Midwifery and Women's Health in Cambodia

What is Jaqxun up to now?
I am a student midwife. I am going to work for three months in a women's health clinic in Cambodia, leaving April 22nd and returning July 23rd. I hope to learn a lot from both the Khmer and western midwives I will be working with. I am funding my own costs (which include over $1000 going directly to fund the organization I will be working with in addition to travel and living expenses).  I want to contribute more to the community I will be working in while I am there. 

What does that have to do with me and my money?
I am asking my friends and family to donate money and supplies to fund midwifery work in the community I will be working with. The funding will all go to support local Khmer midwives, both by buying much needed equipment and by sponsoring trainings, education, and conferences that the midwives and traditional birth attendants ask for. 

What is pregnancy and birth like in Cambodia?

In 2005, the Cambodia DHS found the rate of maternal mortality to be 472 per 100 000 live births. The neonatal mortality rate is around 45/1000. 

In 2000 89% of births were delivered at home. Most babies are still borna t home in Cambodia, often without a skilled attendant (78% as of 2005). Of the 22% of births delivered at health facilities, a great proportion are located in urban areas, pointing to a difficulty of access of women in rural areas to health centres.

Obstetric care by a trained provider during delivery has moved from 32% in 2000 to 44% in 2005. More than half (55%) of births are assisted by traditional birth attendants. Sixty-nine percent of women received antenatal care from a health care professional at least once. The majority of care was provided by midwives, followed by doctors and nurses.

What kinds of things will my donations be paying for?
Donations pay for supplies to provide safe prenatal, birth, and postpartum care to local women. The clinic I will be working with sees about 40-50 births every month. In addition to that, they have a mobile birth clinic that serves more rural communities. There is also a program that sends community member directly to women's homes postpartum to provide support, healthcare, and resources. The types of supplies needed include:
Gloves (both sterile and non-sterile)
Sterile gauze
Sterile suturing equipment and sutures
Dopplers, doppler gel, and batteries
Headlamps (there is not always electricity in the clinic) and batteries
Ziplock bags of all sizes
Sterile needles for injections
Hot water bottles
Sheets and towels
Donations also pay to sponsor the Khmer midwives by providing assistance and training. Donations also fund the cost of providing prenatal care, midwifery care during birth (including transport to hospitals and cesarean births when necessary), postpartum services, and general healthcare. These services are generally lacking in the Cambodian health system, especially in rural areas, where there is a shortage of midwives and a lack of adequate facilites and support.

How can I learn more about the organizations my money will be funding?
I will be working with Life Options and Women's Health Cambodia, through Midwife International. Life Options and Women's Health Cambodia are both run by Denise and Gary Love, two Australians who have been living and working in Cambodia for nearly 20 years. Denise and Gary fund their own cost of living and also donate a lot of personal funds to the organizations to keep them running. 

While I was learning about theses organizations, I was struck by the commitment to listening to the Khmer communities and responding to what the Khmer people say they want and need. Here are the words used on the Life Options website: 

"We come with an open heart and and determination to hear. We are determined to listen and be guided by the village people. We will know when our job is done when Khmer people feel empowered to support and train others in their village, city or country." 

It was this fact, among others, that really stood out and helped me reach the decision to go live and work in Cambodia for 3 months. 

Midwife International is a fairly new organization dedicated to training midwives. Here is what they say about their mission: 

The mission of Midwife International is to improve women's health and birth outcomes by providing excellence in midwifery education... Our solution is to train midwives who will be equipped to provide high-quality maternity care in a variety of settings, especially in resource-constrained regions where birth outcomes can be improved, and the need for professional midwives is greatest. Our comprehensive academic and clinical programs encourage participants to develop themselves as leaders (not just practicing midwives) who understand world culture and women's issues, embrace civic participation, and promote the development of midwifery as a whole.

I chose to work with Midwife International because I am hopeful about the vision they have for transforming the overseas midwifery education is accomplished. For example, a beginning midwifery student must spend a year observing, doing community service, and studying midwifery in classes before being allowed to act as an assistant at births. To me, this demonstrates a commitment to only allowing students who are competent and prepared to work directly with the women in the sites that Midwife International partners with. 

How is Jaqxun preparing for this trip?
This decision was made with a little over a month to prepare. I am doing my best to learn Khmer, the language most commonly spoken in Cambodia. There are other dialects and languages spoken there, however, and I expect communication to be a challenge. I am also learning everything I can through books and media about the history of Cambodia. I am trying to focus my efforts on first-hand accounts from Khmer people. I am doing all the other usual things, buying plane tickets, culturally appropriate clothing, getting vaccinations, etc.  I want to arrive in Cambodia ready to listen and learn with an open heart, leaving everything I think I "know" behind me. 

Can I donate supplies I already have?
Yes! Please contact me through Facebook to discuss direct donations of materials. 
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Jaqxun Darlin 
Minneapolis, MN
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