Unsung warriors of Chikwawa

Triza Amos, a 23-year-old first time mother, wakes up to excruciating labour pains at midnight.

Her husband Peter, 27, and his mother Innocentia Amos, 54, quickly rush her to Makhwira Health Centre in Chikwawa District.

It takes them three-and-a-half gruelling hours to reach the health centre, arriving just past midnight, exhausted and desperate for care.

At the health centre, they are met by midwife nurse technicians Suzgo Kalinjeka and Peter Sefasi, who examine Triza and inform them that it is not yet time for her to give birth.

The health centre does not have a waiting home, forcing Triza and Innocentia to sleep in a shed designed for conducting health education.

Innocentia lays her chitenge (wrapper) on the ground for Triza to lie on and uses another to cover her.

Triza joins eight other expectant mothers who are sleeping under the open sky, enduring mosquito bites and risking malaria.

Innocentia instructs Peter to inform Triza’s family in a neighbouring village as per their Mang’anja customs. Then, she lies down beside Triza on the bare ground.

Lack of maternity homes is a widespread challenge in the district.

At Mapelera Health Centre, expectant mothers and their guardians also sleep on an open space designed for conducting health education.

After birth, some guardians sleep under beds in the postnatal ward. “Due to lack of a proper space, sometimes guardians sleep under beds in postnatal wards,” says the facility in-charge Russel Ngwira.

The district hospital also faces a grave situation, with guardians scrambling for every space in the corridors of the labour and maternity wards.

The district’s safe motherhood coordinator Nylon Sekani says only Ngabu Rural Hospital and Chikwawa District Hospital have waiting homes, the rest do not.

The Ministry of Health encourages expectant women to seek hospital care before labour advances to dangerous stages.

The ministry uses the ‘Three Delays Model to evaluate circumstances surrounding maternal deaths: the delay in deciding to seek care, the delay in reaching a health facility and the delay in receiving treatment at the facility.

But maternal health advocate Margaret Chembezi argues that the first delay is worsened by the lack of waiting homes, bathrooms and toilets in the district’s health facilities.

“We need to do more to reduce maternal and neonatal deaths. How can we expect expectant women to rush to the hospital for delivery when there are no waiting homes, good bathrooms and toilets?” she quizzes.

The state of most health facilities in the district is deplorable.

At Gaga Health Centre, for example, expectant mothers and their guardians are crammed into a small and dilapidated structure that serves as a kitchen, storeroom and waiting home.

The smoke from the kitchen makes the environment unbearable. “The lack of a waiting home and other water, sanitation and hygiene [Wash] facilities discourages women from coming to the health centre early for delivery,” admits Brenda Mpemberera Goba, Gaga Health Centre’s in-charge.

She also notes cultural factors at play. “While some women wait for their husbands to allow them to go to the hospital, others visit witchdoctors first, and yet others only come at night to avoid being seen.”

Goba adds that these cultural beliefs and lack of Wash facilities discourage expectant mothers from seek timely medical care.

Some African cultures believe that an expectant woman should visit the hospital at night to avoid curses that would prolong labour.

Experts urge government to make hospitals more conducive for expectant mothers and their guardians.

Malawi University of Business and Applied Sciences communication lecturer Paul Mphepo stresses the need for more information to foster health-seeking behaviours among people.

Nation Publications Limited (NPL), through its flagship project Mother’s Fun Run (MFR), is advocating for better conditions for mothers and their babies in Chikwawa.

MFR seeks to raise K300 million to address some of the challenges faced by Chikwawa District Hospital and its health facilities.

These challenges include not only Wash problems and lack of waiting homes, but also shortages of drugs, staff, electricity and essential medical equipment like BP and suction machines, vacuum extractors, penguin suckers, wheelchairs and weighing scales.

By improving these facilities, MFR hopes to contribute towards the reduction maternal and neonatal deaths, aligning with Sustainable Development Goal 3, which aims to ensure healthy lives and promote well-being for all at all ages.

Triza’s story symbolises systemic issues affecting countless mothers and babies in Chikwawa and beyond.

Supporting the 2024 MFR can help create a future where every mother has access to basic necessities needed for safe childbirth and healthy beginnings for their children.

Join the 2024 MFR to be part of changing the maternal and neonatal story of Chikwawa.