It was midafternoon, and Farhiya Yusuf Karagre, age 40, was in labour with her twelfth child. She stood bent over a bed in the Dr. Alag Health Care Centre in Burao. When Farhiya went into labour earlier that morning, she came directly to the health centre, as her friends had told her it would be safer for her to deliver there than at home.
Having given birth to half of her children in health centres, Farhiya has come to understand the differences between what clinics can provide and what the local birth attendants are capable of doing: “Traditional midwives are very ignorant,” she says, breathing heavily while leaning against a metal bed frame. “They cannot read, they have no medical background,” she continued.
One of mothers’ biggest challenges and fears about giving birth at home is hemorrhaging. Traditional birth attendants often try to assist with the labour but, without proper training, can end up causing more problems than they can provide solutions. “A proper midwife knows everything,” Farhiya said. “There’s a big difference giving birth in a health centre. There is more help and more medication, you can get assistance for bleeding, and if you are weak, they will give you some more energy.”
Farhiya visits the health centres frequently with her children to receive immunizations or treatment for malnutrition, diarrhea, and malaria. “If you are not feeling well, you can go to the health centre and get assistance for both you and your child,” she said, adding how pleased she was that the services are free of charge, “if they charged me, I could not come back.” With eleven children and another on the way, it would not be possible for Farhiya to cover any medical costs.
Trust, knowledge, and awareness about the services provided by the heath care centres are as important as the treatment itself. The most effective way of educating the members of a community about health care is often by sharing stories of patients’ positive experiences at the facilities. “Every time I come to the health clinic, the health workers explain the services that are available from here and the importance of being connected to the centre. And then we spread the message,” says Farhiya. Just like she learned about the clinic from her friends and neighbours, she will continue to pass on the message of the importance of health care and giving birth in a safe environment.
The lifesaving facilities at the Dr. Alag Health Care Centre are part of the Essential Package of Health Services, made possible by the Somali Joint Health and Nutrition Programme (JHNP).