Fieldwork in Chilipa and Makanjira

August 29, 2009

This weekend, I went to interview the husbands of the women in our study. This was extremely important to me since all of the women’s interviews had been done before my arrival. I wanted to go to the sites and see the conditions there and try to better understand why women fail to make it to the hospital for delivery. As soon as we got onto the dirt road, I understood. Even in a Land Rover, it was difficult to manage. There were bumps everywhere and we sat there like bobble head dolls. But far scarier were the massive ditches that would appear in the middle of the road. Our driver managed to keep from falling in them although it was a harrowing ride for me. At one point, I thought that the car was going to nosedive into the road. It reminded me of Pink Jeep Tours in Sedona, Arizona. But then, this was day-to-day life!

Besides walking, the major mode of transportation in Chilipa is bicycling. Women who have difficult labors must go, by bike, to the local health centre. If they don’t have the resources to deal with it, they refer her to Mangochi hospital (again by bike). Sounds like a painful trip- no wonder the maternal mortality ratio is so high.

On Friday, we interviewed four husbands. All of them had stayed with their wives when the women developed obstetric fistulas. From my recollection, two were in polygamous marriages and two were in monogamous arrangements. The latter two are especially noteworthy as many men stay with their wives but also get a second wife. I don’t understand all of the details of their stories and need to wait and have the interviews translated to better understand what they said.

While we were interviewing one of the husbands, a woman came to the house to talk to Mary, the Safe Motherhood coordinator. She explained that she has been living with fistula for 15 years and asked for help. There was no comparison between her demeanor and that of the women who had been repaired. She looked completely defeated and didn’t even look Mary, Siyenji (the interviewer) or I in the eyes. Mary was compassionate but could only tell her to come to the hospital for repair. She said that there was nothing else that we could really do. Most of the women that we have been interviewing were repaired at UNFPA funded repair camps that they were brought to. For other women using regular hospital service, we could not provide transport, food etc. Still, I wanted to bring her with us back in the ambulance and get her services. Kind of naïve and unsustainable but still…

On the Saturday, we went to Makanjira, which is very close to the border with Mozambique. The roads were better but still extremely bumpy. We left at 6:00 am and hoped to get seven husbands. We arrived in Makanjira a few hours later and began our search for husbands. Several of the husbands were nowhere to be found. One was out fishing and then came back and we found him. However, while the interview was being conducted, he refused to continue on. He insisted that we were wasting his time and that he needed to get back to his job, just as we were doing ours. He said all of this with a smile on his face and I completely misread his body language. Rita, the interviewer, packed up to leave and I (not knowing that the respondent had refused to participate) pointed to the next page of questions that she had missed. It was a pretty awkward moment when Rita and Jean had to explain that he would not be continuing. Oops.

Other respondents were much friendlier and were elated to have received services. One particular village made an impression on me. The older women were sitting in a circle picking seeds/fruits out of a husk. This group included the woman who had formerly lived with fistula. I sat down with them and started doing the same and they all started to laugh. I could only stay for about five minutes but when I went to leave, the woman who previously had fistula handed me to entire husks. It was a sweet gesture.

Overall, the trips were good but exhausting. I came back to my place around four, showered, and lounged in bed watching “Ferris Bueller’s Day Off.” Around 7:30, Jamira, Maxwell and the girls came by and we went for ice cream at the Ice Cream Den down the road. Tasha fell asleep almost mid-bite and we said goodbye. It was an early bed time but I was happy to go to sleep.