When Catherine Nyawere came to Reach Out Mbuya (ROM) Community Health Initiative in Uganda last summer, she had just discovered she was pregnant – right after she and her husband lost their jobs to COVID-19-related layoffs.
Like the thousands of people who live with them in Nakawa, a section of the capital city of Kampala, Nyawere lives on the edge between barely enough and not enough to survive.
The staff at ROM gathered her in their collective arms, just like they do with other pregnant women who come to the clinic for medical care. Their goal is to empower parents to keep themselves and their families healthy and self-sufficient.
ROM clinicians provide medical care, including an ultrasound. Another more experienced mother from Nakawa, who is trained in basic maternal and child health, became her mentor. Social workers and counsellors are available to assist as needed. The staff makes sure mothers who have HIV give birth to babies without the virus.
All these services are supported by MCC, through ROM, for 100 pregnant women each year. From prenatal care, through giving birth, until the child is 18 months, ROM provides health care for the parents and child.
“The way we respond to the needs of our bodies affects both our spiritual and physical health and also our ability to receive guidance from the Holy Spirit. The knowledge from this project may go a long way to prevent diseases and deaths,” said Fred Bobo. He and his wife Betty Bobo serve as representatives for MCC’s work in Uganda.
“The Mother-to-Mother program was especially helpful,” said Nyawere while she waited for her 5-month-old baby, Martha Theresa Abila, to be examined at the ROM clinic. Her mentor, Lillian Akot, who had previously come through ROM’s program as a pregnant mother, came to the house where she lives and helped her make space for a water tap, soap and toilet facilities.
The two mothers talked about nutrition – how to add vegetables and protein and vary what she eats without adding cost. The mentor explored whether the mother felt safe in her household and with the baby’s father. And, of course, they talked about labour and delivery.
For each pregnant mom, ROM provides a “mama kit,” which has a collection of basic medical supplies that all pregnant mothers are required to supply when giving birth at a hospital. If transportation to the hospital is a financial obstacle, ROM provides transportation fees.
“The mama kits are so important because we lack the money to purchase the kits,” said Jude Obbo, a father who came to ROM’s clinic with his wife Elizabeth Adikini and their 4-month-old baby, Favour Nyawere.
The mama kit and the transportation fees are inexpensive, about US $5.50. Yet, for people living on almost nothing, these costs can prevent women from delivering in a medical facility, said Paul Fast, MCC’s health coordinator. ROM encourages hospital deliveries as the safest option among the urban poor.
After delivery, the care continues. Babies are weighed and measured at the clinic. And mentors make home visits to ensure that the mother is nursing well and to check on the mother’s nutrition. As holistic helpers, the mentors are looking for any way that ROM can assist, including referring them for advanced help at the clinic.
When the parents bring their baby to the clinic for immunizations or checkups, health care extends to the parents too, said Mary Namugalu, a nurse at the clinic. If the parents are together, she encourages them to come together, so they parent as a team.
For example, she said, if both the father and mother hear that soap is important for keeping the baby healthy, the man is more likely to go buy soap when his wife asks him to.
Favour’s parents brought her to the clinic in February because she had a cold. Namugalu took the opportunity to not only check the baby but to take the parents’ blood pressure and to talk with them about birth control.
Although Favour was their sixth child, she was the first of their children to be part of ROM’s program. Adikini said she is grateful for the information she gets to keep Favour healthy. “Her health is OK. She is not regularly falling sick,” she said, comparing Favour to her other children’s infancy.
ROM offers fatherhood classes for men who are open to learning more about how to care for their children. Obbo said he didn’t need the class because he is already convinced a father should be involved in caring for his children.
“I do it because the family is mine,” Obbo said, “and the responsibility in the house is mine.” His wife earns money as a housekeeper, he said, and he helps at home and looks for a job.
Social worker Sarah Nassolo encourages them and other clients to join one of ROM’s village savings and loan groups. But that requires at least some money, something Nyawere doesn’t have right now.
She would like to start her own sewing business at home, she said, but she needs a sewing machine. If she can get a sewing job with a business, she needs childcare. In February, with a jobless husband who has multiple wives, she had no money.
Most families earn very little money, Nassolo said. “So we really squeeze because we want them to save even if a little. If they have something put aside, that can enable them to go and attend to an emergency.”
Teopista Nabukwasi, a mentor in the Mother-to-Mother program, understands the value of a savings group. As a client at ROM for the last 15 years, she became involved in a savings group. After saving for quite a while, she eventually was able to start two businesses, one collecting metal to sell for recycling and another selling vegetables. She now uses her own example to inspire other young mothers.
Having your own business means mothers don’t have to depend on others or to beg, Nabukwasi said. “They can depend on themselves by creating a small business and support their families.”
Top photo caption: In Kampala, Uganda, clinician Mary Namugalu, left, talks with Elizabeth Adikini and her husband, Jude Obbo, about their health at the ROM clinic in addition to examining their baby, Favour Nyawere. MCC photo/Matthew Lester