The birth of a child is normally a time of joy. But for the most vulnerable families around the world, it can be filled with fear and uncertainty. One mother’s story shows how a lack of adequate maternal and child health care can be devastating for generations of women and children.
By Rita Mu
In remote Kalaki District, in east Uganda, children play in their villages as parents tend to household chores and farming activities.
Dirt roads and paths, spanning across kilometres through bushland, connect homes to schools, health facilities and bustling cities. Some families, if they have enough money, pay for a vehicle to get to these places. For most, however, it is a long and, often, dangerous journey on foot.
For Joyce* and her family it is about a six-hour walk to the nearest health centre. Joyce has made the journey many times – when her babies were sick, and when she was pregnant and in labour.
Joyce lives with her husband, their eight children, and their granddaugther, Rose*, in a poor, remote village in Kalaki.
The family rely on the growth and sale of crops such as maize, millet, beans and cassava for income.
It is a difficult life, but Joyce works hard to put food on the table.
She is strong and resilient – she has to be for her children.
Over the past few years, however, Joyce has experienced unimaginable heartbreak.
She lost two of her children. Both died because of complications during childbirth.
The first child was a newborn. Joyce had walked close to six hours, fighting through labour pains and contractions, to her nearest health centre to give birth, only to find the facility closed due to a lack of staff and funding. There were no doctors or nurses in sight. Out of time and nowhere else to go, Joyce gave birth on the verandah.
Sadly, her baby died. “The baby didn’t even cry,” Joyce says. “I had no idea what the problem was. If the nurse was present she would have been able to deliver my baby, check and find what the problem was.”
The loss of child, and a mother
A year after losing her baby, Joyce found herself grieving the loss of another child, her 18-year-old daughter Grace*.
Grace was a shy teenager, but she had many friends.
She loved children, and wanted to become a teacher.
Grace became pregnant at the age of 18.
She never spoke about her pregnancy to her family, but Joyce suspected she was pregnant and made sure Grace attended all the recommended antenatal check-ups.
Joyce and her husband were out when Grace went into labour.
They came home just as Grace was about to give birth. Hours from the nearest health centre, and with no skilled health professional present, Grace delivered a baby girl at home.
Soon after, Grace passed away.
“I can’t tell what really happened because she never told us about any unusual pain,” Joyce says. “She was sweating like someone was pouring water on her. We checked and checked on her. She was not breathing.”
Grace did not even get the chance to meet her baby.
Joyce welcomed a beautiful granddaughter – Rose – into the world that day, but lost her daughter.
And Rose lost her mother.
Today, Rose is almost two years old.
Joyce is raising Rose as her own. "People have suggested I take her to an orphanage or somewhere else," Joyce says, "but I can't do that."
"I will do my best to raise her myself."
It has been almost two years, but Joyce still does not know the cause of Grace’s death.
“If she had reached the hospital the doctors could have figured out what the problem was,” Joyce says.
A huge gap between rich and poor
Stories like Grace’s are all too common in poor, remote communities around the world.
Ninety-four per cent of all maternal deaths around the world occur in low and lower middle-income countries.
Statistics like this highlight the huge gap between rich and poor when it comes to accessing quality maternal health care.
A baby born in Uganda is 11 times more likely to die than a baby born in Australia.For every 1,000 births, 33 infants die in Uganda compared to three infant deaths in Australia.
The difference in maternal death rates between Uganda and Australia is even more staggering. In Uganda, 375 mothers die for every 1,000 births, compared to only six maternal deaths in Australia.
Mothers and babies are dying from complications during, and after, pregnancy and childbirth. Common complications include severe bleeding or infections, high blood pressure during pregnancy, obstructed labour, malaria and heart disease. These complications are often preventable or treatable with the help of a skilled health professional.
However, for mothers and babies living in poverty and remote villages, one of the major barriers to accessing quality maternal and child health care is the long distance they need to travel, usually on foot, to health facilities. Health services are few and far between for families like Joyce’s.
Basic maternal and child healthcare services are often under-resourced and under pressure. The COVID-19 pandemic has further strained these services.
*Names have been changed.
How you can help
Your support can help mothers and babies access the health care they need, and be in safe hands.
ChildFund is working with local partners and skilled health professionals on the ground in disadvantaged communities to deliver interventions such as:
Health outreach clinics: Skilled health professionals such as nurses at these clinics provide essential services such antenatal care, COVID-19 and child vaccinations, family planning, nutrition assessment of children, and malaria testing and treatment.
Community health volunteers: Trained village-based health volunteers identify and treat common illnesses and diseases such as malaria, which can lead to maternal anaemia, miscarriage, or premature delivery if left untreated. They also connect pregnant mothers with skilled health professionals and antenatal care services.
Birthing kits: Clean birthing kits help pregnant mothers living in remote villages deliver their babies at home more safely if they cannot access a health facility. These kits include the necessary tools and equipment, such as clean sheets, soap, gauze, and a new scalpel and clamps to cut the umbilical cord, for a safer delivery at home.
Medicines and medical supplies: Increased demands for health services and travel restrictions around the globe during the COVID-19 pandemic have led to shortages in essential medicines and medical supplies.
Breaking a multi-generational cycle
No mother should lose a child, and no child should lose their mother during childbirth.
Children are hungry because of the COVID-19 pandemic
The birth of a child is normally a time of joy. But for the most vulnerable families around the world, it can be filled with fear and uncertainty. One mother’s story shows how a lack of adequate maternal and child health care can be devastating for generations of women and children.
By Rita Mu
Jacob, age 12, is the second oldest of four siblings living with his family in one of Kenya’s largest urban slums. A working poor family, they have always struggled to make ends meet but, before the pandemic, there was always enough food to go round and, with Jacob and his siblings attending school, the chance for a brighter future.
Like most families in Nairobi’s slums, Jacob’s father made his living selling goods at a nearby market; the kind of informal work that four in five Kenyans rely on to make ends meet.
To stop the spread of COVID-19 and protect the country’s struggling healthcare system, Kenya’s government needed to swiftly implement a series of safety measures.
One of these measures included shutting down the busy market where Jacob’s father worked, leaving the family without a source of regular income.
Joyce lives with her husband, their eight children, and their granddaugther, Rose*, in a poor, remote village in Kalaki.
The family rely on the growth and sale of crops such as maize, millet, beans and cassava for income.
It is a difficult life, but Joyce works hard to put food on the table.
She is strong and resilient – she has to be for her children.
Over the past few years, however, Joyce has experienced unimaginable heartbreak.
She lost two of her children. Both died because of complications during childbirth.
But work is scarce.
And it is difficult to predict when the country’s economy will recover.
Before COVID-19, Jacob was not always hungry
The first child was a newborn. Joyce had walked close to six hours, fighting through labour pains and contractions, to her nearest health centre to give birth, only to find the facility closed due to a lack of staff and funding. There were no doctors or nurses in sight. Out of time and nowhere else to go, Joyce gave birth on the verandah.
Sadly, her baby died. “The baby didn’t even cry,” Joyce says. “I had no idea what the problem was. If the nurse was present she would have been able to deliver my baby, check and find what the problem was.”
The loss of child, and a mother
A year after losing her baby, Joyce found herself grieving the loss of another child, her 18-year-old daughter Grace*.
“I would love to be a construction engineer.”
“So that I can help my siblings to ensure that things get better.”
COVID-19 is putting Jacob’s future at risk
The community impact of COVID-19 has placed an extra burden on families living in slum areas. In Jacob’s community, the threats to young people are many: persistent hunger, interrupted vaccination programs, and the risk that many children may be forced to drop out of school.
Low-paid workers like Jacob’s father rarely get the chance to put money aside to prepare for a disaster. One in three families in Kenya live on less than $3 per day and this means they have no savings to fall back on.
With no social safety net, these working poor families are extremely vulnerable.
“We just go hungry.”
“We can eat today.”
“But then tomorrow and the day after we sleep hungry.”
COVID-19 is putting millions of children at risk of hunger.
The long-term effects could be devastating.
Urgent help is needed.
Dr. Lorna Sangale has spent more than 20 years working as a specialist paediatrician in some of Kenya’s largest and busiest hospitals. She is on the advisory board of ChildFund Kenya and helps provide guidance to our teams on the ground.
As a doctor, she is extremely worried about the potential threat of COVID-19. During her career, she has seen firsthand the scourge of infectious disease in her country, and the impact these diseases have on vulnerable children.
“To stop this, we must nip this in the bud in crowded community areas, and we must work even more closely with communities,” she says.
“We must be able to provide for them and cater to their essential needs – water and food. Then, we can increase awareness about general hygiene: wash your hands, use a mask, and practise social distancing whenever you are talking to somebody.
“But before we can provide those essential needs, it will be virtually impossible to stop the spread.”
With the experience of people like Dr Sangale,
ChildFund Kenya is reaching the families who need support.
This includes providing urgent food packs.
And cash transfers so families can buy food.
ChildFund prioritises families with members who are either very young, living with disability or ill health as well as families who have suffered a significant loss of income due to COVID-19.
This relief will help provide a bridge for families to get through this pandemic so ChildFund can continue its long-term work and help communities survive this crisis.
This will not only ensure Jacob and his siblings do not go hungry, but it will allow them to focus on their education, one of the most effective ways to break the cycle of poverty.
