Hero community health worker in Mbaula, Limpopo, delivers baby during flood disaster

On Wednesday, 14 January, floods caused by a low-pressure system that began in Mozambique, but quickly moved into the neighbouring South African provinces of Mpumalanga and Limpopo, caused immense destruction. Homes were gutted, roads washed away and more than 30 lives were lost.

At the heart of the areas most affected by the floods was Mbaula, a village in Giyani, Limpopo. Daily Maverick reported about homes and lives that lay in ruin in the aftermath of the extreme weather event, but in the words of Mbaula resident Maggie Sethagane, 14 January was also the day “God performed a miracle”.

It was on this day, as the Mbaula River swelled and flooded part of the village, that Sethagane, with no medical equipment or access to healthcare services, helped a young mother bring new life into the village.

Sethagane has been working as a home-based carer since 2001. In her role as a community health worker, she takes care of the sick, visiting them in their homes, explaining treatment and assisting them to take their medication correctly.

But on the first day of the floods, she found herself taking on another role – midwife.

Late that evening, Evidence Ramoshaba, a pregnant mother experiencing contractions, came to Sethagane’s door asking for help to reach the local clinic as she was in pain. The nearest health facility, Makhuva clinic, was in a neighbouring village, which could only be reached by roads that had been blocked by rapidly swelling rivers.

“I told her, ‘It is impossible for me to take you to the clinic because there is no road. It has rained a lot. And even if we used the road through Phalaubeni… to get to Makhuva clinic, there is a river ahead. We won’t be able to pass,’ ” Sethagane recounted.

Read more in Daily Maverick: Limpopo’s villages are a site of wreckage and resilience as floodwaters subside

With no other option, Sethagane advised Ramoshaba to return home and wait with her sister-in-law until it was time for the birth. A few hours later, when the mother’s family told Sethagane that the situation was becoming dire, the home-based carer came across to assist. She had no equipment, not even gloves, as the clinic issues these to community health workers on an as-needed basis.

“I told her, ‘Push, push, push, there is no other way’. She pushed, and the child came out. At that point, we didn’t have a razor [to cut the umbilical cord], we didn’t have anything. We didn't know what we were going to do,” said Sethagane.

She told Ramoshaba to sleep, with the baby in her arms, until they could figure out what to do.

It was only the following morning that Sethagane, along with Ramoshaba’s mother, was able to organise a razor and purchase wool from the local seamstresses, who sewed xibelani, traditional Xitsoga skirts. Using those two everyday household items, Sethagane was able to cut the umbilical cord and discard the placenta.

“We took a risk, but there was nothing else we could have done,” said Sethagane.

“The child was born on Thursday, 16 January… The child only went to the clinic when she was three days old on the 19th because … the roads were not alright. You could not use them. It was basically on Monday that I took [Ramoshaba] to the clinic when I was going to work. That’s when they checked her to make sure she was alright, and the baby as well.”

The baby girl, Kutshemba, which means “hope’ or “believe in” in Xitsonga, was found to be healthy despite the unusual circumstances of her birth.

“This child was born on the day of the disaster. She came on a very hard day, a day with problems… God performed a miracle by making sure this child was born okay, even though she wasn’t born in a clinic,” said Sethagane.

Cradling a sleeping Kutshemba in her arms, a quietly-spoken Ramoshaba told Daily Maverick that she chose to give her child that name because the manner in which she was born held no promise that the baby would survive.

“It was 10pm or 10.30pm, and the rain was falling hard. It was raining so hard... there was no way we could leave the village. There was water everywhere, and the bridge to Makhuva was blocked. There was nowhere to go, but we did try our best; that’s how the baby was born at home,” she said, motioning to the house.

Ramoshaba said she had lower back and abdominal pain for three days with no access to medication before she could seek medical attention at Makhuva clinic.

Access to health services

Sethagane is a contract worker for the Makhuva clinic under the Limpopo Department of Health. Her work can be a bit inconsistent – some weeks she’s on, others she’s off. She said her lack of matric had held her back from being permanently employed.

In the early days of her career in community health, Sethagane was a volunteer under a non-government organisation. It was not made clear to her and her contemporaries then that not having a matric would hold them back down the line, she said.

“I personally don’t feel happy because the health department didn’t hire me [permanently]... The job we do is very hard. Some people have tuberculosis, others have HIV… We change [nappies] and even bathe sick people, but the department doesn’t care about us,” she said.

Another issue is the difficulty in accessing health services in the area, noted Sethagane. Some villages, like Mbaula, do not have their own clinic, forcing residents to travel long distances for care.

“It is hard to get to clinics or hospitals from Mbaula. If only the government could come and build a clinic for us… If you don’t have the money to hire a car, the possibility is that you will die at home, but the government does not see this. Many white communities are progressing, but here, many children have died because they couldn’t get to the clinic,” said Sethagane.

A mobile clinic visits the area once a month, along with an ambulance, she said. However, at other times it could be difficult to get an ambulance out to the village.

“That area is small [where the mobile clinic is placed], but if they can [build a permanent clinic], it will help us a lot. A person who is about to give birth would not have to go and find transportation to get to a clinic in town,” said Sethagane.

“There are people with sugar diabetes and high blood pressure here… Someone who has [diabetes] could just suffer an attack, and then we have to go through the process of finding transportation and rushing to the clinic in town. By the time you get there, that person has already died… What is the health department’s response? They have nothing to say about the lives of people; they have nothing to say at all.”

Daily Maverick asked the Limpopo Department of Health about any interventions in place for communities without a hospital or clinic, but had not received a response at the time of publication. DM