It’s 8am in Kibera, and the aroma of fresh chapatis and milky tea wafts through the air. Kaia’s house feels like home, even on the first visit. It’s a place where you’d want to curl up on the couch and watch the news while someone hands you a steaming cup of tea. It makes sense for it to feel this way, seeing as so many new lives have been ushered into this world in this very house.
Outside, a bunch of kids squeeze past each other in the narrow corridors between houses, eager to go play, or count cars on the road. Many of these kids were brought into this world, kicking gently yet firmly in the way that newborns do, by Kaia.
Kaia Mwikya Nzeki is well above 80 years old, but still sure of herself and in control. The locals call her ‘Shosho Ann’. She mostly speaks in Kamba, and uses sign language too. But every once in a while she will give an instruction in Swahili, “Hapana shika mtoto kichwa,” in that stern way that reminds us of our own grandmothers. But her clients understand her, and most importantly they trust her, even though they may not speak the same tongue.
She has served this community for nearly three decades, having come to Nairobi herself to assist her ailing daughter with delivery and raising the children. Her name has since spread far and wide, with people coming from all over the country, as far as Kisumu and Mombasa, to seek her services.
Kaia is a midwife. But that doesn’t fully encompass what she does. If you ask her, she’ll say that she mostly helps out before birth, with massaging pregnant women’s bellies to reposition children who are breeched, and ease any pain that they may be in. But because childbirth is an unpredictable thing (and how would it not be, when it’s literally life coming to?), a lot of times, she’s had to deliver children, and sometimes in the middle of the night, because the women are in extreme pain and there’s just no time, or money, to get to the hospital.
Her recommendation to everyone still is that they should go to hospital immediately after she has delivered the child, and even before if they are in any pain, but we all know how hard this can be, especially with the government-sponsored safe motherhood program ‘Linda Mama’ program being scrapped, a lot of women can’t afford even the consultation fee that’s needed before seeing a doctor.
She does charge for her services, but the payment isn’t mandatory. She says that for her, the main priority is for the mother and child to be healthy and well.
A testament to this is the fact that mother and child mortality rates have dropped since she started this service for Kibera, and no mother or child has died in her hands, which is not something any of our hospitals can boast about.
Kaia was born with this gift, and has delivered babies since she herself was a little girl. A gift, because she can place her hands on babies and know what ails them, even when doctors and lab tests cannot figure it out. She can look at a child and immediately tell you what they need even before you, the parent, clock that there’s a problem.
She doesn’t only help with new life, but loss too. For women who’ve suffered a miscarriage, she has a concoction of traditional herbs that she uses for their aftercare, that also help with preventing future loss.
Kaia would want to pass this gift down to anyone who’d be interested to learn so that this skill is not lost and can help more women in future.
Across the road from the section that Kaia lives in, we find Rose Adhiambo. Rose is younger, bubbly, and fluent in Swahili. She started midwifery in Kibera in 1995 after she moved there from her hometown in Siaya, and her gift has contributed an equal amount of good in Kibera, beyond her small home in Kisumu Ndogo. She tells us her gift was passed down, from her grandmother, to her mother then down to her.
When she started working as a midwife, she was pregnant with her second born, but that wasn’t her first time at childbirth – she had already delivered her firstborn herself, and now has delivered all six of her children herself, and alone. Knowing how to track her labour process, and prepare everything in advance from surgical blades to cut the umbilical cord, cotton wool, a plastic bag to lay down on the floor, five litres of hot water, a fresh pair of underwear, clothes for the newborn, a leso to tie her stomach and ‘tengeneza’ herself with, which is the process of delivering the placenta removing blood clots and any other remnants of pregnancy from her womb, and porridge to drink after she’s done.
The level of care that she gives to herself is the same that she gives for her clients. One of them is in the room as we speak, and we get to watch her belly and back get massaged so that she’s not too stiff and tired – flexibility is key during labour- and afterwards, we watch them do some exercises. From yoga-like stretches to frog jumps, all this is done to enhance the body’s fluidity. Rose recommends these workouts be done thrice a week, but these workouts cannot be done before the seven month mark, because they can induce early labour.
Much like Kaia, she insists that the mothers that come to her go to hospital too for antenatal visits, childbirth, and checkups once the children are born, but they have the same complaints. They can’t afford the hospital fees, and they face a class bias from the hospital staff meaning they don’t get proper treatment, which has in some cases led to death of the mother and/or child.
She also boasts of a zero mother and child mortality, and will still offer her services even if the parents cannot afford it.
Thankfully, Rose’s expertise extends to services offered in hospitals. She can measure blood pressure by tying a cloth on the upper arm and feeling for the veins, attentive to how the blood flows. She can also read clinic books, so if a mother has already paid visits to the hospital, she can study their progress and understand any diagnosis they were given.
In situations where the mother needs urgent medical attention, she has to move fast – like in an scenario that she gave us where a man had physically abused his pregnant wife leading to a miscarriage, but because they couldn’t afford to get the D&C procedure done, they put it off until the foetus’ body parts started disintegrating inside her, and one of its legs came out. Panicked, her husband dumped her at Rose’s house, something that Rose says is a common occurrence; men being violent and unsupportive to their pregnant wives, and wanting her to take the blame if their complications kill them. Rose had to pay for the mother’s transportation to hospital, and thankfully her life was saved.
Rose has been in some intense situations, another one being the time where she had to help with an underage girl’s birth process. The girl was just 14 years old.
Her quick mind’s ability to handle situations like that, and give these women encouragement in such tense times, is what has earned her a reputation as a trusted midwife far and beyond, even conducting training in conferences across the country.
Since the ‘Linda Mama’ program became a thing of the past, she’s seeing more and more women go back to the midwife route. Even after birth, she’s able to offer guidance to the mothers, but more out of her own experience as a mother of six children.
She also doesn’t underscore the importance of traditional herbs in helping with different aspects of childbirth. Her go-to is a root she shows us that she heats up using fire, and recommends the mothers to chew on to speed up contractions and induce labour.
Kaia and Rose both tell us that their priority isn’t getting money but ensuring that these women and children to whom the government has turned a blind eye, still get a chance to safely deliver their children. Using a mixture of traditional and modern methods, they have offered hope to communities otherwise forgotten, making sure we don’t lose our African roots and healing practices, but also keeping in touch with modern medicine.
These unsung heroes have saved countless lives for decades.To Kaia Mwikya Nzeki and Rose Adhiambo, we thank you.
Writer: Ngito Makena
Photographer: Edwin Ndeke