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Thanks to the support of our generous donors, our partner Alam Sehat Lestari’s (ASRI) clinic in West Kalimantan provides an array of women’s health services, including obstetrics, maternity care, family planning, and vaccines for both women and newborns. They’ve also implemented new educational programs to provide materials to all of the moms and children that come to ASRI, not only for delivery services but also for general maternal and child health.
ASRI’s clinic is the only place in Sukadana that provides obstetric/gynecological ultrasounds. And with the construction of ASRI’s Community Hospital and Training Center, they have a new delivery suite. Unsafe home delivery is one of the biggest health challenges women in this part of West Kalimantan face. ASRI’s maternity services are now available to address this need for the area’s ~50,000 women.
Today, I met with ASRI’s new midwife, Rina, to talk more about the program.
(Translated by Dr. Chaisari Turnip, ASRI’s Maternal and Child Health Program Coordinator)
Sara: Tell us about your background. Why did you become a midwife?
Rina: I was born in Central Java in a city called Wornogiri. I am 27 years old now. All of my education was completed in Wornogiri, from elementary school through my midwife training. I moved to Sukadana in 2013 and interned at a government clinic before applying to work at ASRI.
I wanted to become a midwife because my aunt is also a midwife and I was curious about what she was doing. Seeing women having normal, healthy deliveries (healthy mom and healthy kid) makes me very happy.
S: Why did you choose to work at ASRI?
R: I have a few reasons. First, I love the closeness of the staff, and how everyone acts like a family. I wanted to be part of that family. Also, I knew of ASRI’s good relationship with the local community, and that they help the community a lot. I heard that a lot of foreign doctors come here to learn and teach and I thought that would be a good opportunity for knowledge sharing.
I also have a personal reason. Before I got married, I lived with a family here in Sukadana. One day, the husband of the family fell from a tree behind our house and was unable to move both of his legs. Something happened to his back in the fall, and the family couldn’t afford to pay for his medical bills. Finally, he was treated at ASRI. As one of ASRI’s non-cash payment options, his wife was able to work for ASRI to pay off his medical bills. It is very hard to get medical care with no money, but because the clinic provided non-cash payment options, the man was able to get the care he needed. I wanted to work at the clinic that made this possible.
S: What excites you most about your new job?
R: What makes my work interesting is that I learn a lot here at ASRI. At my previous job, there were many midwives. I was not the first, and the delivery service was settled. But here it is new; I’m the first midwife. As such, I’ve learned a lot about the process of setting up and planning the delivery suite, learning how to prepare our maternity services, and I’ve even learned how to use an ultrasound for prenatal care. Since there are a lot of doctors here, there is a lot more opportunity for discussion and shared knowledge, so I feel that I am being enriched.
I’ve also learned more about general medicine. Sometimes I go to the laboratory to learn how to do a simple workup so that I am able to do more than just a basic pregnancy test. Sometimes I also help with other patients at the triage when there are no pregnant patients. I have learned about wound care, electrocardiography, and a lot of other things.
S: What are your main focuses in this job?
R: The main focus of my job is to ensure the safety of both the mother and the baby. This is done through proper, thorough examination during pregnancy. I help to ensure safe deliveries and provide postpartum care.
Sometimes when people deliver at home or just with local shamans, the delivery process itself is not safe because the women are told to push before the safe period, or sometimes the placenta is stuck and shamans wait too long before telling the women to go to the clinic or hospital. There is also a local practice where women are advised to put lime on the umbilical cord to make it fall off early, which causes infection.
My focus is to reduce wrong local wisdom to help improve the maternity service. Giving more education to the moms will help reduce the maternal mortality rate.
S: What are your hopes for the future of the hospital?
R: I hope in the future that the hospital will grow and there will be more services, like c-sections and surgeries. When the OB/GYN specialist, Dr. Willy, returns from his residency (sponsored by HIH donors) next year, patients who need advanced care won’t have to go far for treatment.
One of the things that increases mortality rate is when women are too late to reach the hospital. Sometimes people that need surgical intervention receive care too late, causing complications or even death. Having an OB/GYN specialist here and being able to perform surgeries will help people so they don't have to travel multiple hours to Ketapang.
S: How will new maternity services effect ASRI’s success?
R: Having a midwife, and later the delivery service and OB/GYN specialist, will help ASRI to broaden the scope of their care. By extending the scope we hope that we will bring more patients to ASRI and help more expectant mothers.
S: Is there anything else you would like to add?
R: To expectant mothers, it is important to remember that however difficult your pregnancy is and however difficult the delivery process may be, one of the most important things is just that mom and baby are safe. In addition, the road to nurture the baby is just as important as the pregnancy and delivery itself.
In closing, I am excited about the opportunity to work here and really hope that I can give the best maternity service.