By Thandiwe Garusa
AN empty drink can has become a makeshift surgical tool in the poverty-stricken community of Epworth where a traditional birth attendant, Tapiwa Vhinya, uses it to cut umbilical cords during home deliveries.
With no access to surgical blades, cord clamps, sterile strings or tapes, she improvises with whatever is at hand, tying cords with ordinary draw threads. It is a dangerous practice, yet one many women turn to because hospital births are beyond their reach.
Locals call Vhinya (34) Ambuya Va52, a nickname she has earned from the 52 babies she has delivered in Epworth, a high-density suburb about 12 kilometres southeast of Zimbabwe’s capital, Harare, since she started in 2019.
In an interview with NewZimbabwe.com, the traditional birth attendant said she has delivered most of these children with her bare hands, as neither she nor the expectant mother have access to surgical gloves.
“We live in a poor community where most people are unemployed and can barely afford to put food on the table, so most of these women are turned back home from the local (Epworth clinic) as they cannot afford it.
“I have delivered most of these babies, touching blood with my bare hands as I do not have access to gloves.
“I use empty drink cans to cut the umbilical cord and draw threads to tie the baby’s cord after cutting it and that is the biggest challenge I have been facing since I started,” Vhinya said.
Vhinya does not have a proper delivery room for the home births she attends. Most of them take place outside, exposed to the elements. Despite the risks and the effort involved, she does not charge the mothers she helps. Instead, she receives small tokens of appreciation often just a bottle of milk and a bar of soap. According to tradition, the milk is used to wash her eyes, as it is believed failure to do so could eventually cause blindness, while the soap is meant for cleaning her clothes after the deliveries.
Epworth’s traditional birth attendant Tapiwa Vhinya
At the local clinic, women are required to bring their own delivery supplies: ten pairs of gloves, surgical blades, cord clamps, linen savers, cotton, methylated spirit, and other essentials.
In addition, before admission, expectant mothers must pay a registration fee of US$45 for a normal delivery, along with an extra US$40 to cover the cost of an ambulance should complications require transfer to a larger hospital. Without the supplies or the fees, women are simply turned away.
Several women who spoke to this publication said these steep costs and requirements are what force them into the hands of traditional midwives, despite the dangers of home deliveries.
Mary David (19), a young mother whose 11-month-old baby was delivered by Vhinya, recalled her ordeal: “They wanted a lot of money that I did not have, I did not even have enough preparation for the child, even food to eat here at home so hospital delivery was not an option.”
Corruption and mistrust of nurses
Some women who spoke to NewZimbabwe.com raised serious corruption allegations against nurses from the local hospital, saying they demand bribes for you to get help with ill treatment meted out to those who refuse to pay.
Ruvimbo Nyakawuru (27), who also had two of her babies with Vhinya’s assistance, said she wanted to avoid ill treatment by nurses.
Ruvimbo Nyakawuru (27) had two of her babies with Vhinya’s assistance.
“I gave birth to my first child in a hospital and after that experience, I vowed to never go back there again.
“If you do not pay the nurse a little something for ‘ a drink’, even when you are in pain and require attention, they will ignore you and speak to you rudely, in my case, they even told me that kana usingade kubhadhara hameno hako, mwana wacho ndewako akafa hameno (if you do not want to pay, we do not care, the child is yours).
“I saw women giving birth on their own whilst in hospital,” Nyakawuru said.
Ruvimbo Nyakawuru (27), had two of her babies with Vhinya’s assistance.
Noster Chitiva (49) also weighed in, saying the women are treated according to how they look and how much they have paid.
“The nurses treat their patients according to how you look, if you have given them some money for drinks and it is totally different for those who would have paid something.
“If you do not have the money, you suffer,” she added.
This has led to some women deliberately avoiding going to the clinic, even when they can afford it, citing ill treatment by nurses.
For Freddie Zenda (46), his wife was initially helped by Vhinya to deliver their second-born child as it was an emergency, but their decision to use her services for their third child was intentional.
“When my wife went into labour the first time, things were really tight and I did not have money for maternity registration at the clinic, so we settled for Ambuya Va52.
“However, for the second baby, we simply chose her because of the good care we had received the first time as compared to what we had to go through at the clinic during the birth of our first child.”
Births in wheelbarrows
Transport remains one of the biggest barriers for women seeking safe deliveries.
In some cases, expectant mothers in labour are pushed in wheelbarrows for as far as three kilometres because their families cannot afford to hire cars or ambulances.
Samuel Chigwesa, a father of three, recalled how his wife went into emergency labour even after the family had managed to raise the hospital registration fee.“I had managed to raise the required money for hospital delivery, however, my wife got into an emergency labour and I did not have time and money to hire a car and the available option was carrying her to the hospital in a wheelbarrow and she ended up giving birth as we were about to leave.
“Most people here cannot afford to hire a car and they end up having to be carried to the hospital in a wheelbarrow, which can take up to an hour,” he said.
The clinic is about 3 kilometres away from Epworth Ward 1.
Chigwesa added that in many cases, women give birth on the way, unable to reach the hospital in time, making the journey both painful and dangerous for mothers and their newborns.
“Most of these women give birth before they even get to the hospital,” Chigwesa added.
While home deliveries are common in communities like Epworth, they often come with serious complications.
Vhinya said one of the most difficult cases she faced was delivering a baby who had long died inside the mother’s womb, suspected to be due to high blood pressure.
“The child came out in pieces; it had long died inside and turned black in colour. It was a scary experience.
“The mother never went for antenatal visits at the hospital; she was just living like nothing was happening and these are some of the challenges we face”, she said.
In another case, Vhinya described delivering a baby in an abnormal position, with one leg emerging first, a situation that would normally require an emergency caesarean section.
“It was a very difficult childbirth, but we managed,” she added.
Besides the childbirth process, these women also struggle to obtain documentation for their babies.
“If you give birth at home, getting to have a birth record or baby card will be the worst nightmare as the officials will give you a difficult time,” another Epworth resident added.
A child health card
Isheanesu Chirisa, the Women and Law in Southern Africa (WLSA) National Director, said poor maternal healthcare in Zimbabwe requires government action to remove financial barriers, improve access, and integrate traditional birth attendants with skilled medical care.
“Poor maternal health care remains a huge stumbling block for most women in Zimbabwe, particularly in marginalised communities.
“To ensure that women in marginalised communities like Epworth have access to safe maternal healthcare, strategies by the government should focus on removing financial barriers, improving health system accessibility, and adaptability, including investing in integrating traditional attendants with skilled healthcare,” Chirisa said.
The situation in Epworth mirrors the reality of home births across many Zimbabwean communities, highlighting the broader crisis of access to healthcare as a fundamental human right.
Zimbabwe’s Constitution enshrines this right: Section 76 guarantees every citizen access to basic healthcare services, including reproductive health, while Section 81 provides special protection for children, affirming their entitlement to healthcare.
Beyond its national laws, Zimbabwe is also bound by international commitments. As a signatory to treaties such as the International Covenant on Economic, Social and Cultural Rights (ICESCR) and the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), the state carries an obligation to ensure equitable, non-discriminatory access to maternal health services.