As she lay bleeding to death in Valente Inziku’s arms in a Ugandan government hospital in October 2010, Jennifer Anguko, pregnant with the couple’s fourth child, wished her husband well as a single parent.
“She said she’s going and I have struggled in vain, that no-one has helped her and everything is finished,” Inziku said, recalling the moment when his wife bled to death. “She told me to look after the children.”
Nearly four years later, her husband is still waiting for the government of Uganda — where an estimated 16 women die though childbirth-related complications every day — to face up to the gruesome reality of maternal health.
The widower is one of four petitioners who sued the state in 2011 over its alleged lack of midwives and doctors, frequent shortages of essential drugs, a lack of emergency obstetric care services and deadly negligence when it comes to handling pregnancies.
The 2012/13 State of Uganda Children report, released by the country’s health ministry in August, found Uganda’s maternal mortality ratio is at 438 per 100,000 live births — one of the highest rates in the world.
SHORT OF MDGs
The country was also warned by The World Bank in 2012 it was failing to meet its Millennium Development Goals (MDGs) of lowering the toll by three-quarters by 2015.
Anguko’s death, according to papers filed in the landmark case in the Constitutional Court, was due to an absence of “basic maternal commodities” and a lack of attention of health workers.
The petition argues her death was an “infringement of her rights to life and health guaranteed under the Constitution”.
Sylvia Nalubowa was another pregnant woman who bled to death in August 2009 at Mityana District Hospital, about 80 kilometres outside the Ugandan capital Kampala, allegedly after corrupt medical staff wilfully neglected the mother of seven.
Rhoda Kukiriza, who was with her daughter-in-law until the end and accused health workers of leaving Nalubowa unattended after she refused to pay a bribe, is another petitioner in the landmark case.
According to a health ministry investigation into the deaths of Anguko and Nalubowa, both women went to hospital in time to be saved.
But in June 2012, the Constitutional Court threw the case out, ruling that it was a “political” and not a legal matter.
Last week after a Supreme Court appeal was adjourned pending judgement, activists accused Uganda’s judiciary of being “disinterested” and “disconnected” when it came to dealing with the issue.
Nakibuuka Noor Musisi, programme manager at the NGO Center For Health, Human Rights and Development (CEHURD) and another one of the petitioners, accused the government of lacking “political commitment”.
“The very week we filed the case, in March 2011, the government was buying fighter jets,” she said. “To protect whom? When women are dying?”
As such, the case could have punishing implications for the Ugandan government and for veteran President Yoweri Museveni as he campaigns for re-election in 2016 — which will be his 30th year in power.
According to a recently released survey by Columbia University researchers and the Coalition to Stop Maternal Mortality in Uganda, a quarter of voters in the impoverished east African nation believe health care should be the top national priority ahead of the polls.
“The reason we are taking the matter to court is the government has the responsibility of providing health and health facilities to the people,” said Inziku, a 47-year-old teacher.
He said he thought his wife would be proud of him for taking a stand: “Definitely, because when you see something bad or wrong there is a need to fix it.”
Godfrey Wamala, another Ugandan widower, recounted how his wife Remie had an incident-free pregnancy before she, too, bled to death at a Kampala hospital in 2013. Her baby survived but has cerebral palsy.
“Pregnancy is not a disease but in Africa we treat it like it is,” he told AFP. “The health system is lacking.”
Ironically his late wife was a coordinator for the Parliamentary Forum for Children, and had campaigned tirelessly for maternal and child health rights.