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The traditional village midwives.


 The training of the village midwife, (a position not to be confused with official or council midwives who work in an established dispensary), in Western Cameroon, is complicated by traditional notions of childbirth and pregnancy. The need for midwifery with a medical background is obvious from the following statistics, gleaned from 100 reported pregnancies: of the 100 pregnancies reported, there were 7 abortions, 24 stillbirths before Day 10 of life, and 69 surviving infants. In a culture where pregnancy and childbirth are trials, the maternal-child health centers are attempting to train women as midwives who can intercede in difficult pregnancies and diagnose medical complications at an early stage of labor. The aim of the training is to impart the basic rules of cleanliness and to make clear the notion that time is very important: when a medical emergency is perceived by the trained midwife, she will refer her patient to the hospital which trained her. Midwives in Cameroon are recruited by 200 volunteer health representatives who were trained 2 years previously by the maternal-child health center the author represents. Recruits, though mostly illiterate, undergo a 4-week training course in medical midwifery. 2 weeks are spent in the delivery room of the hospital, 1 week in a maternity wing, and 1 week in an antenatal maternal-child health center. Responsibilities for this training are with the doctor in charge of the hospital, a maternity midwife, and a clinic nurse with training in elementary courses. Trainees live in town during their education, and later return to native villages (with white coats, an essential feature). The training of village midwives is gaining acceptability in this population; presently 8 groups of 21 midwives have been trained. The need for money to provide the most minimal supplies for these health care personnel is emphasized (with an estimate of 1000 CFA francs/voluntary midwife).
