KIWAYUU, Coastal Kenya - The story of mother-of-six Aisha Tiro Bahero, 30, is not only one of resilience and determination, but also of how access to maternal and child health services is critical in saving women’s lives and empowering them to lead productive and healthy lives.
Aisha lives in Kiwayuu, a small island located in the eastern part of the Lamu Archipelago in Coastal Kenya. The only health facility on the island was established two years ago by the Lamu County Government, and it serves 600 inhabitants. Prior to its inception, patients, including expectant mothers would travel to Lamu Island, a seven-hour trip by dhow or an hour's trip by motorboat.
“I got married when I was barely 18 years old and I delivered my first child at home,” says Aisha. Her three subsequent deliveries also took place at home.
“As a marginalized community, we were ignorant about the importance of antenatal care, largely because we didn’t have a health facility in Kiwayuu.”
The community relied heavily on the services of traditional birth attendants, who had limited knowledge and skills. “In the event of pregnancy-related complications, or even maternal deaths, we would conclude that it was God’s will,” she says.
As I went into labour, I began to bleed profusely. I couldn’t stop the bleeding. I knew something was wrong. It was scary and, frankly speaking, I thought I was going to die. - Aisha Tiro Bahero
Three years ago, everything changed for Aisha when she was expecting her fifth child. “I was set to deliver at home as usual,” she says. “The traditional birth attendant who had helped me deliver in the past was at hand to assist.”
Aisha was looking forward to another normal deliver, but this time she was not so lucky.
“As I went into labour, I began to bleed profusely. I couldn’t stop the bleeding. No one could,” she says. “I knew something was wrong. It was scary and, frankly speaking, I thought I was going to die.”
The only nurse at Kiwayuu Dispensary was called, but she too couldn’t figure out what was wrong with Aisha. Her verdict was quick: it was a life-threatening, pregnancy-related complication that needed urgent medical care if Aisha was to survive.
Her nightmare on a boat
For Aisha, the nightmare was only beginning. The nearest hospital apart from Kiwayuu Dispensary was on Lamu Island, an hour's trip by motorboat. After thirty minutes on the rough seas, with difficulty Aisha delivered her fifth child while still in the boat.
“It's an experience I never wish any woman to go through,” she says. “Not only did I come close to losing my life and my child’s, but the trauma of delivering on a motorboat on rough waters was unbearable.”
When she arrived at King Fahad County Refferal Hospital on Lamu Island, she was diagnosed with postpartum haemorrhage and the baby was diagnosed with low birth weight, as a result of intrauterine growth retardation, also known as intrauterine growth restriction, which refers to poor growth of a fetus while in the mother's womb during pregnancy. The possible causes of intrauterine growth retardation are many, but most often involve poor maternal nutrition, anaemia or lack of adequate oxygen supply to the fetus.
Anaemia in pregnancy is a risk factor for heavy bleeding during delivery. Aisha admits to not having access to appropriate antenatal care during her pregnancy, which almost cost her life.
Leading cause of maternal deaths
Complications in pregnancy and childbirth continue to be a leading cause of death for women in developing countries. Aisha’s story is a representation of what many women go through in parts of Kenya where access to maternal health services, in particular antenatal care and skilled birth attendants, is lowest.
Ironically, simple acts such as providing health education to pregnant mothers on the importance of antenatal care services is enough to save the lives of millions of mothers and children.
Ending preventable maternal deaths
UNFPA, the United Nations Population Fund, works with national and county government and partners to train health workers, improve the availability of essential medicines and reproductive health services, strengthen health systems, and promote international maternal health standards.
For instance, at Kiwayuu Dispensary UNFPA has improved capacity by supporting the procurement of assorted maternal and newborn health and family planning equipment, as well as improving availability of essential medicines and reproductive health services. Community health workers have been trained in provision of emergency obstetric and newborn care (EmONC).
Advocacy efforts have been stepped up amongst religious leaders to support efforts towards ending preventable maternal mortality and morbidity, and the elimination of harmful traditional practices such as female genital mutilation (FGM) and child marriage.
With support from UNFPA, I have been trained as a community health volunteer, and I now work in my community to raise awareness about maternal mortality, its prevention and access to maternal and child health services. - Aisha
Empowered to make choices
For Aisha, who is now empowered to make informed choices, including the use of family planning methods, her ordeal changed her life.
“With support from UNFPA, I have been trained as a community health volunteer, and I now work in my community to raise awareness about maternal mortality, its prevention and access to maternal and child health services,” she says.
Her community, too, is now empowered with most seeking reproductive, maternal, newborn, child and adolescent health services at the newly upgraded Kiwayuu Dispensary.
For mothers, having a child should not equate with a possible death sentence. Childbirth should be a happy moment for families and communities, not one that brings misery. Because no woman should die whilst giving life.
It is for this reason that UNFPA and partners are determined to deliver a world where every woman’s health is protected, every pregnancy is wanted and every childbirth is safe.
- Douglas Waudo