Ima, 24, a recently qualified midwife from Indonesia, is a panellist in the Global Dialogue for Citizen-led Accountability for Women’s, Children’s and Adolescents’ Health at the World Health Assembly this week.
Here Ima talks about the special challenges of working in rural Gowa district in South Sulawesi , Indonesia - having to reach clients on a motorbike, answering schoolchildren’s sex ed questions by text and how there’s much more to being a midwife than delivering babies.
My name is Mukrimatunnisa but people call me Ima.
After I graduated from high school, I didn’t want to continue studying midwifery. I originally thought that midwives just delivered babies but we do so much more that that - counselling, promotion, education. My cousin encouraged me to stick with it and I’m glad I did. In Gowa district, where I live, there is a high rate of maternal and newborn death. My personal ambition is to help bring down the maternal and newborn death in my district.
Everyday I go to work at public health centre of Tamaona. I live with my uncle and his family. I go to pray at 5am, then, after breakfast, I get on the motorcycle I need to go to work. It usually takes me between 15-30 minutes to get to work, but in the rainy season the mud makes conditions so bad it can take a lot longer.
At the health centre, I see patients for antenatal care, contraception and everything related to pregnancies and delivery. Every midwife has a two day shift each week when we work from afternoon to night helping with deliveries.
Pregnant women don’t usually come with their husbands. They don’t think it is important to go with their wives. But it is! Husbands need to understand about the pregnancy and how to get the wife to health facility.
It’s the same with contraception, it is usually the woman to come to the facility. Even for the condoms. It could be that the husband is shy. The women usually ask for their husbands’ permission before they come to the facility to get contraceptives. After every delivery, we tell the mother about contraception. We give priority to women who have many children. The most common contraceptives I prescribe are implants, injections and pills.
I was a bit nervous when I gave a woman an implant for the first time, but I had a senior midwife with me and it was fine. It’s all worthwhile when I hear women saying how pleased they are that they can use contraceptives. They say that they have more time for other things.
Every year we have to visit all the schools in our area to provide reproductive health education for children aged 13-18. The girls are a bit shy of asking questions so I ask them to write it down on a paper and pass it on to me. The boys on the other hand are not at all shy! Many families understand the importance of contraception so I don’t get any questions from parents. I enjoy working with young people, they have so many interesting questions.
This work is so important! It is about the future of the family. It’s about helping children get a good education and it can prevent maternal and newborn deaths.
Increasingly I see teenagers who have the confidence to ask about their reproductive health. I even get text messages on my phone asking about menstruation. I make friends with the students – that’s how I found out that some 12 year olds are dating and, of course, they have questions. I provide counseling over the phone when I have time.
Some people can’t access our facility due to the horrible road conditions. We reach out to these communities every three months, travelling by motorcycle and 4-wheel drive car. Sometimes women will give birth in a car while driving to the facility because the road conditions are so horrible.
As for the future, I want to continue my studies and get a master’s degree in midwifery so that I can learn more about maternal and newborn health and help bring down the mortality rates – that’s my vision.