Guest post: The cost of labour - 'for women in Kenya, even minor complications can be deadly'
When Claire Meeghan gave birth, her complications were treated swiftly and effectively. Having witnessed the lack of maternal healthcare provision in Kenya, she realises just how lucky she was, and urges everyone to support Christian Aid’s Christmas Appeal to make this a reality for more mothers
Posted on: Tue 02-Dec-14 14:46:22
(2 comments )
‘You have a retained placenta,’ the midwife said to me. ‘Is that bad?’ I asked, having no clue. ‘No, it’s not bad, it’s just you’ll need to go to theatre instead of spending time bonding with your son’. And that was that: I was drugged up, whisked off to theatre and, 45 minutes later, I was back holding my newborn. It was so straightforward the incident barely made it into my ‘birth story’ - but it was a very different story for Semeyian Ndayia, whose mother, Nashoro, I met last month in a small Maasai village in Kenya.
In rural Kenya it is normal to give birth at home. In Pusangi village, where I met Nashoro Ndayia, the nearest hospital is 46 kilometres away. There are no proper roads; just dirt tracks along rugged land, so - if someone is able to get hold of a vehicle - the journey can take up to three hours. As in any country, women suffer complications before, during and after birth, but the difference between experiencing them here and in Pusangi is the difference between life and death.
After two days in labour, 19-year-old Semeyian had given birth to her third son. The birth went well but the placenta was not delivered afterwards, just like mine. She felt sick and was bleeding heavily. After two hours, Nashoro started to look for a vehicle to take her daughter to hospital. At the time there were no ambulances in this part of Kenya, so Nashoro started negotiations with her husband to agree to pay for a vehicle. This meant selling one of their cows. For Maasai, cows hold enormous significance and represent status as well as wealth, so it is not a decision that a Maasai man takes lightly. He was reluctant to sell the cow but agreed as they needed 7,000 Kenyan shillings (around £50) to pay for the car to take Semeyian to Kilgoris hospital. Eventually Semeyian was taken, but she died five minutes away from the hospital.
As in any country, women suffer complications before, during and after birth, but the difference between experiencing them here and in Pusangi is the difference between life and death
This is not uncommon. Many of the women I spoke to during my trip told me similar stories - common problems like obstructed labour, haemorrhaging and eclampsia had led to the death of their daughters, sisters and friends, and often their babies. One mother of seven told me: 'there are very many women who have passed on. Many children are without their mothers now because they have died from those kinds of complications. The wife of my brother passed away because of excessive bleeding in birth. If the ambulance was there, these people would have survived. They would have got the medication and the bleeding would stop. Very many children are orphans'. A lack of even basic healthcare means the odds are stacked against pregnant women. According to the Kenyan government, women in Kenya are 40 times more likely to die in childbirth than women in the UK.
A large portion of these deaths could no doubt be prevented if the work of the Transmara Rural Development Programme (TRDP), which is partnered with Christian Aid, was scaled up. Thanks to them, there are now monthly mobile health clinics that reach some of the most remote communities, offering a range of services including vaccinations and antenatal care. They have provided a 4x4 ambulance which acts as a lifeline to communities who struggle to pay for private vehicles, a service which could have saved Semeyian, who died in 2012.
They have their work cut out, though – not only are they up against the social norm of having babies at home, but also the deep-rooted beliefs of the Maasai people. Despite the fact that Maasai women raise the children, look after the livestock, collect the firewood, milk the cattle and feed the family, it is the men who make decisions. The men are in charge, and they’ve been brought up to believe that women should give birth at home, and that they can rely on traditional herbs to soothe ailments including those experienced throughout the birth process. To address these ingrained beliefs, TRDP work with both men and women in the villages, forming support groups for each, offering a space to share experiences and learn more about their rights and the benefits of accessing professional healthcare. Progress takes time, but change is happening.
Visiting this maternal health project in Kenya was a really emotional experience. As a mother I felt the pain of the parents who had lost their children in childbirth, the very moment that should offer hope and excitement within a family. I also felt grateful for the care I had received from my local hospital, a service these women can only dream of. But I also felt frustrated that women should die so unnecessarily, often leaving newborns as orphans, just because they happened to be born in a country where there is little basic healthcare. Next time you complain about the NHS, think about what you would do if it was not there.
This year Christian Aid’s Christmas Appeal is focussing on vital maternal healthcare projects in Kenya and Malawi. Between 7 November 2014 and 6 February 2015 the UK Government will double each pound donated to Christian Aid’s Christmas Appeal, up to a total of £5 million. You can find out more here.
By Claire Meeghan
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