Rose

At the age of 40, Rose Ilwoku has been pregnant 18 times. Eighteen times, she has expected to welcome a child into her family. Ten of those babies have died. Miscarriages, stillbirths, measles and poverty have taken 10 of her children.

Rose was born into a very poor family. She was the second of six children. Her father died when she was very young leaving her family with no means to earn money for food, let alone school fees. Relentless poverty forced her to marry young to escape a desperate situation and to align herself with someone who might send her back to school. “I was still young [when I married], but what forced me was that my father died and I needed someone to pay the school fees. In my home, they didn’t have food. There was no work and no food so we could not help the six children. Even bed sheets were not there.”

Now, Rose lives with her husband and eight children in the remote parish of Kamuda in a leaky grass-thatched hut in the village of Aboket, where TSMP conducts monthly medical outreach. She first learned of TSMP when she was pregnant with her youngest, Mariema Akello (pictured above), who is nearly two years old. She began seeking our services for antenatal care, but today, she is seeking family planning services. She explains why, after 18 pregnancies at the age of 40, she is eager for birth control, “We help to look after some animals and are paid a small amount [30,000 shillings or about $10 U.S. dollars a month]. But my husband keeps on drinking, and by the end of the month, the money is finished. We are left helpless. Even when I was pregnant, the man leaves me there to take care of the children, and I struggle. That is why I entered family planning because the man doesn’t care when I am sick or when the children are sick. He cannot pay even 1,000 shillings [about 28 cents] for hospital fees. The only way I manage is because the government gives free primary education, and at home I make mats from reeds by the lake. I cut them and carry them to the market to sell. That allows me to buy some soap or some food.”

Rose has been receiving family planning services from TSMP for one year because she doesn’t want any more children. Her husband, however, still wants to have more children. The method of birth control that Rose receives from Sister Imelda during her visit allows her to receive birth control without inflaming a conflict between her and her spouse, who has beat her in the past for unrelated reasons, leaving Rose with chronic back pain. The Depo Provera shot she receives effectively eliminates her chances of becoming pregnant. In Rose’s case, she is empowered to take control of her own fertility and to make the decision to stop having children through our free outreach medical clinic. “TSMP has allowed me to live up to now. Let them continue to help us.”

Machulate

On October 4, 2011, Areo Machulate rode her bicycle nearly four and a half miles to TSMP Clinic from her home village of Owalai-Asuret with her five-month old baby, Agnes, in tow. She made this arduous journey to our clinic in Soroti even though there are a few health clinics closer to her residence. Health centers in rural villages are woefully understaffed, often lack medications, and can be very unwelcoming places. “I come to this clinic even though there are several clinics closer to my village because I always receive better care here. At the other clinics their attention is not good, and they just give treatment, but here they investigate problems and give good treatment.”

Machulate is a 19-year-old housewife with four children. The oldest, Isaac, is six years old. This family of six lives in grass huts, and her husband gives people rides with his bicycle to earn income for the family. She has been coming to TSMP for the past eight months after learning about our clinic from neighbors. She first came last March when her daughter, Luka, now two, was sick with malaria.

But on this day, she was here to choose a birth control method and met with Registered Comprehensive Nurse Apuret Morris to discuss when she must return for her follow-up Depo-Provera shot.

Machulate had received Depo-Provera from another health center in the past, but did not receive adequate education about her chosen birth control method. Agnes was conceived from her confusion about the birth control method. Machulate was breastfeeding Luka when she opted for family planning and received two Depo-shots. But, she forgot the date of the third shot and thought she could not come late to get the shot, so she got pregnant again. She came to TSMP on October 4 for family planning counseling and birth control because she would like Agnes to be five before she has another baby. She said, “The children at home are too sickly. I decided to space my children so I can care for them better.”


Rachael

At age 21, Apio Rachael has already experienced much hardship in her life. Her father died when she was young, leaving her mother and Rachael alone to gather cassava for a living. When Rachael got pregnant by a boy at school, he abandoned her and the baby while she was still pregnant. Now, Rachael lives alone with her mother and newborn in a slum village of Agama in Agora Parish. She came to TSMP while pregnant to seek the free antenatal services we offered, as she had been told about TSMP by other pregnant mothers in her village. She feared for the birth of her first child. “I was afraid because some time back this place did not deliver first-time mothers. I was relieved to find I would be able to have my baby here.”

In fact, when Rachael first attended TSMP for antenatal appointments in March 2011, that was true. It was just this summer that the local government bestowed special permission on our clinic to attend first-time mothers and mothers who have birthed five or more babies. Considered high-risk births in Uganda, these mothers are usually required to go to the regional referral hospital to have their babies. Many women fear giving birth in the hospital and opt to stay home instead, putting them at even greater risk during childbirth.

But Rachael was fortunate to have our birth center when her baby boy was born. “I came here yesterday morning with labor pains. The pains started around midnight after I had gone to bed. The labor progressed until this morning when I was delivered. I am very grateful for the excellent care I received here. I was attended very well for antenatal services and very happy to have the beans and rice I was given. I am sure this is much better than hospital. I pray the services are here as long as I am delivering children. God bless all of you in this organization.”