Dar Es Salaam — TRADITIONAL midwives have been there since time immemorial and their contribution in helping mothers to deliver safely especially in rural areas cannot be underestimated.

However, experts say that the time has come for traditional midwives to go for training on safe delivery as there has been an increase of diseases that require delivery assistants to be well equipped before taking care of pregnant women. In Mwanza region, reports indicate that over thirty per cent of maternal deaths in a year emanates from infections acquired from traditional midwives.

The Regional Medical Officer, Dr Meshack Massi, says there has been a programme of training traditional midwives to help mothers deliver safely but only a few of them have participated.

He says though the government was working hard to bring health services closer to people, maternal and infant mortality would not be phased out completely if the traditional midwives are not be ready to go modern. Over 200 women die every year in Mwanza region due to pregnancy related complications, thirty per cent of which are caused by infections acquired from traditional midwives.

"We are not against the traditional midwives but the problem is that most of them shun the training and as a result they have been causing more harm to pregnant women than help as they lack skills on hygienic aspects," he says.

The doctor says some traditional midwives have gone as far as providing technical expertise to pregnant women making them reluctant to attend clinic until when the labour pain starts and when traditional midwives fail to provide assistance.

Dr Massi explains that for the past ten years the trend of maternal mortality in the region has remained high. The RMO was speaking amid a recent tour of the city by the East African Caravan on Maternal Health on its way to Kigali, Rwanda before it makes its final destination to Kampala, Uganda where a special message from East Africans will be presented to the AU summit of head of states on maternal and newborn deaths.

Dr Massi notes that to address the situation, the region's health sector has embarked on training to pregnant women on the importance of attending clinic from the 16th weeks after conceiving and follow the medical officers' instructions.

He said that Mwanza, the second largest city in the country, has a fast growing population which is now estimated to be over 3.7 million people hence more challenges on maternal health, asking the government to consider increasing the region's health budget.

Speaking at Makongoro Maternal Clinic in the city, the head of the caravan, Dr Angelina Dawa, who is also the Director of ABANTU for Development of Kenya said the campaign was aimed at pressuring governments to increase health budget to 15 per cent of their respective national budget as per the Abuja declaration.

"We all know that road accidents have won a huge concern among leaders in the continent, and when they happen they always send condolences to the bereaved families but seldom do we hear such concerns on maternal deaths. We want leaders to act now and ensure that no woman should die while giving life," she said.

She said that the year 2010/2020 has been declared by AU as a decade for African women, adding that with maternal deaths ranked high in most African countries, the declaration would have less meaning if leaders won't act positively.

"Taking the caravan across East African countries will help us present our stand as the people of one community -- East Africa Community -- and if we succeed in bringing changes, it would be for the region's good and the continent at large," she said.

The Caravan which begun its journey in Nairobi early this month was scheduled to reach its climax in Kampala, Uganda where the petition signed by East African women and men would be presented to African leaders attending the AU Summit on maternal and newborn deaths.

The Ngaranaro Health Centre's Doctor In-charge, Dr Japhet Kivuyo says that maternal deaths in Arusha Region have also remained high because of infections acquired from traditional midwives and the advices they give which depend mainly on experience.

"On our part, we have taken precautions including proposing possible dates in which a pregnant woman is expected to come for delivery, we also tell them what the risk signs are ...but when such signs happen, traditional midwives would tell them that it is a normal thing," he said.

Dr Kivuyo noted that such women whose doctors' advices are being intervened by traditional midwives are the one who in most cases lose their lives as they decided to go to hospital when it was already too late.

Bahati Samson (60) is a resident of Mto wa Mbu area in Arusha. She is a traditional midwife whose experience in the service has lasted for over a decade now. She understands that the world she lives in today is quite different from what existed ten or 20 years ago.

"Then, it was a normal thing to provide services without protective gears, but with increased diseases, the change on how we operate is inevitable," she said.

Ms Samson could stand as a role model before other midwives because at the time she granted this interview, she was at Mount Meru Hospital escorting her in-law to attend clinic. She does believe much in professionalism.