The mid day sun was at its zenith and taking an easy stroll in the dusty uneven path was a heavily pregnant young woman, probably in her early twenties, and from the look of things she is coming from the clinic as she is holding a hospital record book.
By Elia Ntali
Yes, it is true that pregnancy is not a sickness but a condition. But for rural mothers, burdened with the hardship of manual work, and long distances endured to the nearest health facilities, pregnancy very often, becomes a sickness.
Unlike in the cities and towns where expectant mothers can easily go for clinic visits to ascertain health of the fetus and then start antenatal care with the support of mechanisms that can be built along the nine month journey under the supervision of experienced personnel, expectant mothers in Mukambirwa village and other surrounding areas in Buhera have to grapple with limited access to health services. In addition, poor road network limits efforts for assisted delivery as the major hospital, Murambinda is more than sixty kilometers and the nearest clinic is twenty 20 kilometers away.
In most cases, the expectant mothers in Buhera resort to home delivery as they cannot with stand the agony of travelling long distances to access medical care. In addition, religious and traditional beliefs play a part in women’s lack of access to health care.
The worst scenario has seen expectant mothers travelling more than 20 kilometers to access medical attention and this has seen many people resorting to home deliveries and at times under the supervision of self proclaimed birth attendants. This exposes mothers and babies to complications such as asphyxia, low birth weight, neonatal tetanus, and pneumonia among others.
Complicating the situation is the fact that pregnant women in some rural communities in Buhera District are expected to perform farm duties and undertake household chores throughout the nine months of pregnancy. This exposes them to a lot of dangers such as miscarriages, growth retardation of baby, and increase in the chance of maternal mortality when antenatal care is not regular.
Besides the challenges, women are often blamed and accused of witchcraft when they lose their babies. Without a way out from these mishaps the mothers suffer from psychological trauma perpetrated by these accusations.
Sophia Chingombe of Mukambirwa village lost her 28-week pregnancy after succumbing to severe bleeding and she had to suffer the trauma of being labeled a witch after the incident.
“I lost my pregnancy at seven months and had the clinic been nearer, my baby would have been saved. However I was labeled a prostitute and a witch after the incident” said Sophia.
“They consider it abnormal to lose a pregnancy at such an advanced stage as the community accuse you of not confessing your sins and it is very disturbing considering you are in pain” said the distraught woman.
Another victim Marvelous Shonhiwa said it is disturbing for one to be accused of killing their own baby despite the fact that hey would have been the ones who would have planned to conceive.
“Can I conceive to kill my child?” she asked.
However, a birth attendant in the area, Mbuya Muchena dismissed the accusations as a smear campaign against the victims.
“I have assisted so many women to deliver and some of them suffered the same fate as these two but it’s totally absurd to accuse them of causing the mishap, it is just a smear campaign as the community does not like these women”, said Mbuya Muchena.
On the contrary, Mbuya Muchena said though she was a birth attendant, there was need to have clinics in the area as at times she is overwhelmed and there are emergency cases that are beyond her control.
“Kunyange ndiri nyamukuta panoda makiriniki nekuti ndinokurirwa uye panoita zvimwe zvandisinga kwanisi (though I am a birth attendant there is need for clinics as I am overwhelmed and sometimes there are cases beyond my control)” said Mbuya Muchena.
Though the government crafted and adopted a policy that saw user fees for maternity services being scrapped the issue still remains the distance between the villages and clinics, a scenario that the Member of Parliament for Buhera South Joseph Chinotimba described as problematic.
“We have a problem the whole of Buhera as there are not enough clinics and people are travelling 20 to 30 kilometers to access clinics and the most affected areas are Nyadi and Mukambirwa” said Chinotimba.
While his counterpart Ronald Muderedzwa from Buhera Central concurred with him saying there were efforts to build clinics but the current economic environment is hampering the efforts.
“It is true we have problems in terms of health facilities but we are trying to ease the situation by building some clinics and already we have one at Ndyarima and has been put on hold due to water reticulation and once that has been sorted it will help.
“Given the current economic environment the government has no money to carry out some of the programmes as outlined in ZimAsset under the social services cluster and the other problem is that most people in those areas have religious beliefs that do not allow them to visit clinics so it becomes a challenge to the expectant mothers” said Muderedzwa.
In the 2014 maternal mortality report released by the World Health Organisation, the country’s mortality rate stands at an astonishing 614 deaths per 100 000 live birth in 2014, it often leaves sad realities in unreachable remote areas such as Mabhoko, Nyadi, Matsakanure and Mukambirwa where expectant mothers and infants die on a daily basis without cases being recorded.
As to why the maternal mortality ratio remains high, the report said there are specific concerns in Zimbabwe that need to be addressed.
“Religious and traditional objectors to modern medicine, for instance refusal to seek care at the health facilities, refusal of blood transfusion, refusal of modern medicines or surgical procedures, and use of traditional uterine contracting medicines to quicken labour”.
“Social determinants of health which include poor public transport system, and clarity on application of user fees. Although it is Government policy not to charge user fees for maternity services, some facilities still charge some indirect service fees, inadequate healthcare budget which seems to be worsening”, read the WHO report.
The situation in Buhera is one of many in the country as more expectant mothers are facing challenges in their efforts to bring life and urgent interventions are required to save their lives and that of the infants.
