The Rural Health Center currently serves between 14,500 and 15,000 individuals from 12 different catchment areas and over 30 different villages. Four of the current catchment areas are over 20 km from the clinic. Based on population, annually, the clinic expects to have 610 births or about 51 births monthly. Furthermore, the four catchment areas that are 20 km or more from the clinic comprise of the expected average of 231 births per year. In the past two years, the clinic has received no more than 32 births in any given month. After meeting with 22 different headman in the area, the largest identified problem is the lack of available space at the clinic for mothers to reside prior to and after giving birth; therefore there is a substantial amount of home births still being practiced. During community entry, the most common discussion centered around the clinic and community member's desires to build a maternal shelter. Not only was I told many stories of newborns being brought to the clinic due to a complicated home birth from my clinic staff, but at least two community member's shared stories with me about how they had given birth on the way to the clinic. At least one of these stories ended in a fatality for the child. Many mother's feel if there were space available for them prior to and after giving birth, they would have gone to the clinic as opposed to their homes. All over Zambia, pre- and postpartum complications attribute to the high rates of maternal mortality. The community identified the best way to address these needs is with the construction of a maternal shelter. This shelter will better address the complications some mothers face in order to lower mortality rate and promote healthy beginnings in children's lives.
Throughout community entry, both headman, clinic staff, and community members approached me to discuss the possibility of constructing a maternal shelter. After working with and learning from previous volunteers, the community has shown their commitment to empowering women with tangible space to have healthy births. First, myself and the head nurse at the RHC formed a Project Committee consisting of 10 members who would spearhead the project including coming up with a budget, timeline, and ensure the construction goes smoothly. After a community meeting with over half of the local headman, community members, clinic staff, and the project committee, the community decided to put this project in motion. Together, they decided their contribution to this project would be through the donation of sand, stones, water, and bricks. As of current, there are more than 5 tons of sand near the intended site of the maternal shelter. Furthermore, community members have taken turns during their free -time to clear the land in preparation for construction. The design of the Maternal Shelter was provided by DHO as well as the proposed bill of quantity. Community members have graciously donated their use of oxen and carts to carry bricks to the site. Currently there are 3,500 bricks set aside for the construction that were created and donated by community members with at least 500 more promised. I am confident that not only are the stakeholders and committee members committed to this project, but community members have shown their full support and dedication to this construction to improve the overall health of their community.
Being a third generation volunteer, I have witnessed the effects of my predecessors. I have confidence that this will continue even after I am gone and when Peace Corps no longer has a presence in the community. Community volunteers are already successful in giving important health talks to mother's and will continue to provide the community with education regarding the need to utilize this maternal shelter to promote giving birth in the clinic. Furthermore, by including NHC members and opening these monthly meetings up to the public, participants will be able to disseminate the information throughout the community. Previous volunteers have built an insaka to be utilized for under 5 weighing; not only is this an important structure to the community, but it is evident it has been cared for to promote it's longevity. Secondly, the initial community contribution and displayed commitment gives me the utmost confidence that the maternal shelter will be left in good and capable hands, ensuring it is kept well for generations to come.