A novel, set in rural Zimbabwe, intended to stimulate discussion in seminars and training programmes for health workers in the field of maternal and child health. The book, which portrays the lives of four generations of women, uses dramatic devices to illustrate the many cultural factors that surround the care of mothers, particularly during pregnancy and childbirth, to show how such practices may conflict with established medical knowledge, and to demonstrate the difficulty of improving health care under conditions where severe poverty and rigorous adherence to traditional beliefs are the norm. Readers will also be able to discern several cases where traditional birthing practices depicted in the novel are in line with current medical knowledge. The children who sleep by the river are the victims of hunger, disease, and witchcraft laid to rest where the water can wash away the evil that killed them. Other themes that can be explored in classroom discussion include the tension that often characterizes the relationship between midwives and clinic-based nurses, the reasons why pregnant women may fail to seek medical care, the dangers of a patronizing attitude towards cultural beliefs, and the factors that can motivate people to change. The events described in the novel are regarded as representative of real-life conditions in many rural areas of the developing world.

WHODOC

WHO monograph

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