Involving fathers in family planning and parenting will make a difference.
Yusupha is a midwife and he has been working at MRC Keneba for some years now. He has the assurance of someone who knows his job inside out and does it well.
Together with Fatou, Yusupha runs the Thursday clinic at MRC Keneba, where expectant women are monitored from the 12th week of pregnancy. That is, if they are willing to come... but these days they tend to be, as the government is giving them 200 Dalasi (it makes 3GBP if you convert it, and it's worth a lot to many people in West Kiang) if they report to a maternity unity in the first trimester.
The scheme is meant to encourage women to have skilled assistance when it comes to pregnancy and birth. But Yusupha is not convinced it will work long term. "Once the monetary incentive stops and women find out they don't get paid anymore when they come in," he says. "People will revert back to usual: Traditional Birth Attendants and Marabus' wisdom".
Before the scheme was introduced, the MRC used to train Traditional Birth Assistants in Keneba, so that their knowledge could be expanded and they could help people in the village. Then the government decided to encourage people to attend the maternity unit. Which Yusupha thinks is a great idea. However, he believes the best way to encourage people to come in, is to offer great service.
"I see it. I see it on the faces of the girls" Yusupha tells me enthusiastically. I almost have a feeling there are tears in his eyes. "Last month there was this young girl from the coast. She came in and she was so worried. She had nausea and was vomiting a lot. Very typical first-term-of-pregnancy symptoms, to me. But not to her: she was thinking 'evil spirits' and everyone around her (even the pharmacist!) was thinking the same. When she saw the baby on the scan... her face lifted. You could see the relief and joy where there had been worry and distress. 'There is no witch' I said. 'The only witch is this cute little one in your belly'. And she was happy."
Yusupha believes that this is the kind of impact the MRC midwives can have. They can change lives for the better. They can bring joy where there is fear. And Yusupha's point is that to do so, they must involve the fathers.
"We have been here for 30 years now. And for all this time we have spoken to women about family planning, assisted birth, hygiene and all things family related. We have assumed that fathers will not be interested. But we are wrong. They are only waiting for us to invite them into the conversation.
And it is in our interest to do so. They are the decision-makers in all household after all. If we educate a woman, we don't empower her to act upon what she has learnt. We give her the task to educate and convince her husband first, which is difficult and probably not her first priority. It might even backfire and cause strife between husband and wife, which is really the last thing we want during pregnancy...and at any time. We are probably better equipped than that woman to do the job of educating and convincing her husband, and it definitely should be our first priority to do so. With the whole family on board, things can actually change for the better." And this feels true. True when it comes to the MRC in Keneba. True when it comes to midwives and beliefs about pregnancy and birth.
But it actually hits much closer to home. And much further away into the wide world. Whenever a group of people work towards the same common goal, they will enjoy the satisfaction of good teamwork, be better equipped in case of unexpected challenges and increase the chances of a positive outcome. This is even more true of families, where unity can make the difference between a safe haven and daily hell. Our call to action from the Gambia comes loud and clear, and it applies throughout our global parental education work: include the dads!