Inadequate health facilities failing Mozambique's mothers

A woman in Macomia, northern Mozambique assesses the damage after a mature baobab tree slammed into her home during Cyclone Kenneth. (Emidio Jozine, AFP)
A woman in Macomia, northern Mozambique assesses the damage after a mature baobab tree slammed into her home during Cyclone Kenneth. (Emidio Jozine, AFP)

Alda Lucas Balide is expecting her sixth child, but carrying this child to term will be different from past pregnancies.

Unlike before, the 33-year-old has contracted maternal anaemia and malaria - a major cause of maternal mortality in southern Africa.

Her house was destroyed and her medication washed away by Cyclone Kenneth which made landfall in northern Mozambique on April 25 weeks after Cyclone Idai pounded the country's central region killing over 600 people.

Balide is one among an estimated 10 000 pregnant women in the coastal Cabo Delgado province affected by the fierce storm.

As with many poor pregnant women and new mothers in the country's poorest region, Balide has to start from scratch preparing for the newborn, but starting over will be no easy feat.

"I have the food to give strength for the birth and I know I will make it, but I don't know what I will give to this child," she said.

Low birth weight

Balide's due date is two months away, but Maria da Silva, the attending doctor at Macomia hospital, over 200km from the tourist town of Pemba, said her medical condition increased the risk of complication: Going into a premature labour or delivering a baby with a low birth weight.

Although Mozambique's maternal mortality rate of 489 per 100 000 live births has significantly reduced, it is still among the highest in the world.

The global maternal mortality stands at 216 deaths per 100 000 live births.

Malaria is endemic to the southern African nation and over 28 000 have been infected as a consequence of the two cyclones that battered the impoverished nation of nearly 30 million.

During pregnancy, anaemia is often a consequence of the deadly fever. According to da Silva, Balide's condition could mean she will need an assisted delivery at Macomia's district hospital, but the labour ward is barely functional.

The Macomia hospital has no electricity or piped water. The water system, cooking facilities, electronic equipment, and even beds were damaged during the heavy downpour.

The maternity ward is no longer functional after the roof was blown off and the infrastructure inside the unit impaired by the cyclone.

Across Cabo Delgado, 19 health facilities have been damaged by the category 4 storm which killed at least 45 people.

More than 1.8 million people have struggled to recover from the damaging cyclones, but Mozambique's mothers might be the most in need of help.

Gynaecological examinations

Mothers who need to have their babies weighed, immunised or measured, have to consult outdoors.

A temporary unit for gynaecological examinations and assisted procedures has been setup by the medical charity, Medicins Sans Frontiers (MSF), but a better equipped structure is urgently needed at this rural hospital where on an average 120 women give birth each month.

Ingo Pieglier, the humanitarian co-ordinator of the UN Population Fund (UNFPA), said the aid agency was preparing to provide temporary reproductive health centres in 20 sites across the affected areas in the northern Cabo Delgado and Nampula provinces.

The one-stop health unit is intended to enable women to consult with health workers on prenatal and ante-natal care as well as a range of other health issues.

Pieglier said the biggest challenge in the establishment of the temporary units was remoteness and inaccessibility in some areas of northern Mozambique.

"It's quite an endeavour to bring everything from far away to here, particularly this location [Cabo Delgado province], but we are thankful to the government for providing us with the transportation for our supplies," he said.

While UNFPA is optimistic the reproductive health centres will be setup very soon, in the meantime, many women still mill about Macomia hospital's yard, waiting for nurses to check their baby's health.

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