Editor’s note: Part of a special series on the global health workforce, in partnership with the Frontline Health Workers Coalition. Checkout #HealthWorkersCount on Twitter for more from coalition partners. Issue No. 18 of Impact, focusing on the global health workforce, launches next week.
By Kristina Grear
It was a hot Sunday afternoon in Aras Kabu, Indonesia, and midwives Pitnawati and Piolina were busy at work at the local public health center when a woman burst into the facility, crying for help.
Ibu Sakdiah’s pregnant daughter has collapsed and was having seizures — Please come and help her, she pleaded. Pitnawati and Piolina gathered their equipment and rushed to Ibu Sakdiah’s nearby home. There, they found 18-year-old Yusni, eight months pregnant, unconscious and lying on the floor.
The midwives examined Yusni and immediately diagnosed eclampsia, a potentially fatal condition brought on by untreated high blood pressure during pregnancy. In Indonesia, eclampsia is the second leading cause of maternal deaths that can threaten not only a mother’s life, but her baby’s as well.
Recognizing that they had a short period of time in which to save Yusni’s life, the midwives immediately started emergency treatment for her condition. Fortunately for Yusni, Pitnawati and Piolina had learned just weeks before how best to respond to an emergency brought on by a complication of pregnancy.
They had participated in an emergency response training for providers at health centers and hospitals sponsored by the U.S. Agency for International Development’s Expanding Maternal and Neonatal Survival (EMAS) program. EMAS is supporting the government of Indonesia in efforts to significantly reduce maternal and newborn deaths in six provinces in the country, including North Sumatra where the midwives worked.
Carefully and confidently, Pitnawati and Piolina cleared Yusni’s airway, began administering an IV drip and then gave her a dose of Magnesium Sulfate, the recommended treatment for an eclampsia-related seizure. Yusni’s seizures stopped and her condition stabilized. But the midwives knew from their training that Yusni would need to give birth soon to safeguard her health.
They called the nearest district hospital, which was an hour away, and arranged for an ambulance. Yusni was taken to the hospital in Deli Serdang, where she would deliver her baby and receive any additional treatment.
Today, Yusni is healthy and she and her husband Zainuddin are the proud parents of a son, whom they named Ayusni Dafna.
In Indonesia, nearly 10,000 women die every year from complications of pregnancy and childbirth, yet many of these deaths are preventable. Emergency drills at health centers and other practices are assisting frontline health workers to help save lives. With support from EMAS, the focus is on strengthening the quality of emergency maternal and newborn care at health centers and hospitals.
As a result of this work, midwives Pitnawati and Piolina and others have updated their skills. Health centers and hospitals are better prepared to deal with emergencies and mothers are surviving pregnancy and childbirth.
“I cannot imagine what would happen to my wife and my baby if they did not get immediate help at the (health center) in Aras Kabu,” said Yusni’s husband, Zainuddin.
Kristina Grear is the Deputy of Program Management for the Jhpiego-led Expanding Maternal and Neonatal Survival (EMAS) program in Indonesia.
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