Today reading the story of Sri Lanka’s emergence as a success story in safer childbirth with a remarkable decline in maternal deaths, I mused about how I took for granted that childbirth would be safe when I had my children way back in the early 70’s. It was joy unlimited as I breezed through pregnancies always under the stern but very caring eye of my GP, Dr. Navaratnam. The news today that Sri Lanka should be held up as an example for other South Asian countries makes me very grateful for the high quality of medical care that was available to us in the Sri Lanka system.
Presenting a paper at the Royal College of Obstetricians and Gynecologists, UK, South Asia Day, Dr Hemantha Senanayake, from the University of Colombo, said the “ mortality ratio of Sri Lanka has declined dramatically as a direct result of the availability of midwives and trained assistance. “In 1960, the child mortality was 340 per 100,000, however, it was lowered to 43 per 100,000 live births in 2005.”
Dr. Senanayake attributed it to Government policies adopted in the past few decades and among these the decision to increase the number of midwives. The number of women in Sri Lanka having a minimum of 4 antenatal visits has reached 99 percent in Sri Lanka, said a news report on this conference on the Sri Lanka Government’s Official website.
Visiting the Mahiyangana Base Hospital supported by the World Bank assisted Health Sector Development project last year it was a lovely sight to see young mothers with their babies in an attractively decorated waiting room. There were a fair number of twins, and this was the regular Friday baby clinic. There were also fathers and grandmothers, aunts and uncles—holding, helping, coo-cooiing and going ga-ga over the offspring . Babies usually bring out the best in families here, and this was proof indeed. But was even more amazing was that there was not a single mother with a baby bottle. All babies were breast fed and they were there with their babies for regular health checks and immunization.
Sri Lanka has encouraged breast feeding and discouraged home births (1 percent in 2006) and the availability of comprehensive emergency obstetric care is being expanded. Presently, 85 percent of births take place in facilities that have the services of a specialist obstetrician.
We did visit also a smaller clinic run by a midwife in Moneragala too on that visit. But she said she had only one delivery for the whole year! Most of her work is on pre natal and post natal care.
Midwives like her are recruited from villages close to Maternal Care Centers where they are meant to serve, which ensures minimal geographic and cultural barriers to providing a service we can deservedly be proud of.
The midwife is known, if not related , and tends to bond easily with the mothers to be. As was the case with Dharshini Perera, a health nurse I met at an Internally Displaced People’s (IDP) camp at Nannadan in the North of Sri Lanka. Dharshini spoke fluently in Tamil, her mother’s tongue. Caring and tender, I watched her as she checked on the children and had a following like the Pied Piper in a little while. She is a fine example of the hallmark of the service — low-cost and indigenous.
Going back to the time when I was born many many moons ago, and an oft repeated story by my father springs to mind. Father to be was waiting at the railway station to meet the Midwife who was coming from Colombo for my birth . For no apparent reason on that New year’s day, the train whizzed past the Hikkaduwa station to Galle, leaving my father gaping in disbelief. My father’s Colonial relic “ clerk” came to the rescue of his panic stricken boss and a local midwife was rounded up. The rest as they say is history. But the fact is that even way back then it was a hallmark of a good service. Thank you Sri Lanka, we owe much to you .
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