to a Home-Visit Nursing Group

The Role of Midwives who Visit Local Expectant and Nursing Mothers

In Zambia, 13.5% of adults (1 in every 7 people) are HIV-positive. Since 2004, AAR JAPAN has been implementing comprehensive measures to combat HIV/AIDS in Zambia. In the Shimaballa district of Chipapa area near the capital of Lusaka, we are carrying out a wide range of activities, which include dissemination of proper knowledge of HIV/AIDS to prevent infection, expansion of a home-visit nursing program, and construction as well as maintenance of facilities where examination and counseling services are provided.

Locally active midwives* also take part in the home-visit nursing group. In addition to assisting expectant mothers during childbirth, the midwives are responsible for explaining to them the dangers of HIV infection from the mother to the child during pregnancy and childbirth. They also give recommendations to the mothers to get tested for HIV and to give birth at medical institutions. Even if the mother is infected with HIV, taking appropriate medicine at the time of giving birth or undergoing Caesarean section can decrease the risk of transmitting the disease to the child. Therefore, in Zambia where it is estimated that 8.9% of women between the ages of 15 and 24 are infected with HIV (2011 State of World Population, UNFPA), such activities by the midwives, who frequently visit the homes of pregnant women, are extremely vital as measures to combat HIV.

The midwives who protect the health of local expectant mothers.

“I want to recommend HIV-testing to as many pregnant women as possible.”

The emergency cart can be hooked behind a bicycle, and transport a patient lying down. In an area where most people don’t have access to cars, this is a valuable form of transportation.

However, there is no public transport available in the large district of Shimaballa, and the midwives have had to make their rounds on foot. Seeing their situation, AAR JAPAN donated bicycles and emergency carts to the home-visit nursing group. The emergency carts that can be hooked behind bicycles are being used to transport emergency patients, women who are about to give birth, and HIV-positive people experiencing a sudden change in their condition to medical institutions. Moreover, we held a seminar to teach them how to fix the equipment on their own, where the members learned about the mechanism of the bicycle and how to replace a flat tire. This is because most of the roads in this area are unpaved, and the bicycles often malfunction or end up with flat tires. One of the midwives said to us, “I want to use the bicycle to make rounds around the area and recommend HIV-testing to as many pregnant women as possible, so that we can lower the risks of mother-to-child transmission of HIV.” In Shimaballa District, the majority of childbirths are performed by the assistance of midwives. In the future, we hope to hold seminars to strengthen the role of these midwives, who play a significant role as mediators between expectant mothers and medical institutions.

*Midwives, in this context, are local women who assist the birthing process. They have learned the necessary skills through their personal experiences or through the apprenticeship of other midwives, and are different from medically trained specialists such as doctors or maternity nurses.

A scene from the bicycle repairing seminar. The participants put disassembled bicycle pieces back together.

On the right is a midwife who attended a bicycle repairing seminar. On the left is AAR JAPAN staff member, Akemi KITA.

Akemi KITA, Zambia office
KITA was assigned to the AAR JAPAN Zambia office in November 2011. After working as a clinical laboratory technician at a hospital, KITA studied public health in Canada and Thailand to pursue a career in the field of international cooperation. She joined AAR JAPAN upon returning to Japan.