By Zoe Alsop
Sunday, October 28, 2007
Kenya's maternal death rates are among the highest in the world, despite its relative prosperity, health care reforms and U.S. funding. Beatings of women in labor in hospital maternity wards are common, as are rejections of women without funds.
During a recent visit to Kenyatta's maternity ward, 59 women shared 39 beds. Ten others rested on the scruffy linoleum floor with their newborns.
"Those ones will stay," said Anna Abwao, the maternity ward's charge nurse, referring to the women who have claimed they cannot pay the delivery fees. "Of course we are trying ways of sorting them out. But some tell the truth; others are liars. So we try to evaluate them." Gesturing toward the floor, Abwao said, "We keep them down there."
Based on their own experience and that of mothers they'd attended, midwives told Women's eNews of beatings, verbal abuse, filth and blood-soaked beds. They also recounted the infamous month two years ago when medical students performed Caesarian sections on most women who walked through the door, regardless of whether the operation was necessary.
Some women would rather risk giving birth at home, said traditional birth attendant Ann Mbuthia, even when they suffer heart conditions or are infected with HIV, making them more vulnerable to complications.
The political will to reform the health sector is faltering.
Ngilu, whose ministry received just 9 percent of the national budget last year, was sacked this fall after abandoning the ruling party, partly over its inability to rein in corruption.
An official at Kenyatta said Ngilu had been the driving force behind recent improvements. Meanwhile, the reform agenda still has far to go. The 1,800-bed hospital routinely admits more than it can hold, sometimes up to 4,000 patients. In a room meant to accommodate six beds, there are sometimes 15, he said.
A younger generation of health workers, however, offers promise.
On a recent Monday in Kenyatta, a clinic offered free operations for women suffering from vaginal fistula, an incontinence-inducing injury caused by difficult deliveries or violent rapes.
Dr. Charlotte Kaliti, 31, cajoled thorough histories from a long line of women, many of them hunched after years of abdominal discomfort and enveloped in the humiliating odor of leaking urine. Kaliti said her contemporaries are struggling to make things better in spite of tiny salaries and a gargantuan workload.
"We are all aware that that type of abusive attitude exists so we talk about it," Kaliti said, referring to nurses and doctors who beat and verbally harass women during delivery. "If I go to the ward and I see somebody treating a patient badly, thereafter I can go and tell them, you know what, she's having a hard time. Maybe if you talk to her more gently she might be more cooperative. We want to encourage them to come back. We want to encourage them to open up."
Zoe Alsop is a freelance journalist based in Kenya. Before moving to Africa she studied international affairs at Columbia University and was researcher for the book, "The Brotherhoods: The True Story of Two Cops Who Murdered for the Mafia." She expects to deliver her first child in Nairobi this February.
Center for Reproductive Rights, "Failure to Deliver: Violations of Women's Human Rights in Kenya's Health Care Facilities":
U.N. Population Fund, Safe Motherhood Initiative:
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