A melting pot called Hillbrow

Hillbrow - [Source: 2summers.net]
Hillbrow – [Source: 2summers.net]
Roselyne Sachiti, recently in JOHANNESBURG

Hillbrow, South Africa, is a unique settlement, crowded and bursting with many social challenges. It houses criminals, sex workers and drug peddlers and has a high HIV and TB prevalence. South Africa has an HIV prevalence of 18 percent. In this part of Johannesburg, one finds

many South Africans and thousands of migrants seeking greener pastures.

Zimbabweans make up a huge chunk of migrants living in what urban planners there call slums in the sky as one apartment houses up to four different families.

With their families back home, most Zimbabweans in South Africa lack family support in times of illness and bereavement.
There are an estimated 3 million Zimbabweans living and working in South Africa.

Many women in their reproductive ages, too, fall pregnant there, get free maternal services but also face challenges.
Back home, women expecting their first child usually stay with their mothers or older female relatives during the last few days of the pregnancy.

They return to their husbands a few weeks after delivery.
Their mothers, aunts and sisters easily offer advice outside hospital care and most importantly when the baby is born.
With such family support lacking for the migrant woman in South Africa some have found new hope in mobile technology Mobile Alliance for Maternal Action (MAMA).

A mobile/private partnership between the Gauteng Department of Health, Vodacom Foundation, Altech, Altron and Wits RHI, the Shandukani Maternal Health Centre in Hillbrow provides expert medical care to pregnant women and children.
Zimbabwean women top the number of migrants who deliver at Shandukani Clinic.

A nurse at the clinic, Sister Esther Mabanga, says three quarters of migrants who give birth per week, six are usually Zimbabwean women.
She confirms that most of these women are usually alone and lack family support.

And as such, she says, most access the MAMA service, which delivers health information via mobile phones to new and expectant mothers.
Hosted by the United Nations Foundation, MAMA provides age and stage-based text messages aligned with global best practices, empowering women to make the best decisions for themselves and their families.

It is also an effort to meet millennium development goal 4, which calls for two thirds reduction in the 1990 under-five mortality rate and MDG 5 which calls for a three quarter reduction in the 1990 maternal mortality ratio and universal access to reproductive healthcare.
South Africa’s target for MDG 5 is n38 deaths per 100 000 live births, which is highly unlikely to be realised come the 2015 deadline.

In South Africa, the MAMA project was an instant success since 25 percent of mobile phones owned by people in that country are capable of accessing data services.

Shandukani medical officer Dr Nicola Wattrus said MAMA South Africa was officially launched in May last year and had reached out to more than 350 000 women and their families.

“South African, Zimbabwean, Nigerian and Ethiopian women come here for their ante-natal and post-natal care and are also benefiting from the MAMA service. We do not turn away anyone. We assist every baby that comes here,” she said.

She added that the SMS service consists of two weekly messages pushed to a subscriber’s phone until the infant turns one year old.
“Women do not often have funds in airtime to sign up via the USSD-based registration process pegged at 20 SA cents/20 seconds. As a result, MAMA has put in place a variety of assisted sign-up methods to help mitigate this issue,” explained Dr Wattrus.

She said the USSD service consists of a set of interactive quizzes twice a week.
“USSD subscribers who request additional HIV content are almost 70 percent. This may be because the information is not stored on the handset once the USSD session has timed out. The cost of the programme is low because it is user initiated ‘pull’ service,” she added.
Dr Wattrus explained how they reviewed local literature on maternal and child mortality and morbidity, especially around barriers to accessing care at the beginning of the exercise.

“We interviewed local medical experts in obstetrics, midwifery, paediatrics, neo-natology, breastfeeding, infant feeding and health and human rights, and conducted a stakeholder workshop with the South African government and civil society organisations in September 2011. The team also interviewed several mothers and pregnant women, including a group of mentor mothers working with mothers, mothers, a non-profit-making organisation providing peer counselling on prevention of mother-to-child transmission (PMTCT).”

Sarah Nyathi (19), an immigrant from Bulawayo, says she has benefitted immensely from the knowledge imparted to her from the time she fell pregnant until when her baby was born.

“I came here three years ago and all my family is in Bulawayo. When I fell pregnant it was just me and my husband and none of us quite understood many things. We were also afraid of what would happen after the baby was born since we were all alone,” said Nyathi, who stays in Hillbrow’s Berea area.

Her baby, Nobuhle, is now three months old and she will be receiving more information until she turns one.
During her pregnancy she would be reminded of her next appointment through text messages.

“At one time, Nobuhle could not breathe properly. It was around midnight and I was scared. I sent a text message to MAMA and a doctor immediately responded and told me what to do. I have been telling other Zimbabweans to use the service,” she added.
She said she also received relevant information on prevention of mother-to-child transmission during her pregnancy.

Nyathi, who works in a clothing shop, says she leaves her baby at a day care centre and pays R500 per month.
“I hope the service also extends to the daycare workers so that they can use it when our children are in their care,” she suggests.
Another Zimbabwean benefitting from MAMA, Nyarai Chipunza (20), said she has had peace of mind since she started using the maternal mobile service.

“I have been away from home for a long time and had my first baby here. I was scared to bath the baby, breastfeed and even put him to bed. I panicked when, one day, he started coughing like something had chocked him. I immediately sent a text to MAMA and the doctor immediately responded and told me what to immediately do. The doctor also referred me to a hospital through the text message,” she said.

The HIV-positive Nyarai also said she also received information on prevention of mother-to-child transmission, the importance of condom use during pregnancy and safe infant breastfeeding.

South African Lucanda Sentiwe (26), also from Berea, Hillbrow, says most women were initially afraid to use the service.
“They thought that they would be giving away their children by signing forms, which asked for contact details and their names. I had to convince some of them to come since I benefitted a lot during my pregnancy. I have many Zimbabwean friends who also access this service,” she added.

Her husband, she says, also received text messages and would remind her of her clinic appointments when she was pregnant.

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