Mother’s Day in Sierra Leone should be a day of reflection and not celebration because too many of our women die trying to give life. For every 100,000 births each year 1,360 women die. Sierra Leone is the deadliest place for women who want to be mothers.
When I was pregnant I had access to prenatal care, each time I went to the hospital, I saw a doctor, and when it came time for me to give birth, I did so in a facility with world class expertise in New York City. Women like me have the privilege to opt out of the local birthing experience, and we have a choice between the US, UK, South Africa and Europe to access safe delivery. We are the One Percent. For the rest of our women one in seventeen has a risk of dying during or up to six weeks after birth.
The causes of maternal mortality in Sierra Leone are varied but it is always a question of access to quality health care. Women don’t see health care workers during pregnancy so when there are complications it is almost too late.
According to a 2017 report from Ministry of Health and Sanitation the main causes of maternal deaths are post partum hemorrhage, pregnancy-induced hypertension, infection, and unsafe abortions. Other causes include anaemia and malaria during pregnancy. We also have a very high rate of teenage pregnancy because 39% of girls in our country are brides before the age of 18. Two of every ten maternal death is a teenager between the ages of 15-19.
What needs to be done?
The first and most important thing that needs to be done is that Sierra Leone has to value the lives of its girls and women. Our pain and our suffering should not be accepted as the status quo.
“Mek wi lef foh tel wi uman den foh bia.”
I have been in a maternity ward when a woman went into labor and as she screamed with the contractions she was shushed and told to stop making ”rudeness”. We need to stop measuring how much pain a girl or woman as a sign of strength.
When a woman in our family or community becomes pregnant we have to treat her with care. If a pregnant woman wants to rest, she is not lazy. It is our culture to look down on women in pregnancy who slow down, so a lot of women continue to labor, work, and toil even when pregnant because they don’t want to appear as weak.
Every family has a responsibility to protect women when they are pregnant. This means if you have information about prenatal care pass it on. It means if you notice a woman not getting access to prenatal care you educate her about why it’s important and become an ally to make sure she does access care. If this means you schedule the appointment for her, and you go with her, you do it!
A lot of us don’t access care if ”wi belle no at” and we don’t feel pain but when you are pregnant by the time you feel pain it is too late. If a woman working in your office is pregnant create corporate programs that ensure they get prenatal care. The well being of women in Sierra Leone is everyone’s business. We have to come together and say in this country no woman should die while giving life.
This past year we have been talking about human capital development. We have allocated 20% of our budget for spending on education but what is the point of educating a girl through secondary school only for her to die 5 or 10 years later at child birth? If our women are dying while giving life, they are also leaving behind children to care for. Sierra Leone is already tough enough for all of us, let alone those children without mothers. So to change and transform our maternal mortality outcomes we first of all need to reset our families and our communities to value the life and health of girls and women.
On the clinical aspect Dr. Fatu Forna who until recently was the Maternal Health Country Lead for World Health Organization in Sierra Leone says that a holistic approach is what is needed to save the lives of pregnant women.
”A stronger emergency care system for pregnant women in Sierra Leone combined with effective antenatal services and concerted actions to prevent, detect and tackle these common causes of death, promote healthy behaviours, and improve access to family planning services.”
And she is right because UNICEF is building more Basic Emergency Obstetric and Neonatal Care (BEmONC) centres across the country. These are facilities where women will be able to get access to the care they need should any complications arise. Of Course we need more than we have so the government must make health spending a priority. Sierra Leone also needs more trained midwives, and doctors that specialize in obstetrics. To date the College of Medicine (COMAHS) still offers no specializations. The only way for someone to become an OBGYN is to leave the country and go specialize elsewhere. The more we send away, fewer will return or return and stay to practice.
That we have been at the bottom of the maternal mortality index for over two decades means that we have still not gotten it right. But the time has come for that to change. Just as the political will is now in place for education we need the same amount of bravado towards women’s health and well-being. The reason why 8 women die every day in Sierra Leone during or after childbirth is because on the whole, the society doesn’t care for its women. The poorer you are, the more rural you are, the more illiterate you are, the less society cares for your well-being and the more at risk you are to die from birth. Our maternal mortality rates to me is an indication of obscene and unacceptable gender inequality. If our women’s lives mattered we wouldn’t allow them to die like this. It is not that we don’t know how to save the lives of our women, it is years of misplaced priorities and government ineptitude. A free health care program for mothers and children was launched and then botched.
This needs to change. We have to protect our girls and women.
Sierra Leonean girls must be protected from becoming child brides and teen moms. This means we change our customary marriage laws that allow parents to consent to child marriages. We must legalize access to safe and early termination of unwanted pregnancies so our women and girls don’t have to seek unhealthy abortions that leave many dead. And finally we have to protect women in Sierra Leone when they are pregnant so that no one dies while giving life. This means access to prenatal care services, increase the capacity of our midwives and birth attendants, and make sure all hospitals and clinics have the capacity to handle emergencies that arise during pregnancy.
Ultimately the buck starts with us, the people. We have to say to our government, to the President that our women should not die at birth. We should not let anyone die for nothing.
In 2019, if anybody die pan bon biznes given all we know, and all that is medically available, na foh natin. Na negligence. Whether its happening at Choithrams or in some remote village women dying while giving birth in Sierra Leone is unacceptable. As we have seen time and time again, where there is no political will, nothing happens.
Uman die pan bon e do so now!