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Cruelty in labour wards: Maternal health problems in Malawi

Nyasa Times

November 10, 2016
This article originally appeared in Nyasa Times and was written by Luciano Mzazi

White Ribbon Alliance for Safe motherhood has shed more light on the current maternal health situation in Malawi, indicating that there are loopholes that are too deep to cover, hence the continued challenges in the field as many expectant women have accused some nurses of being rude and others go to the extent of hurling insults at them and even slapping them.

Chairperson for the Alliance, Nancy Kamwendo made the revelation during an interface meeting held recently in Mulanje district, through which community members were given an opportunity to interact with midwives from a number of hospitals in the country in order to raise their concerns on maternal health and also listen to what the midwives had to say for themselves on all the accusations they have been receiving for a long time.

According to discussions done in several forums, it is apparent that many women continue to face what they describe as “torture” and poor treatment in public hospitals and health centers when they report for delivery.

Those who survive the horrifying ordeals are always thankful they made it out of the hospital alive.

Speaking in an interview with Nyasa Times, Edda Malanga attested having been ill-treated at Mulanje District Hospital when she went to deliver her first born son in the year 2000.

“When I went to deliver my first child, I was not treated with respect: the midwife that was there shouted at me for every little thing that she wanted me to do, and at a point in time when I could not do what she wanted me to do, she got angry and slapped me on the thighs,” explained Malanga.

She added that while she understood that the midwife was doing her job and was trying to save the baby’s life the beating did not go well with her, and she decided to start delivering at Traditional Birth Attendants’ (TBAs) as opposed to hospitals .

Malanga confirmed that even government banned Traditional Birth Attendants, she continued to use them.

Commenting on the worries that she raised, Safe Motherhood Coordinator for Mulanje district Yankho Gondwe concurred with some of the women who accused midwives of acting out-of-their-profession while helping women in labor, saying there are some midwives who simply don’t belong in the field they are working.

“For a long time we have been receiving complaints from our clients and when we receive a complaint we always try to reason with the particular service provider who has been mentioned as the aggressor in the complaint, and this has proved to change behaviors in many of the midwives hat were not well-behaved, but still there are some who were simply not meant to be in this field and are literary unable to change,” said Gondwe.

She however added that some rough speaking that happens during child delivery is not meant to hurt the mother but rather to give her strength so as to bear a live baby.

“You also must understand that the delivery process is a crucial one and any mistake happening during that period can cause maternal death, and that is why when we reach that stage there is no soft-talk between the midwife and the woman because the midwife has to play her part in strengthening the woman to finish the work she has waited for all the nine months,” further added Gondwe.

However, Nancy Kamwendo noted that although a great deal of the midwives’ population across the country was trying its best in delivering services in a manner that furthers the Malawian Safe motherhood dream, the field was faced with so many challenges ranging from people’s attitude to poor staffing, causing some of the midwives to actually misbehave.

According to Kamwendo seldom are midwives appreciated by their clients for having helped them deliver a live baby without making a mistake, but yet a lot of stories emerge out of one simple mistake committed by a midwife during her work.

“This is so because people have a bad attitude towards midwives and all they expect to see is poor treatment and rudeness, to an extent that even when the midwife does a good job there is not even a simple thank you said by a client,” Kamwendo worried, adding that this was sad for a nation termed “warm heart of Africa”.

The Chairperson further added that Malawi had a very big challenge in terms of staffing, where only 3 420 bedside midwives are expected to serve an overwhelming population of 4.1 million fertile women across the country.

According to the World Health Organization, a midwife is supposed to serve 175 women, but currently in Malawi a bedside midwife serves an average of 1 209 women.

As Kamwendo explained, this causes a lot of challenges such as some midwives skipping procedural stages in their work due to work overload.

“Under normal circumstances, a midwife is supposed to tell her patient everything that she is going to do to her, and the reason why that has to be done. But where a midwife is standing in a delivery room with three women waiting for her to help and are all nearing critical stages, I just don’t see how the midwife can find time to spell out the procedures to all the clients,” said Kamwendo.

She went further to ask government to consider deploying graduated midwives who were currently jobless and some were looking for jobs outside the country, a thing she described as counter-productive.

“We are losing a lot of midwives to other countries and private hospitals due to our government’s delays in recruiting graduated midwives.

“For instance, currently you might be surprised to note that at the Nurses and Midwives Council of Malawi we have a total of around 12, 000 registered midwives, but yet only 3, 420 are currently ticking and available for the women in our hospitals: now I can’t explain that, but that’s how things are like on the ground,” she concluded.

Meanwhile, the White Ribbon Alliance is going across the country empowering communities with messages aimed at promoting rights to access and demand for proper maternal health services and promoting the ‘thanking the midwife’ spirit among women who attain maternal health services.

The expectant women are calling upon the concerned stakeholders to bring about systemic reform in the health sector to ensure the inhumane treatment in some of our hospitals by some nurses is brought to an end.

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