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Wake-up call on maternal health reporting

Gender Focus with EMELDA MWITWA
THE death of a mother is in one too many, says Minister of Health Chitalu Chilufya and I agree with him.
Dr Chilufya made the remarks after the shocking death of Zambia Daily Mail sub-editor Sitembile Siwawa Zulu.

Sithembile, 29, was virtually still on honeymoon, having gotten married on September 24 last year. The news of her having given birth to a baby girl, brought good news to the Zambia Daily Mail family.

She too was super excited and phoned some friends to share the good news. After her baby was born, her WhatsApp status changed to, ‘He who is mighty has done a marvellous thing,’ apparently thanking God for the gift of a daughter, oblivious that she would not live to see and nurse the infant.
While congratulatory messages were filtering through to Sithembile and husband Victor Zulu, word came to us two days later that she had died.
“How? But she was not sick, but she was fine after giving birth? ”, were some of the questions we were asking at the office.
As women, we talked about how the experience of giving birth and going back home with a bouncy baby is a big miracle.
As we mourned Sithembile, we remembered our own fears when pregnant, and those moments of hope, quiet prayers to God and self-reassurance that everything would be okay.
Every pregnant woman, even in the developed world with the best medical facilities at her disposal, does go through those moments of worry and self-reassurance.
In my view, although humans may do their best to provide the best maternity services, walking out of a maternity ward with a smile on your face, is purely by the grace of God.
Every pregnancy they say, is a risk, even with the state-of-the-art healthcare services and best medical team at one’s disposal. However, having good medical services and caring midwives and other medical personnel makes a whole lot of a difference.
Much as pregnant women may put their trust in God, an uncaring midwife or lack of proper maternity services can ruin everything.
I believe that all health workers who deliver babies in the labour wards and hospital theatres are God’s servants chosen to do the noble job on His behalf. When they do a good job, they make God smile, when they don’t, they make Him sad.
No woman can imagine going through the process of giving life without the help of midwives, doctors and other health personnel.
A good midwife is simply unforgettable; an encounter with such a one, remains in a woman’s mind the rest of her life.
Similarly, bad maternity treatment remains etched in one’s mind.
And when a loss of life occurs during that process, people will want to probe to know if it was due to negligence by the medical team or if it was something beyond human intervention.
When Sithembile died, there was a backlash on social media by journalists who wanted to know what went wrong. But some people took us journalists to task and asked us why we were not interested in maternal issues involving people we did not know.
Someone said we needed to probe the health stories and bring out issues beyond the speeches and press briefings of health officials.
Others said journalists like to cover scheduled events instead of taking an extra mile of following up pending issues and rendering a voice to the voiceless.
In other words, they were prodding us to be proactive watchdogs who could see human faces behind the statistics in our stories.
While I was reflecting on the challenges that had been thrown at us, Dr Chilufya was quick to provide guidance on our immediate problem by ordering a thorough maternal death case review and post-mortem to determine the cause of Sithembile’s death.
“Dr Chilufya is profoundly shocked by this turn of events as he holds that even one maternal death is too many,” said a statement issued by Ministry of Health permanent secretary Kennedy Malama.
Data from the MoH indicates that maternal mortality rate in Zambia stands at 398 per 100,000 live births (2013-14). This indicates a reduction of maternal deaths from 591 per 100,000 live births as recorded in 2007. The stance of Government and other stakeholders is that 398 maternal deaths per 100,000 live births is still high. Therefore Government has committed itself to come further down to 70 per 100,000 live births by 2030.
Major causes of maternal deaths, according to UNICEF, are home deliveries, poor care of pregnancy and limited access to healthcare in rural areas.
UNICEF further says only 47 percent of births are attended by a skilled health worker at health institutions. Home deliveries are quite common in Zambia at 53 percent.
Access to health facilities is good in urban areas with 99 percent of households being within about five kilometres radius to a health facility. In rural areas, only about 50 percent of the people live within this radius.
So, in urban areas there should be no excuse for anyone giving birth at home because child birth has unforeseen complications.
As journalists we should not get tired of raising awareness on the benefits of pregnant women attending antenatal and giving birth in health facilities.
We also need to cover rural areas to remind Government of the commitment it has made to close up the healthcare service gaps in those areas.
We ought to remind them of the commitments they have made to transform Zambia into ‘a nation of healthy and productive people’, according to the Seventh National Development plan (7NDP) 2017-2021.
In the 7NDP, Government actually says health will be a top priority and key economic investment that will drive Zambia’s socio-economic agenda in the next five years.
It further commits itself to strengthening health systems and services. There will be infrastructure development along other programmes such as equipment improvement, medical commodities supply improvement, healthcare financing improvement and health service delivery enhancement, the plan says.
In the plan, Government also promises to better maternal health and improve deliveries by skilled people in healthcare facilities.
“Given that reduction of maternal mortality is a key health sector objective, there will be increased attention to increasing proportion of skilled attended deliveries and where pregnancy complications occur, there will be need to enhance access to emergency obstetric care services,” an extract from the 7NDP says.
Anyway, post-mortem findings say the death of Sithembile two days after she underwent a caesarean section at Levy Mwanawasa University Teaching Hospital, was caused by pulmonary embolism (PE), a sudden blockage of a major blood vessel or artery in the lungs, especially by a blood clot.
The hospital’s consultant pathologist, Aaron Shibemba said they found a clot in the arteries that supply blood to the lungs.
Dr Shibemba said every pregnant woman is at risk of developing PE because of the physiological changes that occur during pregnancy.
In the media fraternity, I am sure that the death of Sithembile will always remind us of the cause for safe motherhood. When we think of her, we will be reminded of making mother and child health, especially in rural areas, an important aspect of stories.
In fact, as a reporter on our gender desk, Sithembile did a lot of stories on maternal and child health. She did her part. Phone 0211-221364/227793