In Uganda the “war of childbirth” continues

December 15, 2008

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KAMPALA, UGANDA – Her name is Fatmata. She is an African mother. And this is her story.

Fatmata grew up with 25 relatives in a cluster of small shacks. She is the fourth of 16 children of her father’s, a polygamist with three wives.

A girl who never attended school, Fatmata is light-hearted, well-liked. But this day, in birthing pain, she is taken down a muddy alley to a local nurse who offers a home birthing room: a tiny and hot cubicle with a dirty, sagging cot. There’s no running water, nor time to move Fatmata to a clinic.

She quickly delivers a boy without problem. It’s midnight and she has tea with her husband, holding their newborn. But at 4 a.m. Fatmata wakes with severe bleeding. Without equipment, the nurse says, “I don’t do complications.”

Fatmata’s husband runs around the muddy streets looking for a car to get his wife, now delirious, to Princess Christian hospital, Sierre Leone’s best maternity centre. Stifling hot, the hospital has a broken light in the operating room, overpowering stenches, flies and few supplies. Last year, during 1,230 births, 141 mothers died.

Fatmata arrives there at 6:06 a.m. She has no blood pressure.

She gasps weakly for air. She’s anemic. Nurses send her husband to the hospital’s blood bank. It’s empty. They buy a pint from the street’s black-market, part of the costs—often a month’s wages—that African families pay for their medical services.

Nurses push a needle into Fatmata’s arm and hang an IV at her bedside. It drips life-giving blood. But it’s too late. And so, by candlelight, with a hot rain coming through the window, Fatmata exhales her last breath. It’s 7:14 a.m.

Her body, wrapped in bright clothes, is loaded onto a stretcher. The hospital’s ambulance is broken down so a delivery van moves the body, with six of Fatmata’s relatives, through the rain and chaotic traffic to the shacks that are home, where there is both wailing and quiet acceptance that this is all God’s will.

At 4 p.m. Fatmata’s body is put into a wooden box. It is driven to the cemetery where many dead mothers have gone before her.

And there, 10 hours after Fatmata’s death, her sad-eyed husband tosses the first shovelful of dirt.

This story, recently on the front of the Washington Post, reveals what Africans call “the war” of childbirth. I wish I could tell you that the rich world is helping greatly. It’s not.

Most westerners don’t even know this war exists, don’t know that another mother just died as you’ve read this, don’t know how normal this is considered in the developing world where some 525,000 mothers now die annually, invisibly, from what one commentator calls “sinful neglect.”

Most don’t know how millions of motherless children then suffer or die themselves.

Halfway through the timeline of the UN’s Millennium Development Goals, officials admit that, unlike other health indicators, maternal deaths aren’t budging. They are far from even old targets like the Safe Motherhood Initiative set in Nairobi in 1987 to halve these deaths by 2000.

And when 15 per cent of worldwide births need emergency skills and equipment, the math becomes rather clear. In just one country, Uganda, where I live and where my wife Dr. Jean has founded a charitable program called Save the Mothers, 6,000 mothers died this year. Some went horribly, in agony on dirt floors. Alone. Some bled to death. Some died of overwhelming infection. Some with a half-born child wedged in their wombs.

Meanwhile, in Canada—a nation with a similar sized population—about 10 mothers die annually.

This must all be so very close to God’s heart. The birthing experience of His earthly mother, after all, wasn’t that different. Mary was young and poor with an unplanned pregnancy. She delivered in an unfamiliar and hard place. Joseph and some animals may have been around. But in an ancient small town there were likely few obstetrical skills. In an emergency, what would or could have happened?

Yes, this old war in today’s impoverished regions must surely break God’s heart.

Knowing this may not save a needy mother this minute. But it should help us see Christmas through different eyes. And, when opportunity arises, respond in love.

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December 15, 2008 • Posted in ,
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