On August 13, the Central African Republic celebrates its Independence Day. On this occasion, we are reminded that true freedom begins with the right to life. We speak with Izabela Cywa, coordinator of the Safe Mom project, about the upcoming edition of the training sessions and the latest report from the CAR Ministry of Health, which presents the program's impact in numbers.
Marta Czajka: You’ve had a busy time recently, presenting the Safe Mom project in parishes across Poland. At what stage are the preparations for the next edition of the training in the Central African Republic?
Izabela Cywa: Preparations have actually been underway for quite some time. In the Central African Republic, we are constantly analyzing potential venues for the next edition of Safe Mom. This time, we’ve chosen Bimbo — specifically, the Padre Pio Center. It’s a small clinic run by a Polish missionary from the Diocese of Rzeszów, Brother Janusz Gaweł.
Why did you choose this particular location?
There are many places in need of the Safe Mom program. We chose this particular center because the needs there are especially urgent. For the first time, our training sessions will be held so close to the capital of the Central African Republic — Bangui. Bimbo is a district located on the southern outskirts of the capital and includes surrounding villages. Many matrons and midwives work there, delivering babies both at the health center and in people’s homes. Sometimes, a single matron attends as many as five births a day — which is truly a lot. We felt that this place urgently needs our support.
Have you visited the center before? Were you able to personally assess the needs?
Yes. As part of another missionary project, we were carrying out operations there — including gynecological surgeries. And that’s when it became clear just how dramatic the situation was…
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Do you mean the situation of the center itself or the entire region?
Both. That’s why, in the next edition of Safe Mom, we won’t focus solely on traditional matrons. We also intend to support the center itself — we’ll demonstrate what modern childbirth practices should look like and provide training for the staff. The facility has no medical equipment, and its team hasn’t received any training in decades. They are in real need of a new approach to managing a delivery room — especially since so many women end up giving birth there. We want to help them gain the knowledge necessary to make childbirth safe, so that neither mothers nor babies die or get infected while coming into the world.
That is, this time not only traditional matrons will take part in the training, but also hospital staff?
Yes. We will train midwives from the Padre Pio Center, as well as matrons from other missionary health facilities and some midwives referred by the Ministry of Health.
Does this mean the trip will be longer and more extensive than usual?
Paradoxically — no. Normally, a lot of time is consumed by the long travel to remote destinations. This time, we'll already be on site, which will allow us to use the time saved for additional training sessions.
Do you already have a completed team of volunteers?
Yes, our team is ready. We will be joined by Sara Suchowiak — midwife, Tom Skręty — paramedic, Ilona Blasiak — pediatrician and neonatologist, and Michał Rudnicki — gynecologist.
Do you already know the date of departure?
The sixth edition of Safe Mom will take place in November/December.
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Over the past few months, you’ve been visiting parishes across Poland, sharing the message of the Safe Mom project. How were your visits received, and what kind of reactions did you encounter?
I must say, the reception of Safe Mom has been amazing. I’ve encountered a lot of openness and genuine interest. I also truly see God’s guidance in all of this. The attitude of Poles and their willingness to help is honestly humbling. For example, during one of my visits, I met representatives of another women’s support organization — and through a simple conversation, it turned out they, too, wanted to join the effort to help women and children in the CAR.
Sometimes all it takes is one word, and people’s hearts open, right?
Absolutely. I’ve come to realize that many of us — as Poles — are somewhat lost in consumerism. When we see how people in other parts of the world live, often in conditions far worse than ours, something awakens in us. As Catholics, we feel an inner call to help. We also start to appreciate more what we have. That was the tone I tried to strike during my parish visits. It wasn’t about money. I get the feeling that, more than anything, it’s about awareness — especially among women — that other women are truly suffering. And suddenly, we realize that maybe our lives aren’t so bad after all…
You recently received reports from the Ministry of Health in the CAR that highlight the changes Safe Mom is bringing to the communities where the training has already taken place. Can we really say that the effects are visibl?
Yes, absolutely. The latest reports don’t yet include direct data on maternal mortality rates, but they clearly show an increase in early detection of diseases by matrons and more frequent referrals of women to health centers for check-ups. In many cases, these are the only medical tests a woman receives during her entire pregnancy. In fact, 95% of women in the CAR don’t undergo any medical testing throughout pregnancy. Just the act of referring them to a clinic makes diagnosis possible — and that gives them a real chance at a safe delivery.
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And this, in turn, leads to a reduction in maternal and child mortality rates.
Exactly. For example, if a postpartum hemorrhage occurs, a trained matron now knows how to respond — she wraps the mother's abdomen with a sling and immediately refers her to the nearest health center. This kind of response truly saves lives.
Are we talking about specific regions or a broader, nationwide change?
These are data from the specific regions where we’ve conducted training: Bouar, Bossangoa, and Bouka. It’s worth noting that in Bouka — a very dangerous area of the country — the training was carried out by our African partner, I3D. We provided them with a birthing phantom and proper training. They are the ones who reach areas that are inaccessible to us, mainly due to safety concerns.
What areas does the report focus on specifically?
One of the charts presents statistics on high-risk births — specifically, live births. According to the data, 51% of women now give birth in health centers, while 49% still give birth with matrons. This shows that the matron was able to recognize complications — such as fever, absence of fetal movement, or anemia — and refer the woman to the hospital in time. That is a huge success. We want women to give birth in hospitals because, in many cases, they have no real chance of survival if they stay at home.
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So, thanks to the Safe Mom training, the matron becomes not just someone who delivers babies, but also someone similar to a general practitioner — able to detect complications and respond appropriately.
Exactly. Even if we provide the matron with only basic tools and knowledge, in situations where, for example, the baby isn't breathing, CPR alone may not be enough. In such cases, the mother and baby have little chance of survival if the birth is attended only by the matron. That’s why we teach them how to react quickly and refer the woman immediately to a health center.
What are the most common reasons matrons refer women to medical facilities?
The report shows that 7% of women were referred due to high-risk pregnancies. 88% were referred because of symptoms such as fever, dehydration, uterine bleeding, or absence of detectable fetal movement. The remaining 5% were referred for confirmation of HIV test results. These are all warning signs that a trained matron can now recognize — and that knowledge is saving lives.
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You mentioned that up to 95% of women do not undergo any medical testing during pregnancy. Have you observed any positive changes in this area?
We don’t have comparative data from previous years, as no one was collecting such statistics before. However, the report includes a very important figure — in just one quarter of 2024, as many as 3,500 women from the four mentioned villages underwent CPN1, that is, basic blood and morphology tests during pregnancy. This is a significant step forward.
It will be interesting to see how that number evolves in the coming years.
Yes. I’d also like to draw attention to the graph showing the number of women and children referred for postnatal check-ups. This is another huge success, because just as women often don’t get checked during pregnancy, they are even less likely to attend any postpartum follow-up.
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The report shows that most births still take place at home, assisted by matrons. But it’s clear that your work is starting to produce tangible results. That must be very encouraging.
Yes, we can see that the situation is gradually improving and moving in the right direction. But we can't rest on our laurels — there's still a great deal to be done.
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