Choosing her path
When Christine started her career in Kenya as a Midwife, she had always wanted to work internationally. Today, she has worked across a total of 7 countries – Kenya, South Sudan, Pakistan, Afghanistan, Malawi, Zimbabwe and Bangladesh. Looking back on her career, she reflects on the moment her heart was set on supporting mothers and newborn babies.
‘In South Sudan as a Midwife, there was an outbreak of Hepatitis E, which was very fatal. If you go unconscious, the next thing – you’ll pass on. I managed this mother – she was 34 weeks pregnant (8 months). She had Hepatitis E, and she was unconscious for one week. We were doing supportive care to help sustain her. But one day, what shocked me, she gave birth –to a 1.5kg baby – in South Sudan, a place where these babies don’t survive. She gave birth, while unconscious,’ Christine reflected.
‘After two days, she woke up. Then, the 1.5kg baby – we just took care of it. It was a refugee camp, so we had to be innovative… The baby survived; the mother survived. This really touched me. After she was discharged, she used to come back for follow up checks. The baby grew health, after six months – the baby was so big. This is what made me really want to focus on being a Midwife… If a baby can survive at 1.5kg, and a mother can give birth unconscious – this really changed my passion about maternal and newborn care.’
It was this passion that has helped her to empower the next generation of healthcare professionals in Cox’s Bazar.
Overcrowded and under resourced
In Bangladesh, maternal mortality ranks as one of the leading causes of death for women aged 15-49, with a vast majority of women in Cox’s Bazar giving birth at home without professional support or healthcare facilities. Many of those deaths are preventable, and Christine and her colleagues work tirelessly in Cox’s Bazar refugee camp to ensure the mothers and their babies receive the necessary care, support and services.
‘The maternal and neonatal mortality rate in Cox’s Bazar is very high and this high mortality rate is related to the skills and knowledge of healthcare workers, whereby the services – which are to provide services that help avoid preventable deaths – they don’t have the skills or the knowledge. That is what I’m working on with my colleagues, to ensure that we empower the midwives, healthcare workers and doctors to reduce maternal and neonatal deaths,’ said Christine.
Across 33 camps in Cox’s Bazar, there are 102 healthcare facilities servicing a population of around 1 million people. Out of the 102 healthcare facilities in Cox’s Bazar, only 2 are Comprehensive Emergency Obstetric and Newborn Care (CEmNOC) referral centres, which can provide specialised services – such as caesarean sections. With overcrowding and resource constraints, it requires a significant amount of perseverance, patience and knowledge to explain to families the type of care they need, where to go, and why.
‘It takes a lot of energy to explain to a mother, who is in labour, and their relatives to refer them to CEnMOC facilities for further healthcare services that is not available in primary healthcare to get through the cultural differences. For them, they don’t understand and if the services aren’t provided here, they just go home,’ explained Christine.
'That is what I’m working on with my colleagues, to ensure that we empower the midwives, healthcare workers and doctors to reduce maternal and neonatal deaths.'
Collaboration saves lives
Working together in challenging environments is critical to success, especially when it comes to saving lives. Christine has ensured that a culture of collaboration and working together is prioritised.
‘Whenever there is a maternal or perinatal death, the Maternal and Perinatal Mortality Surveillance Response committee does an audit. Most of the cases during the audit discussion, we identify gaps in collaboration between the midwife and the doctors. The trained midwife has the knowledge of what needs to be done… but the doctor is the final decision maker, of a patient management,’ said Christine.
‘In Bangladesh, the doctors are the decision makers… So, through mentorship, coaching and trainings of midwives and doctors, the midwives have improved in their confidence among the midwives and collaboration with the collaboration in patient management,’ said Christine.
Elevated quality of care
In 2024, Christine helped deliver training and mentorship to 483 midwives and 42 doctors in Cox’s Bazar. In that same year, they saw a 23.5% decrease in the maternal mortality rate – a testament to the long-term mentorship, training and support provided to the midwives and doctors in Cox’s Bazar.
’It’s still high, but we’re proud of the progress,’ said Christine. ’This improvement has been the result of hard work, dedication, and commitment from the mentors, midwives, and doctors to reduce maternal deaths. In 2023, the number was very high at 57. By 2024, it decreased to 45. We’re hopeful and determined to bring it down even further.’
Christine takes immense pride in the midwives she has mentored and coached. She witnesses their growth daily through the skills and confidence they now possess, a remarkable transformation from when she first began her deployment.
‘There have been many moments when midwives successfully managed complicated cases they previously didn’t know how to handle. Those moments brought me immense joy,’ recalls Christine. ‘I’ve also witnessed instances where midwives faced complex situations, managed them successfully, and both the mother and baby survived. Those experiences are truly rewarding.’
‘As we train midwives in Cox’s Bazar within the refugee camps, many of those who have been trained, coached, and empowered are later absorbed into government roles. This significantly enhances maternal and child health services across Bangladesh as a whole.’
As we train midwives in Cox’s Bazar within the refugee camps, many of those who have been trained, coached, and empowered are later absorbed into government roles. This significantly enhances maternal and child health services across Bangladesh as a whole.'
Disclaimer: The information and views published here are the individual’s own and do not necessarily represent the partner organisation, Australia Assists or the Australian Government’s views, positions or opinions.