Whenever 63-year-old Malawian midwife Charity Salima strolls along the streets of Lilongwe, her country’s capital, mothers from different houses would scream out in excitement, “Charity! Charity!!” The women would walk up to her, their babies nestled in their hands, saying: “Here’s your grandchild.”
Ms. Salima is now accustomed to such open displays of affection, having delivered about 12,000 babies without a single fatality since 2008.
When a woman comes to us in labor, gives birth and goes home with her bundle of joy, that makes me really happy.
She retired from Malawi’s public health service in 2006 after 26 years and in 2008 she established the 10-maternity-bed Achikondi Women’s Clinic in Area 23, a deprived township in Southeast Lilongwe. Achikondi means "love."
Ms. Salima herself is a mother of three children and three grandchildren. She ascribes her motivation to the joy that women get upon giving birth. “When a woman comes to us in labor, gives birth and goes home with her bundle of joy, that makes me really happy,” she tells Africa Renewal.
“I was pained seeing pregnant women in Area 23 walk long distances to receive birth services and medicines,” she explains, describing the circumstances that led her to set up a clinic. “So, I thought to bring these services closer to the people. As you know, labor can start anytime—night or daytime.”
She says women in labour sometimes come knocking on her door late at night asking for help.
Achikondi does not charge fees for services; instead, patients are encouraged to make a voluntary donation to cover electricity and water bills. Those who can make such a donation do so, but the vast majority who cannot also receive needed services.
Ms. Salima admits receiving financial support from institutions in foreign countries, including the Freedom from Fistula Foundation in Scotland, while students of the George Watson College, also in Scotland, have chipped in.
In addition, her clinic works closely with the Kamuzu Central and the Mutharika Maternity Wings, which are Malawi’s largest referral hospitals.
“We’re not an island,” she maintains. “We work hand-in-hand with fellow midwives at the referral hospitals.”
Notwithstanding Ms. Salima’s outstanding success as a midwife, the child-birth mortality rate in Malawi is troubling.
As of 2020, on average 38.6 babies under the age of five die out of every 1,000 births, reports UNICEF, listing the main causes of neonatal deaths as prematurity, birth asphyxia or the loss of oxygen and blood flow to the baby, trauma and bacterial infection known as sepsis.
High childbirth mortality in Malawi is due to “a cocktail of factors and includes underfunded public hospitals, few midwifery specialists and late diagnosis or no diagnosis of birth-impacting conditions like HIV and Fistula,” adds Dr. Stanely Samusodza, a public health expert and a nurse who has worked in many Southern African countries.
Better equipped “Private clinics staffed with gynecologists charge high fees that most mothers simply cannot afford,” he laments.
On what budding nurses can learn from her, Ms. Salima says they must see beyond a nursing diploma. “As a midwife, I have ears to hear, nose to smell. It means if a woman has not given birth by a certain time, a skilled nurse must quickly determine the reason. You may need to refer as soon as possible? In midwifery, there is no trial and error,” she warns.
She is also busy sensitizing traditional chiefs and women in the communities on ensuring that babies are delivered in maternity clinics instead of homes where they are managed by untrained traditional birth attendants.
The seasoned midwife also sensitizes women and girls on teenage pregnancies and other medical problems. “I tell young girls to continue with school. I also tell women that cervical cancer is treatable.”
She has received many accolades for her work.
Achikondi Women’s Clinic was recently adjudged to be the best in Malawi’s Central Region Province. In 2019 Queen Elizabeth of England, through the UK High Commission in Malawi, handed to Ms. Salima a “Point of Light Award.” The Award recognises outstanding individuals making a change in their community.
“Achikondi Women’s Clinic delivers around 60 babies and sees 1500 patients per month. Charity has delivered 8,000 babies with no recorded deaths since opening her clinic in 2008,” commented the UK High Commission at the time.
And in 2020, President Lazarus Chakwera announced Ms. Salima as the country’s “Midwife Lifetime Achiever.”
Despite the awards, Ms. Salima is keen to ensure that “the good work of the Achikondi Women’s Clinic, even when I am no longer there, continues.” To achieve that goal, she is mentoring young nurses who will likely step into her shoes.