Betty Kahima is a midwife. After years of being woken up late in the night by desperate husbands from her village and neighboring areas seeking assistance for their wives undergoing labor pains, Betty realized there was a gap in her community that could be filled by her midwifery skills. She wanted to provide a service to her community but lack of space was a problem. An opportunity came when the family moved to a new house. Betty, with support from her family, turned the old house into a domiciliary and got a license to operate a home-based domiciliary at her homestead.

What used to be the living room is now a village drug shop, Betty sells non-prescription drugs such as for first aid, cough, headache, balms, and she is an agent for family planning and child immunization services. Former bedrooms now have two beds and baby cots. After delivery, mothers are kept for observation overnight. Complicated cases are referred to the district main hospital. The master bedroom was renovated and turned into a delivery room. It is amazingly clean with a delivery bed similar to the one in hospitals. There is a big plastic bucket well covered for storing the delivery instruments, are clean gowns, gloves, gum boots, protective mouth and head covers etc. After delivery, Betty used to take the instruments to a government referral hospital 30 km away for sterilization. But she has now acquired a gas cooker with support from her son, so she does the sterilization at home.

Waste materials from the delivery are disposed off in a special place in the banana plantation. Betty’s husband assisted in the construction of a very deep hole covered with a tight fitting cement lid under a corrugated iron sheet rooftop. The hole is kept very clean; Betty’s husband regularly prepares ash from special herbs to purify it and there is no smell at all.

Maria first visited Betty in 2000, and when she went back three years later, there was a lot of improvement. With approval and training from the district health authority, Betty added child immunization and HIV/AIDS counseling and testing to her services. Betty is now offering HIV/AIDS positive women the opportunity to deliver healthy babies with dignity, as they are comfortable with her. HIV/AIDS positive women sometimes face prejudice and discrimination in some hospitals during delivery and the post-natal period.

Betty and her husband have many roles in their home and community. On an ordinary day as farmers, you will find Kahima feeding the pigs and selling chicken to the village butcher. Betty will be either drying coffee or working in the clinic. She often wears a white coat similar to the one worn by medical personnel with a stethoscope around her neck as she delivers a baby, counsels and tests a couple intending to marry for HIV, or immunizes babies.