The royal baby [a topic I am dabbling in plaintively] was born as
predicted, the mother walked out of the labour ward without being aided; the
baby actually waved at the hundreds of news-mongers who gathered there...such a
lucky family, how I wish the same was true for African women...
Lucky Kate |
Fatima Mphondera
is just 21, she dropped out from school before she could get to standard 8 and
being married at age 20 was actually an achievement; In Chidzuma village, Dowa,
Central Malawi, her friends got married by 15.
Fatima is
carrying child and she is in her ninth month, she potters about the waiting
area at Chankhungu Health Centre located in Dowa, an hour’s drive from Malawi’s
capital, Lilongwe. She constantly moves from her room to make sure the beans
she is cooking have enough fire, her mother-in-law watches her cautiously as
anytime from now, her water might break.
“My village is
far from this hospital and when I saw that my pregnancy was advanced I decided
to come and wait it out here. I can develop complications in the village and
nobody can help me there where there are no nurses.
“This is my
first pregnancy and I wanted to be sure I am safe, plus the chief has banned
giving birth in the village, there is a fine of one goat for anyone who gives birth in the village,” said Fatima.
But is Fatima
safe? Is the baby she is carrying safe?
About to mother in one of the most dangerous places to mother - Fatima |
Save The Children
the international nongovernmental organisation has just released the State of
the Worlds Mothers 2013 report which places Fatima in one of the worst
countries to be a mother in.
Out of 176
countries, Malawi is the 144th worst places to be a mother in, that is 144
places after the best places to be in. If Fatima was a Finn, living in Finland she
would be one of the luckiest mothers.
As for Fatima’s
baby, all manner of risk awaits its arrival, by
Fatima joins the
rest of the Sub-Saharan women in being justifiably afraid. In the Save the
Children report, 10 bottom-ranked countries are all in Sub Sahara. In this
part, one in 30 women on average dies from a pregnancy related issue. And one
in every 7 babies dies before their fifth birthday.
It is almost as
if this part of Africa is cursed as many indicators seem to be worst here. No
wonder Bruce Willis once said in his movies that God left Africa a long time
ago.
Save the
Children however says most babies that die actually succumb to preventable
deaths such as prematurity, infections and complications at birth.
Back in
Chankhungu Health Centre, a centre that serves about 20000 people from over
5000 households in 72 villages. Fatima joins the 87 women who deliver babies
there every month.
This is advanced as a Malawian labour ward can get |
Jane Sibande is
the Nurse Midwife at the centre and she says that they expect about 13 birth
complications every month. She lists the most common complication as loss of
blood during and after birth.
“We have a
motorcycle ambulance and when we have a case we cannot deal with we send it to
the district hospital. We are very serious with pregnancies once a woman comes
here we check her thoroughly for HIV, Malaria, anaemia and possible
complications so that we put her on treatment and watch her closely.
“This has worked
and the last time we saw a woman dying in childbirth here was in January and it
was a rare thing,” said Sibande.
Part of the
success of the hospital has come with the intensification of outreach
programmes. In 2008 Save the Children trained 19 Health Surveillance Assistants
(HSA) at Chankhungu in community mobilization and maternal and neonatal health.
Acting HAS
Supervisor at the health centre Christopher Luvela hails that intervention as a
turning point in the fight against maternal mortality in the area.
Trying hard - Sibande |
“We now have 19
officers, 15 placed in hard to reach areas. We go in the villages and every
pregnancy we register and follow up, we offer counselling and encourage the mother
to report to hospital early, that has worked and now an HSA can go a year
without a home delivery,” said Luvela.
And it is not
just the hospital. The chefs in the area have made bylaws against home
deliveries, anyone who dares to deliver at home pays a fine equivalent to a
goat to the chief and in the village a goat is too high a price.
The community
has also supplied the hospital with mats for the pregnant women and guardians
to sleep on.
Minister of
health, Catherine Gotani Hara when asked about the report acknowledged the
risks mothers and babies face by virtue of them being in Malawi and said
government is in an advanced gear to try to root out the deaths.
Hara - its unacceptable |
“The launch of
the safe motherhood initiative shows commitment at the highest level, we don’t
want to see a mother dying while giving birth and it is just one of the efforts
we are implementing to fight maternal mortality,” said Hara.
Gotani said the
high mortality rates can be attributed to the fact that most mothers are young
and said the solution might be in keeping the girl child in school so as to
keep her away from pregnancy until she is mature.
The report
recommends that country should invest in empowering women, investing in health
workers especially those at the front line and in low cost technologies that
can save lives at childbirth.
Senior Chief
Kwataine, who heads the presidential initiative on safe motherhood, said more
resources are needed in the area of safe motherhood to tackle the deaths.
Melinda Gates has
said: “Any report on the state of the world mothers is by definition a report
on the state of the world.”
The HSAs - are there enough of them? |
So far the world is a sick and dying one and
Malawi will be the witness to this and the evidence will be the way Fatima and
her peers fare.
Meanwhile the
royal baby is already predicted to live long....back here, if Fatima’s baby
hits age 50, it will be a record as life expectancy is way below five decades.