In early 1974, Nodjiouamel Rachel abandoned her first year of the secondary school in Ndjamena after an ailment forced her return to her village of Djam. Although she was living with relatives in the capital city she still need to be with her parents during this difficult time.
"I was really disappointed I had to abandon my education. There were very few girls in school, much less those who succeeded to complete secondary school," she explains. She would have become at least the first girl from her community to achieve this. She was just 12 years old at that time and had just completed her primary education level .
There was no secondary school in or around her village and at that time and Rachel reserved herself to the fact that she would no longer go back to the school. Finally, she married in 1986 and become a housewife like many other women in rural areas all over the country. Their fate was to give birth, take care of children, cook for the family and work with their husbands in the farms.
"For the eight years that I was helping women in my village, I have not recorded a single maternal death, yet I was dealing with 15 to 20 women per month."
This would have been her lot for the rest of her life how ever there was a watershed moment in the Laokassy area.
"In 1988, World Vision came into our village and asked our chief to propose a woman who knows to read and write to be trained as a traditional birth attendant," recounts Rachel. "Being the only woman in my village who could do so I was chosen. There was not a single woman in the area who could read and write at that time. Those who can read and write, live in the cities; not in the villages. I was selected and trained by World Vision to become a traditional birth attendant and vaccinator," Rachel explains, her eyes full of joy.
Rachel was trained the same year as a traditional birth attendant by the government's regional health technicians in partnership with World Vision. She was given the necessary equipment to use in the "hut of health", built in her village by World Vision as part of her project, “Child Survival”. The project was funded by the Canadian International Devlopment Association.
"For the eight years that I was helping women in my village, I have not recorded a single maternal death, yet I was dealing with 15 to 20 women per month. I was given a cluster of 6 villages that I worked in. I made sure that all those who may have critical deliveries are sent to the Hospital of Moundou to recieve the special treatment,"she explained.
In 2001, the community of Laokassi Canton built a health center with the assistance of World Vision. The health center covers 52 villages. Beside the nurse in charge, Rachel is the only matrone who helps pregnant women in their deliveries. Every month, she attends to up to 40 deliveries at the health center.
"Had I not been trained, I cannot imagine what would have happen until 2013, when the first midwife was sent to the hospital by the government."
"Though WV has trained of 24 traditional birth attendants in the Laokassy programme area, I am the only matrone who works at the health center because the other ones are in their villages and with the new policy on safe maternity, their role is to advise pregant women to go the health centers where they are assited by trained professionals."
In 2002, Laokassi was upgraded to district hospital and Rachel was moved to the maternity ward as the only matrone for more than 7 years.
"At the hospital, I was even busier because of the number of villages it served . I am not very well paid but I am happy because I know how my little contribution has made a difference in my area. Had I not been trained, I cannot imagine what would have happen until 2013, when the first midwife was sent to the hospital by the government," she said.
Before World Vision's work in the area, infant and maternal deaths reached alarming level. The closest hospital was about 80 kilometres from Laokassi and there were no roads that can be used in case of emergency, especially during the rainy season.
Mothers' died due to bleeding after delivery and child death caused by tetanus are very frequent. Few mothers were properly followed up on by health professionals and deliveries during pregnancies were done in households by old women who did not understand the critical importance of hygiene is delivery.
“In most cases, the umbilical cord was cut with a piece of sugar cane skin and the navel was massaged with warm ashes until it dried,” Rachel explains.
Today, the function of traditional birth attendant no longer exist because pregnant women are advised to go on prenatal visits to health centers. The traditional birth attendant is now an adviser to pregnant and lactating mother within the new structure.
"I was not able to finish my studies because of my ailment but I will make sure that all my daughters do."
"I am now a mother of seven children and I am happy because all my children know my position on child protection and rights. I am not just helping mothers to deliver their babies or get pregnant. I counsel them to allow their girls to go to school and avoid giving them into marriage before 18. Everybody here in the village knows that I cherish my daughters and nobody would even dream of taking them into marriage before they finsihes their studies. I was not able to finish my studies because of my ailment but I will make sure that all my daughters do."