Just last month, four major international organizations announced in a jointly released report that worldwide there had been a drop in maternal deaths by a third. The report, ‘Trends in Maternal Mortali-ty,’ released by the World Health Organisation, UNICEF, the United Nations Population Fund and the World Bank, revealed that the number of women dying annually from pregnancy-related complications had dropped by 34%; from 546,000 in 1990 to 358,000 in 2008. The organizations said this was progress. But any celebration of it should be tempered by the fact that 358,000 deaths in 2008 still meant that women were dying at the rate of 1,000 every day; the report listed the major causes of their deaths as severe bleeding after childbirth, infections, hypertensive disorders, and unsafe abortions.
Guyanese are sharply aware of these major causes of maternal deaths given that Guyana did then and still does contribute somewhat significantly to the 1,000 per day average. Just last week, a 28-year-old Corentyne school teacher, Esther Dwarka-Bowlin, bled to death at the Skeldon Hospital after having given birth to a baby boy. Last month, 26-year-old Rebekha Chinamootoo of Number 36 Village, Corentyne died after giving birth to a healthy baby boy by caesarean-section at the New Amsterdam Hospital. Two days prior to Chinamootoo’s death, a 16-year-old primigravida (first-time pregnant woman), Nadira Sammy of Number 69 Village Corentyne, who was diagnosed with high blood pressure, lost her life at the New Amsterdam Hospital. Sammy died before she could give birth.
It is possible that a parallel can be drawn from the fact that all three of these women lived in Berbice and two of them died at the New Amsterdam Hospital. However, what is even more telling is the similarity among these cases. In each instance, the woman in question needed more than the regular almost offhand care that is more often than not meted out to pregnant women in this country. The families and relatives of each woman complained that they were apparently ignored by nurses in the hospitals. Mrs Dwarka-Bowlin was in obvious distress, but her relatives were ordered to leave the hospital and she was promptly ignored. Mrs Chinamootoo should have had a c-section much earlier than she had it, but someone decided to play God. Mrs Sammy was diagnosed as hypertensive – a worrying sign for pregnant women. Plus, as a primigravida her case warranted extra attention – it appears she received very little.
Lest there be an assumption made that there is a campaign on against Berbice hospitals, it should be noted that there have been too many similar cases at other public hospitals – and some private ones also – throughout the country. A case in point, as recently as early last month, Aseelah Haqq died at the Georgetown Public Hospital after she was forced to endure normal childbirth, despite instructions being given by a physician that she should have had a c-section. And in May this year, Waheeda Haroon Basil died at the West Demerara Regional Hospital, also while in childbirth.
The common factor in all of these maternal deaths is that these women suffered complications, which are not unheard of in childbirth, but which were compounded by a lack of due care and in some cases none whatsoever being offered to them. A woman giving birth is not sick per se, as childbirth is an act of nature, but she is advised to have her baby in a hospital so that she is close to expert medical attention should the need arise. However, this becomes pointless when trained medical professionals don’t do what they are supposed to do.
After each maternal death, Minister of Health Dr Leslie Ramsammy has said, a report must be made within 24 hours and an investigation conducted. It’s hard to say whether negligence – as often seems to be the case – attracts any disciplinary measures as the tendency is for health officials to clam up and refuse to discuss the findings of the investigations. However, it is painfully obvious that in Guyana’s case, maternal mortality is not so much a poor health care system problem as it is an attitudinal issue. And unless health administrators bite the bullet and truly mete out the necessary punitive measures it is not going to go away. No amount of state-of-the-art hospitals and equipment can save lives if the people entrusted with operating them are not interested in so doing. We all know that nurses are grossly underpaid, but note must be taken of the fact that not all of them operate in a callous manner. Harsh discipline will either reignite the interest of the unconcerned or force them out of the system. Either way, something has to be done; enough is enough.
