Paidamoyo Chipunza Senior Health Reporter
Tucked away in the thick forests of Makonde district lies Kanyaga village. Apart from agricultural, mining and other social activities that make up the daily routine of an adult man and woman in Makonde, sex and sexuality completes their diary.
At some point, clinics capable of assisting pregnant women to deliver in the event that they decided to get pregnant were limited and scattered.
The few clinics that existed had no shelter to accommodate pregnant women who stayed far away for them to get medical assistance as soon as they started showing signs of labour.
Some women had to travel as long as 30 kilometres to the nearest clinic leaving them with no option but to give birth at homes or along the way as they failed to make it on time to the clinic – a situation that could result in the deaths of both the mother and the newly born child.
Thirty-two-year old Stancia Makochekerwa is one of the strong women of Makonde who lost four babies – all of whom were delivered at home – but can still afford to put on a smile with her fifth pregnancy as she waits patiently to give birth at Kanyaga clinic.
Ms Makochekerwa said on the first and second occasions, she was assisted by a traditional birth attendant and by her mother respectively but sadly both children died within 48 hours of birth.
She said her third pregnancy was a stillbirth, which was also handled by her mother at home while the fourth child died at the age of two years.
The child was also delivered from home and did not receive medical intervention.
She said the child looked sickly from birth and had stunted growth that resulted in his death two years on.
“Then Kanyaga clinic was not there and we would go to Kenzamba clinic, which is far away from our village. Kenzamba did not have a mother’s waiting shelter and women would only go there when they started showing signs of labour,” said Ms Makochekerwa.
She said her other option was to go to Chinhoyi Hospital, about 70 kilometres away but she would still require money for transport and other associated costs.
“I did not have that money to go to Chinhoyi Hospital and after weighing my options I decided to give birth at home with the assistance of a traditional birth attendant,” she said.
Traditional birth attendants are usually paid with a goat, soap, 20kg mealie-meal and hens.
“It pained me as I kept on losing my children one after the other. I was only relieved when I heard that Kanyaga homestead would be turned into a clinic and that a temporary room had been set aside for pregnant women to live in as their day got closer,” she said.
Ms Makochekerwa said she did not think twice when she carried her fifth pregnancy but rushed not only to register it, but also to join 13 other expecting mothers waiting for delivery at Kanyaga clinic.
Although conditions at the shelter were appalling with all the expecting women and two others who gave birth sharing a small tobacco ban with little ventilation and space, all the women concurred that the room was a better alternative as they awaited completion of a proper shelter currently under construction.
The house is being constructed by the community through Kanyaga health centre committee and the district development committee.
Ms Alice Mutendagayi (30) from Katsvamutimu in Murombedzi also testified to the importance of mother’s waiting shelters saying if the homes had been there long ago she would not have lost her child.
Ms Mutendagayi said unlike her other pregnancies, she did not show signs of labour early.
“It was a Tuesday afternoon when I was working in the garden with my other children. From nowhere and with no pain or any discomfort, I broke my waters and I knew it was time,” she recalled.
“I quickly packed my bags and sat foot on the road for Madzorera clinic together with my aunt but before we went any further, the baby was on her way,” she said.
Ms Mutendagayi said her aunt helped her deliver but still they proceeded to Madzorera clinic in a scotch cart with the umbilical code still tied to baby.
Sadly, the baby failed to make it; she was pronounced dead upon arrival at the clinic.
“Then, there was no waiting home at Madzorera clinic but this time around I came early before my expected delivery date so that when it happens, those trained to do the work can take care of me and my child,” she said.
A former traditional birth attendant from Zumbara in Makonde who is now working with the Zumbara health centre committee to educate and encourage villagers on the importance of delivering in health facilities said institutional deliveries served to reduce the number of women and children who died during child birth.
Ms Rumbidzai Kapunga, popularly known as Madzimai Jennifer in her apostolic circles, said she saw light when she fall pregnant and could not assist herself to deliver forcing her to seek medical attention from a health facility.
Although she made it on time to Zumbara clinic at the onset of labour, Madzimai Jennifer said her delivery was marked by complications ranging from the child tying himself with the umbilical code to mucus blocking his nasal passage making it difficult for him to breath.
“I remember vividly sekuru (Petros) Spanera (a nurse at the clinic) getting a little instrument which he used to draw the mucus from my child’s nasal passage. I said to myself, what if it was a client’s child, how could I have handled these complications with no medical equipment at home? The child could have died,” she said.
She has joined the Zumbara health committee as a community monitor.
“We work with communities educating and encouraging them to register pregnancies early and visiting health facilities as soon as they start showing signs of labour. We also encourage those who stay far away from the clinics to consider staying at the clinic’s mother’s waiting shelter so that they do not delay in getting assistance as soon as they get into labour,” she said.
She said the response had been overwhelming as statistics from the clinic showed an upward increase in the number of woman delivering at the clinic per month versus home deliveries.
Zimbabwe’s maternal mortality rate currently stands at 610 per every hundred thousand live births.
Although on a decline, the figure is arguably still one of the highest on the continent with most deaths attributed to home deliveries as villagers lack both skill and scope to assist with deliveries.
Some deaths have also been attributed to delays in reaching a health facility to get skilled attendance.
Complicated deliveries can lead to the death of either the mother or the newly born baby.
This prompted Government to partner with the Community Working Group on Health and Save the Children to conscience communities on what they can do for their health facilities through a programme called strengthening community participation in health.
Through the project, most communities have mobilised resources for developmental projects at their clinics such as construction of waiting mother’s shelters, clinic refurbishments and have assisted in procurement of drugs and other necessities.
The communities have also identified influential people trained to promote health seeking behaviour among villagers particularly regarding maternal and child health.