A midwife’s night duty shift, Malawi, 1963

We are proud to have Alison Cameron as our Scottish Patron. So we were thrilled to see her 1963 snapshot of one night’s work published in the Society of Malawi Journal, Vol. 72, No. 1, 2019. We are grateful to the Journal for permission to share it with you on our website. In this article Alison describes the pressures and uncertainties of giving birth in Malawi. It was a dangerous business then and, even though maternal and infant mortality rates have fallen considerably, it is still a dangerous process for mother and baby.

Malawi infant mortality today is 39 per 1,000 live births (https://data.unicef.org/country/mwi/#), down from 64 in 2007. The SDG target for 2030 is to reduce it to 12 deaths per 1,000 live births globally. As a means of comparison, it is currently 4 deaths per 1,000 live births in the UK. Maternal health is also an area of grave concern in Malawi. Malawi’s most recent estimated maternal mortality ratio (MMR) is 439 per 100,000 live births (NSO Malawi & ICF, 2017); below the WHO (2015) estimate for the sub-Saharan African region of 546 ( in 2000, it was roughly 1120, so it has more than halved in 20 years).

Malawi’s proportion of institutional deliveries has increased sharply from 55% in 1992 to 90% in 2015-16 (NSO Malawi & ICF 2017). Malawi provides free maternity care, but quality of care appears suboptimal (Leslie et al, 2016; Ministry of Health Malawi & ICF International, 2014). Health centres offer basic emergency obstetric and new-born care; a limited number of referral hospitals offers more comprehensive services. Malawi’s health system is affected by severe lack of physical, financial and human resources (Chimwaza et al., 2014).

Alison  has been a supporter of the Mamie Martin Fund since it was founded. She and her husband, Colin, have worked for 60 years to build and maintain civil society and governmental links between Malawi and Scotland. The Scottish Government has honoured that work by creating an endowment fund in Alison’s name and asking us to administer it. This fund supports 45 girls through school and 4 at university over four years each.

Source: National Statistical Office – NSO/Malawi and ICF (2017). Malawi Demographic and Health Survey 2015-16. Available from: https://dhsprogram.com/publications/publication-fr319-dhs-final-reports.cfm. Accessed 31 January 2019. Zomba, Malawi, and Rockville, Maryland, USA: National Statistical Office and ICF.