WUNRN
CONGO - MATERNAL & INFANT
MORTALITY
July 28, 2010
Rosie DiManno
Mother Pamela and baby, not yet named, pose in Democratic
Republic of Congo, where four women die every hour from complications of
pregnancy.
The
But few countries on Earth are worse to be pregnant in. Every
hour of every day, four females in the Democratic Republic of Congo die from
complications of pregnancy and labour, according to statistics from the United
Nations Population Fund. For every woman who dies giving birth, between 20 and
30 suffer serious health problems such as obstetric fistula.
The infant mortality rate is 81.21 for every 1,000 live births,
a figure that has actually gone up by 2 per cent since 2008, while maternal and
infant deaths have otherwise dropped globally.
“Women continue to die as they are giving life,” fretted Congo’s
first lady, Marie Olive Kabile, recently, as her husband, President Joseph
Kabila, committed the government to improving maternal health by earmarking
more funds for prenatal and obstetric care.
Six million dollars — that’s what has been allocated in the
Congo’s budget to finance the entire
health sector, while at least $60 million is urgently required.
“We are still waiting,” Marie Jeanne Mpembe, director of
planning for Safe Maternity, a health ministry agency, told the Star Tuesday, in
reference to whatever increased funds will eventually come down the pike for
maternal health care.
A distant rumour, adds Mpembe, is the $5 billion package for
boosting maternal and child health in poor countries — the Muskoka Initiative —
pledged at the recent G8 summit in Canada, one-fifth of it to be ponied up by
Ottawa in new funds over the next five years. (A further $2.3 billion in
contributions has been promised from six non-G8 nations and the Gates
Foundation.)
“I know only what I’ve read on the Internet,” says Mpembe. “Here
at the ministry, nobody has said there will be more money coming from
international donors or how much.”
From her small and understaffed office, Mpembe feels overwhelmed
by the health issues facing her country’s women and the babies they are producing
— way too many babies, starting at way too young an age for young mothers and
spaced way too close together.
Half of Congo’s 35 million women give birth by age 19 and have
an average of 6.2 children during their fertile years. They start too soon and
continue too long. Only an estimated 6 per cent of Congolese use contraception.
Added into that mix, of course, are catastrophic rape figures driven by the
continuing conflict in the eastern part of the country.
One survey undertaken last year revealed that half the 2009
births — 3 million in all — were unwanted babies. It’s unknown how many
newborns, the progeny of sexual violence, are killed at birth.
There are few options for reluctant mothers looking to
dispossess themselves of babies. Often turned out from their homes, both
mothers and children must beg for alms on the street. Infanticide, a terrible
crime, can be understood only from the perspective of women with nowhere to
turn beyond overburdened humanitarian agencies.
“The central problem is poverty,” explains Mpembe. “We don’t
have enough facilities, we don’t have enough health workers, we don’t have
enough medical equipment, doctors or drugs.”
Maternal health care has for too long been at the bottom of
issues to be addressed in the Congo, as in other developing nations. Childbirth
is considered a natural and private event, something that occurs in the home
rather than a matter worthy of medical attention. This is a view also advocated
by out-of-hospital birthing proponents in the West, who claim that midwives are
sufficient for the purpose.
Which may be true — certainly trained midwives are capable — but
pregnant women in the First World can be rushed to hospital if labour
difficulties arise, and those identified as at risk receive close obstetric
care through regular office visits.
That kind of attention for expectant women simply doesn’t exist
in the Congo.
“It costs about $20 (U.S.) to give birth in a hospital here,”
says Mpembe, herself a mother of five, all born in the hospital. “That’s a lot
of money for an ordinary family. And that’s just if nothing goes wrong and the
mother can go home right away.”
Most Congolese women never see a doctor during their pregnancy
and show up at the hospital only to give birth.
And those hospitals are not well-equipped.
Some lack such basic items as surgical gloves and masks and
clean water. Hygiene is difficult to maintain, so ward infections spread
easily. More sophisticated medical equipment, such as incubators for preemies,
is sparse on the ground. Blood for transfusions is rarely available.
“Doctors run around looking for blood from family members and,
in the meantime, women die.”
While childbirth may be a completely natural and normal process,
the bodies of 13-year-old girls were never intended to deliver babies.
“Most of our first-time mothers are adolescents — 13, 14, 15
years old,’’ says Mpembe. “Many parents prefer to marry them off early, to get
them out of the house so they won’t have to be responsible anymore.”
Daughters are a drain, too often not worth educating, not worth
keeping around as they grow older, unless they can contribute to the family’s
income — valued for whatever bridal price they can attract, a formality
traditional throughout Africa and Asia.
Then they start to breed — children having children, pubescent
girls wracked by labour and infants dead out of the womb.
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