The project that contributes to the training of future midwives at the Monkole and Binza hospitals in Congo received the “Co-Responsible Initiatives” Award at the 10th edition of the Nursing in Advancement Awards. EFEgreetings spoke with one of the professionals participating in the initiative, the head of the maternal-child area of the CUN in Madrid, Mercedes Gutiérrez.
Life expectancy in Congo does not exceed 60 years. Women tend to become mothers at a young age and, on average, have around six children. Those who give birth in hospitals, others do so at home, are assisted by nurses who do not have training as midwives.
According to estimates from the report “Trend in maternal mortality from 2000 to 2020”, prepared by several organizations, including the World Health Association (WHO), Congo is among the countries with the highest maternal mortality rates.
Specifically, Nigeria tops the list, with an estimated 82,000 deaths in 2020, accounting for more than a quarter of the total. This contry is followed by India (24,000), the Democratic Republic of Congo (22,000) and Ethiopia (10,000).
The CUN collaborates with the Higher Nursing Institute of the Congolese city of it’s morningwhere a professor from that institute is Spanish and carried out a training stay at the Madrid branch of the Navarre hospital.
This is how the collaboration for this project began, during which several CUN nurses, including Domínguez, traveled to the country. Previously, telematic meetings were held with the professionals of that institute to understand the training needs of the students.
“We accompanied Congo’s first class of midwifery students on thier placements to guide them on how thay were carrying out the training they were receiving. Moreover, we offer various training sessions,” explains the CUN nurse.
The objective, he continues, is to try to ensure that future midwives follow the WHO strategies aimed at a normal birth, in short”empower these future midwivesso that they become aware of the reasons for the strategies and are able to implement them”.
“In the end they are the ones who have to carry things forward, not us, it was about making them understand the importance and reviewing their practices a little, seeing how they were doing things,” explains Gutiérrez.
For the CUN nurse, collaborating on the midwife training project in that school in Congo “was a marvelous experience” and several students managed to come to Spain to do training trips at the CUN headquarters in Madrid.
“It is a project that is not about now going away and not coming back, but rather this training which has great continuity. In Congo you have to go little by little. You give training, you empower peopel, you come back, see if they are doing it and, if not, what difficulties they have, including cultural ones but also because of poverty,” he says.
Scarce resources
And while they have resources in Monkole hospital, Binza maternity hospital, which they also visited, the gynecologist goes for an hour a day from Monday to Friday. the rest of the time there are no gynecological professionals, so the nurses take care of the women. In that maternity hospital, for exmaple, it is indeed not possible to perform caesarean sections.
“Imagine how accustomed these people are to death and pain, because not all of them can go to give birth in hospital. ”manny people give birth at home”, explains the nurse, who adds that the fault lies not only in economic resources, but also in distances, but above all in the state of the roads, which are unpaved.
Only mothers
Men cannot enter the binza maternity hospital because in the country, by culture, they consider that childbirth is something that belongs to the mother. In Monkole the father figure is introduced.
“Parents never enter Binza, they enter the process alone, it is a maternity hospital where they are not fed, they have to carry food with them and they occupy corridors and corridors. Those who are about to give birth dilate in the same place as those who are miscarrying or those who have given birth to a deceased child. It’s really notable,” says Gutiérrez.
The nurse tells the case of a woman whose twins died in childbirth and the next day, when they returned to see what she needed, she told them it was a sandwich. “You think they’re going to ask you for encouragement and what they ask you to do is eat,” the nurse explains.
“And for cultural reasons, in that maternity hospital where they are not fed, they are all in the same corridor, where the lady herself gets on the birthing chair and gets off herself and she doesn’t even have pads, there is a hair salon because culturally, when mothers leave the hospital, they leave with all their braids done,” she comments.
WHO guidelines
In the training of midwives, provided thanks to the ongoing project in Congo, we try to guarantee that after birth the child is not separated from the mother, that we try not to do episiotomies, that breastfeeding is well established, that is, bringing forward the essential principles established by the WHO.
“Accompany mothers, so that they are more protagonists, so that they have alternative measures to control pain. Doable things for which you don’t need a lot of money, but which you can really apply and understand the importance of,” says Gutiérrez.
Despite all this, remember the nurse the CUN“when you go to Congo you see many young people smiling. It attracts attention, with the amount of difficulties they have and the poverty, you see a constant smile.”
– What impact has the midwifery training program had on maternal health in the Democratic Republic of Congo?
Interview Between Time.news Editor and Mercedes Gutiérrez
Time.news Editor: good afternoon, Mercedes. Thank you for joining us today to discuss the impactful project at the Monkole and Binza hospitals in Congo. Congratulations on receiving the “Co-Responsible Initiatives” Award! Can you share with us what motivated your team at the CUN in Madrid to initiate this midwifery training program?
mercedes Gutiérrez: Thank you for having me! The motivation came from a clear need to address the high maternal mortality rates in Congo. With the life expectancy in the country being under 60 years, and many women giving birth young—in fact, an average of six children—the urgency for skilled midwives was evident. We recognized that many births occur at home and are assisted by nurses lacking formal midwifery training, which greatly contributes to these high mortality rates.
Time.news Editor: That’s a sobering statistic. The report you mentioned notes that the Democratic Republic of Congo has one of the highest maternal mortality figures—22,000 deaths in just 2020. How did your team begin the collaboration with Congolese nursing institutions?
Mercedes Gutiérrez: Our collaboration started with establishing a connection with the Higher Nursing Institute in Congo. We had a Spanish professor who had previously trained there and facilitated our outreach. Initially, we held telematic meetings to discuss and understand their training needs. After that groundwork, several of our nurses traveled to Congo to accompany the first class of midwifery students during their practical placements.
Time.news Editor: It sounds like a meaningful effort was made to ensure the training was tailored to the local context. What specific strategies or methodologies did you implement to empower these future midwives?
Mercedes Gutiérrez: Our approach was heavily aligned with WHO strategies aimed at promoting normal birth practices. We focused on empowering the students to not only understand the ‘how’ but also the ‘why’ behind these strategies. It was crucial for them to take ownership of their learning and practice. We provided various training sessions and guided them to reflect on their current practices while emphasizing the importance of adapting evidence-based care to their specific habitat.
Time.news Editor: Reflecting on your experience in Congo, how would you characterize the challenges faced by the healthcare professionals there?
Mercedes Gutiérrez: There are numerous challenges, ranging from limited resources to high patient loads. Many healthcare workers are incredibly dedicated yet lack the formal training necessary to deliver the best care.Our goal has been to bridge that gap by providing education that is sustainable and empowering.It’s not enough to impart knowledge; we want these students to feel confident in their ability to implement what they have learned once we are no longer present.
Time.news Editor: That sounds like a valuable goal, especially in regions facing significant challenges.Can you tell us about a particularly memorable moment from your time working on this project?
Mercedes Gutiérrez: Absolutely! One of the most memorable moments was during a training session when we saw the students begin to build their confidence. They started to ask questions and engage in discussions about patient care approaches they had never considered before. It was a turning point where they began to connect the theory with practice,and witnessing their enthusiasm was incredibly rewarding.Many of these students are now inspired to continue their education, which has a ripple effect on their communities.
time.news Editor: That’s inspiring! As we wrap up, what message do you have for those who might want to support initiatives like yours in the future?
Mercedes Gutiérrez: I would say that every contribution counts, whether it’s sharing knowledge, providing resources, or even raising awareness about maternal health issues worldwide. It’s vital for us to understand that these aren’t just statistics; these are lives. The more we invest in education and empowerment for midwives, the better the health outcomes for mothers and children in vulnerable areas like Congo. Together, we can change the narrative and create a brighter future.
Time.news Editor: Thank you, Mercedes, for your insights and for your transformative work in midwifery training. It’s been a pleasure speaking with you today.
Mercedes Gutiérrez: Thank you for having me! It’s been a pleasure to share our journey.