Minister of Health David Parirenyatwa
AFTER giving birth to her first child, Patience Maphosa started haemorrhaging profusely.
The doctors assured her that they would save her uterus and ovaries, but if that failed she was to undergo a hysterectomy, a surgical procedure to remove the uterus.
And if the bleeding continued after the surgery she risked dying.
What had been nine months of a drama-free pregnancy had now turned into a nightmare that fateful Christmas Day after Maphosa encountered a long, but relatively incident-free labour that lasted almost eight hours.
She is said to have smiled while holding her son, perhaps reassuring the toddler that she would always be around for him.
Barely an hour after giving-birth, the mood in the hospital room changed after nurses discovered that she was seriously bleeding.
Her husband and new baby were rushed out of the room and taken into the nursery.
Blood was pouring out of her body as her life hung in the balance. The hospital staff tried all they could, but, sadly, later that evening, she died, leaving behind her 17-hour-old son.
Her death became yet another statistic to the ever rising and very disturbing figures of maternal mortality in Zimbabwe.
According to the World Health Organisation (WHO), approximately 830 women die from preventable causes related to pregnancy and childbirth daily.
About 99 percent of maternal deaths occur in developing countries and are higher in women living in rural areas and among poorer communities.
Figures released by the Ministry of Health and Child Care this month revealed that 16 women died while giving birth in Zimbabwe last November.
This brought to 316 the number of mothers who have died while giving birth from January to November last year.
Without including the December figures, which are yet to be released, it could translate to almost a soul being lost daily to child birth complications.
The major causes of maternal deaths include haemorrhage, infection, high blood pressure, unsafe abortion and obstructed labour.
According to the Southern African Development Community Gender Protocol Barometer 2015, Zimbabwe’s mortality rate stood at 470 in every 100 000 live births.
“This is way too high…The rate must go down. We need to move towards the Zambia rate which is 280 in every 100 000 births or even better the Namibia one, which is 130 in every 100 000 births. The bottom line, however, is any maternal death, even one, is too many. No woman should die while giving life,” said Sibusisiwe Marunda, the country director for the Regional Psychosocial Support Initiative.
She said the implications of maternal death for children are too ghastly to contemplate as children who lose their mothers grow up orphaned and might not have access to the love, care and support they need to thrive and become functional citizens.
According to WHO, maternal death is the death of woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy or its management, but not from accidental or incidental causes.
To reduce maternal mortality, Marunda said pregnant women should get adequate antenatal care.
“They (pregnant women) should visit an antenatal clinic or a doctor at least four times a week during the term of the pregnancy. All births must be attended to by a skilled person at a health facility. Where there is need for a transfer to a referral facility, this should be done as quickly as possible,” said Marunda whose non-profit making organisation is working towards lessening the devastating social and emotional (psychosocial) impact of poverty, conflict, HIV and Aids among children and women.
Marunda said access to contraceptives and sexual and reproductive health rights education should be enhanced to ensure only wanted and safe pregnancies are conceived.
She said more effort should be put towards educating communities about how to avert maternal death.
Some risk factors that contribute to maternal death are perpetuated in private spaces and only become public when a death occurs. Communities therefore need to be conscientised.
“Government should work towards at least allocating 15 percent of the National Budget to the Ministry of Health and Child Care as agreed in Abuja. The 2016 budget allocated 8,25 percent to the Ministry. This obviously stretches resources within the Ministry and affect the quality of antenatal care,” she said.
Musasa Project’s gender and peace building programme officer, Nyasha Mazango, said the economic, political and social upheavals in the country play a role in exacerbating the situation.
“Our health delivery system has been severely affected. As a result, the quality of service that should be delivered to pregnant women has significantly suffered. Staff shortages can be alleviated by training more midwives and paying them a decent wage to prevent the brain drain. Junior and sometimes inexperienced staff are left in charge to care for these women, and when complications arise they are at a loss,” she told the Financial Gazette.
She added that the working conditions were so bad to the extent that other midwives preferred to stay at home than earn meagre salaries for such a demanding job.
Her organisation, Musasa Project, fights against gender-based violence, with particular focus on women, targeting groups in society to change retrogressive beliefs, attitudes, behaviours, laws and policies in order to end gender-based violence.
“Shortages of equipment and use of meagre supplies also play their role in putting at risk the lives of pregnant women. In rural settings, unavailability of transport, transport costs and the long distance travelled to the nearest health facility can be a hindrance to a pregnant woman who wants to access health services,” she said and further pointed out that the health delivery system needed to have vibrant, health-friendly policies.
“The political climate and social services also need to work in sync to support health delivery in the country. This can only be achieved when the government starts being serious about women’s health. Retrogressive economic policies, which restrict extra funding from the donor agencies could be relaxed to attract more funds to assist our health budgets,” Mazango said.
As has become the custom in Zimbabwe, many wonder if it would continue to be talk and more talk in 2016, while more mothers and children die because either there is shortage of staff, brain drain, inexperienced staff with no proper supervision, no money to go to the nearest health facility or no equipment to perform surgery to pregnant mothers.
Former women’s affairs, gender and community development deputy minister, Jessie Majome, told the Financial Gazette that government must develop a sense of responsibility and concern so that it can fulfil its constitutional duty of fulfilling the rights to life and health care, including reproductive health guaranteed by sections 48 and 76 respectively.
“Government must also explore ways of making the responsible men pay for maternity costs, including publicising and giving legal aid,” said Majome who is also Member of Parliament for Harare West.
She also emphasised the need for government to fully commit itself to the Abuja Declaration that requires that the State spends at least 15 percent of its budget on health, Majome noted.
“The number of maternal deaths is a chilling and tragic indicator of the failure of government. Government should declare a state of emergency over these maternal deaths and seek international expert help. But for this to happen, it must come clean on the abuse of the maternal component of the health transition fund and recover pilfered funds, which are contributing to these horrendous and avoidable deaths,” she said, further asserting that the number of maternal deaths in Zimbabwe could be more as they are chances that the figures do not account for those who die while giving birth at home.
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