The Sarobidy Maternity Center is a response to the maternal and infant health care needs in Mahajanga, Madagascar. Sarobidy is the word for 'precious' in Malagasy. Its team believes that every woman has the right to quality and compassionate medical care and education as it relates to her pregnancy, birth, baby and the postpartum period. The Sarobidy Maternity Center offers a 14-month program which provides full-scope, free-of-charge prenatal care, laboratory and ultrasound services, weekly health education, labor and delivery services, as well as postpartum care and well-baby care for six months. To read more about the Sarobidy Maternity Center, visit http://www.redislandrestoration.com
In January, a young family came to the Sarobidy Maternity Center (SMC), the mother holding the hand of her 2-year old and her husband, carrying a 5-week old infant. After talking with them, it was discovered that this baby boy was their nephew and they had assumed total care of him after his mother died 10 days after birth due to unknown causes. When the mother died, the father of the baby left. This young family was struggling to provide the formula the baby needed and they were referred to the Sarobidy Maternity Center by the minister of health in our region. Though they welcome new families into our postpartum program, they eagerly invited this adoptive family into the program so that they could follow this baby closely, monitor his growth and provide the necessary and expensive formula for him. The adoptive mother and grandmother took turns coming to the program each Thursday, engaging in the weekly education lessons while Franklin continued growing and thriving week after week. Just last month, baby Franklin, together with his grandmother, graduated from the Sarobidy Maternity Center. (2 pictures below)
Shortly after Franklin graduated, Pao, a friend and former SMC graduate from the community came to the maternity center, bringing with her a 12-day old baby boy. His young mom, who was not in our program, developed severe pre-eclampsia-- a dangerous and persistently worsening condition characterized by high blood pressure and protein in the urine, which left untreated, can be fatal for both mom and baby. At 36 weeks, it was picked up, she safely delivered at the government hospital via c-section and was discharged 5 days later. Unfortunately, there is a total lack of postpartum care in Madagascar, including in the major cities. After six days, with her blood pressure out of control and not being monitored, this young mom developed eclamptic seizures and died en route back to the hospital, leaving her newborn baby. Pao's sister-in-law (pictured on the right) will assume care for this baby boy and was welcomed into the postpartum program at the Sarobidy Maternity Center where they will monitor his growth, development and bonding as well as provide the costly formula, in the same manner they did for Franklin.
Earlier this month, in the midst of a string of six births at the Sarobidy Maternity Center, a young mom in their program came to the center in early labor. As the midwives monitored her, they noted that her blood pressure was dangerously high despite normal blood pressures at all previous prenatal visits. She was quickly developing severe pre- eclampsia. The midwives recognized this, acted expediently and transferred her to the hospital where she safely delivered her baby. Thankfully, both mom and baby are well, they are at home, they are bonding, and the midwives have monitored them closely during her frequently scheduled postpartum home visits. After two weeks, this young mom and her baby returned to their weekly postpartum program where she will continue to be monitored, receive postpartum health education and medical care.
These stories are but a few that represent the masses of the grim reality that is maternal healthcare in Madagascar. They are sad yet thankful that there is a stark contrast between the level of care and monitoring that is provided at the Sarobidy Maternity Center and that provided in local facilities!
The BiliDx is a novel system for diagnosing jaundice. The device uniquely meets the Target Product Profile (TPP) developed as part of the NEST 360 initiative in that it allows blood-based testing at the bedside. This initiative is part of an emerging global consensus in the Every Newborn Action Plan that countries need functional WHO level-2 inpatient units to care for "small and sick newborns."
Now as a next step, we ask what could be done to lower the costs of the implementation of the E-MOTIVE bundle? The most obvious answer is to consider displacing the tens of thousands of disposable plastic drapes with a purpose-built reusable device.
Fortunately one of the obstetricians involved in the E-MOTIVE study, Dr. Justus Hofmeyr, had been innovating around this very issue, designing a tray with wells that could fit under a woman’s buttocks, collect and accurately measure the. blood. This tray, theMaternaWellTraywas conceived as a device that could be sterilized and reused, and is manufactured in South Africa by Umoya.