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In Uganda, 16 Women Die Everyday From Childbirth-Related Complications

Posted: 16/07/2012 00:00

As she cradled her baby, just a few hours old, on the bed opposite me at the birth centre Natooro told me Kikome, her new daughter's name, meant 'cloudy' in Luganda, a local language spoken in Uganda.

Although the sun was shining outside the traditional banda hut and the new mother was beaming, for me the name conjured up images of stormy weather, of trouble.

"Was it a cloudy day when you gave birth?" I asked gently.

"It was maybe the pain, because the baby was not coming so soon, so the midwives had to intervene," explained the 19-year-old, her proud husband Moses looking over the pair proudly.

Last time, during the birth of her son Muswingwa, Natooro, 19, nearly died from (primary postpartum hemorrhage) PPH.

The childbirth-related complication is the leading cause of maternal mortality in Uganda, said midwife Sister Mary Namusisi, who delivered Kikome.

"Whens someone's dying of a hemorrhage she doesn't yell, she doesn't scream, she's just like somebody going to sleep," she told me in the examination room of the centre run by Shanti Uganda, which aims to improve infant and maternal health, provide safe women-centred care and support the well-being of women with HIV/AIDS.

"The blood comes and comes and then there is no pain anywhere and they just sleep," Sister Mary explained.

"If you're lucky they'll (medical staff) find you unconscious and intervene but if they don't find you at that stage then..."

Unbelievably, in Uganda 16 women die every day from PPH, antepartum hemorrhage (APH) and other childbirth-related complications.

According to Robinah Kaitiritimba, the National Coordinator of the Uganda National Health Consumers' Organisation (UNHCO), "these are just the ones we know about".

The situation is now so dire that the country's Center for Health Human Rights & Development (CEHURD), the husbands of two women who tragically died while giving birth and a professor have taken the Ugandan government to court in a bid to force them to allocate more resources for maternal health and prevent the deaths. The Constitutional Court threw the case out in early June. The parties say they'll appeal to the Supreme Court.

I discovered Shanti Uganda, which was founded by Canadian Natalie Angell-Besseling and began working in Uganda with HIV-positive women in 2008, through Twitter.

The women completed a jewellery skills training program which included business and finance skills.

"Our members needed a place to work and the women in the community wanted a place to birth their babies that felt like home," says Natalie.

"The Shanti Uganda Birth House is staffed entirely by our Ugandan midwives and a Traditional Birth Attendant (used largely in rural communities).

"The women who come pay a very small fee which we set up to encourage them to have ownership in their health and the birth of their babies."

They're also provided with everything they need to give birth and receive access to all educational workshops and classes on site. Many women who deliver at the government hospitals are unable to afford the supplies they are required to bring with them.

When my friend Anne and I arrived at the Shanti Uganda Birth House in Luweero district, about an hour-and-half outside the capital Kampala, for a visit one Thursday morning recently we were greeted with two lines of black writing painted on the wall of their waiting room.

"Sister Mary will translate what it means for you," Shanti's project coordinator Sadie, also from Canada, told us.

The midwife, who has 34 years of experience and estimates she's helped bring about 3,000 babies into the world, happily obliged.

"There is a secret in our culture and it is not that birth is painful, but that women are strong," Sister Mary said, reciting the words of writer US writer Laura Stavoe Harm.

The Ugandan midwife, who had three grown children of her own and says her first time in labour was difficult, has also worked in public hospitals in Uganda where there are "too many mothers" and not enough staff.

It's not uncommon to have 20 deliveries a day with just two midwives in some centres," she said.

Transport is also a problem in rural villages, and if women go into labour at night getting to a hospital is often impossible.

Men are being encourage to play a part in their partners' pregnancies, like Moses, but in some cases are forced to use wheelbarrows as ambulances to rush their wives to hospital.

If a mother and baby survive, diseases such as polio are a threat unless the child is immunized. Recently Uganda's Ministry of Health conducted a mass immunization against polio, measles and River Blindness.

After Anne and I say goodbye to Natooro and her husband Moses, the family getting a boda, a motorbike taxi, home ("We like them to stick around but they're keen to get home," said Sadie), we met Maureen.

The 19-year-old had brought her daughter Primer, wearing a bright green traditional dress, to the Shanti Uganda Birth House to be vaccinated against polio, whooping cough, diphtheria, tetanus, Hepatitis B and Haemophilus influenzae type b with just one jab.

"Sorry baby," said Sarah the same midwife who had delivered the 10-week-old and was now giving her the needle.

Outside we found three woman stretching on colourful mats under a hut with Shanti intern Domanique who was leading a prenatal yoga class. Around them another group of women, all HIV-positive we were informed, sat at sewing machines making colourful bags from traditional fabric, which would then be sold.

"You must remember everyday to focus on your breathing. It is good for your babies," Domanique told them.

"And the stretches and the exercises that we did today will help your labour and it will help you sleep better."

Nawume, 18, was six months pregnant with her first baby and attending her third yoga session.

"I have gained fitness and after doing yoga I feel much better and feel that the baby is okay," she said.

Afterwards her instructor told Anne and I that working with the local women had made her realise how body-obsessed their western counterparts were.

"It's shocking, I realize coming from Toronto, how much time we spend on ourselves. The women here don't spend any time on themselves," Domanique said.

"And for me to be able to say that Shanti's assisting and connecting itself to labour, and to say that when they give birth it might be a little bit easier for them because they took the time to take the class, is just amazing."

Shanti Uganda are holding a doula training this fall and leading a 10 day yoga, service and fundraising retreat, Celebrate Uganda 2013, in January.

For more information and to find out about their Birth Partners Program see www.shantiuganda.org

 

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