Rosemary Shikari, 34, started Mama Toto Childbirth and Breastfeeding Educative Services to support mothers through the pregnancy, labour and postnatal period. She tells Irene Ingolo how her own struggles birthed the idea
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I studied clinical medicine at Lake Institute of Tropical Medicine, Kisumu and later worked work as a programme officer at Kenya Medical Research Institute (KEMRI).
I am a mother of two. After my first child was born, having gone through the experience of being a first time mother, I felt it was important to always be there for my friends -- from the time they were pregnant until the time they delivered. I would rush to the labour room to cheer them up and encourage them. It ended up being something I was passionate about and my friends were so used to me acting as their ‘personal doctor.’
However, when I was expecting my second born in 2014, I really had a rough time. I remember going to my friends to cry about morning sickness but all they could tell me was, ‘you are a medic, you should be able to battle all of it by yourself.’
I was so depressed and I realised that if as a doctor I could not handle it, what of those who were not medical practitioners? That was when I realised that pregnancy is not business usual but something that has to be taken seriously as it comes with various health challenges.
So in September 2016, I quit the job to pursue my dream of starting a breastfeeding educative initiative to help couples, and especially the first time mothers, who face a lot of challenges including post-partum depression. By January 2017, I had started the initiative, which I named Mama Toto Childbirth and Breastfeeding Educative Services.
To boost my skills, I went for specialised training by Elizabeth Project International in Childbirth Education and Lactation. I was also trained as a pre-natal educator by Tunza Mama, an affiliate of AMREF.
What happened next:
I also got mentorship and support from Lucas Wadenya, the director of Stipa, a community based health insurance in Kisumu.
My initiative works together with Stipa organisation. So far, we have supported 2,500 women under an umbrella called Safe Motherhood Project (SMP). Through SMP, we sponsor women who are in need of our services but cannot afford it and support them throughout their delivery journey.
I have learnt a lot in this field, especially the pain a patient experiences when she loses a child. I now know how to support such a patient and approach various issues.
Like the scenario where a couple is expecting a baby boy and have even shopped for male clothes and toys but they get surprised by the outcome. At this point, most mothers are left in despair; they feel disappointed. But as an agency, we are there to cheer them up and give them all the support they need to recover safely and accept their blessings.
We advise pregnant couples on what they need to do, what to refrain from, how to make their pregnancy journey memorable and how to manage their expectations. After delivery, we offer home visits to observe the status of the baby and check if they are feeding appropriately and then advise the mother on what to do.
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Many mothers have a difficult time when trying to breast feed their babies for the first time. If, for example, the baby does not get enough milk or refuses to suckle, we have mechanisms to assist the baby to suckle because many a time, the problem is with the mother’s nipples. Many a time, the mother has dimpled or inverted nipples. In this case, we provide them with artificial nipples called vacuum pump which are placed on the nipples to facilitate the flow of milk to the baby’s mouth.
For us, the patients matter a lot and besides office services, we even prefer home visits for breast-feeding mothers where we can get both parents and educate them better.
Running a start up:
It was tough at the beginning because this was a new and unique concept in Kisumu. I am so far the only one who has such a programme. Convincing mothers, doctors, midwives and general public that a couple needs to attend a childbirth education in preparation for birth has not been easy. The phrase “why fix it and yet it’s not broken” is what they thought.
I am still struggling to convince them and I rely on the clients that I have supported for referrals.
Mama Toto is my everyday office. I wake up every morning so that at the end of the day a mother somewhere will be writing a positive story on labour.
I am not only a professional child educator but a friend to expectant couples because I take them through all the steps they need to follow from pregnancy.
At Mama Toto, we walk with mothers even up to the labour rooms because at the end of the day, our main aim is to encourage and support them psychologically.
Mama Toto offers four birth preparation classes: labour support, breast feeding classes, post-partum home visit, introduction of complementary feeds and grief counseling.
As much as some of these services are offered in hospitals, ours are much more compassionate and responsive. At times, we attend to our clients at their homes because pregnant women are always tired, especially at the period of the third trimester when visiting a mother at home makes a huge difference. They are able to be themselves and it is also a good opportunity to engage both parents.
The journey to the hospital for clinic appointment can be a huge strain on a pregnant woman. She might also feel compelled to try to disguise any facial changes and swellings with makeup. Upon reaching the hospital, she might also be subjected to long queues.
As long as one is dealing with maternal health, there are both happy and sad moments. In one incident, everything was very fine until the last minute when things just changed and a client lost her baby. It was so sad but we came in and offered grief counseling.
At some point, our clientele multiplied so fast I could not handle all of them by myself. I hired five child birth educators. They assist me in providing services especially when it comes to home visits.
Where I am now:
I am happy that I have supported over 800 mothers who have delivered successfully. Most of them are able to tell positive labour and parenthood stories.
We recently held a free expo where we offered child birth education, lactation counseling and advising the parents on the right food for babies.
I am working on an exercise to uplift maternal awareness through educating and supporting women. I believe that cultural expectations force some women to conceive -- for example when their spouses or relatives are looking for a certain gender of a baby. I want to reach out to as many women as possible and sensitise them on the importance of self-awareness and reproductive health.
Patience is key. Passion and persistence to champion maternal -- infant health has been my driving force. Business people should have a driving force even when there is no financial breakthrough.
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