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...
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.