| Rural hospital helps to curb maternal deaths | Send to a friend |
| Friday, 04 February 2011 22:35 |
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On an ordinary day in Kibiti Village, Mr Jonas Chagi takes 45 minutes to walk from home to his workplace, a maternity ward, where he usually arrives at 7.30 am. Immediately after reporting he starts a long day of his challenging job that includes performing caesarean operations, taking care of malnourished mothers and HIV patients, supervising safe child delivery services and treating all sorts of ailments. “The condition of the group that comes here are normally very delicate,” he says, referring to his patients. “It is very important to take good care of them.” Mr Chagi is an assistant medical officer in Kibiti Hospital, and by the nature of his profession, a popular man in the locality. His fame is enhanced by people’s esteem for his dedication to work, and the readiness to give a helping hand to dozens of mothers attending the clinic. He is among five health workers at the hospital who got an opportunity to attend a three-month training programme at the Ifakara Health Institute on emergency obstetric care. The training was sponsored by the World Lung Foundation (WFL with support from the Bloomberg Philanthropies, under the auspices of Maternal Health Programme in Tanzania. “I am happy that I got the chance to advance my knowledge. I am very passionate about my career, and it is my ambition to help mothers deliver safely,” he says. Saving lives Kibiti is located in Rufiji, one of the six districts in Coast Region, the others being Bagamoyo, Kibaha, Kisarawe, Mafia, and Mkuranga. It is mostly rural, and majority of the inhabitants are subsistence farmers. The hospital is the second public health facility in the district that provides maternal health care. Before the donors chipped in with aid it had no caesarean section operations and its services were largely unreliable. But under the ongoing Maternal Health Programme, there is a newly built, full-equipped theatre at the hospital and the outpatient department and staff quarters have been renovated. The changes started taking place in mid 2008 when Mr Chagi and his co-workers came back from the Ifakara training. At that time he was the only practitioner trained on how to perform the caesarean, while the rest of the staff worked as his assistants. “It was hard at the beginning, but later another surgeon came in,” he recalls. Currently the situation has improved to a certain extent, as there are three doctors at the hospital who can perform the caesarean operation. In a recent interview for this report, Mr Chagi he gave an insight to the complexity of his job when he narrated the case of a patient who came to the hospital with obstructed labour. The woman was in such a bad condition that she wanted to deliver at home. Mr Chagi was able to operate on her, but unfortunately the baby died the next day. “She came to the hospital very late because she had earlier decided to deliver at home. If she would have delayed for another day, she could have also died,” he says. The ‘3-delays’ The chief medical officer, Dr Deo Mtasiwa was recently quoted as saying: “Training non-doctor - assistant medical officers - to do emergency obstetric care and equipping local health centres to carry out complicated deliveries is a proven model for saving lives in rural regions of Tanzania.” Dr Staffan Bergstrom, the project director of WLF supports Dr Mtasiwa’s observation, that training assistant medical officers in basic obstetrical surgery, such as caesarean-section deliveries, has the potential of increasing the number of babies born safely and averting needless maternal deaths. Available statistics show that 67 under one-year old child deaths occur in Tanzania for every 100,000 live births, with an additional 450 deaths from pregnancy-related cases taking place per 100,000 live births. “Pregnancy is not a disease but it kills…. We believe we’ve found a model that works and we are very pleased that the Government of Tanzania and our Bloomberg Philanthropy partners have enabled us to scale a solution that could potentially save lives in many rural areas around the world,” Dr Bergstrom says. He explains that there are “three delays” that cause maternal deaths--- delays in seeking healthcare, delays in transportation and delays in getting medical attention when the parent arrives at a health facility. Additionally, shortage of doctors and trained medical professionals in sub-Saharan Africa poses a significant challenge to safe child delivery. Kibiti hospital is among nine health centres and five district hospitals that have been upgraded so far under the programme. Since 2006 the WLF, with support from the Bloomberg Philanthropies, has been working closely with the ministry of Health and Social Welfare and other Tanzanian partners like the Ifakara Health Institute to implement the Maternal Health Programme in the country. The programme has covered personnel training, renovation of health centres and construction of operating theatres, maternal wards, laboratories and staff houses in rural areas in Kigoma, Morogoro and Coast regions. The project is in now being extended to Singida Region. Gained trust With the support from the programme, Kibiti is today a modernised hospital. It handles up to 36 mothers at a time, some with serious complications, but deaths rarely occur. This is a big achievement considering that in the past it used to manage cases of less than 20 mothers per month. It is now very popular and a favourite of women in the whole of Coast Region and surrounding areas. It is constantly supplied with water and uses solar for emergency lighting. Ms Siwengine Ali is among the mothers who decided to give birth at the hospital after she heard about its good services. “Since I live far from the hospital, I hired a mini-bus to bring me here at a cost of Sh20,000 before my due date. I refused to go to the dispensaries as some elders advised me. And I got nice treatment here,” says Ms Ali who went through c-section for delivery. Mr Chagi, the hospital assistant medical officer trained in c-section, says unlike in the past many mothers nowadays come for antenatal visits and many start reporting as early as their first trimester. “Services for mothers are offered free of charge and our team is motivated to provide good services,” he says. Overworked With the improved services and facilities, mothers benefit but the service providers become overworked. In many cases, Mr Chagi is forced to extend his working hours to meet the needs of many mothers. Besides, the available facilities are increasingly becoming overwhelmed. “We have all facilities but we lack enough medicines, staff, and transport. The government has to be aware that things have changed at Kibiti Hospital since the number of patients has increased,” he says. Among other things, Maternal Health Programme seeks to help Tanzania meet health aspects of the Millennium Development Goals (MDGs) by 2015. The MDGs’ health target includes reducing maternal, neonatal and under-five mortality from 578 to 193/100,000; 32 to 19/1000; and 112 to 54/1000 live births, respectively. Ms Margaret Mhando, the director of curative services at the ministry, says that scaling up of the various programmes in the sector would greatly help attain the MDG targets. “The government has a special programme known as the Primary Health Services Development Programme or MMAM, which aims at establishing a hospital in every district, a health centre for each ward and a dispensary for each village. Its implementation will greatly enhance the provision of maternal health services in the country,” she says. She also added that more medical colleges had increased enrolment to solve the problem of staff shortage. Add this page to your favorite Social Bookmarking websites           |
