Every Mother Deserves a Healthy Birth Story

Mothers everywhere face many unknowns when bringing a new baby into the world. Access to safe water during birth shouldn’t be one of them.

Engineers Without Borders USA (EWB-USA) is currently working with field partners to help eliminate this risk factor for mothers in Malawi and Ethiopia, two Sub-Saharan African countries where maternal mortality rates remain unacceptably high.

The good news is that this grave problem has known solutions. As UNICEF says, “Almost all maternal deaths can be prevented, as evidenced by the huge disparities found between the richest and poorest countries.” EWB-USA is utilizing our engineering expertise to design, repair and build sustainable water systems that will continue to close that gap.


It is illegal to give birth at home in Malawi. This law, passed in 2007, targets the country’s high maternal mortality rate of 574 deaths for every 100,000 live births.

But for Malawians that live in rural villages, simply getting to a health center is no easy undertaking. At Chiunjiza Health Center, one of the health centers where EWB-USA is working to improve access to clean water, heavily pregnant women walk up to 12 miles with the hope of giving birth to a healthy baby in a safe setting.

After a long journey, the wait for near-term mothers continues at a maternal waiting shelter, where they stay with a female “guardian” that has accompanied them. The shelters are typically a brick shell of a building with a concrete floor and no running water or electricity. Guardians spend their day hauling water from the nearest borehole — sometimes within site of the shelter, sometimes a few hundred yards away — and gathering firewood for cooking.

EWB-USA began a partnership with the Malawi-focused NGO Freshwater Project International in spring 2017 to assess the water systems at 16 rural health centers across the country. Over the past few months, we’ve used the technical expertise of volunteer engineers to design and implement sustainable solutions such as electric or solar-powered pumps, new taps and tap stands at six of the centers. Where before we saw scenes of pregnant women, guardians and staff pumping and hauling 44-pound jerry cans of water, we now see lines at tap stands a few short steps from the center and shelter.

Inside the centers, a nurse’s flick of the wrist turns on a tap in the exam room where a mother waits to deliver. That ease of access to reliable, clean water profoundly increases the likelihood of a safer birth experience for the mother and baby.

Clinic staff tell us the biggest change they experience when safe water is available is handwashing. When water flows from a tap onsite, they wash their hands before they treat patients. When they have to haul water from afar, they don’t.

Clean hands save lives. It’s the “do-it-yourself” vaccine that is referenced by medical professionals the world over as the best way to keep from getting sick.

EWB-USA will be sending volunteer engineers back to continue life-saving repairs and improvements at Malawi’s rural health centers this February and April.  


Ethiopia also has one of the world’s highest rates of maternal deaths in the world, with women having a one-in-52 chance of dying from childbirth-related causes each year.

We’re working with Village Health Partnership, an NGO whose mission is focused on safer motherhood in rural Ethiopia, to combat this dire statistic and end preventable deaths by equipping medical facilities with access to safe, reliable water.

In December 2017, two EWB-USA staff engineers assessed the water systems at 12 medical facilities that serve a combined population of approximately 1.4 million people. Users of each facility echoed stories of water rationing, the public health effects of dry season, and, ultimately, water sources that can’t be relied upon to meet the demands of facilities where consistent access to clean water can be the difference between life and death.

The engineers’ assessments showed that almost all of the facilities were using water systems that were inadequate for their patient volume. To meet their daily needs, water is being hauled in buckets from distant sources that include springs, rivers and shallow wells.

At Jomu Healthcare Centre, 400 liters of water from a spring is delivered daily by donkeys and stored in a 55-gallon drum. Cattle and donkeys also utilize that same source, and the water delivered may be contaminated. Even at facilities where the water hauled in originated from a clean source, it is typically stored in open containers, exposing it to contamination.

At Shey Bench Health Center and Chebera Health Center, our engineers were able to do more than assess the technology — they used their expertise and creativity to fix the existing rope pumps at these sites. This basic hand pump is intended for household use, not the 20,000-plus people served by these facilities. A rope pump is not sustainable for this setting, but they left with water flowing onsite as an interim solution and having identified an Afridev Pump, a heavy-duty hand pump, as a sustainable solution that can be installed by Village Health Partnership.

Bachuma District Hospital, which serves approximately 250,000 people, is being served by a city well that supplies water about 30 percent of the time. The engineers worked along local government staff to repair an Afridev Pump a short walk from the hospital, leaving staff at the hospital with the certainty that they would have reliable access to water every day.

Water is flowing today at three medical facilities because of the expertise, dedication and innovation (a broom handle and spare wire brought one pump back to life!) of EWB-USA’s engineers. But the implementation of appropriate, lasting technology that will have lasting impact on maternal mortality remains the goal. The engineers provided staff at the centers and our partnering NGO with recommendations for sustainable solutions for all 12 sites, ranging from Afridev Pumps to piped gravity systems with secure ground-level storage. This spring, Village Health Partnership will move forward with the implementation of those solutions at the facilities.

About the Author
Engineers Without Borders USA builds a better world through engineering projects that empower communities to meet their basic human needs and equip leaders to solve the world’s most pressing challenges.