By Irene Best Nyapendi
While strides have been made in reduction of infant mortality, prevalence of obstetric fistulas due to inadequate health care continues to be problematic, especially for developing countries and with the diminished number of health care workers since the Covid-19 pandemic. Obstetric fistula, in which there is a hole between the birth canal and bladder or rectum, is an ongoing problem in Uganda because of gaps in timely, high-quality medical care.
Prioritizing treatment for safe motherhood is critical, according to Dr. Jean Chamberlain, a Canadian obstetrician/gynecologist, who made the plea during the annual conference hosted by Save The Mothers (STM) Organisation, which Chamberlain co-founded. Under the theme, “Re-imagining Safe Motherhood Post-Pandemic,” she spoke at Uganda Christian University (UCU) on May 5.
Chamberlain argued that among all the world’s issues, safe motherhood should come to the top, especially in light of workforce loss and fatigue as a result of the pandemic.
“In the clinic where I work in Canada, we had around nine nurses at the beginning of the pandemic, but by the end of the pandemic, there was literally no nurse because all of the nurses left during the pandemic,” she said. “The challenge we are facing now is how to build the workforce again, looking for people who are really dedicated, who understand what they are doing and are qualified.”
Chamberlain emphasized the dire need to prioritize safe motherhood aligned with the STM vision: No mother or child should die from preventable causes related to pregnancy and childbirth.
In support of the vision, STM started a Master of Public Health Leadership (MPHL) at UCU in 2005 with the aim of training multi-disciplinary professionals and improving maternal and child health in developing countries. Over 600 East African leaders have graduated to work towards overcoming preventable maternal and child death.
Chamberlain urged safe motherhood professionals to be pillar-people by being present, committed, reliable, steady and go the distance for the mothers so that when people look at them, they see people they can lean on.
“Two million people worldwide suffer from fistula, but no one hears about them because the power actors have been silent to date,” she said. “This is why as Save the Mothers, we need to be a voice for these mothers.”
Dr. Jessica Nsungwa Sabiiti, the commissioner for maternal and child health at the ministry of health, reported that most deaths registered are due to patient delays at healthcare facilities.
“Most mothers bleed a lot which is as a result of delaying to be attended to at these facilities,” Nsungwa said. “We have been pushing for four visits for antenatal care, but we want eight visits to help identify those with risks.”
According to Nsungwa, a lot of what they do depends on the number of “champions” such as those trained through STM who can translate the information and be in the society to ensure that there is cohesion. Shesaid maternal mortality in the country has reduced from 18 to between 10 and 14 mothers a day since 2010.
Robie Kakonge, the Ambassador of Uganda to the USA and an alumnus of MPHL, appreciated her fellow alumni for the steady effort displayed towards positive change in safe motherhood.
“At the embassy each week I get not less than two requests related to public health” with many wanting to know how they can help, Kakonge said.
The executive director of Save the Mothers East Africa, Edward Mukooza, said their “Mother Baby Friendly Hospital Initiative” is now effective in 13 health facilities in Uganda. Under the initiative, STM graduates work with hospital administrators and staff in improving maternal and newborn services.
“We also have high dependence units currently in five hospitals to help manage complications to reduce maternity morbidity and mortality. Through such programs, we provide emergency medical funds to vulnerable mothers,” he said.
