Posted on 31st January 2019 by Chris Jones

It was a delight to accompany one of our specialist midwifes from the UK, Frances Barnsely, on her seventh visit to Myanmar (Burma) in December 2018. 

We have been running Traditional Birth Attendant (TBA) training since 2013 from our base in Lailenpi, nestled in the jungles of western Chin State. As a result, many lives have been saved, with the local under-5 orphanage closing down in March 2018 thanks to the reduction in maternal deaths during childbirth.  

With 166 women having received at least two trainings covering basic and advanced topics over the five prior years, there were now geographic challenges in reaching the more remote villages.  To put this in context, some of the women had previously walked 5-6 days to participate in the week long training course, and on top of the return journey, it was proving too difficult to ask them to spend up to three weeks away from their families.  

As such, at the beginning of 2018, we brought seven of the most experienced women together to take on new roles as local trainers. Each of the trainers were to visit 2-3 remote villages close to their homes to help expand the reach of the service.  Key to the success of this new approach was how effective the local women would be at running their own training courses, in addition to whether they would be accepted in their local communities. With support from the local women's association, the trainers were able to deliver training to 91 new TBAs covering ten core topics.  In addition, birthing bags and clean delivery kits were distributed through the network of trainers. 

During our visit, Frances undertook a review of the trainers work through visiting villages on the back of a motorbike. After a gruelling ride over rough mountain tracks, she arranged a three day assessment for the women who had received the local training.  In addition, Frances continued to up-skill and update the knowledge and professional practice of the trainers who attend a five day workshop at the Health and Hope clinic.

"I was so surprised how much the local women knew. I had never expected the trainers to be able to deliver so much of the course and so well.  There were obviously differences between the villages, however overall, topics such as hand washing and knowledge of diet were excellent.  There was still a need to support the women in greater understanding of the mechanisms of birth and they continue to need more practice in emergency drills, but this will come with time. 

I think what struck me most was the impact of the training on the women's self-esteem.  It was clear how the initiative had raised their status within the village which had a knock on effect on their confidence.  Previously they were very insecure, lacking the self-belief that they had the ability to benefit from the training in Lailenpi. However, because they had the opportunity to practice with a local trainer and then meet us in person, they overwhelmingly expressed a deep desire to attend the full training course.  The support of their local community is vital for this, and this was confirmed again and again by the village elders.  

Overall, there was such excitement and joy in learning together, it was absolutely thrilling to be a part of it!”

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