A matter of life and death

A matter of life and death

In a remote area of central Vietnam, a lone midwife is making a vital difference to fight infant mortality

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Y Thuan with her own baby son born at the commune health centre.
Y Thuan with her own baby son born at the commune health centre.
Photos: Leon Lee
In the past, it was common practice for expectant mothers to give birth at home. To make sure everything went smoothly, a midwife would be on hand to help. These days more and more mothers opt to deliver their children in hospital, and the services of midwives are less needed. But that is not the case in rural parts of Vietnam.

A group of Hong Kong students made the discovery during a summer trip to the Southeast Asian country as part of a Unicef Young Envoy programme. They saw how modern medicine and traditional midwifery can coexist.

Y Thuan, aged 23, is the only traditional midwife in her remote village of Te Xo Ngoai, in the mountains of the Tu Mo Rong district in central Vietnam. A trip on dirt roads to Te Xo Nogai is like a journey back to a simpler time, when people lived in handmade wooden huts without electricity and running water.

Y belongs to the Xe Dang ethnic group. She began practicing as a midwife in April 2010 after spending 18 months training in Ho Chi Minh City, and a further three months in Kon Tum City, the capital of Kon Tum province. Her mother was a nursing assistant at a district hospital where she studied the skills of child delivery and then taught Y what she had learned. When the district was recruiting midwives, Y jumped at the chance.

The young woman has delivered about 20 babies so far. She makes house visits, providing both pre- and post-natal care to mothers. When she is called to deliver a baby, she lays a sheet of nylon on the floor and sterilises the equipment and her hands with alcohol and boiling water.


Patients attend an information session at Te Xang's health centre.

Y works with the local commune's health centre to ensure the safety of the mothers. "I always advise mothers to give birth at the health centre because they have better facilities," she says. "But they prefer to have the baby at their own home. They will come to the centre only if there's an emergency."

Health centres like the one in Te Xang commune were recently set up, so locals are still learning how to look after pregnant women. They have been taught about nutrition, hygiene and baby care.

With the help of the government, Unicef and various NGOs, more health centres are being set up in the most remote areas like those in Tu Mo Rong district to help reduce the high death rate among infants.

In Kon Tum province out of every 1,000 babies born, 38.1 will die as infants and 59.5 will die before their fifth birthday. These figures are more than double the country's national average.

Trained health workers hold monthly sessions in villages, teaching young mothers about breastfeeding and telling them how foods, such as eggs and meat, are vital for the development of their children.

Even if mothers might prefer to go to the health centre to give birth, they may decide not to, for financial reasons.

Y delivers babies for free, even though she also struggles with poverty. She makes her living by farming, much like others in the village and province. But she refuses to take any money for her services. "When I was trained, I was told not to charge anything because I'm helping the community," she says.

Previously, she was paid 50,000 Vietnamese dong (HK$18.50) for each case through a project set up by the European Union to improve health conditions in rural Vietnam. But now she makes a living only from farming.

Y enjoys being a midwife and says she feels great satisfaction after helping with each birth. She also plans to continue learning more vital skills. "I want to study more in Kon Tum Hospital. They don't have any specific courses for midwives but there is a nursing course that I would like to take."

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