This post was authored by Idil Ibrahim, a Producer of Kadi: Saving Mothers and Babies, One Voucher at a Time. Kadi is a thirty-minute documentary spotlighting the reproductive health voucher program in Kenya, a Government of Kenya Vision 2030 flagship program. The film was produced in 2011-2012 by the Gobee Group and was made possible through a grant to the Population Council from the Bill & Melinda Gates Foundation. In addition to the documentary, the project produced a series of five webisodes exploring specific topics with the Kenya and Uganda voucher programs.
While filming in southwestern Uganda, I was continually amazed by the country’s lushness. Beautiful rolling hills, banana trees visible almost everywhere I looked. Red earth and every shade of green imaginable- it was one of the most beautiful countries I’ve ever visited, and I quickly understood upon arrival how the country received its nickname as “the pearl of Africa.”
However, I was not visiting as a tourist, and my itinerary did not include forest gorilla treks, birding or fancy game drives. In fact, tourism was the farthest thing from my mind (though my team and I did pause quickly during our 4-hour journey from Kampala to Mbarara to take photos at the equator, which cuts through the country made visible by a thick yellow line). I was heading to the western part of the country close to the Rwanda, Congolese and Tanzanian borders to learn more about Reproductive Health Vouchers, and to produce and film an evaluative documentary on the program.
I visited employees and representatives from Marie Stopes International Uganda and interviewed individuals who worked on the RH Voucher project. I was interested in learning more about the program as it operates in Uganda, as well as how mothers and health practitioners felt about the program as it relates to maternal health.
Though we were traveling for our project, traveling vast distances, particularly to seek care for childbirth, is not unique to women in Uganda and other parts of the world- it is the norm. I soon realized how difficult it was to go such distances with a camera.
One day we planned to visit Bitooma Health Center. From a production perspective I was struck at the logistical difficulties accessing the place—miles down a bumpy road in a valley, incredibly far from the main road and even farther from the nearest rural or semi-urban center. Bitooma was definitely off the beaten track- a picturesque location indeed, but a nightmare location in the event of any serious medical emergency.
Upon arrival at Bitooma medical center I was struck by the number of women in the waiting room and people milling about outside. I was told that the women I saw were mothers waiting to be seen, some had the RH Voucher and were there for antenatal visits, others were women who wanted general check-ups. I was astounded by the number of mothers actively seeking care. That was just the waiting room. As we met with the doctor and received a tour of the facilities, there were numerous mothers in the other buildings. One mother was in labor.
The doctor told us that just a few days prior to our arrival, the delivery room was spilling over with so many mothers in labor that there were not enough beds to keep them. It was quite humbling as I stood there with my discomfort from carrying the camera equipment and stiff from my long and bumpy ride. What a position of privilege. I had the ease and choice without bearing the weight of bringing a child into this world in incredibly difficult circumstances—logistically speaking. I shuddered when the doctor spoke to me of complications in situations when mothers had no access to medical care. The doctors explained that in dire situations some mothers died en route to the health clinic.
I appreciated my candid discussions on and off camera with the doctors and mothers onsite at the facility. However, it was my treks in the surrounding area to speak with mothers from the local community that left an indelible mark. My trip to Bitooma is one in which I will never forget and if I close my eyes, I can still see the rolling green hills, vast distances in each direction.
(Photo credit: Idil Ibrahim, from the webisode Distributing Vouchers in Rural Uganda; shown: Anne Mary Atwiine, Marie Stopes Uganda)