Heartrending events involving pregnant mothers, defined by a marked lack of accountability in the healthcare sector, continue to prevail in this country, even in these modern times when elsewhere there are significant improvements owing both to science and technology, and punctiliousness and integrity. Three recent incidents which occurred here in August, September and October bear this out.
Around mid-August, Dawn Jose, a Region One (Barima-Waini) mother of five related to this newspaper, her experience of being ignored during labour at the Suddie Hospital and birthing her sixth child alone, despite the nurse on duty being in the same room. This resulted in the newborn falling off the birthing table into a garbage bin and the umbilical cord bursting. The mere thought of the possible ramifications of those events was chilling, to say the least, but by providence, the mother and her baby were both okay up to the point at which she spoke with this newspaper.
On the last day of September, Jacinth Seleen Muhammad Osborne, a 22-year-old teacher of the Berbice River died at the New Amsterdam Hospital after undergoing a caesarean-section to deliver her first child. Mrs Osborne’s mother related that labour was induced and continued for close to 36 hours before a decision was taken by medical staff to perform the C-section on her daughter. The young woman did not survive the operation, but her mother recalled that she and the young mother’s husband had received conflicting reports regarding Mrs Osborne’s condition.
On October 31, Devi Samaroo, 24, of Bloom-field Village Corentyne, Berbice died at the New Amsterdam Hospital after giving birth, reportedly to a stillborn baby, some 24 hours earlier. According to her husband, the mother of one was in perfect health when she was admitted to the hospital as was the child she was carrying. He was later informed that his wife had succumbed after haemorrhaging, but told this newspaper he was awaiting the results of autopsies on his wife and child as communication from the medical staff had been poor.
It is worth noting here that though pregnancy is not an illness, women die during and after childbirth owing to high blood pressure, obstructed labour, severe bleeding and sepsis, all of which are preventable as there are highly effective medical interventions available. According to the most recent data from the UN, globally, some 800 women die every day from preventable causes related to pregnancy and childbirth. This is about one woman every two minutes. Furthermore, an estimated 20 to 30 women sustain injuries, infections or disabilities during childbirth, most of which are also preventable.
The obvious missing link is that many women are not being afforded access to the health services that could easily make giving birth safer. Antenatal care, skilled birthing attendants (midwives and/or nurses), emergency obstetric care (as should be available in a well-staffed, adequately-equipped medical facility) and quality postnatal care are key to keeping mothers alive during pregnancy, childbirth and after. When one or more of these are lacking, situations can quickly become dicey, making safe motherhood a matter of chance. This should not be.
One of the huge stumbling blocks that has to be overcome is the global shortage of midwives. According to the State of the World’s Midwifery, a report released in May this year by the United Nations Population Fund, the World Health Organi-sation, the International Confederation of Midwives (ICM) and partners, it is estimated that the world needs some 900,000 midwives. However, this is unlikely to happen now or anytime soon owing to the havoc wreaked in hospitals by COVID-19, which is ongoing in many countries, like Guyana.
Already affected by the global nursing shortage, which has seen many of this country’s best nurses migrate to the developed metropolises that offered better compensation and a higher standard of living, COVID-19 has served to make a dire situation that much worse. Initially it meant that the bulk of the nursing staff had to be deployed to the coronavirus battle. To wit, there is now an entirely new Infectious Diseases Hospital at Liliendaal for which the staff was undoubtedly pulled from other public institutions. More recently, vaccine hesitancy saw scenarios where scores of nurses were locked out of health facilities and in some cases opted out. The result being that those who remain are overworked and under tremendous stress, diminishing their capacity to provide the optimum level of care.
The attempts by government to pretend this problem does not exist only exacerbates it, when in fact extensive resources should be expended towards alleviating it, including the remuneration of nurses as a priority. As an aside, the time has come to toss out the antiquated and patriarchal notion that for years have seen women-led vocations like nursing and teaching on the lower end of the pay scales.
The wheels of health infrastructure cannot turn without human resources, the majority of whom are women. Globally, women account for 93 percent of midwives and 89 percent of nurses. Clearly this is also an area that needs gender parity and perhaps more aggressive moves towards addressing the stigma attached to men entering the profession would help.
As one of the 193 countries that have officially adopted the Sustainable Development Goals, Guyana is not doing all it can to ensure the attainment of 3.1 which is to reduce global maternal mortality to less than 70 per 100,000 live births by 2030. If it were, government would show far more recognition of every woman’s right to live through childbirth and emerge whole on the other side with a healthy infant. There would be vigour in its approach to decreasing Guyana’s maternal mortality ratio which was 169 deaths/100,000 live births in 2017.
