Features / Photography

Elena Heatherwick captures the spirit of hope and happiness embodied by Liberian midwives


Lucy Bourton


Elena Heatherwick

The act of holding a camera has a distinctive charm to it. It starts conversations, but it’s an opener before a word has even been spoken. It intrigues people to come on over, to ask why you have it, what you’re doing, who you are. These pleasantries and the inevitable conversation that follows is an experience every photographer has undoubtedly had, but the accounts photographer Elena Heatherwick has from a trip to Liberia are some of the most joyful, heartbreaking and life affirming ones we’ve heard.

Elena, a London-based photographer who’s shot most subjects from plates of food to portraits, got offered a job earlier this year that she’s always dreamed of. “It was one of those emails that only come in every now and then,” she tells It’s Nice That. “One where you really feel like spam has landed in your inbox. Too good to be true.” The email was from the UNFPA, the United Nations Population Fund, inviting the photographer to travel to Monrovia, Liberia, and shoot the capital city’s selflessly diligent midwives.


Late afternoon at the Tubmanburg Hospital in Bomi County. Head midwife N
\eneh, 59, with her team. “Even during the war, most of us were not working, But when there was a call to help a woman in labour we would rush to her. We were working across the line.”

A year earlier, Elena had shared a photograph with the UNFPA for an Instagram project the organisation was running. It was for International Women’s Day, asking photographers to share a photo capturing the essence of what it means to be a woman. Elena submitted a photograph of her mother, a birth companion for women in child labour known as a doula or, “a sort of bodyguard, protecting the space of the woman in labour,” as her daughter, the photographer puts it. “She is my mother, but she has also been a mother figure to the hundreds of women who’ve given birth with her by their side.”

The photograph was unforgettable. It’s an image that stayed with Usen Esiet who works in communications at the UNFPA, and when looking for a photographer for this midwifery project Elena came to mind. The fact that she didn’t have a portfolio of humanitarian work didn’t matter to him. “I believed she would empathise with the midwives and mothers in an authentic way that would come to life in her photographs,” he explains.

Unknown to Usen, Elena had been intrigued by Liberia for some time. Like many during the Ebola outbreak from 2013 to 2016, she couldn’t stop reading about it, “checking the news, heartbroken that this was happening and feeling totally helpless,” the photographer explains. Ebola, despite fading from headlines more recently, “took an an unprecedented toll on the health system in Liberia, and the country is still yet to fully recover from this crisis,” Usen explains. As a result, pregnant women and new mothers are left without the essential care they need, but Liberian midwives in response have only grown stronger “working tirelessly to make motherhood safer, and to ensure that this period remains a time of joy for mothers,” he continues. “In spite of the many challenges they face (from inadequate pay to insufficient equipment), midwives continue to save the lives of women and their babies. This spirit of hope and happiness is what we sought to capture and showcase.”

Dilation chart above delivery beds in the labour room in the Tubmanburg Hospital

Neneh in her office: “I want to save lives. I love babies. So each time I see a pregnant woman and see her bump, I look down and think I want to catch that baby, I want to see how that baby looks.”

Still reeling from the UNFPA offer sitting in her inbox, Elena was cautious about getting her hopes up, convinced the trip still might not happen. “I would have loved to have spent hours surrounded by books reading up on the history, politics and culture of Liberia and the role of midwifery in the context of it all, but that’s not quite how it panned out,” she says. “There’s a lot of paperwork involved with projects like this. Although the initial conversations started earlier on in the year, the flights were only booked a few days before I was due to fly. Up until then I didn’t want to let myself believe it would happen.” In reality, Elena’s planning for the trip “was actually a bit of a whirlwind,” she explains. “Trying to figure out who would look after my son while I was away, persuading bank managers to write letters for me and getting last minute vaccinations done in a dodgy place in Shepherds Bush.”

Unsurprisingly Elena’s whirlwind of an experience only continued, an inkling of the personalities she would meet began by boarding the plane. “The flight from Brussels to Liberia is a bit like a bus, stopping in Sierra Leone to drop off and pick people up. It was a flight filled with people from all walks of life,” she begins to explain. “When we landed in Sierra Leone we had to wait on the plane for an hour. It was hot and humid. I had three seats next to me before a woman came and sat at the end of the row. She had bright orange curly hair and huge bosoms bursting out of a shiny blue dress.” The woman was sweating and seeing her struggle to fan herself, Elena passed over a magazine. “She accepted it but asked it I had any deodorant. I did, but it was a roll on. ‘Skinny girl like you don’t sweat, you don’t need it!’ she replied,” Elena continues. “Well, actually yes, I was sweating but anyway, she took it, used it generously then held it towards me hopefully but said, ‘Do you really want it back girl?’ I told her she could have it.”


Houses surrounding the Grand Cape Mount County hospital in the north west of Liberia.


Georgetta, 29, a midwife at the Grand Cape Mount County hospital who works tirelessly, often overtime, to provide care for mothers and their babies.

Conversation sparked — as it always seems to with Elena — and it turned out the woman was a Ghanaian gospel singer, heading to Liberia for two weeks touring churches across the country. “I asked her if she could sing me a song and without hesitating she leaned towards me, held my arm gently, and starting singing ‘Aaaamazing Grace’. The hairs went up on my arms. It was incredible.” This was Elena’s first experience of the trip and a precursor of what was to come; a journey that at times was a little up close, sweaty for sure, but memory forming. “When we arrived in Monrovia airport, friendly carnage ensued. Bags flying all over the room, people shouting and digging through piles of suitcases. Slowly, everyone left the airport expect for Usen, myself and… my gospel singer friend. All our bags had been lost in transit. So, the trip started (and ended) with no luggage, no deodorant, but a heart full of hope ready to work.”

Elena’s four-day trip followed a regular routine. Herself, Usen and a filmmaker would wake up early, head to the UN’s base for security briefings, before piling into a truck for hours on the road with a destination in mind. Elena’s role was to naturally capture what she saw quietly. Her position on the sideline was purposeful, formal images weren’t what she had in mind, instead aiming “to get a sense of the individuals and their environment,” she explains. Also trying to keep quiet so as not to get in the filmmaker’s way. “Shooting with a Pentax 67 didn’t do me any favours on that front, the sound of the shutter firing is far from subtle.”


Georgetta holding baby Musukawa during a routine check up. She’d helped deliver her at the hospital eight months ago.


Musukawa asleep in her mother’s arms.

Recalling her trip, the photographer rarely mentions locations; it’s names and personalities instead that she remembers. One instance could be a home visit to Yamah who gave her a mango upon leaving to give to her son, but who also told Elena a significant story of the project at hand, underlining the importance of the UNFPA’s work. Yamah told the group about her first day at Redemption Hospital in Monrovia, a day when all staff refused to go in the delivery room for fears of Ebola, but there four women in labour. “She said to them, ‘Okay, you guys can stay away, I’m going to go in there alone,’” Elena says explaining Yamah’s story. Each of the to-be mothers in labour were Ebola positive and “despite her best efforts all four mothers and their babies died,” the photographer continues. “She couldn’t understand what she’d done wrong but at that point she made a decision: ‘I will work to save my people’. And so, despite having to lie to her husband and her family who were against her putting her own life in danger, she’d go back to the hospital. By then it was an Ebola holding centre, and Yamah would treat every woman who came in, never knowing who was infected and who wasn’t.”

Elena’s photographs are a result of her attitude, a calm and thoughtful one, creating images which make you stop what you’re doing immediately. Their natural of the subject matter at hand, but the sheer weight of the project, her trip, the fact she was with the UN, and the important work carried out by these women, can be felt in each frame. Since the Ebola outbreak many people still fear medical professionals in Liberia, and Elena hopes the photographs raise awareness. “I’d always ask mothers in the clinics how they’d heard of it or midwife support. The answers were often through friends or local radio,” she points out. “So where do photographs fit in with all of this? How can they help spread awareness where it is very much needed? That’s what I want to figure out.”


Washing line, Grand Cape Mount hospital.


Bendu, 21, holds her baby girl the morning after giving birth under Georgetta’s care.


Yamah, a midwife at the Redemption Hospital, Monrovia who continued working during the Ebola outbreak. “The thing about life is that once you decide to do something, once you see in yourself that you can make it, you will continue to have that courage.”

Despite Elena’s camera being the gateway to many of these conversations and the subsequent stories that have followed, “an encounter that will always stay with me is one that didn’t result in an image,” she says. And so, I’ll leave her to tell it:

“I was sat by myself on some steps in the Redemption hospital cradling my camera on my lap. A man with a camera bag hanging from his shoulder approached me and asked me what I was doing. He sat down next to me and we talked about cameras. I’m not really technical and know very little about cameras, so I moved that conversation on quite quickly. He told me he always had his camera with him in case a job came through, he was a passport photographer as that was the best way for him to make a living. I then asked why he was at the hospital. He told me his wife was in labour with their fourth child and previously she’d had three caesareans. Unlike here, caesareans can be incredibly dangerous as hospitals don’t often have the correct or clean equipment.

“The chat about cameras gave way to a chat about his life. He’d been married before but his previous wife had died in labour. The child survived but died weeks later as he wasn’t able to feed it sufficiently. There was so much sadness in his voice when he spoke to me. His second wife was now having contractions and unfortunately, once again, complications had started to arise. As we sat and talked I wished so much that I could help. I knew his wife was in the best hands possible, but still.

“Something about having a camera opens up conversations and that’s what feels most important about this job: to listen. His story was the reality of why the work of midwives is crucial, and why support from the UNFPA is more important than ever. As one health professional told us, ‘without midwives there will always be more death than life’.”

With funding from Johnson and Johnson, UNFPA is training midwives in Liberia to save lives. Please consider making a donation to help UNFPA ensure that no woman dies giving birth. Further work by the UNFPA can be seen in its First Moments project here.


Yamah’s family home.


Yamah’s son’s having breakfast on the porch before school.


Yamah in the labour ward at the Redemption Hospital where she continues to work. Her dedication and sense of duty to mothers is clear “You have to be their guardian angel”.