Midwifery beyond retirement - a calling for life

Date: 05/05/2015

The sight of nurses in their garb and the way they carried themselves in the wards of the Sigatoka Hospital some 40 years ago made such an impression on the girl child Alisi Volavola of Cuvu Village in Nadroga, that she vowed to become one.

She found out the hard way that it took more than just passion and being old enough to "become one of them". The commitment and discipline to get through nursing school was fuelled by a steely determination to earn her place in the nursing profession - and the mantra - one day I will become a nurse.

Retired midwife Alisi Sefeti (right) reports for duty at the maternity unit at Vila Central Hospital; she is one of the nine Fiji midwives on mission in Vanuatu requested by the Vanuatu Ministry for Health after Cyclone Pam; the mission is being facilitated by the UNFPA Pacific Sub-Regional Office, in collaboration with the Government of Fiji. Picture: UNFPA PSRO/Ariela Zibiah.

After graduating as one in 1979, Alisi began working mainly at the Lautoka Hospital until she joined community health teams in 1985 attached to maternal health clinic. Thus began her involvement with mother and babies but at the time, it was most about post-natal follow-up rather than pre-natal.

Two years later and married to a police officer and starting a family herself, Mrs Sefeti completed a post-basic public health nursing course and a year later, she was on her way to Rotuma where her husband was posted.

In 1989, one of the two midwives at the Rotuma Hospital was transferred to Lautoka Hospital, Mrs Sefeti was directed to "catch the next flight" and so began her path to midwifery, something she considers a life-long passion.

The necessity of her midwifery course stemmed from the fact that at the time, the only midwife in Rotuma was the sister-in-charge but in preparedness for complications during pregnancy or childbirth, there was always a second to ensure skilled birth attendants were on hand.

Mrs Sefeti has never looked back. While she has been mainly stationed in the Western Division including the maritime zones, the Nadroga woman never stopped upgrading her skills including the completion of her Bachelors in Nursing in 2006.

Mrs Sefeti who retired in May, 2012 at 55 years has been home ever since, until last month. She was asked if she would be interested in joining a group of midwives as part of the Cyclone Pam response, through the United Nations Population Fund (UNFPA).

"When I was asked I was so excited because I just thought 'somebody needs my service' … I've been home all this time and almost felt useless, not useless at home because I have things to do at home but when it comes to my experience as a nurse as a midwife I felt wasted, sitting home not practising anymore.

"It hurts to go home with your experience at that age because I believe that is the age we are more confident with our experience, with our knowledge, with our skills but this opportunity came, we grabbed it, I did that.

"And I'm here (Vanuatu) and I'm happy to be here helping at this time. Vanuatu nurses will have time to take their leave - at least one week - and some still need to fix their home so we are happy to be helping out this way so we man the place, they take their rest that they deserve.

"We are not coming in to lead or change or whatever, but we are just coming in to work with them so we are helping them in any way they want and in any way we can and we learn from each other at the same time," Mrs Sefeti said.

Mrs Sefeti is one of nine retired midwives who this week begin to man the maternity ward of the Vila Central Hospital (VCH) as their contemporaries take some time off since Cyclone Pam wrought havoc on the island nation on March 13.

Christine Jackson, the midwifery technical adviser for the Vanuatu School of Nursing and Education, said of the assistance from the group of Fiji midwives was both timely and "it will work" referring to the specific request for Fiji or Melanesian midwives.

"Midwives do not only support women in labour and birth, but provide health awareness, health education, promote physiological birth, provide family planning counselling for individuals and or couples, they are there for maternal child health, they are there for social aspects, psychological and physiological," Ms Jackson said.

"You do need to know the context of where you are working, of how you will be working and the resources you have and the commodities you have. And so now we have our next phase which is having a great, lovely, a 100 per cent of our workforce, thanks to the Fijians.

"This is going to be great, and I think this a way of giving the midwives not only support both clinically and expertise wise, but also allowing them to have one week of well-deserved break that is unrelated to their annual leave, just acknowledging their work and the time they'd worked.

"It's a big crew that's come in so it's a big impact on the staff and I'm hoping it's going to be very positive. It's a very busy time in our birthing time, this is our peak time, so between April and July, we have our 'birthing bulge' so monthly averages are about 300 births."

Commemorating International Day of the Midwife today as we approach the deadline to achieve the Millennium Development Goals (MDGs), UNFPA is proud of the progress made for Goal 5, to improve maternal health. Maternal deaths have dropped by nearly 50 per cent, down from an estimated 523,000 in 1990 to some 289,000 at the latest count.

UNFPA executive director Dr Babatunde Osotimehin said however that while the above indicated progress, it was not enough as today, nearly 800 women continued to die daily from complications of pregnancy and childbirth.

"We must do more. And we must start with training and providing more midwives," Dr Babatunde said in a statement marking IDM.

"Evidence shows that midwives who are educated and regulated to international standards can provide 87 per cent of the essential care needed by women and their newborns.

"Today, we call for greater investments to increase the number of midwives and enhance the quality and reach of their services. Strong political commitment and investment in midwives is needed to save millions of lives every year."

Alisi Sefeta, during an interview at the Vila Central Hospital in Vanuatu, Picture: UNFPA PSRO/Ariela Zibiah.