The battle for better maternal health care in Uganda
March 17, 2015Childbirth deaths around the world are down by half in recent years – and by building strong demand from citizens in countries like mine where women are most at risk, I have seen how we can bring the death rates down still further, and rapidly.
I live in the rural area of Kabale in south-west Uganda. I am a mother and work in the local radio station, Voice of Kigezi. A year ago, I became one of six volunteer citizen reporters with the White Ribbon Alliance, which is holding our government accountable for its promises to women’s health.
We did a three-day training course in using cameras to track and report on progress – or lack of it – and also raising awareness in our communities about women’s rights to maternal health services.
In 2011, the government of Uganda promised us that by 2015, comprehensive emergency obstetric care – which can save women’s lives through caesarean sections and blood transfusions – would be available in half of all our top-tier health centres, which are close to where most women live. That would mean an end to pregnant women walking long distances to receive healthcare, often in the late stages of labour and sometimes giving birth and dying by the side of the road. So often we see babies with their umbilical cord tied with a torn strip of a mother’s kanga.
I was pregnant at the time. My task was to check on the gaps between what has been promised by our government – and the reality. There are many wide gaps.
Citizens in my area had already gathered evidence through a White Ribbon Alliance Uganda checklist and survey. We found that not one of the health centres in my district even had a doctor. We found that many women were dying terrible deaths that could have been prevented, and even more newborns were dying for lack of basic care and simple resuscitation.
We began to mobilise our community, and thousands of people demanded faster progress through petitions, meeting with our MPs and reports to the media.
Our district health officer took action. He invited doctors to come to the area and tell us about anything that would deter them from living and working in Kabale.
The young doctors reported back about the difficulties they would face, including poor salaries, lack of electricity and of decent accommodation. In one health centre, they found electricity was off because the bills had not been paid and midwives were trying to do caesarean sections by the light of their mobile phones. One small house built to accommodate a doctor was already home to half a dozen other health staff, and where would they live if a doctor arrived?
The district health officer made a major effort to overcome these problems, and to encourage new medical staff to stay in post. Now, for the first time, we have seen six doctors working in my district, available to save many lives.
However, during all of this good news, I went into labour and I lost my own baby in childbirth. If this had happened before I had started citizen reporting, I would have shrugged my shoulders like most women in this situation do and said: “It is God’s will.”
But because I had done this training, I realised that the hospital was negligent and my baby’s death could have been avoided. I understand that nothing will bring back my baby, but I know I have a right to demand better services for myself and my fellow women in the future, and so I have filed a case against the hospital.
I am determined to hold those responsible to account. We will not meet the millennium development goal for maternal health in Uganda, but we are making progress, and we are holding citizens’ hearings in a number of areas across the next few weeks to have a dialogue with our leaders and work together for better health for women and newborns. We must also make sure that accountability is built into the next set of goals, the sustainable development goals.
People like me can and must speak out about the poor state of maternal health in our country. I have also written a song about my experience which I hope will be broadcast on the radio to alert other families of their rights. Justice must be done.
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