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Time to get serious about maternal health


Time to get serious about maternal health

The saddest thing about maternal mortality is that though it is largely preventable, we have all not done enough to prevent it.

It has been a really tough year for the medical fraternity, who have lost four young female doctors in the past four months. What makes it even more painful is that they were all young mothers, two of whom died of pregnancy-related complications.

The saddest thing about maternal mortality is that though it is largely preventable, we have all not done enough to prevent it. When young women who spend their days trying to stop mothers from losing life, die of the same monsters they are trying to slay, it is a sad irony.

Approximately 10 per cent of pregnancies will have complications, but the vast majority are expected to be normal. It is terrible when a mother, whose only desire is to have a baby, ends up in the intensive care unit for weeks on end or spends the rest of her life in a vegetative state because of conditions like eclampsia, in which high blood pressure causes a pregnant woman to have seizures and can be fatal.

Too often for comfort, we deal with cases like that of Mary*, a 26-year-old who walked into our maternity unit healthy and excited about meeting her firstborn daughter. She had a sunny disposition. She laboured like a champ and delivered a beautiful and healthy baby girl, but in the space of five minutes, our celebration turned into a nightmare.

STARVING IN MIDST OF PLENTY

The baby was whisked away to the new-born unit as we started a monumental fight to save Mary. The glaring lack of resources saw us lose this woman. She held my wrist with a strength surprising for a woman on the brink of death, looked me in the eye and said to me, “Thank you for putting all this effort doc, at least I’ll die knowing I wasn’t neglected.” Despite pumping three units of blood into her simultaneously while trying to get her into the operating room, she died without ceremony.

The laboratory technician at the blood transfusion unit shed tears for Mary.

He would prepare the blood and rush it to the ward personally, if only to eliminate the delay of someone having to come to the lab, for it would help save Mary’s life. Mary died as he was bringing a fresh batch of three units for her. He looked like he had been punched in the stomach when we drew a bed sheet over Mary’s face. I will never forget that look. All our collective pain and will could not keep Mary alive long enough to get her on an operating table.

We were denied a fighting chance because we had only one functional operating room at the time, and there was a patient already in surgery. We were grateful that blood, the rare life-saving commodity, was available for transfusion. However, despite great team response, we sorely lacked in numbers.

We also did not have all the necessary equipment and we did not have an intensive care unit. These are the requirements needed by the 10 per cent of mothers whose pregnancies will result in complications. We may invest in ambulances but isn’t it better to provide the resources needed to save life at the point of contact with the mother? We may buy fancy equipment for hospitals, but without the requisite skilled personnel to operate the equipment, the patient will still die; it is called starving amidst plenty.

As a country, we may have made some strides in preventing maternal mortality but with the resources this country can afford, we should be doing so much better. Celebrating a maternal mortality ratio of 362 per 100,000 live births is nothing to write home about in a trillion-shilling economy.

Maternal mortality and child mortality ratios are regarded as a yardstick for the state of healthcare in a country.

FAILING BIGLY

Being ranked 30th worst country worldwide in maternal mortality is nothing to be proud of. It puts us only 29 positions behind South Sudan and 27 behind Somalia yet we haven’t been in a two-decade war.

It is good to see effort and resources being channelled into the fight against maternal mortality but why is all that effort not bearing adequate fruit? How coordinated are these efforts? Are they the best investment money can buy? How many of these investments actually have an impact on outcomes? We must guard strongly against highly popular interventions that do not result in reduction in the loss of life.

For as long as we continue investing in training schools for nurses and midwives, who are our first line of defence in fighting maternal mortality, and once we graduate these precious skills, refuse to invest in employing and retaining them in our health facilities, we are wasting resources!

When we train highly skilled doctors and refuse to equip facilities and ensure that doctors have everything they need to save a mother’s life, as a country, we continue to participate in the murder our mothers.

We missed our Millenium Development Goals by a wide margin, as far as maternal health is concerned. We can sugar-coat it all we want by saying we are on track, but the truth is, we are failing terribly and must stop the downward spiral we are caught up in.

Let us take collective responsibility for this epidemic that is leaving a devastating trail of pain behind. If we don’t, our orphans will judge us harshly for it.