Speedboats, midwives and ambulances - delivering maternity care on remote islands in Bangladesh

Shaila Kenia cradles her daughter Sinthia, who is just two months old. Shaila beams with happiness as she discusses becoming a mother and says she is grateful to God that they are both happy and healthy. As Shaila outlined above though, many mothers and their babies still have no access to healthcare in the area that they live in southern Bangladesh. 

Welcome to Manpura and Char Fasson, remote islands under Bhola District. Which is home to roughly a million people with extremely limited access to healthcare.  

In these remote islands, with support from the Swedish Postcode Foundation, Concern Worldwide and Partners in Health and Development (PHD) have been working for the past two years with the communities and local government to support the Union Health and Family Welfare Centers (UH&FWC) that provide government health services in rural Bangladesh.  

The project was dedicated to developing a sustainable, locally managed, midwifery-led maternal, neonatal and child health service for women and children, which provides skilled institutional deliveries and awareness-raising services.  

Midwife Eiti Akatar explains: “Previously, people here were unaware of maternal care. The island residents were unaware that going to the hospital was necessary for a healthy childbirth.  

“After our intervention, we gradually raised awareness among them. We launched this project in July, and the first delivery took place in October. Before that, we educated those who visited us, initially, they were very hesitant.” 

Tasnu is a mother-of-five living in South Shakuchia on Manpura Island, she spoke about how much more supported she felt thanks to the project when she welcomed her son, Mohammad, six months ago, compared to when she gave birth to her four older children. 

Tasnu explained: “Before midwives came along, babies were delivered with significant risks in rural areas. Children would die, both girls and boys. There was a considerable risk. Babies had to be taken to the hospital quickly, as they might not survive at home even before the ambulance arrived. 

“(This time) I went to the hospital and midwives gave me a card. Regular checkups were conducted every month. 

“I went to the hospital when I was in pain, midwives gave me their best when I arrived at the hospital. I was in pain due to the lack of blood in my body. Midwives had tried a lot. They rented a speedboat at 3pm and took me hurriedly. 

“They rushed me to the hospital by ambulance, the doctor said that I needed blood. I was given two bags of blood, and then the baby was delivered healthy.” 

The cost of the ambulance, boat and medical services were covered under the initiative, a midwife also visited Tasnu and her baby at their home after they were discharged from the hospital.  

She continued to say: “Pregnant mothers have benefitted from this center. My first four children were born with many risks and difficulties, I didn’t receive this level of service during the delivery of those four children. 

“Now it’s convenient for doctors and midwives to understand everything, ensuring the well-being of the baby, preventing harm, and ensuring a safe delivery.” 

As well as supporting women and their babies during the birth, there were also awareness sessions, covering topics like nutrition, hygiene, and general wellbeing. 

Shaila said: “I learned from the mother sessions about the symptoms that indicate risk factors for the baby and mother. Then how many times to do checkups during pregnancy, to eat nutritious food and take care of the baby.  

“We, as well as the elders, have become aware through the mother sessions. Before, they thought that no harm would happen by doing heavy tasks. Now they have become aware and forbid us to do any heavy work because it will cause harm to the baby.  

“People who live far can’t come to the health center so a satellite clinic has been set up there and midwives visit them to check up on them, give them medicines and any other necessary help.” 

Like most parents, Shaila has already started dreaming about what baby Sinthia’s future may look like. 

“We used to be very anxious about the baby and mother’s wellbeing during the labour before the midwives came. We feel very assured that the delivery will be risk-free when the midwives deal with it. 

“Just like the midwives here are providing health support, I dream of enrolling my daughter into midwifery and see her become a midwife and help people.”