From Monitor Online
When hospitals are death traps Posted in: News <http://www.monitor.co.ug/artman/publish/news/index.shtml> By Monitor Team Nov 26, 2008 - 2:30:51 AM Kampala When labour pangs started to hurt Ms Eunice Mpagazi one evening early this year, the biggest worry for this resident of Nyamiryango village in Kabale District, was how to quickly get to the hospital at the district headquarters for safe delivery. Nyamiryango village, an island on Lake Bunyonyi, is 36 kilometres from Kabale town. Ms Mpagazi's labour pains started after the last passenger boat had left the island so she could not make it to the hospital on time. She was taken to the home of a traditional birth attendant in the village but it could not save her pregnancy; she lost her twins. "I could not make it to the general hospital because of transport hurdles," she said while narrating her ordeal recently. Like Ms Mpagazi, a considerable number of women in Uganda still deliver at home with the help of traditional birth attendants. Many of these are not trained to handle a number of complications that arise during delivery. In Nakapiripirit District, according to a recent health sector report prepared by the District Health Officer, Dr John Anguzi, 98 per cent of the expectant mothers deliver at home. "Although we have government medical facilities here, given the illiteracy levels, intact traditional system and remoteness of our people, the deliveries in the government health facilities are as low as between one to two per cent," Dr Anguzi told Daily Monitor on September 18. "For example because of these factors you don't have to get surprised that there are health units here that have not registered any deliveries throughout the year." "These figures are too low and have been stagnating for the last three years," added Dr Anguzi. This problem is being experienced in many parts of the country. The Health Ministry estimates that 58 per cent of Uganda's women deliver at home with the help of traditional birth attendants. In Arua, the district Public Health Officer, Ms Aciro Munduga, told Daily Monitor on September 25 that 59 per cent of the women still deliver at home. She said lack of sufficient facilities in the government health centres has driven even the women who could afford to pay for better healthcare away from the hospitals and to the traditional birth attendants. "Our health system is badly eroded which is responsible for the many deaths of our mothers. The government must double funding and equip the health centres sufficiently to improve services," said Ms Aciro. According to Ms Aciro, 30 per cent of the women in the district die during labour due to severe bleeding, eclampsia, obstructed labour, most of which are cases she says the health centres in the district are not able to competently handle because of poor funding, lack of drugs and other medical facilities and a shortage of personnel. "These health centres do not even have doctors. This is an appalling situation for our mothers who die at the expense of inadequate service delivery," said Ms Aciro. Most of the health facilities across the country have complained that they are under-staffed, with entire hospitals or, in some cases, even districts saying they have either just one or two doctors. Even the national referral hospital, Mulago Hospital, is over-stretched; it was build with the capacity to conduct 18 deliveries per day but now carries out 70 or more. The result of such challenges is that millions of women in Uganda continue to lose their children or their own lives. According to the Uganda Demographic and Health Survey, an annual average of 435 deaths occur for every 100,000 live births countrywide. This is far higher than the UN Millennium Development Goals targets. The UNDP recommends that to meet the MDG target, Uganda will need to reduce its mortality rate from 435 to 131 per 100,000 live births by 2015. Currently, according to figures from the Ministry of Health, Uganda loses over 6,000 mothers to pregnancy and childbirth-related complications every year. The State Health Minister in charge of Primary Healthcare, Dr Emmanuel Otaala, admits that the government has not done enough. "There is a lot which we are not doing for new borns and mothers and yet it does not require rocket science to do it," he said. "In my experience as a health worker and a parent, the loss of a baby at birth or soon after birth is very traumatizing" According to the Ministry of Health, the government plans to construct health centres within a 15 kilometre radius of each. However, by Dr Otaala's own admission, whereas government has put in place good health policies and programmes, the implementation remains wanting. The ministry has also developed a Roadmap to Maternal and Newborn health and Child Survival Strategy whose strongest components are mobilisation, education, and support for mothers and children under five at the community level using village health teams to increase access to new born care and their mothers at family level. Until such programmes are effectively implemented, however, safe delivery will continue to elude ordinary women like Ms Mpagazi as the risks of their own lives being taken while their giving birth to others remain high. Warom Felix Okello, David Mafabi, Sheila Naturinda, Otushabire Tibyagye and Jane Nafula C Copyright 2008 by Monitor Online I am Peter-Rhaina Gwokto and I approve this message. _____ Remember: "Even a small dog can piss on a tall building" Jim Hightower http://lakitgum.wordpress.com <http://lakitgum.wordpress.com/>
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