TAMBACOUNDA, Senegal – In a hospital delivery room here, a 20-year-old woman on a rusty bed goes into labor surrounded by local midwives, known as “matrone.”
Among them is Michiru Ukai, 28, sent to this West African country as a member of the Japan Overseas Cooperation Volunteers in March 2007.
In less than 30 minutes, a pair of tiny legs appear. The baby is in a breech position. A matrone desperately tries to pull the baby out, but it is a struggle. At last, the head emerges, but the baby is silent.
Ukai tells the matrone to slap the baby’s back, and after a few minutes, the newborn begins to cry. Relief pervades the room.
“You can relax now. You’ve given birth,” Ukai tells the mother in the local language. The baby girl weighs 2,400 grams.
“In Japan, it was a Caesarean section case,” Ukai would say later. “Here, you never know until the last moment whether babies have been born safely. When I hear the sound of crying, I always feel relief.”
Ukai was born in Saitama Prefecture in 1979. When she was a sophomore in her university’s nursing science department, she attended a childbirth for the first time as part of her practical training. The experience led her to become a maternity nurse.
“I still remember the expression on the mother’s face when she gave birth,” Ukai said. “I thought, how wonderful to be able to give birth and become a mother.”
After graduating, Ukai went to work as a maternity nurse at Shizuoka Hospital.
Although she enjoyed her job, she quit after four years because she had doubts about working at a large hospital, where there was only short-term help before and after childbirth, and little contact with the mothers, babies and their families.
Something also bothered her in conversations with pregnant women. She got the impression that many cared more about their careers and were not pleased to have become pregnant.
After quitting the hospital, she ran across a Japan Overseas Cooperation Volunteers advertisement on the Internet for maternity nurses. She decided to apply for a job in Africa because she wanted to work in a challenging environment.
When she reached Senegal, the reality was much harsher than she envisioned. At the hospital in Tambacounda, which she visits twice a week, there are two stillbirths a month versus only two or three every four years at a Japanese hospital. Malnutrition and malaria appear to share the blame.
When there is a stillbirth, only Ukai cries. Neither local staff nor even the mothers shed tears. The mothers simply return home as if nothing has happened. For Africans, death is more immediate than for people in other parts of the world, she feels.
According to UNICEF statistics, Japan’s infant mortality rate for children less than 12 months old was three per 1,000 in 2006, and four per 1,000 for children less than 5 years old. In Senegal, the figures were 60 deaths per 1,000 for less than a year old, and 116 for less than 5 years old.
The infant mortality rate in Senegal and other countries in sub-Saharan Africa is high because many people live in remote villages with scant access to medical facilities, not to mention there’s a chronic shortage of doctors, nurses and other medical staff.
“In Africa, childbirth is part of daily life. Contrary to nuclear families in Japan, large families are common here. It is natural that there are pregnant women and babies at home. Women risk their lives in giving birth to children, but it is ordinary happiness,” she said.
If women in Japan come to think of childbirth as a happy event, more women would want to have babies, which can solve the problem of the falling birthrate, she said.
Ukai is scheduled to return to Japan next March.
“I would like to work at a maternity hospital in a small town in Japan and become a midwife who can monitor people before their births, see them be born and watch them grow up,” she said.