Transition from traditional to professional midwifery (West Africa)
Milton Margai, a doctor and the first post-colonial President of Sierra Leona in 1961, organized one of the first programmes of recruitment and incorporation for traditional Sandea midwives into health training for women. These midwives, of recognised standing among the local peoples, taught songs about obstetrics, prevention of venereal diseases and basic hygiene, using music from traditional songs. They applied their botanical knowledge during labour, which usually ended up with the mother squatting. They used Ficus exasperata or Carica papaya to regulate contractions.
10 years of war, together with a complicated history, combine so that in 2015 the country had the highest rate of maternal death in the world (1,360 deaths per every 100,000 deliveries), despite the fact that 60% of deliveries are attended by professional medical staff. In Nigeria only 35% of deliveries are attended by professionals and maternal deaths, though high (814 per 100,000 deliveries) are considerably fewer than in Sierra Leona.
Photo, Ángel Otero