Lushi Rashid (C), a 29
year old muslim South Sudanese woman, gives birth to her fifth child at
her family home with the help of her aunt (R) and Regabia Ahmad (L), a
qualified birth attendant, in Juba, the capital city of South Sudan,
July 18, 2011. Regabia has been delivering babies in South Sudan for
over twenty years. she was trained by the health ministry and works at a
local primary health clinic. With fewer than 100 trained midwives for a
population of over eight million, South Sudan has the highest maternal
mortality rate in the world.
Lushi Rashid throws her arm up in the air, stretches out on the yellow sheets and ululates in pain.
“Jiijiijiiijiii,” she cries as the
contractions grow stronger, emitting the high-pitched trilling noise
that South Sudanese women make to show emotion.
Sitting on a stool at Rashid’s
bedside, midwife Regabia Ahmad shushes her. “It’s not good to shout,”
she says gently. “If you shout there is pain; if you don’t shout there
is pain. So you keep quiet.”
Though she lives near the country’s
best public hospital in Juba, South Sudan’s largest city, the
29-year-old Rashid has decided to have her baby at home with a midwife.
“At the hospital, everyone is trying
to do something to make the baby come when it is not yet ready,” she
says. “At home. . . there are not so many people.”
Ahmad, 42, takes off her watch,
washes her hands and puts on plastic gloves. The baby will be born in
about an hour, at 5:30 this afternoon, she predicts.
Ahmad has been delivering babies for
more than 20 years, through the country’s civil war and afterward. She
was trained by the state health ministry and works at a local health
clinic. Rashid is one of the lucky 10 per cent of women in the country
who will see a qualified birth attendant.
With fewer than 100 trained midwives
for a population of more than 8 million, South Sudan has the highest
maternal mortality rate in the world. For every 100,000 live births in
the country, 2,054 women die, according to statistics from the United
Nations Development Program (UNDP). It’s a situation the health minister
of the East African nation has called “our greatest nightmare.” A woman
in South Sudan has a one-in-seven chance of dying in childbirth over
the course of her lifetime.
The world’s newest country — it
gained independence in July after more than 20 years of civil war —
South Sudan is chronically underdeveloped. Even among African nations,
where the maternal mortality rates tend to be highest, it stands out. In
neighbouring Uganda, for example, only 435 women die for every 100,000
births, says the UNDP. (In Canada, the number is 12, according to
Unicef’s 2008 figures.)
Here, “most of the population doesn’t
have a health unit and if they do, there’s no health provider and no
drugs,” says Dr. Abadallah Mergani, head of obstetrics at Juba Teaching
Hospital, the nation’s largest.
On a busy weekday morning, Mergani
rushes between making rounds, operating the ultrasound machine and
administering the ward. He’s one of only a handful of obstetricians in
the country.
The majority of women who die in
childbirth here suffer from haemorrhaging and sepsis, treatable problems
in the developed world. The absence of qualified medical personnel,
along with the lack of health facilities and transportation difficulties
— the nation has only 50 kilometres of paved road — can render
otherwise minor complications fatal.
And a lack of medical supplies means
doctors are sometimes unable to help even those women who do make it to
the hospital. “Some even die while we are looking for blood,” says
Mergani. The hospital has no blood bank.
Since the end of the civil war in
2005, there have been efforts to reduce the maternal mortality rate, but
the country has a long way to go. “In some areas you are starting from
the ground up,” says Gillian Garnett, a midwifery specialist with the
United Nations Population Agency.
The agency has a recruitment program
for midwives but has found it difficult to attract people since
midwifery is traditionally considered a low-status profession in South
Sudan.
And there are other cultural factors at play. Even where hospitals are accessible, women often choose not to go to them.
It can be seen as a sign of weakness
to give birth in the hospital. “Women feel that they have to show
strength,” says Garnett. “In the hospital, they feel like you are
pampered.”
Furthermore, “it’s the culture that a
lady should deliver at home with her family around her, her mother, her
grandfather, her sisters,” says Mergani.
Accordingly, standing over Lushi Rashid in her bedroom are her aunt and sister.
Her 3-year-old son has been shooed
outside by the midwife, but he peers in the window. A neighbour pops her
head over the fence to check on the progress of the birth.
Rashid’s mother enters the bedroom
and sprinkles water over her daughter’s abdomen. It’s a blessing for the
good health of mother and child. There’s no need for her daughter to go
to a hospital, Marcelina Dudu believes.
“Before, during the war there were no
(hospitals). I had three sets of twins without fear at home. Even Lushi
was born at home. They were all born at home,” she says.
The contractions become closer together and Rashid ululates louder and more frequently.
Ahmad reaches under the sheet
covering Rashid’s knees and, almost before the others in the room know
what’s happening, pulls a baby boy out from between the mother’s legs.
After a second, he emits a strong, healthy cry.
The midwife wraps the baby in a
purple blanket and consults her watch. Just as she predicted, it’s just a
few minutes before 5:30.
Mama Dudu pulls out her mobile phone and calls friends and relatives.
Despite the pain of the ordeal, and
the fact that she has four other children, Rashid says she wants to have
more. “I want to take some time and then I want a girl because I have
all boys,” she says.
Her husband, Amin Rashid, arrives
home about an hour later. He’s been at work; men rarely attend their
children’s births in South Sudan.
He knows of women who have died in
childbirth but he approves of his wife’s decision to deliver at home.
“The hospitals in Juba are poor. All the (government) ministers here,
when their wives have one or two months remaining, they go to Nairobi or
Kampala (to deliver).”
Collecting her medical supplies,
Ahmad prepares to leave. She doesn’t know it yet, but when she arrives
home she will be called to attend another birth that will keep her out
until the early hours. Given the small number of midwives in the nation,
she’s always on call.
Ahmad gets paid for her work as a
midwife by the government. But despite long hours and a culture in which
government workers often ask for a little something extra from those
for whom they perform services, she doesn’t charge the families.
She sees her work as a kind of
vocation. “If you give me something, I will take it; if you do not give
me anything, I do not ask. This is the work God gave me to do.”
OK...I know a woman that is a friend of mine living in the tiny country of Eritrea. They have many ties to Sudan and not only that she has been one of the fore-runners in trying to get more Birthing hospitals in SUDAN (dun dun dunnnnnn)
This is an article that is misleading, and parts are fabricated. I am shocked to think this is supposed to be a pro- give- birth- at- home article!
Let's Start with each fact as they are given.
This article is just a lie, glamorizing how easy it is to give births to babies in Africa. Given the fact that Africa has one of the highest malnutrition-ed rates, why would Doctors put babies at a greater risk by inducing pre-term or early labor? That is just not making any sense at all. That is a full blown lie.
Not so many people?
There are kids watching you have your baby through the window and you think that is more private to have a baby in the living room of your home than in a hospital?
Qualified Birth attendant is not correct either.
I have a friend who works for the Department of State in The Region (Sudan and Eritrea). One of the projects they are working on is more facilities for giving birth. In order to do this they must meet with the local people and they have to see the needs of the people. Qualified is not correct because the "Midwives" just walk around telling people they know how to deliver and they basically can there. FACT: The same person that delivers babies in Sudan also circumcises young girls. (Another topic I will be talking about soon)
Another Fact: In Sudan there is only one Hospital, and there is only one OBGYN. All the women interviewed by the Dept of State and by a Doctor who is Sudanese and she is also very knowledgeable of the Culture and country, she said that the women DO want to have their babies in hospitals and that the women there do not understand why Western Women, upon hearing opting to have their babies at home, and not in a hospital.
Having a baby in a hospital is a luxury there but they are not condemned by having babies in the Hospitals at all. In fact, they can not get to the hospitals in time and Upon interviewing Eritrean women they laughed when told that American women were having babies at home because "African Women can do it" well, yeah, African women have no choice in the matter.
Another Fact: There is less road than what the article mentioned.
Another Fact: Midwifery is not considered a low status job, it is the cold hard truth that when you are hired by the Government, now to be a midwife or any Medical Profession in Sudan, to get rid of FGM (or Circumcising Females) They must not perform this Traditional and yet horrible and needless practice and so the Midwives that are not choosing to work as one under legal terms are actually still doing that practice which makes the jobs of the hospitals more difficult.
Notice how when she says there are less people in home and more people in the hospital, later you read about how the whole family is there, how neighbors peer through the fence to see if she has had her baby, how the children are being shooed out of the living room and how the Grandfather, mother, sisters, etc are all there waiting for the arrival of the baby? Don't you think that is in itself contradictory? The only thing that was correct in the article was the fact that Sudan is the highest death rate among newborns and the highest death rate while giving birth in the world. The fact that in The Star they mention that the woman giving birth was Muslim is a huge slap in the face to Muslims and had nothing to do with article. Why mention t? There are idiot Christian women in Europe and in USA that give birth to their children at home, and so why would they mention it? does it make the article more factual? What would that make readers think about Muslims? About how they give birth? Their ideas of giving birth at homes? I found it annoying to think that they would even say anything about the Religious practice of anyone mentioned in the article.
This article after reading it myself, made me more inclined to tell people how stupid they are for having babies at home. those that are in Africa most women have no choice! But First World and even Second World women (yes.. You Europeans) You guys should never be playing with your life nor your child's life by thinking you are smarter than a Doctor and cleaner than a Hospital. Why do you want to risk infections, diseases and all kinds of problems by having a baby in your living room? It is disgraceful and you do not know more than highly trained doctors.
I know someone that had 8 children. 7 born at home but her 7th was born and lived a very short life and died. I am inclined to say that she is an idiot for never seeking Prenatal Care never having ultra sounds that would have saved her baby not only from dying but from SUFFERING because she had no idea her baby was SUFFERING and dying!!! That is pure being stupid and Brutal.
Clearly her 8th child born the one year anniversary of the death of her 7th child, was indeed born in a hospital. And oddly... She even had an epidural and said, "If I'd have known all my births were like this I would have had ALL My children born in a hospital"
Women in the Second and First world countries have the choice of having a Doctor there at the birth only if it is a medical emergency, and can have nurses and midwives deliver the babies if they wish. These trained and qualified people can deliver in Clinics, and Birthing Centers and do not have to be in a hospital yet you still get the feeling of home but you are in a cleaner environment than that of a home surrounded by little kids, neighbors and the family dog chasing a ball while you are trying to have a baby.
I would even respect a mother choosing to have her child at a Clinic and saying... Well, I have had bad experiences with Doctors... I prefer a Midwife.. I respect that more then the women that say, "Babies in Africa are born all the time with no problems in conditions worse than mine... I don't need a Dr"... For those women I say, Your Stupidity Stifles Me
Posts
