Looking at the photographs pinned to the wall of my studio in Hackney, I feel overwhelmed by the stories I have heard and inspired by the defiance and utter joy staring back at me.
I started the original One Day Young project in East London back in 2008, photographing over 150 mothers at home with their babies in the first twenty-four hours of life. When WaterAid invited me to extend this project to Malawi, to raise awareness about women giving birth without clean water or sanitation for their Deliver Life appeal, I was apprehensive. Every minute a newborn baby dies from infection caused by a lack of safe water and an unclean environment. The challenges women in Malawi would have to overcome just to give birth would be very different to the mothers featured in the London series.
Their stories will always stay with me. The young woman who'd walked 13 hours to reach the health centre, women who'd collected water until the day they gave birth, the dilapidated washrooms, the crammed maternity room with women sitting on a filthy concrete floor, some having contractions, others cradling their newborns. In these conditions the life threatening risk of infection looms over mothers and their babies, always preying on their minds.
As I look through their photographs now, I'm reminded of their struggle, their fight, but overall of the triumph that shines out of these images. Despite giving birth in the toughest conditions I've ever seen, the euphoria of bringing life into the world is just immensely powerful. I am so grateful to have had the opportunity to meet these women and hear their stories.
Meet the mothers in One Day Young Malawi
I will never forget Alinafe. She was the first woman I met when we arrived at Simulemba Health Centre in Malawi, beaming her beautiful warm smile and brimming with excitement to have her photo taken. Alinafe was two weeks early and had been very anxious about going to the centre, she'd heard stories of people who'd died there, and must have had to suppress this fear during the birth.
This is Efrida. I met her on the maternity room floor, just twenty minutes after giving birth to her son. The delivery bed was needed for the next woman in labour. She's a woman that just exudes strength. This is a tight family unit trying to fight their way out of poverty. While her whole family (husband and five children) all sleep in one small room, Efrida proudly tells me that they now own eleven cows and even have a small truck which they hire out. This family are hopeful about their future, but when they show me the water they drink, my heart sinks. It's brown, filthy and murky. The last thing you would want to wash you baby in. Despite all their strength, this is a real danger for Efrida and her family.
Arriving at Liviness's home we're greeted with warm smiles, laughter and chickens. This is a vibrant place to live. Liviness was at the health centre with her mother and mother-in-law and they're here now, by her side, reassuring her. The joy and relief of being home just pours out of this photograph. We get on so well with Liviness and her family that we leave with a live chicken clucking in the back of the car.
Say the name Joyce in this house and you'll get the attention of four people! Not only is Joyce the name of Esther's new baby, it's her mother, sister and sister-in-law's name. Despite having a tough delivery yesterday - giving birth back-to-back and having had stiches post-birth - she proudly bounces baby Joyce on her lap without a care in the world. The midwife did an amazing job; reassuring Esther and helping her deliver the baby safely. There's no ambulance service at the health centre, and with the nearest hospital over an hour away, baby Joyce could have been in grave danger.
Perched on a remote hill Jennifer's home was the most isolated place we went to. The health centre is a four hour walk. Even by car the journey felt arduous. Tragically, Jennifer suffered a still birth with her first baby, making baby Joseph even more precious. Jennifer looks so happy to be home with her family around her. I thought she was so strong and warm to invite us in, with all the emotions this birth must have brought up for her. When her young cousin takes me to see where they collect water, again my heart sinks. This should be a happy occasion, and it is, but you can see that again a tiny baby is at risk, when the only option is to bathe him in water that has been scooped from a muddy hole in the ground.
What you can't see in this picture is that all around Joyce is a hive of activity - people are coming and going, women are in labour. The curtains in the background are thick with dust; they don't look like they've been moved since the 1970's. There's not enough water to clean this room properly. Yet Joyce maintains this quite calm, mesmerised by her newborn baby. Nothing that happens around her - the uncomfortable conditions, the lack of water to wash - can affect her in this moment.
Of all the homes we visit Justina's strikes me as the most stark - aside from a reed mat on the floor where she sleeps with her family, there's very little else. Justina was at the health centre for nearly four weeks because she was very overdue. Water retention in her legs meant she struggled to collect water at the centre; her legs would often go numb.
In a house of boys, baby Jonathan is the fifth male addition to her family. Water is a women's issue, it falls on Justina to fetch the water for the family. She has to collect water in a six hour round-trip, which involves walking over a small mountain and digging for water by hand.
Madalitso named her baby Linda, after the midwife at Simulemba Health Centre. That's how important their roles are seen here. With no clean running water and proper hygiene at the centre, midwives battle to bring life into the world against the odds.
When I photographed Miriam she was in a lot of pain. She had been bleeding heavily since the birth and is clutching a pack of Panadol. Her mother reassures her that she has had this experience before herself and that the blood and pain will pass. The water at Miriam's home has dried up and they now have to walk even further to find water, knowing all the while that it isn't safe to drink.
Rita was collecting water right up until she gave birth. The bucket she showed us could carry as much as 40 litres of water - that's 40 kilograms. There's hope and laughter in Rita's home. Her husband, convinced she was having a boy, bought several outfits form the local market in preparation, much to Rita's amusement. Incredibly, Rita's mother Elizabeth was the first woman to give birth at Simulemba Health Centre when the maternity ward opened in 1979.
I'll always remain in awe of the vast distances these women travelled, usually by foot, to reach Simulemba Health Centre. For their great effort I wish the health centre was a safer place for them to give birth. With no clean running water, just four toilets for over 400 people and the washrooms a tumbling down ruin of bricks, open to the road with no doors or roof - the situation was appalling.
This map shows the huge area the centre serves, with over 70,000 people accessing their healthcare here. The nearest hospital is Kasungu District Hospital, over an hour's drive away. With no ambulance service most patients cannot afford the transport cost this involves.
I would love to see Simulemba Health Centre when it has clean running water, good hygiene and sanitation. To see the difference it would make to the women of this community knowing that their next birth, and that of their own daughters, will be so much safer.
WaterAid's Deliver Life appeal aims to reach 130,000 mothers and their families around the world with safe water. Every £1 donated to the appeal until 10 February will be doubled by the UK Government - meaning it can help twice as many mothers and babies stay safe and well. For more, visit www.deliverlife.wateraid.org