Death and birth on the water
into motion the chain of events needed to save the lives of mothers and babies.
At the district’s main hospital, Francess Kenjah, 22, has just arrived. Malnourished and silent, she’s about to give birth to her second child. She’s just spent seven hours on a boat from her village at the opposite end of the district.
Without Cuamm subsidising her trip, it would have been impossible for Kenjah to afford the $220 (R3 120) boat ride here.
But even when mothers make it safely to the hospital, as Kenjah did, there are still many other challenges to giving birth here, Yellia Kargbo, a midwife at the hospital, explains. The demographic and health survey shows that about one in three Sierra Leonean teenage girls between the ages of 15 and 19 have fallen pregnant. In Bonthe, half the women will welcome their firstborn before the age of 20, the report shows.
“We handle too many early pregnancies, even 12-year-old girls,” Kargbo explains. “They usually do not go to school so they get married at a very young age. When they are pregnant they run serious risks, for themselves and their children.”
Childbirth at an early age brings a host of problems for the women and their babies.
Adolescents who fall pregnant are less likely than adults to access the care they need before and after the baby comes, 2011 WHO guidelines on preventing early pregnancy say. Babies born to young mothers are also at an increased risk of dying before their first birthday.
In many low- and middle-income countries, pregnancy or childbirth complications are a leading cause of death for young women.
Women’s and girls’ problems don’t end there. A 2013 survey reveals that one in four women here have also experienced domestic violence.
Edna Tuckev is the chief of a town called Mattru. Together with Nhawu, Tuckev created structures to train women on health and hygiene issues, as well as on their fundamental rights.
“Here, you can see women who are dried up,” she explains. “The bones of their neck are protruding because many husbands leave them without food. So we try to sensitise people on women’s rights and wellbeing for the wellbeing of the entire community.”
Inside the hospital, meanwhile, another patient is waiting for an obstetric check.
The baby is in good health, but the nurses tell the mother that her legs are too swollen. She needs to rest more often.
The patient answers with a wide, bright smile.
“All right, girls. I promise you that I’ll go to bed earlier,” Nhawu says.
“Since I’ve been pregnant, I’ve got a completely new vision of my work,” she tells Bhekisisa later.
“Now I can deeply understand how pregnant women feel and all the difficulties and the fears of a pregnancy,” she explains.
“I’m more and more determined to push for them to receive quality health services so that they can go home happy and healthy to celebrate their newborns without any shadow of sickness or death.” — Additional reporting by Laura Lopez Gonzalez
This story is a part of the multimedia project “Crossing the River” on maternal mortality in sub-saharan Africa, by Emanuela Zuccalà and the photographer Valeria Scrilatti. Produced by Zona, www.zona.org/en/, it’s been funded by the Innovation in Development Reporting Grant Programme of the European Journalism Centre. https://ejc.net/