Hell of giving birth in Chididi
The talk is that Malawi is doing well in safe motherhood. But for people of Chididi in Nsanje, this is hollow and distant talk, as EPHRAIM NYONDO found on his recent visit to the area.
When she was due to deliver her baby, Grace Peter, 25, together with her mother-in-law, packed a basin and clothes before leaving for a clinic in Nsanje. It is 30 minutes of walking in the twirls of Chididi rocky paths.
The two did not find a medical attendant at the clinic and no one knew where he was. After three hours of waiting impatiently, the officer showed up.
“He touched my womb, examined my eyes and told me to come back after a week. He said I was not due for delivery,” said Peter.
But back home, things became tricky in the evening of the same day. Peter’s mother-in-law had left for her home and her husband was away. Without a phone, the only person who would come to Peter’s rescue was her four-year-old first born boy.
In a quavering voice, she sent the boy to relay a word to her mother-in-law.
When she came, the mother-in-law found Peter dazed, tired, but holding a baby in her arms—she had done it on her own!
“I lost a lot of blood. I was weak, and I don’t know what would have befallen me had my mother-in-law not turned up in time,” she said.
In the dead of night, they left for the clinic where, again, they did not find the medical officer. After sending for him, he turned up, but being a private clinic, Peter had to part with K2 000 to be treated.
Peter’s ordeal has echoes to the experiences of Martha Fote, 27, who also lives in Chididi.
Fote’s ‘motherhood illness’ began at around 1:30am on October 3 2012. She went to the clinic in the company of her mother-in-law.
For about an hour, they hobbled through the paths to the clinic.
A little luckier than Peter, Fote found a medical officer. Yet, her luck soon ran out: the only officer on duty had just finished helping another woman to deliver and was tired.
The officer told Fote to wait for him to rest a little at home, but the pricking baby inside her could not wait.
So, without medical attention, Fote gave birth to her third child at the clinic with the help of her mother-in-law.
“Although we struggled on our own, we were surprised that the attendant demanded that we pay K2 500. He said we had used the clinic’s beds, water, and electricity. We had no choice but to pay,” she said.
Peter and Fote’s ordeals could pale compared to that of Evelyn Molisho, another local in Chididi. Molisho’s is not a story of pregnancy, but her one-year-old nephew.
“My sister, who lives in Thyolo, came with her child to unveil a relative’s tombstone. It was around 10pm when his temperature shot up. We suspected Malaria,” she recalled.
They rushed him to a clinic where they did not find an attendant. But after sending for him, the attendant rushed to the clinic and upon examining the boy, recommended that he be referred to Nsanje District Hospital.
“We called the authorities at the boma, but they told us that while the ambulance was available, it does not have fuel. So they advised us to source K3 000 for fuel,” said Molisho.
The family hastened up. They sent a boy to buy fuel at the boma and drop it at the hospital.
“The ambulance arrived at 5am, only to find that the child had died,” recalled Molisho.
These problems—women giving birth at home, on the roads or at a health centre without medical officers, of deaths of pregnant women and under-five children due to late medical response—are not unusual in Chididi.
They are painful occurrences people live with every day.
Gift Nyalugwe, a mid-wife technician at Chididi Private Clinic, understands the challenge of safe motherhood in the area.
“There is a high turn-out of pregnant women during ante-natal visits. I can say we get an average of 60 women in the antenatal clinic a month. But I can tell you that out of these, maybe only 10 or 15 turn out for labour.
“This gap tells you that most of the women still give birth in their villages. A woman will turn up for ante-natal. Next time, you will see them coming for the under-five clinic. You ask them ‘where did you give birth?’ they just laugh,” said Nyalugwe.
But what is the problem?
“Geography plays a critical role. Most villagers find it difficult to commute to the clinic. This is particularly so for pregnant women,” said Nyalugwe.
Chididi—with four Group Village Heads and 33 villages—is a rural community located 26 kilometres west of Nsanje boma. It is hilly and rocky, making travelling difficult.
The road connecting the area to the boma is narrow and bumpy. It snakes like coils in the hills of a dense forest.
But the challenge of safe motherhood in Chididi is more than just geography.
There is no public health centre to cater for the 33 villages. Although government guidelines say there should be a public health centre in a radius of eight kilometres, according Ministry of Health spokesperson Henry Chimbali, the closest public health centre for 33 villages in Chididi is the Nsanje District Hospital, 26 kilometres away.
Group Village Head Mchacha said the only solace for people in the village is that there is a private clinic around, built by missionaries ages ago.
“The problem is that it is only accessible to those who have money. We have had cases of the clinic refusing to release newly-born babies to families because of unsettled bills. With giving birth costing not less than K2 000, most women have no choice but to deliver at home,” said Mchacha.
The Women’s Legal Resource Centre (Worlec), an NGO running a governance project in the area funded by Dan Church Aid, has been training people in Chididi in health rights.
“We want them to understand that they have rights and they should demand them,” said Lazarus Nyantakanya, Worlec project officer for Nsanje.
Chimbali said according to the 2011-2016 strategic plan, the ministry is building 78 health centres.
“We know about the challenge of not just Chididi, but also many other areas. It is my hope that Chididi will be among the 78 health centres earmarked for construction by 2016,” he said.
With many rural areas bogged down in problems haunting Chididi, will Malawi achieve the Millennium Development Goal (MGD) on maternal health?
The year 2015 for achieving the MDG looks a long way for Malawi, which registers 675 deaths per 100 000 live births.
Reaching the target of 155 deaths per 100 000 live births will take something special, especially if women such as Grace Peter continue to lie at the margins of quality health services. n
