Two Calif. midwives saving babies in Sierra Leone

SAN FRANCISCO -- Retirement is anything but slow for two Episcopal deacons saving lives a half a world away.Each year, the Revs. Christie McManus, 60, and Patricia Ross, 57, journey to from San Francisco to Sierra Leone to help deliver babies in remote villages with some of the highest infant mortality rates in the world."Doing this fits in with my core values -- I have the knowledge and money and if I don't share it, that's not doing what I was created to do," said Ross, a certified midwife.Both women, who worship at St. John's Episcopal Parish in Clayton, Calif., wanted to do something useful with their golden years. So they became MOMS -- Midwives on Missions of Service, which is a nonprofit helping West African women deliver healthy babies.Together, the pair turned MOMS from a distance-learning course for midwives into a traveling midwifery and maternal health education program. MOMS has a board of directors and a few volunteers, but it's largely a nonprofit of two -- McManus and Ross travel several times a year to Sierra Leone for six-week stints to lead the courses and meet with government officials. Their next trip is in January.In the past two years, the San Francisco women have trained 97 women in 33 villages in basic prenatal care, birthing techniques and postpartum procedure. They rely on small individual and corporate donations and donated medical supplies, and they host baby showers in the San Francisco area to collect baby blankets, clothes and toys.The lifetime risk of dying during pregnancy or childbirth in Sierra Leone is 1 in 8, according to UNICEF and the World Health Organization. Many women cannot afford a doctor visit or simply can't get to a clinic when the pitted dirt roads wash out during the rainy season.In a country of 5 million, there are fewer than 150 doctors, according to MOMS. More than a quarter of all Sierra Leone children die before age 5 -- the majority in their first six months, according to the United Nations.MOMS was invited by the Sierra Leone government to work in the Kailahun District -- the epicenter of the country's civil war during the 1990s. Many of the women who survived the bloodshed tell stories of hiding in the rain forest while their husbands were killed by rebels wielding machetes. Many women were raped; others had their babies brutally cut from their bodies.Today cell phone reception is spotty, making it hard to arrange appointments with a doctor. Many women are too weak to make the two-day walk to a clinic, or can't afford to leave their crops and risk the chance of their food sources withering.When Ross and McManus first arrived in West Africa in 2005, they found women giving birth in what amounted to an "old chicken coop." There was no doctor, no ambulance, no emergency room. Instead, women were attended to by volunteer traditional birth attendants -- a worldwide designation for community members with a month of government childbirth training.During that visit, one woman bled to death on the floor and seven babies died during or shortly after birth due to malaria and malnourishment.They were shocked to see birth attendants pushing on women's stomachs during birth -- which can jam the baby into the pelvic bone or rip the placenta. Once delivered, babies were wrapped up in a blanket without an exam. Instead of waiting for the afterbirth, when women naturally release the rest of the placenta, birth attendants were pulling them out.So on a return trip in 2006, they started holding classes in a village called Pellie, with translators who could repeat their words in the Mende language. More than 50 West African women showed up for the lessons, many of them walking for several hours from their homes.On their June 2008 visit, they found that a female health network was starting to form. The birth attendants had begun routinely checking on new mothers.In their assessment reports for the Sierra Leone government, McManus and Ross recommend placing midwives with a team of traditional birth attendants in rural clinics so there's at least some expertise and a place to go for minor pregnancy needs.They are working on creating a second tier of "advanced traditional birth attendants" who could monitor women's prenatal care and develop connections with urban clinics to help village women make the journey in emergencies.Ultimately, they want to pass on their knowledge so there's no need for MOMS in Sierra Leone anymore, McManus said."That's what our faith is about -- making the world better, not worse."E-mail Meredith May at mmay(at)sfchronicle.com.(Distributed by Scripps Howard News Service, www.scrippsnews.com.)