Rotary initiative aims to lower maternal death rates in Papua New Guinea
Gwyneth Weuta is the only midwife serving a population of 12,000 in a rural part of Papua New Guinea. The area is a remote place where lush palms drink in the moisture that hangs in the air and forests are sonorous with the calls of shorebirds and tree frogs.
The isolation, as beautiful as it may be, is one of many challenges for the 37-year-old midwife: The clinic where she used to work, a single-story building tucked on a narrow island in the South Pacific nation, had no running water until she procured a grant a couple of years ago. A new health center where she’s now stationed is more developed, but there’s no reliable transportation to get there. Then there are the misconceptions and cultural barriers that lead many to resist birthing in a health care facility.
She recalls a teacher from a nearby village who had been under her care for nine months, a rarity, given that in rural Papua New Guinea many pregnant women don’t visit a health care provider until they’re in labor, if they visit at all.
The baby was overdue, raising the risk of complications, so Weuta urged the woman to deliver at the district hospital. But she soon returned home, either sent back by the doctors or by her own choice, Weuta isn’t sure. More than three weeks past her due date and without transportation, the mother waited and went into labor. The next day, hours passed before a vehicle could be found to bring her to the more fully equipped provincial hospital five hours away. It was too late. By the time she arrived, the baby’s heart had stopped.
The baby’s anguished father was livid and blamed the midwife. “All the bad words you could imagine, he just threw at me,” Weuta explains with a slow, melodic certainty.
Gwyneth Weuta is the only midwife for a remote area of Papua New Guinea.
Delays in seeking and accessing care threaten women’s lives in Papua New Guinea, which has one of the world’s highest maternal and neonatal mortality rates. Compared with women in nearby Australia, a woman in Papua New Guinea is 95 times more likely to die giving birth, and babies are 10 times more likely to die during or shortly after birth.
Most of these deaths are preventable, and midwives are key. Worldwide, universal access to midwifery care could avert more than 60 percent of all maternal and newborn deaths and stillbirths — 4.3 million lives saved annually by 2035, according to the World Health Organization. And the lifesaving work of rural midwives goes beyond birthing: Like Weuta, they are often the only skilled health care workers for miles, supported by community assistants and occasional guidance from doctors over the phone.
In Papua New Guinea, more than 80 percent of people live in rural areas and only half of all births occur in the presence of a skilled attendant. With only 1,600 midwives in the country, the Papua New Guinea Midwifery Society estimates that five times as many are needed to serve the growing population. Mary Sitaing is outspoken about the challenges of giving birth in the country. When she became president of the society in 2022, Sitaing made a public call for more midwives, better support of midwives, and greater awareness of reproductive health care in her country.
Mary Sitaing became the president of the Papua New Guinea Midwifery Society in 2022.
Still, the solution isn’t just more midwives. The country needs more well-educated, supported, and empowered midwives. “If they’ve got a voice, they can ask for the equipment, they can ask for the training,” explains Judith Brown, a retired midwife and a member of the Rotary Club of Morialta in Australia. “They can ask for the womanpower that they’re going to need to provide safe and evidence-based care for their women.”
And that’s where Rotary comes in.
Building the confidence to lead
It’s April, the rainy season in Papua New Guinea, and midwives from across the country are gathered for a five-day leadership workshop in the capital of Port Moresby. They’re paired with midwives from Australia, kicking off a yearlong program supported by Rotary members in the two countries. “Not only their voices come together, but their energy and their passion come together,” says Brown, leader of the Papua New Guinea Midwifery Leadership Buddy Program. “They assist each other and support each other in a way that’s not possible if they’re in another land, never having met.”
Brown, who has spent her career improving maternal standards from Thailand to Morocco to Afghanistan, crafted the workshop to build connection among the midwives. Each morning, the workshop begins with a song, led by a group of midwives from a different region of Papua New Guinea. When the buddy groups are announced at the end of the first day, the room erupts in cheers as the paired midwives excitedly embrace.
Attending the workshop in the city costs the midwives nothing but a week of their time. Airfare, food, and lodging are covered by Rotary, supported by district grants and two global grants from The Rotary Foundation. For participants like Weuta, who is never truly off the job — even here she fields calls from community health workers for updates on the expecting mothers in her care — the days full of learning and connection provide a much-needed respite. “I felt a weight lift off my shoulders,” she says.
The initiative grew out of a twinning program between the Australian College of Midwives and the Papua New Guinea Midwifery Society that started in 2011. In 2019, Rotary members from both countries joined the partnership in developing the buddy program to better support individual midwives. Rotarians in Port Moresby help with logistics and funding, giving the Papua New Guinea midwives a stipend to pay for nonessential trip expenses, while those from Morialta manage the overall project and its evaluation, and organize travel.
Organizers had planned initially for only three cohorts. But Brown says the program was so successful that at the end of the third workshop, the midwives pleaded for them to keep going. This workshop in April is the fifth of the program, with hopes to continue.
While parts of the program are information-dense, the primary focus is on building bonds and encouraging a perspective shift. “We’re not trying to go in there and teach clinical skills,” explains Helen Hall, of the Australian College of Midwives, the project facilitator. “Other groups have done that, and it’s important. What the buddy program does is build confidence to lead.”
During the workshop, the Papua New Guinea midwives establish a project that they will complete with the help of their buddies over the coming year. “You can see that they start to recognize their capacity,” explains Hall, who, impressed by her Rotary partners, decided to join a club in her semiretirement. “And then they’ve got a champion on their side that says, ‘We believe in you and let’s do a small little project together.’”
For instance, one graduate of the program developed a poster with a checklist for each prenatal and postnatal stage. It serves as a guide for community health care workers with less training than a midwife or a nurse. “That simple checklist, I have no doubt, will save some lives,” Hall says.
For each project, the Rotary Club of Morialta sets aside 500 Australian dollars (about US$325) to help the midwives complete their work, but the midwife who generated the posters found another organization to cover the printing costs. So instead, the midwife used the Rotary funds to purchase life jackets. In remote regions of the country, midwives often transport women in labor via canoe. With the life jackets, they can do so more safely.
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Simon James Kopalua (left) is one of five male midwives in this year’s buddy program.
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Helen Hall, midwife and program facilitator, joined the Rotary Club of Rosebud-Rye in Australia after working with Rotarians on this initiative. “The people I’ve met are the people I want to spend time with,” she says. “They look locally, they look nationally, and they look globally at what they can do, and how they can bring their skills into it.”
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As a buddy group in the program, (from left) Noah Noah, Xaviera McGuffin, and Gwyneth Weuta support each other.
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Afzal Mahmood, a member of the Rotary Club of Morialta, is a public health expert and workshop organizer.
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Weuta (second from left) and fellow Papua New Guinea midwives lead the group in a song.
“As a midwife, you can create change.”
Weuta and her Australian buddy, Xaviera McGuffin, sit in the back of a bus, giggling and bobbing their heads to twangy banjo music playing from a cellphone. “We’re heading to the country!” Weuta laughs, as the bustling streets of Port Moresby turn into pastoral rolling foothills out the window.
The workshop group is on its way to Pacific Adventist University, where many participants, including Weuta, received their midwifery training. After a day of touring medical facilities, the buddy cohort will meet midwifery students and deliver donated learning materials toted in the Australian midwives’ luggage.
Geography and lack of resources are not the only challenges that midwives here face. Culturally, giving birth is a “family thing,” explains Sitaing of the midwifery society, so many women in labor stay at home without a trained attendant. To try to shift these practices, midwives work with the whole family and the whole community. They encourage women to come into the clinic early in their pregnancy to ensure healthier outcomes and welcome the father’s involvement throughout the pregnancy and the birth.
Increasing male partner involvement may also lower Papua New Guinea’s intimate partner violence rate, one of the highest in the world. According to a national survey, nearly two-thirds of women in the country who have been married have experienced spousal physical, sexual, or emotional violence. Anecdotally, midwives have seen that getting partners involved in pregnancy and birth helps prevent violence, enabling fathers to feel more connected to their children and see their partner’s strength in the delivery room.
Papua New Guinea has a greater share of male midwives than Australia, says Helen Hall. And male midwives often work in the more perilous regions. This year’s buddy cohort had five male midwives, including Simon James Kopalua.
Kopalua, who sports a button-up shirt and tie on this day, speaks with the measured cadence of a university professor despite being 29 years old. He is a midwife in the remote Highlands region of Papua New Guinea. Kopalua transitioned from being a nurse to a midwife after witnessing several maternal and neonatal deaths on the job. His own mother and sister almost died in childbirth.
His cellphone contains images of ambulances outfitted with off-road tires stuck in rutted rainforest mountain roads. Grinning with pride, he speaks of his work, from advising on family planning to building goodwill with the community to performing lifesaving procedures with only a cellphone flashlight. “As midwives, we must remember that we have multiple skills,” says Kopalua. “Most of the time, we focus on governments and people to create change. But as a midwife, you can create change too.”
Kopalua discusses common misconceptions about going to health care facilities: “Women believe that it’s not safe to deliver in the health facility because the baby might die, the woman might die, sorcery will attack them in the night. Staff attitude and behavior can also become barriers.” He continues, “In my culture and in most other cultures in Papua New Guinea, men are not supposed to touch the blood of a woman because people think that it will reduce their strength, make them weak, or infect them with diseases. It’s so challenging, but I break this barrier because I want to make a change and help people change their way of thinking.”
Weaving a network of supports
The final day of the workshop is a whirlwind of activity. The buddy groups spend time together discussing their projects. They walk on paths shaded by palm trees and huddle over their computers crafting presentations. There are impromptu roundtable discussions about their hopes for the future, and at dinner they discuss challenges they’ve faced working in their clinics.
Program facilitator Julie Kep (left) has worked as a midwife in Papua New Guinea for more than 40 years. Here, she speaks with Sania Ronnie and her child.
For midwives working on their own, like Weuta, the buddy program has provided more than just a buddy. It’s woven a network of supporters. Over the first five cohorts, the buddy program has included 52 midwives from Papua New Guinea and 32 from Australia. Program participants represent all 22 provinces of Papua New Guinea. Some midwives had never left their province before, but now they’ve had the opportunity to visit medical clinics, hospitals, and universities. They’ve met other graduates of the buddy program who hold leadership roles in maternity wards and educational programs.
Weuta plans to focus on preventing teenage pregnancy in the region where she works. Each month, she says, she sees at least one teen mother-to-be. Her project will focus on pamphlets and a program to train educators to teach family planning.
Papua New Guinea’s maternal health crisis cannot be solved by midwives alone. But in between paddling laboring women in canoes and challenging generations of cultural norms, they are championing improvements to maternal and child health. With the help of Rotary, midwives are gaining tools, a voice, and a community. They are striving for a future where no woman labors alone or dies from preventable causes. Says Mary Kililo Samor, a technical adviser for the Ministry of Health who visited to champion the midwives’ work: “We have not done it yet. But we are doing it.”
This story originally appeared in the October 2025 issue of Rotary magazine.