If you empow­er local peo­ple to explore local chal­lenges and come up with local solu­tions, you can make an enor­mous dif­fer­ence. That’s the mot­to of Dr Bar­ry Kir­by AO and RN Kila Dobo. 

The pair’s Baby Bun­dle ini­tia­tive has encour­aged moth­ers to choose a super­vised deliv­ery. The Baby Bun­dle is a plas­tic baby bath filled with prod­ucts includ­ing cloth nap­pies, san­i­tary items and toi­letries, baby clothes, a sarong, and thongs, and it can be col­lect­ed by women if they elect a super­vised deliv­ery at the local health centre.

“We start­ed our incen­tive scheme at three health cen­tres ini­tial­ly, which I must admit sound­ed a crazy thing to do at the time,” says Barry. 

“But the moth­ers imme­di­ate­ly respond­ed and super­vised deliv­er­ies sky­rock­et­ed by over 100%. Moth­ers and health staff were hap­py, so we rolled it out to 15 health cen­tres. Twelve months lat­er, we had an 85% increase in super­vised deliv­er­ies across those centres.

“But the most reward­ing result was we had gone from eigh­teen record­ed deaths to just four in those health cen­tres over the same peri­od. I don’t know any­where else in the world they’ve done that.”

To date, through their not-for-prof­it char­i­ty, The Hands of Res­cue, the pair has deliv­ered more than 8,000 Baby Bun­dles to 25 health centres. 

The Baby Bun­dles are just one exam­ple of find­ing a prac­ti­cal solu­tion to the bar­ri­ers that moth­ers have told the pair about. 

When local women shared the prac­ti­cal rea­sons why they were giv­ing birth in vil­lages rather than at their local health cen­tre, the pair sprang into action. 

“Some of the vil­lages are so remote, it can take days to walk to a health cen­tre, or they have to use a boat,” says Kila. ​“To deal with that issue, we are con­tin­u­ing to build and com­mis­sion new moth­ers’ wait­ing hous­es, attached to health cen­tres, where preg­nant women can come ear­ly and can live while they are wait­ing for their babies to be born.

“We’ve ren­o­vat­ed count­less labour wards and con­struct­ed one TB ward. The total ren­o­va­tion of a tiny health cen­tre at Waila­gi on Good­e­nough Island is an exam­ple of the com­mu­ni­ty tak­ing own­er­ship of a project.”

For years, that health cen­tre had no light, two beds (one not work­ing prop­er­ly) and a roof that was cav­ing in. Water dripped on the women in labour. Now they have a two-bed deliv­ery room and a four-bed post-natal ward, com­plete with an ensuite and a laundry. 

Dur­ing con­struc­tion, the women of the vil­lage and health staff col­lect­ed and deliv­ered sand and grav­el for the con­crete, while the men dug trench­es and helped erect and assem­ble the frame. Even the chil­dren got involved, car­ry­ing rocks for the sep­tic absorp­tion trench.

“It was fun and a great com­mu­ni­ty spir­it per­me­at­ed the entire project.” 

“It was up in 13 days. That was 12 months ago. The morale of the staff remains very high and we’ve not had one emer­gency call from that new cen­tre so far,” says Barry.

“Peo­ple need to take own­er­ship,” says Kila. 

“As we point­ed out to those men, ​‘This is for you, your wives, your sis­ters.’ To get the reac­tion we need in com­mu­ni­ties, though, we have to build up trust. To gain trust you have to do what you say you are going to do, that’s how peo­ple start to trust. And that’s what we did.”

Bar­ry and Kila’s solu­tions-focused think­ing has also formed the foun­da­tion of their Safe Moth­er Pro­gramme, their Fly­ing Doc­tor Ser­vice, edu­ca­tion and train­ing pro­grams for health-cen­tre staff, involv­ing the com­mu­ni­ty in deci­sion-mak­ing – and more recent­ly focus­ing on pro­mot­ing pos­i­tive male role models.

This has includ­ed a TV series, ​‘It takes a vil­lage’, which encour­ages men to be sup­port­ive part­ners who encour­age their wives to have the baby in a health centre. 

The series uses sto­ry­telling to illus­trate the ben­e­fits of seek­ing care ear­ly and pro­motes the active role com­mu­ni­ties can play in mater­nal health, for exam­ple by iden­ti­fy­ing the risks and dan­ger signs early. 

Bar­ry would like a backer to sup­port the sec­ond series, which he says will go a long way towards address­ing ingrained cul­tur­al attitudes.

“Bar­ry and I love our work, going out and help­ing the women,” says Kila. ​“We do what needs to be done. This also includes train­ing the local staff to do the same and I hold the local staff in high regard.

“We install solar lights, run­ning water and fly screens, cur­tains for moth­ers’ pri­va­cy, scrub down dirty labour wards, fix drip stands, repair [the] labour ward bed… what­ev­er is need­ed to make the place moth­er-friend­ly and where staff can per­form their best… If a moth­er was to suf­fer or die from a pre­ventable death, it’s pos­si­ble it could have been a sim­ple some­thing with a sim­ple prac­ti­cal solution.”

Bar­ry, who is also the pilot of the plane, the engi­neer and the clean­er, agrees. 

“A rur­al GP out here can’t just be trained in med­i­cine,” he says. ​“Come to think of it, my back­ground as a tradie was a per­fect pathway.

“We live in the air­craft hangar and take no wages for our­selves,” he says. ​“All this work we do is made pos­si­ble through the sup­port of dona­tions from PNG and Australia.”

For more infor­ma­tion vis­it www​.the​hand​sofres​cue​.org​.au