Dr. Sawyer Serving with Samaritan's Purse

Dr. Sawyer Serving with Samaritan's Purse
Papua New Guinea

Monday, January 30, 2012

Newborn Mortality in the Hewa

This year we are going to spend one of the weeks (June 7-14, 2012) in Papua New Guinea working with a tribe in the Enga Province.  A friend of mine and his wife have been working with these people for over a decade now.  He asked me if we could come and work with some of the leaders, as their newborn mortality rate was unacceptably high.  I wrote to him and asked him why this was the case, and this is his nearly unedited reply.  I have removed their names from the letter.

Dear Allan,

Newborn mortality was extremely high before we first arrived in Hewa in Jan of 2000; I would venture to say it was at 85% or higher.  Bonding between mom and baby took a while and they never named the child until he was 3 months old because they often died before that age. Most of the deaths had to do with the self-destructive cultural spirit-appeasing practices of the tribal folks. As we learned their language and developed relationships with the Hewa and my wife started assisting in childbirth, we were able to save most of the babies of the that we had assisted.

Hewa Woman
The women, however, have been hesitant to release their age-old practices passed down from their ancestors. One of the big factors was their belief that they could not touch a newborn baby at all until the placenta was delivered for fear an evil spirit would gain access to the child and mother. Often the baby would lay un-assisted on the dirty and drafty slat-bark floor, of a hut often shared with pigs, for hours until the placenta was finally delivered. If the baby ‘fell out’, which was always at least a 6 inch drop because they squat, with the cord around the neck, it would stay like that until the placenta was delivered because nobody was allowed to untangle it.

Because the babies were chilled at birth, this caused them to be susceptible to pneumonia, so they often got sick and died just one to two weeks after birth. Since there was no medicine back then, they had no way to fight off pneumonia. Also, for many years, our people would ‘let’ a newborn, or anyone for that matter, die because they didn’t believe medicine could help because they believed it was a spirit possessed lady or child that actually caused the sickness.

Because of their lack of access to stores, they also did not have clothing, blankets or even a towel to wrap around the baby, so the babies got chilled. Another contributing factor was, and still is, the use of a rusty knife/razor/machete to cut the umbilical cord. I always have brand new razors for the ladies that I know are giving birth but our hamlet is small and the Hewa people are many. When cutting the cord, they do not tie it off and often leave it long.  The cord falls between the baby’s legs and gets contaminated. The nursing mother culturally ‘must’ squeeze her milk on the cord opening every time before she puts her milk in the baby’s mouth. This keeps the cord wet and susceptible to infection.
Hewa Child

Another factor contributing to newborn mortality they do not understand that when a child is spitting up or coughing, they should raise the head a bit to let them get it out.  It just is not a natural thought to them. Another factor is their practice of keeping babies in a string bag or bilum. When the un-burped baby spits up his milk, he cannot move around in a bilum, from side to side, to let it drain to the side. He aspirates the milk. The bilum is very constricting. I would love some ideas of alternatives to bilums. 

They are unable to lay their newborn on the ground on blankets while they work because the rats in our area eat our people’s feet and the dog’s ears etc. Another factor to infections with our newborns is the practice of cutting the belly of 1 month old newborn babies with a razor about 25 slices (not deep but enough to let a small amount of blood out. They believe it is a way to prevent them from having swollen bellies.  Bloodletting is still practiced in Hewa.

Our ladies also smoke and chew beetle nut while pregnant.  My wife has taught on the dangers of smoking but it doesn’t seem to have any impact so far.  We really don’t know if chewing beetle nut has any negative effects.

Now the biggest problem in the Hewa area seems to be hemorrhaging of the mothers and retained placentas. Even with my wife’s help we have lost a few women because they were too embarrassed to tell my wife that they had started bleeding.  I’m sure you have heard about the dread of contamination from women’s blood in PNG cultures. Women are often scared to death of being sued (it happens all the time). They cannot travel during childbirth because they will ‘contaminate’ gardens, food, water or firewood and thus render them unusable. They will then be sued. Therefore, they often avoid talking about their bleeding when it is actually critical that it be discussed out in the open so they can get help.

My wife has done a lot to try to teach the ladies about birthing practices, but we feel that education from a medical team is going to have a far larger impact than our tiny efforts. We have about 4 men that have completed the Village Health Volunteer (VHV) program and 3 more that my wife has been teaching. These young men are doing fairly well, but this whole area of childbirth is a huge hurdle that still needs to be overcome. As you know, it is a subject that is strictly taboo for men, so our efforts are not without their challenges, but we feel the Hewa are ready for the next step in their education practice, and we deeply appreciate your assistance. Even though there are no women that understand the Melanisian Pidgin language, we feel the men who have developed the ability to administer medical care have advanced enough that they will be able to translate and continue to re-teach your presentation.

Jonathan, Mikayla, McKenna, Susan & Micah Kopf

The saddest part of the Hewa culture is the killing of women and children suspected of being witches. Every time we lose a mother in child birth or a man or child to sickness, we lose a child or another lady in a horrible murder raid.  It is devastating. In all of Hewa, it is nearly impossible to find a married man that has not murdered a lady or child in the past. They have often participated in killing many. The believers in our tribe have denounced that practice and just started taking a stand against it in the last few years. Our people have even housed a ‘witch’ in our village while we tried to find a place for her in PNG that would be safe. It has been so exciting to see the gospel take hold.  Unfortunately, our neighbors, the Paiela people, are also participating in killing our Hewa ladies and children so it has been sad. They really don’t believe the illness that killed their relative was caused by malaria or pneumonia or AIDS or by mercury poisoning (when the young men pan for gold in the rivers they use mercury to get it ready to sell to gold buyers). They believe all deaths are caused by witches eating the sick person’s insides. They believe that if they do not kill the suspected witch, she will kill some more. I’m sorry if I’m repeating myself from previous letters. We are grateful for your help in giving the people of the mountains a new Biblical perspective that will forever impact their culture.

Please don’t worry for your safety as the Hewa are very grateful for your help and are looking forward to your arrival.


1 comment:

  1. Incredibly heartbreaking. I guess what we all think of as "common sense" is not so common after all. What a privilege you and your family have in bringing practical, life saving knowledge (both spiritually and medically) to people in obvious need of both. You can count on my prayers!!