Delivery Men

A cluster of villages in a remote corner of Meghalaya has a most unusual tradition. The midwives here are male

Ialam is in his thirties, enjoys a good kwai—a combination of areca nut and betel leaf—once in a while, earns his living by making handicrafts, and dotes on his three children. A typical resident of the East Khasi Hills district of Meghalaya, by any reckoning. But Ialam is not just another villager, especially to the women of his village. During pregnancies, he is the person they depend on for a safe delivery. Ialam is a male midwife, one of an unusual group of men who double as midwives or nong tyn ksa ksum as they are known in Khasi. “All men in our cluster of villages are well versed with this skill,” he says, “But only about 15-20 like me make a regular practice of it.”

Called Syntein, the cluster of five villages—Mawkaphan, Domskong, Jympait, Kenbah and Kenmynsaw—is located deep in the interior, far from the modern world. On your way there, the road abruptly ends to give way to a little path strewn with rubble that is almost impossible to walk on. Then there comes a perilously suspended bridge, a wobbly wood-and-iron contraption below which lies 230 feet of sheer nothingness. Finally, the villages come into view. They seem one on top of the other, with the last one being at the foot of a huge hill, very close to the Indo-Bangladesh border. From the first village to the last is an hour-and-a-half long trek downhill. “It is very difficult to get to Syntein, so not many people come here,” says Protik Roy Malngiang, ‘assistant king’ of Mawsynram block (which includes Syntein).

According to a local legend, Syntein’s founders concealed themselves in this remote area 200 years ago to escape the ravages of war. The wobbly bridge remains their only link to the outside world. “The so-called road [rubble path] was built in 1973, says Sanphrang Marbaniang, headman of Mawkaphan village, who works as a driver for a high-ranking government official, and returns to the village on weekends, “It was never smoothened or tarred.” It is this isolation that has given the cluster its unique subculture, of which male midwives are but a part. “We have no option but to be self-sufficient,” says Sanphrang, who is also a midwife,  “Each village has 400 residents, but there is not a single hospital that caters to their needs.” Even today it takes nearly two hours to reach a sick person or pregnant woman to a hospital in Mawsynram. And since vehicles can’t access these villages, this journey needs to be made on foot. Villagers have to rely on the traditional kobiraj (local doctor) for regular illnesses, broken bones, shoulder dislocations and the like, and on midwives like Ialam for safe childbirths.

The male midwife tradition intrigues anthropologists. “It is quite an unusual practice, something that I have not heard of anywhere else. I first read about it some years ago in an article published in a magazine by North East Network, an organisation that focuses on women’s issues,” says TB Subba, head of the anthropology department at North Eastern Hill University, Shillong. The phenomenon arouses several questions. How come men have adopted a role that has for generations been firmly associated with women across the rest of India? Given the inhibitions that even urban Indian women have in going to male gynaecologists, how do Syntein’s women let men share one of the most personal and intimate moments of their lives?

Hasina Kharbhih, an activist whose NGO Impulse works in the fields of child protection, trafficking and rural livelihood across the Northeast, had similar thoughts when she first visited the village 17 years ago. “I had come here to start a rural livelihood project with women,” she says, “That was when I saw two babies being delivered by men. That piqued my curiosity, and I tried to find out if this was a one-off thing or a regular practice.” After speaking with village women and doing further research, she realised that this tradition had been part of their lives for centuries and was unique to just this cluster. “It might be a novelty for you and me, but for them it is a way of life that has been in practice for 200 years and more,” she adds, “When I was questioning them, they seemed to find my tone of surprise amusing.”

After wandering a bit around Mawkaphan, we come across a group of women in a huddle, exchanging gossip while working on handicrafts and tending to their children. A silence descends as they notice strangers approach. Most of them are awfully shy, not even looking directly at us. After a couple of minutes of small talk, a few open up. The most talkative is a lady called Landa. She’s a 40-year-old mother of nine and has an explanation of her own for the phenomenon of male midwives. For centuries, she says, women never crossed the village periphery. Venturing out of the village—to get bayleaves, pepper and bamboo from the forests or to sell handicrafts—was a male prerogative, as was any other ‘serious’ or ‘risky’ task. “And what could be more risky and serious than delivering a child? It is a matter of life and death,” says Landa, “Women are not capable of handling this huge responsibility. Men are far more adept at handling dangerous situations and complications. We are content with crafting hats and baskets out of bamboo.” But don’t they feel awkward with men around during deliveries? She looks puzzled, as if it had never occurred to her. “Why would it?” she asks.

None of the male midwives has any formal training, but their proficiency is remarkable—nearly 95 per cent of the pregnancies in recent years have resulted in successful births. The skill-set is passed down from generation to generation. “But it is not as if only the father can pass it on to his son. Whoever shows talent and an inclination to learn can seek the help of an older midwife,” says Hilda Disiar, another woman in the huddle.

Nowadays, the task of educating the next generation of nong tyn ksa ksums rests with Phromen. In his 50s, he is rated as the most talented midwife in all five villages. “It is our culture to disseminate knowledge and not hold on to it,” says Phromen, who has lost count of the number of babies he has helped deliver down the years.

He teaches the younger ones about complications that can arise during a delivery; and also that being a good midwife is not just about skill, but also mental strength. Deliveries can be difficult. Often, the baby’s placenta doesn’t come out or the baby doesn’t sit right—at moments like these, a midwife needs to keep his wits about him. “Two years ago, Ialam and I were called to a woman’s house in the early hours of the morning. We realised that the baby wasn’t sitting right. It called for a special massage that required a particular kind of hand movement. Finally, the baby came out healthy and strong,” recounts Sanphrang. “Often, the baby is on its way, but the [mother’s] water has still not broken,” he continues, “All one needs do is squeeze hot water onto the stomach. Or put the mother’s hair in her mouth. This helps her vomit and throw out all the dirty water.”

I ask Ialam and Sanphrang the same question I’d asked the women. Is there any awkwardness, being part of such a personal moment in a woman’s life? “Not really. The only thing that comes to our mind is that we have to save lives. But we do realise it can take a toll on us. We usually take the day off after having delivered a child,” says Ialam, who helped deliver his youngest son, Nekeyson, as well.

Every delivery is the start of a lifetime bond. This is evident in the way that the nong tyn ksa ksum have with children, who tug at their shirts, play pranks on them and joke with them at ease. “Each child you deliver is special. You can’t help feeling blessed to be part of such a beautiful process,” says Ialam.

healthcareMeghalayamidwifery