| New maternity clinic brings hope | Send to a friend |
| Monday, 15 March 2010 10:43 |
 By Phyllis Nyambura Informative prenatal care, regular ultra sounds, support from family and friends, a reliable transport service and friendly and helpful medical staff, are some of the wishes any pregnant woman hopes for. Throw in a hospital that is clean, well equipped and has spacious comfortable beds, an eager birth attendant, an Intensive Care Unit incase of emergencies and a regular follow-up once the baby is born, and you would have created the dream that is every expectant woman’s desire. But unfortunately to many women in Tanzania, where mortality and maternal rates are staggering high, these wishes belong in the movies. Of the 2.4 million who give birth each year, 13,000 women die during childbirth and from pregnancy related causes. And 157,000 children don’t live to see their fifth birthday, 45,000 of them having died at birth. Still for those mothers who cheat death by the whisker, 3600 of them suffer Vesico-vaginal fistula (VVF), a condition caused by protracted labour, resulting to a hole in their private parts and causing frequent urine leaks. Grim statistics, that has maternal health stakeholders gravely worried and rearing for action. One such action is in the plan of setting up a maternity hospital in Dar es Salaam. The referral hospital, by the name Baobab, a pet project of Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), and the government, will see a bed space of 192 get realised by mid next year, if all goes well. “We hope to ease up congestion of serious cases at Muhimbili,” says Dr. Brenda D’mello, the technical advisor, reproductive and child health program, CCBRT. The pilot project, which received government's aid in terms of land, is estimated to cost between 12-13 million euros. So far the European Union has pledged 1.9 million euros, and CCBRT hopes to raise the rest through well-wishers. “The hospital will cater for 80 per cent patients from the public, who for them everything will be free, while 20 per cent will be private ones, who have to pay full board,” says the coordinator of Baobab maternity hospital, Annika Unterpertinger. But taking the congestion at Muhimbili national hospital, questions will be raised on whether the additional bed spaces will not suffer the same fate. “This is a pilot project,” Dr D’mello, starts off, “We hope to learn from it, and in future try to see whether we can roll the same out in the regions,” she says. Besides, she says, unless a woman is willing to pay full board, one need’s to be referred as a needy case from the health centre. “ Part of the plans is to have funds for capacity building for nine health centres around Dar es Salaam. The centres will be reviewing the complicated cases and referring the patients to us. We will have transport on standby at these medical facilities for speedy response,” Dr D’mello explains. There are fears however that the health centres might wait until it is too late to refer patients. Cases of mothers dying or helping themselves at public medical facilities, having not been attended is not new. Laxity, overcrowding, lack of qualified personnel and machinery and demoralised staff are just some of the reasons given for this sorry state. “It is a big challenge,” agrees Annika, “But that’s precisely what capacity building will be taking care of. We hope to monitor the situation from the health centres and act accordingly. Though we will be first dealing with nine facilities, eventually we would want to work with all 37 in Dar es Salaam,” she says. These are mundane plans. But critics, will be asking why Dar es Salaam, again, when women from upcountry regions suffer most from lack of health facilities. In fact, a lot of maternal deaths and fistula are caused by delays that occur when women can’t access health centres, which are too far off under an unreliable transport system. Majority of the fistula patients at CCBRT are from the regions. Of the 22 women who have undergone surgery, is Elizabeth Elias Vitari from Luemba, Kilosa. The 37-year-old case is a typical case of too far therefore too late. In January, the mother of five, labour pains came earlier than expected, and the only bus in the region was expected the next day. “I had the other kids at home. Though this pregnancy had been a difficult one, and I had been advised to give birth at the clinic when the labour came earlier we thought of only calling the traditional birth attendant,” says Elizabeth. After an agonising three days, she had a stillbirth. “I still had my umbilical chord stuck, plus I was in a lot of pain, so I was put in a bus to the nearest health centre,” she says. It is while at the hospital where she had been admitted, after suffering fistula that a CCBRT social worker got to know her plight. “She gave me the fare, plus the direction to the hospital,” Elizabeth who still has to do a lot of kegel exercise to control her urine flow, says. It is for women like Elizabeth that many would like to see services diversified to the regions. “Most women are from very far places. They have gone to other health facilities, but they waited for too long to take action for a caesarian. That’s why besides the referral hospital, the fistula ward is still important,” says Dr Vindhya Pathirana, the Doctor in charge of the fistula ward. Still a facility in Dar will go a long way in alleviating maternal deaths. “The population in Dar is quite large. Most facilities are overstretched. Plus there are different partners working with the government to bring down maternal deaths in the regions,” Annika says. 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