Giv­ing life shouldn’t cost a life

Lesotho Times - - Opinion & Analysis -

IN Septem­ber this year, two-yearold Mpho was sup­posed to be­come a big brother. In­stead, be­cause his par­ents could not af­ford to pay for his mother, Lerato, to give birth at the near­est dis­trict hospi­tal, he be­came an or­phan.

Lerato went into labour one af­ter­noon. The women try­ing to help her give birth at home recog­nised too late that her baby was in dis­tress. Fi­nally, in the early morn­ing hours, the life­less body of a baby boy was born. Im­me­di­ately af­ter­wards, Lerato be­gan to bleed pro­fusely. It took two hours for her hus­band to find trans­port to take her to the hospi­tal, but by then it was too late: when they fi­nally ar­rived at the hospi­tal, she was al­ready dead.

Lerato is just one of thou­sands of Ba­sotho women who, ev­ery year, have to pay with their lives to de­liver their ba­bies — just be­cause they can­not af­ford hospi­tal fees.

Of­fi­cial fig­ures from the Le­sotho Min­istry of Health show that Le­sotho is the sec­ond worst-per­form­ing coun­try in the world in terms of ma­ter­nal mor­tal­ity, just be­hind im­pov­er­ished, war-torn South Su­dan.

How­ever, Doc­tors With­out Bor­ders (MSF) and St Joseph’s Hospi­tal in Roma have proven that a sim­ple and rel­a­tively af­ford­able mea­sure could help to change this grim statis­tic. When, in early 2014, we be­gan to strengthen the qual­ity of hospi­tal de­liv­ery care and to cover the out-of-pocket costs for women to de­liver at St Joseph’s, the num­ber early en­thu­si­asm for our pro­posed project, how­ever, the Min­istry of Health ended up re­ject­ing it be­cause they guar­an­teed that an­other or­gan­i­sa­tion, Part­ners in Health, was al­ready cov­er­ing the re­pro­duc­tive health needs of the dis­trict by work­ing in the com­mu­nity.

Our ex­pe­ri­ence in Roma tells us that an in­te­grated ap­proach is nec­es­sary to make a dent in Le­sotho’s un­ac­cept­ably high ma­ter­nal mor­tal­ity rate. In short, com­mu­nity, health cen­tre and hospi­tal must work very closely to­gether. As part­ners work­ing at dif­fer­ent lev­els of the health pyra­mid should col­lab­o­rate at each level of ser­vice de­liv­ery to the greater ben­e­fit of pop­u­la­tions.

With the planned han­dover of our Roma project pro­ceed­ing on sched­ule, by the end of this year we will re­gret­fully no longer be help­ing to re­duce ma­ter­nal mor­tal­ity in Le­sotho. For the sake of Ba­sotho women, we sin­cerely hope that the gov­ern­ment and its part­ners will make ev­ery ef­fort to meet all ma­ter­nal health care needs in Mo­hale’s Hoek.

To all our pa­tients, staff and part­ners in Le­sotho, we would like to say thank you for a fruit­ful and in­spir­ing five years’ ef­fort to im­prov­ing health care for all, and we hope to re­turn to Le­sotho in the near fu­ture.

lan­drew Mews is Head of Mis­sion for Doc­tors With­out Bor­ders (MSF) South Africa & Le­sotho.

mem­bers of msf Le­sotho.

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