For the last week i was on a break in Addis Ababa visiting friends but i kept an eye on news in Uganda. Two things struck me most.
It has become the regular news about pregnant women dying in labour due to our crumbling health care system. No matter how many cases you hear from relatives to friends to work colleagues, it still aches. First you see statistics that tell you 16 pregnant women die daily and when you go beyond the stats you read the horror that families go through. In July, my boda boda (motorcycle) rider lost his wife in childbirth, then came a friend of a friend. So last week we lost another woman. Cecilia Nambozo, a teacher at Busamaga Primary School in Mbale, eastern Uganda. She was left to die because she couldn’t raise UGX 300,000 (USD120). That amount is probably what Cecilia was being paid in 3 months. In a country where health workers are not paid well and the working environment that can easily drive one insane, the negligence has increased as compassion has slowly slipped away. So i don’t see the death of Cecilia as just neglect at the hospital but the whole social injustice system that makes it impossible for even a teacher to access proper health care. In May the Centre for Health Human Rights and Development (CEHURD), a Ugandan NGO, and the families of two mothers who died in government hospitals in 2009 went to the Constitutional Court alleging the women’s deaths were caused as a direct result of Uganda’s failing healthcare system. We are waiting to see the outcome of this case as it will have implications and how to hold government accountable in health service delivery. Although even a positive court pronouncement won’t make a huge difference, i think it would be a good start. Maternal mortality is not just a health issue, it’s a social justice issue.
After Cecilia’s case I received an email from a friend i went to high school with which made me more worried about Uganda. Worried because i feel like with increased economic hardships people are becoming more frustrated and putting their anger on imagined enemies. My friend’s message was in response to an article i wrote on tribalism in the wake of 2009 Buganda riots. I had written on reports of attacks on people because of their ethnicity. I didn’t expect this to end with the riots but these reports make wonder what Uganda might go through given the current projections of political instability in future according to many reports. After seeing over 1000 people killed in Kenya in ethnic clashes in the post election violence, we can’t simply ignore the role of tribe in politics and how one group becomes a target. This is what my friend wrote to me about.
Rosebell,
Imagine today I flagged down a taxi on Kampala road, the driver stopped, took a closer look at me and as I prepared to board he angrily shouted at his conductor to shut the door because tetwala banyankole (he doesn’t take Banyankole in his public passenger vehicle)… I simply couldn’t believe it and was overwhelmed by emotion that my eyes started tearing! I don’t want to imagine what would happen to people like us if all hell broke loose..
Since the year began it’s been tough with the economy on the rocks, inflation rising and discontent brewing. And while many would fault government, to some government is simply a certain ethnicity and therefore they will blame everything happening to that ethnic group. one thing is for sure, power in this country is increasingly in the hands a few people who belong to one ethnic group but blaming the politics of ethnicity and the guilt by association will not give us a secure future. My friend’s email left me pondering how we can go away from this course. We have enough lessons from our own history and that of neighbouring countries on what ethnic politics can do a society.
Rosebell,
When you talk about martenity mortality I think back to the 3 months I spent at a Health Centre IV some where in Bugiri District – Eastern Uganda! (This very community happens to be the most remote and poorest I have ever encountered) I learnt that the Government actually gives them 1 set of surgical gloves for every pregnant woman! Note that these women are required to go for monthly ante natal care/checkups for all the 9 months or 40 weeks that they are pregnant!
These poor and illiterate woman who cannot afford to buy gloves which they are required to come with for every visit, decide to skip the ante natal altogether, complications or not! They are saving that one pair of gloves for the “most important” day of their pregnancy! Even then, that one pair of gloves is not enough and the women know it!
So what do most of them do???
Because these women know that the midwives and nursing assistants won’t touch them without the extra pairs of gloves(remember they are saving that other pair for the “real” moment ) the women opt to give birth at home, which usually ends fatally!
Please note that the women are also required to bring their own surgical blades, cotton wool and whatever else they might need! Without these, the midwives do not touch you…what happens to the women after that is not their problem!!
How many of these women survive?? How many??
All the Government of Uganda can afford is one pair of gloves per woman, for the entire pregnancy!!! Really!!!
Sad! what do we expect health workers to do really? they r not paid and have to risk their lives with possibilities of gettin HIV and govt has put up a consistent campaign of blaming all on the healthworkers.
Hi Rosebell I read an article just the other day in the NYT about women dying during childlabour. NYT also raises broader questions about the unintended impact of foreign aid on Africa’s struggling public health systems. And I quote: “As the United States and other donors have given African nations billions of dollars to fight AIDS and other infectious diseases, helping millions of people survive, most of the African governments have reduced their own share of domestic spending devoted to health, shifting to other priorities.” I thought that was quite interesting.
Quite shocked about the etnic part of your story.