Ma­ter­nal, peri­na­tal deaths alarm­ing

Chronicle (Zimbabwe) - - Feature/opinion - Gen­der Tsun­gaiChek­erwa-Ma­chokoto

THE national statis­tics of ma­ter­nal and peri­na­tal mor­tal­ity in Zim­babwe are alarm­ing. How­ever, it is com­fort­ing to know that since the 2011 statis­tics, the com­bined ef­forts by dif­fer­ent or­gan­i­sa­tions that have been put into de­creas­ing the mor­tal­ity rates have ac­tu­ally been suc­cess­ful.

The ra­tio has gone down sig­nif­i­cantly. In fact, in Au­gust 2014, Unicef re­leased statis­tics sug­gest­ing that Zim­babwe’s ma­ter­nal death rate had dropped by 36 per­cent since 2009, to 614 per 100 000 live births from a whop­ping 960 per 100 000 live births.

Ma­ter­nal death is the death of a woman while preg­nant or within 42 days of ter­mi­na­tion of preg­nancy while peri­na­tal mor­tal­ity is the death of a new born up to the fourth week of their birth.

The main clin­i­cal causes of ma­ter­nal deaths world­wide are haem­or­rhage (25 per­cent), sep­sis (15 per­cent), preeclamp­sia/eclamp­sia (12 per­cent), abor­tion (13 per­cent), and ob­structed labour (8 per­cent).

Hae­m­or­rhag­ing, or ex­ces­sive bleed­ing, can hap­pen at any time dur­ing preg­nancy and can be re­lated to ab­nor­mal­i­ties in pla­cen­ta­tion, trauma, drug use, med­i­cal co­mor­bidi­ties, med­i­cal mis­man­age­ment, co­ag­u­lopathies (blood dis­or­ders), ec­topic preg­nan­cies, uter­ine atony (fail­ure of the uterus to con­tract af­ter de­liv­ery), re­tained prod­ucts of con­cep­tion, lac­er­a­tions, and sur­gi­cal com­pli­ca­tions.

It is said that 85 per­cent of preg­nan­cies are de­liv­ered smoothly while only 15 per­cent ex­pe­ri­ence prob­lems. It is within this 15 per­cent that com­pli­ca­tions arise.

If the med­i­cal fa­cil­ity and the staff are not pre­pared to deal with the emer­gency then the woman’s life and that of her baby are vul­ner­a­ble.

I have an aunt who was told at a check-up that she had blood pres­sure that was so high that she had to rest im­me­di­ately.

Since she wasn’t in any pain and so she de­cided to walk to her sis­ter’s house that was just a few min­utes from Med­i­cal Cham­bers in Harare.

Her sis­ter lived just across the road from the Med­i­cal Cen­tre so she thought it would not do any harm to walk there and rest in the flat.

To cut the long story short, her de­ci­sion re­sulted in her be­com­ing a statis­tic on still birth.

That in­ci­dent was trau­matic to the whole fam­ily, but it was the day I made a de­ci­sion to know more about such is­sues so that I can help women in sim­i­lar sit­u­a­tions.

I came across an NGO named Ark Zim­babwe that is in­volved in pro­mot­ing ma­ter­nal and neona­tal health.

Ark has a pro­gramme that is en­tirely ded­i­cated to saving the lives of both the mother and the child.

They launched a pro­gramme called Safe Ar­rivals, a few years ago, and their vi­sion is “A Zim­babwe where no woman loses her life while giv­ing life, and no child loses its life be­fore it has be­gun”. What a noble cause I thought to my­self when I saw that.

An en­tire branch in Zim­babwe with the sole pur­pose of saving lives? Im­pres­sive!

I had the priv­i­lege of find­ing out ex­actly how they save lives. Ark trains clin­i­cal of­fi­cers to han­dle emer­gen­cies should they arise dur­ing child birth.

Clin­i­cal of­fi­cers are mid­wives who re­ceive fur­ther train­ing to be able to pro­vide emer­gency surgery mainly in ru­ral dis­tricts.

The more clin­i­cal of­fi­cers are trained, the more lives can be saved. In Au­gust, a grad­u­a­tion of clin­i­cal of­fi­cers will be con­ducted at Chi­tung­wiza Hospi­tal.

Ark also trains nurse anaes­thetists on crit­i­cal care that en­ables them to save life through Cae­sarean Sec­tions es­pe­cially in ru­ral ar­eas.

They also equip hos­pi­tals with equip­ment that ben­e­fit ma­ter­nity wards.

They con­duct dif­fer­ent train­ings from Qual­ity Im­prove­ment, In­fec­tion Con­trol to all the other ar­eas that have a hand in pro­mot­ing safe ar­rivals of ba­bies and keep­ing mothers alive.

This week, on Wed­nes­day, Ark had a Han­dover Cer­e­mony at Mpilo Central Hospi­tal in Bulawayo where they presented their dona­tion to the hospi­tal and the com­mu­nity.

It costs a lot of money for the hospi­tal to buy fin­ished prod­ucts for in­fec­tion con­trol. So what Ark did was to buy the in­gre­di­ents that are used to make sani­tis­ing so­lu­tions.

The or­gan­i­sa­tion bought bot­tles to pack the sani­tis­ers in af­ter they are mixed by the phar­ma­cists. At the Han­dover Cer­e­mony, a demon­stra­tion on how to mix the hand sani­tis­ers was done.

Ark fa­cil­i­tated ren­o­va­tions of plumb­ing works in the ma­ter­nity wards in a spec­tac­u­lar way in­clud­ing re­plac­ing or­di­nary taps with el­bow taps for in­fec­tion con­trol and pro­vided new linen for the ward as well.

In­fec­tion con­trol is a ma­jor mile­stone in deal­ing with ma­ter­nal and peri­na­tal mor­tal­ity and the Safe Ar­rivals pro­gramme has achieved that by pro­vid­ing the equip­ment needed to sani­tise the ma­ter­nity ward.

It was a very mov­ing oc­ca­sion in­deed and the com­mu­nity will ap­pre­ci­ate the ren­o­va­tions made to Mpilo Hospi­tal. Ark is headed by Dr Vonai Tev­eredzi who is the Coun­try Direc­tor.

It is easy to ap­pre­ci­ate her ef­forts towards erad­i­cat­ing the in­tri­cate de­tails that af­fect mor­tal­ity rates in Zim­babwe.

I have had the per­sonal priv­i­lege of see­ing Dr Tev­eredzi in ac­tion dur­ing meet­ings and I was im­pressed.

The woman has a wealth of in­for­ma­tion at her fin­ger­tips. It is ei­ther prob­a­bly be­cause she is a woman that she un­der­stands the im­por­tance and need of emer­gency help dur­ing child­birth or be­cause she is a med­i­cal doc­tor, or maybe just pure pas­sion to help women and chil­dren. What­ever it is, the self­driven woman is just amaz­ing.

Ark did a sim­i­lar event at Harare Hospi­tal. They adopted the ma­ter­nity ward and did a shock­ing makeover of the pre-labour ward and the ac­tual labour ward.

The show­ers were re­placed, the plumb­ing was re­done, and they in­stalled new sinks and taps as well as also sani­tis­ing sta­tions.

They re­fur­bished the cur­tains that were there and en­sured pri­vacy and dig­nity of birthing mothers by putting new cur­tains to mark de­mar­ca­tions in the ward.

Ark Zim­babwe has done a phe­nom­e­nal job at Harare Hospi­tal and the trans­for­ma­tion has re­ally ben­e­fited both the pa­tients and the staff there.

They con­tinue to train peo­ple from the aux­il­iary staff to the high­est man­age­ment, help­ing them re­alise that Safe Ar­rivals are pos­si­ble through team work.

It is there­fore crit­i­cally im­por­tant that the women re­alise the role that they have to play in as­sist­ing the cause of or­gan­i­sa­tions like Ark and do their part.

Go­ing for an­te­na­tal vis­its as rec­om­mended by the Min­istry of Health and Child Care is the best way of en­sur­ing that you save your own life and that of your baby.

Once women fol­low in­struc­tions given to them by health pro­fes­sion­als, it be­comes easy to de­tect and man­age symp­toms that could be life threat­en­ing.

It is at hos­pi­tals and clin­ics that women with high blood pres­sure get med­i­ca­tion and ad­vice on life­style changes, anaemic women are given med­i­ca­tion to in­crease the blood in their bod­ies and also ad­vice on what to eat.

HIV pos­i­tive women are able to start tak­ing PMTCT drugs that stop the mother from trans­mit­ting the virus to their un­born ba­bies.

Go­ing for those vis­its could be the sole rea­son that could save a life.

It is sad to note that only a few women go for these vis­its ac­cord­ing to the mon­i­tors and eval­u­a­tors at Ark de­spite the ser­vices be­ing free of charge at lo­cal gov­ern­ment clin­ics.

Women should re­ally take ef­forts to help them­selves by go­ing for their an­te­na­tal vis­its.

Women, upon con­fir­ma­tion of preg­nan­cies should read as much as they can about preg­nancy and child­birth.

This is bet­ter than fo­cus­ing on shop­ping for the baby be­cause with­out knowl­edge on how to help your­self, you might not be able to have the baby, or you might not be around to en­joy the com­pany of your baby.

Lack of aware­ness about the causes of ma­ter­nal and peri­na­tal mor­tal­ity can cause women to ig­no­rantly do harm­ful things to them­selves.

If death can be avoided, lets grab the op­por­tu­nity. We should as women show our ap­pre­ci­a­tion of or­gan­i­sa­tions like Ark that chan­nel funds towards our well-be­ing.

This is the least we can do to com­ple­ment the ef­fort of such or­gan­i­sa­tions.

Knowl­edge + ef­forts + fund­ing = saved lives and that makes it all worth it!

The writer, Tsun­gai Chek­er­waMa­chokoto, can be reached on tsungi­ma­chokoto@gmail.com. For more in­for­ma­tion about Ark Zim­babwe you can visit them on arkon­line.org

It is said that 85 per­cent of preg­nan­cies are de­liv­ered smoothly while only 15 per­cent ex­pe­ri­ence prob­lems. It is within this 15 per­cent that com­pli­ca­tions arise. If the med­i­cal fa­cil­ity and the staff are not pre­pared to deal with the emer­gency then the woman’s life and that of her baby are vul­ner­a­ble.

Dr Tev­eredzi Chimhamhiwa opens one of the taps ren­o­vated by Ark at Harare Ma­ter­nity Hospi­tal

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