It is that time of year again. The United Nations has released its facts and figures on the state of women in the world not least during pregnancy and childbirth. Once again, Sierra Leone is one of the worst places in the world for a woman to get pregnant in. I am not sure about the correctness of these figures, but I have no reason to challenge them after what I saw at the Princess Christian Maternity Hospital (PCMH) otherwise called Cottage, during only three visits I made there last week. Our women are dying unnecessarily.
Our public medical practitioners are struggling without even the basics. The private ones with the requisites are charging exorbitantly, scaring poor pregnant women away forcing them to resort to quacks. And the innocent children are caught in the middle. It’s either they die, or they are born without knowing their mothers, or they die and their mothers die as a result.
According to the UN children’s fund, UNICEF, more than 99 percent of all maternal deaths occur in developing countries with over 80 per cent in sub-Saharan Africa and South Asia. Unicef’s Chief of Health, Peter Salama says, “The tragic fact is that every year more than half a million women lose their lives as a result of complications due to pregnancy or childbirth”. About one out of every 75 pregnant women dies in childbirth.
UNICEF says haemorrhaging, poverty, HIV, and the backward practices and attitude towards women are the main causes for maternal mortality and morbidity. How true!
I spent eight hours at the PCMH. My first visit lasted from 5:30 PM – 1:30 am. I returned at 06:00 and left at 10:15. And then on another day from 9:00 pm – 2:00 am. Those few hours were harrowing. Three women died, almost literally in front of my eyes.
18-year-old Fatmata, not her real name, was brought to the hospital at about 06:15. It was her first visit there. Apparently, she had been attending clinic somewhere in Kissy. On the evening before her death, she started experiencing some strange feelings. The clinic she used to visit was closed. So, according to her relatives, she resorted to going to a nurse, a self-styled midwife. She delivered safely. Then she started to haemorrhage. According to a nurse at PCMH, something could have been bungled by the self-styled midwife.
Kadiatu, again not her real name, had her uterus removed. Dr Sidikie looked reluctant to do it. But it was the only thing he could do to save her life after her child had died in her womb for three weeks. Dr Sidikie is one of those who make one believe that not all is lost in our society. There are still some doctors who hold on to their responsibilities to serve and save mankind. It was late – around 1:00 am. Aided by his team of dedicated nurses, he carried out the operation and the woman survived even though the child had been lost. Again, a quack had tampered with her before she decided to come to hospital.
A relative of Kadiatu told me that even to afford the blood for the procedure was a problem. A unit of blood which I was told would normally be sold for Le 7,000 had Le 500 added to it because it was dark.
The pattern seems predictable. Pregnant women stream into the maternity hospital mostly at night. Apparently after things have gone wrong. Many relatives of pregnant women told me they resort to quacks because it is cheaper and that the hospital, even though public, is expensive. The atmosphere at the hospital they say is frightful. Whatever that means!
Very hardworking nurses I saw on duty on one of those nights told me the patients only pay Le 20,000 for registration. But they were also quick to highlight the problems they were facing at the hospital in which case the pregnant woman must buy her medicines and all those things she needs for a surgery if there is need for one. All this, despite the huge money that is earmarked for the health sector by foreign donors.
Dr Sidikie’s salary is laughable. He is moved by only one thing – to save humanity. The nurses also laughed when I asked how much they were getting as salary. Less than $ 70. And the sister? I better not tell you. Such is the situation that they will all leave at the first opportunity for greener pastures even if the green will soon turn yellow.
Of all the pregnant women brought in my presence, only one was accompanied by her husband. The excuses for the absence of the husbands/partners ranged from the ridiculous to the absurd. Dr Sidikie could not hold back his frustration, asking rhetorically what was wrong with many Sierra Leonean men of today. “The Lebanese, Mandingoes and Fullahs will be by their wives in such situations but not the others”, he bellowed.
It is these men who force their wives against the use of contraceptives to avoid having too many babies; which is one of the causes of maternal mortality. Backward traditional practices make some of these men to send their wives packing. But when that most challenging moment comes for the wife, the husband is nowhere.
All of this is happening despite the existence of Gender Bills that were hailed when they were passed last year, as the key to unshackling the suffering women of our country. Their implementation is thwarted by the paternalistic considerations which force even our politicians to kowtow to these stupid bullying of women by men whose only alibi is that they are men.
The key to saving many more women from dying an unnecessary death at birth is exactly those things some consider basic and is also recommended by UNICEF: better health care not least during pregnancy, delivery and in the post-partum period. But I have noticed that the lack of a skilled attendance at birth and after, is leading to many maternal deaths. Ironically, with only six years to the attainment of the UN Millennium Development Goals, which include the 75% reduction in maternal deaths, it seems the reverse is true. As the calendars change towards 2015, the clock ticks even faster on the life span of a woman who got pregnant last night.
“Saving mothers’ lives is not only a moral imperative, but a sound investment that benefits their children, their families, their communities and their countries,” says Tessa Wardlaw, UNICEF’s Chief of Statistics and Monitoring. How true! God will not have to come down to save our pregnant women. It takes a sound Government policy, and a robust implementation of such. Where are the women rights activists? Someone please tell me. By Umaru Fofana