Nayiga brings midwifery closer to community

In a seemingly deserted house enclosed in a perimeter wall off the Nabweru junction on Hoima road stands a sign post with the writing MILCOT (Midwife-led Community Transformation).  It is here that Nayiga rents a three bedroomed house which she has partitioned into a bed room and an office since 2018.

Born and raised in Mayaaje, Kakuuto, Rakai District, Nayiga is the seventh of 10 children.  She says growing up, there was nothing much to admire from her home community.  Hit by financial constraints, not many people within the community could afford to send their children to school. “My home area was so remote to an extent that there were no professional role models to look up to,” she recalls. 

The best her mother could do was to describe to her different professions, particularly the nursing profession; an indication that she hoped for her daughter to become a nurse one day. As the conversation between the two continued, Nayiga says the idea of becoming a nurse started forming in her head.  

“The fact that I had never seen a nurse, my mother tried to draw vivid pictures of what a nurse looks like and what they do.  I remember the first time I saw and interacted with a nurse was in Primary Four while at Bajja Primary School, Lukaya, Masaka District.  This nurse had come to immunise us, but I could not keep my eyes off her.  I admired her white uniform and head cap,” she narrates. 

Change of course

In order to fulfil a dream Nayiga says she attended school at the expense of her older siblings.  “My elders did not accomplish their education level because mother wanted to see me fulfil a dream.”

After her primary education, Nayiga joined Masaka Secondary School   for both her O-Level and A-Level education.  Passing her Uganda Certificate of Education exams with flying colours, she opted to study Agriculture, Chemistry, Biology, Foods and Nutrition at  A-Level.

“At Senior Six, I passed with 11 points and one of my elder sisters suggested I pursue medicine and was ready to foot my tuition, but my dream was to become a nurse. As we were still debating what I should pursue, I received a call from a friend explaining that I had been admitted to Mulago School of Nursing on a government sponsorship for a diploma in midwifery,” she explains.

Revealing that much as midwifery is something she had not considered before, but due to lack of tuition she had no option but to welcome the sponsorship with open hands

 “I remember my first time in class one of the tutors asked how many of us wanted to pursue midwifery, but I realised that many of us knew nothing about midwifery and were hearing about it for the first time. I should say that we joined the profession because we were given government sponsorship.”

Falling in love with midwifery

After her orientation, Nayiga could not imagine herself being tied to the labour suite only. However, after a few lectures and flashbacks into her childhood, she came to understand the importance of a midwife and that the labour suite was not her only office.

She says as a young girl, she saw her mother and other women in her village deliver with the assistance of traditional birth attendants (TBAs) because hospitals were far. Some were successful yet others and their babies did not make it.

 Reflecting on this reality, Nayiga knew she wanted to be a midwife.  Step by step, she started taking pride in the profession.

“As a student, my placement was in the maternity ward at Mulago hospital and helping a mother bring forth a new life was such a humbling experience.  I came to understand how fulfilling it is to give mothers and their newborn babies care that goes beyond physical healing to soothing them emotionally,” she explains.

 Working in and out of the labour suite, she later developed a soft spot especially for young mothers. She says every single day she witnessed young mothers helplessly walking into the labour suite without any attendant or the required necessities. And because midwives are busy and tired, this young mother does not receive enough care, these are the mothers Nayiga usually looked out for.

 “I would go around the labour ward sourcing gloves and cotton for them. I would offer to be their attendant while in the labour suite, responding to what the senior midwives kept asking for.”  For two years this became her routine and responsibility to look after young mothers that had no one by their side.

As luck may have it, months towards the end of her course in 2013, Nayiga was approached by one of her tutors who recommended her for a midwifery job at Wakisa Ministries, a home taking care of young mothers with crisis pregnancies.

“While I was thinking of what to do at the end of the course, I was recommended for a job even before I would graduate.  At Wakisa, I was hired as a midwife and my role was to make sure the pregnant adolescents had eaten their meals as expected, I had to take them for antenatal care and prepare them for motherhood,” she relates

All was well but the challenging part was taking the girls for antenatal care. Convincing them to attend to their antenatal services was always hard and this was because of the way society judged them each time they went to hospital.

“I used to take the girls to Mulago hospital for their antenatal, but each time we walked through the hospital gate, all eyes were on us.  People would make all sorts of comments about these girls before hearing them out.  I remember some of those girls holding on to my hands tightly and others crying.”

During her three-year stay at Wakisa Ministries, Nayiga realised there was more than just helping these young mothers deliver their babies especially with the provision of maternal healthcare services.  She decided to study further to become a more competent midwife. In 2017, she joined Aga Khan University where she undertook a BSc.

Turning point

Nayiga’s turning point came in 2017 when she was appointed to work as an intern at Kawempe General Hospital. As a midwife she attended to all expectant mothers, but she desired to look out for the adolescent mothers because she believes these young girls need someone who can hear them out and guide them as well.

Among the many cases Nayiga handled was a 17-year-old mother who almost lost her life because of a stillbirth.

“I got to know that four days prior, this mother had gone to hospital and was told the baby in her womb was dead. Instead of waiting to be attended to, she left the hospital and sought prayers instead, but when she realised she had developed fever and other complications she came to hospital and this is when I got a chance to talk to her,” recalls Nayiga.

 In the struggle to save the teen mother’s life, she was rushed to the theatre but bled all the way. She says midwives, nurses and doctors did all they could, but the bleeding could not stop and the only way they could stop the bleeding was to remove her uterus.

“When this girl was out of theatre I stayed by her side till she gained her consciousness. With tears dripping from her eyes I remember her whispering into my ear, “I will never be able to have children.” This tore my heart into pieces, leaving me with no proper words of comfort,” narrates Nayiga.

Nayiga says this moment forced her to leave the labour suite and work closely with the community, where she can easily be accessed and avail adolescents with first-hand information.

 She believes midwives are the people with the right information, but unfortunately they are locked up in labour suites.  Yet the problems forced by mothers need to be solved from the ground before this woman gets to labour suite.

Making a difference

According to Nayiga, adolescent mothers face grave discrimination and because of that they tend to go to hospital late, after complications have already emerged.

It is the aim of Midwife –led Community Transformation ( MILCOT) to prevent these complications.

Challenges and achievements

Nayiga says her biggest challenge has been as a result of the pandemic which forced many young mothers to go separate ways.

“ Before the pandemic, I knew the homes of these different mothers, I knew where to find them, but now most of them have moved to far off places, making it difficult for me to monitor them.”

Nayiga also says that because her job does not bring in a monthly pay, she works with a team of three people, but the community she serves is big.  The other issue affecting her service is transportation because not all areas are accessible.

In 2019, Nayiga was selected by the international Nursing Federation, as a star midwife in Uganda. Thereafter, Nursing Now Glob selected her as a young innovative midwife and she was able to attend the World Health Organisation in Geneva in May 2019. Within that period, she also applied for the International Confederation of Midwives and was selected as a young midwife leader from Uganda together with other 10 leaders globally. 

Saving lives

Harriet Nayiga

Midwife-led Community Transformation International covers seven zones of Nansana,  Ocheng, Nabweru, Kyebando, Wamala, Katooke, Kabulonga Wakiso District. Nayiga says each of the villages has a follow-up programme which shows significant physical and psychological change in the lives of teen mothers enabling them to accept and believe in themselves.

“I work closely with local leaders who help me identify different adolescents, especially those that become mothers at a young age. I try to avail them with the required information depending on their condition, follow up them for antenatal and prepare them for motherhood. It is not a one-day achievement but I make sure I reach out to these different girls and their families,” explains Nayiga.