Hands-on experience in West Africa

Carrying pregnancy has remained a nightmare for a woman on the African continent, even as world leaders brace themselves for the expiry of the Millennium Development Goals (MDGs), which were formed to advocate for women’s health, among other things.

For a country like Sierra Leone, which has the highest maternal mortality ratio in the world, the story of women agonizing in childbirth can best be told by the Sierra Leonean women themselves.

However, the testimonies of women from other parts of the world, who went to the West African country as volunteers and journalists during the Ebola outbreak, can give an additional harrowing story of the realities of pregnant women in Ebola treatment camps.

These are the women who have lived to see with their own eyes, the tribulations of the expectant mothers in the West African country during the Ebola outbreak.

They have had hands-on experience with women going through suffering in parts of Africa that were most devastated by Ebola, perhaps unearthing some of the factors that have increased the toll on African women in the recent years.

When the Ebola outbreak was at its peak, less than 30 percent of Sierra Leonean women sought reproductive health services. That was in the latter half of 2014, according to the United Nation’s Population Fund (UNFPA). The UN Agency cited anecdotal reports pointing to a rise in maternal deaths and pregnancy-related disabilities at that time.

Lending a helping hand

One of the women, who was working as a nurse in Sierra Leone, is a Tanzanian who spent 90 days in Free-Town fighting Ebola. She recently narrated how she held the Ebola-infected women by their hands—especially when their lives were at stake.

She spoke of how she nursed and reassured them throughout their sickness. She has until recently told Woman that after her experience in West Africa, her ‘’next enemies’’ were the deaths of the pregnant women in her home country, Tanzania.

Another woman, a BBC Global Health Reporter, Ms Tulip Mazumdar who came out to tell women’s story in Ebola zones for a global audience, said that the link between Ebola and maternal mortality in Sierra Leone was more of a scientific phenomenon—with palpable horrors.

Ms Mazumdar, one of the few journalists who were granted access to the Ebola Treatment camps by the medical charity Medecins Sans Frontieres( MSF) in Sierra Leone, she reported scenarios of doctors being challenged by how to treat pregnant women with Ebola.

She quoted an Obstetrician, Dr Benjamin Black from the MSF, as saying, ‘’Very little was known about Ebola and pregnancy.’’ Over 95 percent of pregnant women infected with Ebola died, according to a very small study done in similar settings in the Democratic Republic of Congo.

For a country ravaged by the Ebola outbreak, coupled with the weak health infrastructure that resulted from civil conflicts, it may be justifiable to say why Sierra Leone is still facing high maternal deaths until today. The maternal mortality ratio in the country is now 1,100 per 100,000 live births.

According to World Bank (WB), Sierra Leonean economy fell at an estimated annual rate of 2.8 percent in the second half of 2014, during the Ebola outbreak. Before then, the economy had grown at an estimated annual rate of 11.3 percent, says WB.

“Financial constraints within families led to delays related to lack of transport facilities to hospitals,’’ says Ms Loveness Isojick, the Tanzanian nurse who has now decided to specialise on maternal health at Korogwe District Hospital in Tanga, after her work-experience in treating Ebola patients in West Africa

For Tanzania, a country that has enjoyed peace and stability, as well as the absence of deadly epidemics like Ebola, it only takes commitment by the leaders to tame the deaths, says Loveness as she puts a contrast between the two countries’ efforts in improving maternal health.

Insufficient progress

Currently,Tanzania ranks 27th in the world among countries with the highest maternal mortality ratio, standing at 410 deaths of women per 100,000 live births. According to the 2015 MDGs CountdownReport, the country has made ‘’insufficient progress’’ in the goal of reducing maternal deaths by 75 percent.

When Ms Loveness recalls her days in Sierra Leone, it downs on her that the efforts to deal with maternal deaths in Tanzanian settings need more commitment and prioritization. She believes that the cultural beliefs that made women fail to seek reproductive healthcare in Sierra Leone are also prevalent in Tanzania.

‘’Within families and communities in Tanzania, strong cultural beliefs such as using herbs and visiting traditional healers,’’ means that there is ‘’lack of knowledge on the importance of attending antenatal clinics,’’ says Ms Loveness, alluding to what she witnessed in Sierra Leone.

Loveness remembers that some women in Sierra Leone were not ready to accept the fact that when they were infected with Ebola, it was also unsafe for their unborn babies.

‘’If a pregnant mother got Ebola there were high chances of the fetus being infected with the virus too. And most probably a miscarriage would occur,’’ says Loveness, recalling how she used to teach women and their relatives as well as offering them psycho-social support.

‘’Since I once worked at reproductive and child health departments back home in Tanzania, I had some experience in Midwifery and the Gynecologists could rely on me for taking care of the Ebola positive pregnant mothers,’’ she recalls.

‘’My job was to counsel a pregnant mother about the effect of the Ebola virus to the pregnancy and the effect of having Ebola to a pregnant woman. I was supposed to counsel the pregnant women that Ebola kills the baby and because the fetus would be infected, this would mostly cause miscarriage,’’ she says.

‘’I was ready to take the responsibility to save lives. I was very careful in every step because of the risk of being infected. But I was never carried away by my thoughts to give up. I believed in my instincts,’’ she says.

From her experience in the Ebola-hit nations, Loveness believes that she has drawn the courage to continue battling against major public health problems in her country, especially maternal deaths---after drawing inspiration from the teams of committed volunteers who had gone to save lives in the West African region.

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