Inside the Makeshift Maternity Wards of Harare

By
Linda
Mujuru,
GPJ
Zimbabwe

This
story
was
originally
published
by


Global
Press
Journal.

She
stands
by
her
decision
to
give
birth
at
home,
which
she
says
was
the
safest
for
her
baby,
whom
she
named
Nqobile,
a
Ndebele
name
meaning
“victor.”

“I
was
registered
at
a
local
clinic
in
the
neighboring
suburb
of
Highfield
about
10
kilometers
from
here,
but
I
was
transferred
to
[the
hospital]
located
farther
away
from
my
home
because
I
was
underage,”
Mangwanya
explains.

In
Zimbabwe,
local
health
clinics
employ
midwives
who
assist
women
with
natural
births.
But
women
with
riskier
pregnancies
—
such
as
those
who
are
underage
and
pregnant
for
the
first
time
—
are
advised
to
give
birth
at
a
hospital.

“I
would
go
to
the
hospital
for
the
usual
monthly
checkups
and
hear
so
many
stories
about
women
getting
operated
on
unnecessarily
and
ill-treated
by
nurses
that
I
was
scared,”
Mangwanya
says.

When
it
was
time
to
give
birth,
Mangwanya
decided
to
seek
assistance
from
a
local
spiritual
healer.

Many
reasons
lead
Zimbabwean
women
like
her
to
give
birth
in
their
homes
or
at
church
shrines,
including
the
cost
of
public
clinics,
long
distances
to
health
care
facilities
and
a
general
belief
that
they
are
afforded
better
service
at
these
sites
than
at
hospitals.

However,
medical
experts
interviewed
for
this
article
say
such
births
are
often
conducted
under
unsafe
conditions
by
untrained
people,
putting
both
the
mother
and
baby
at
risk.

At
363
deaths
per
100,000
live
births,
Zimbabwe’s
maternal
death
rate
is
considered
moderate
to
high,
according
to
a
classification
system
developed
by
the
World
Health
Organization.
Another
32
of
Africa’s
54
countries
also
have
moderate-to-high
maternal
death
rates,
according
to
a
2023
report
by
Zimbabwe
Coalition
on
Debt
and
Development,
a
nongovernmental
organization
that
advocates
for
citizen
involvement
in
public
policy.

Zimbabwe
is
far
from
achieving
the
United
Nations’
sustainable
development
goal
of
lowering
the
maternal
death
rate
to
70
or
fewer
per
100,000
live
births
by
2030
—
especially
in
light
of
the
health
sector’s
brain
drain.
Zimbabwe
is
currently
grappling
with
a
deficit
of
nearly
30,000
health
professionals.
Almost
4,500
medical
professionals
have
left
the
country
since
2020,
mostly
seeking
better-paid
employment
abroad.

Apolonia
Takaedza,
who
helped
Mangwanya
deliver
her
baby,
practices
midwifery
out
of
her
house
in
Hopley.
In
Zimbabwe’s
public
hospitals,
it’s
common
for
pregnant
women
to
be
asked
to
provide
such
supplies
as
gloves
and
cotton
wool
at
the
time
of
delivery
—
and
that
tends
to
push
people
away,
she
says.

“Some
don’t
have
money
or
even
proper
clothing
for
the
baby.
…
When
one
is
giving
birth
at
the
hospital,
they
are
required
to
buy
[these
items
that]
they
cannot
afford,”
she
says.

Free
maternity
care
used
to
be
available
in
Zimbabwe
through
a
program
tied
to
the
World
Bank,
but
lack
of
supplies
has
led
hospitals
to
increasingly
charge
patients.

Takaedza
adds
that
some
women
have
beliefs
that
are
not
recognized
at
hospitals,
including
that
vaginal
growths
lead
to
infertility
or
miscarriage,
and
they
prefer
to
be
treated
by
someone
who
takes
these
concerns
seriously.
She
also
mentions
fear
of
cesarean
sections.
“Some
choose
to
give
birth
at
home
to
avoid
being
operated.
At
home,
they
are
guaranteed
a
normal
delivery.”

Takaedza
charges
25
United
States
dollars
for
her
midwife
service,
the
same
fee
charged
for
a
natural
delivery
at
the
nearest
local
clinic.
“It’s
always
negotiable
and
payable
in
installments,
and
that’s
why
some
prefer
my
service,”
she
says.

But
she
has
faced
difficult
situations
which
may
have
been
better
handled
at
a
hospital.

“A
friend
who
also
assists
women
to
give
birth
came
with
a
woman
to
me
after
failing
to
help
her
deliver.
The
baby
had
already
died
in
the
womb,”
Takaedza
says.

To
guard
against
such
occurrences,
Takaedza
says,
she
always
does
an
assessment
before
agreeing
to
help
someone
deliver.
“Some
have
children
in
breach
positions
and
some
situations
need
the
hospital.”

Dr.
Mugove
Madziyire,
an
obstetrician,
says
there
are
many
risks
associated
with
home
deliveries.
“Any
person
supervising
labor
and
conducting
deliveries
must
be
trained
and
certified
by
a
responsible
authority.”

He
adds
that
labor
and
delivery
can
present
complications
during
and
after
birth.

“There
are
also
medications
to
be
administered
to
both
mother
and
baby
at
the
time
of
delivery
which
prevent
complications,
such
as
excessive
bleeding
from
the
mother,
bleeding
disorders
in
the
baby,
and
eye
infections,”
he
says.

Donald
Mujiri,
spokesperson
for
the
Ministry
of
Health
and
Child
Care,
says
registered
nurses
with
a
minimum
of
three
years
of
experience
are
eligible
for
a
free,
one-year
training
in
midwifery
offered
through
the
ministry.
These
trained
midwives
are
eligible
for
employment
in
local
clinics
that
perform
natural
births.

A
few
kilometers
from
Takaedza’s
residence,
Hilda,
a
member
of
an
apostolic
sect,
also
assists
women
giving
childbirth
from
her
home.
Unlike
Takaedza,
Hilda
—
who
asked
to
be
identified
only
by
her
first
name
as
her
sect
doesn’t
allow
members
to
speak
to
the
press
—
has
a
waiting
shelter
for
such
women;
they
usually
stay
at
her
house
from
about
seven
months
of
pregnancy.

Inside
Hilda’s
makeshift
delivery
room,
walled
with
plastic
and
lined
with
grass,
a
young
mother
smiles
as
she
holds
her
newborn
baby
boy,
delivered
the
previous
night.
Other
pregnant
women,
also
members
of
the
same
church,
gather
around
her,
congratulating
her
as
they
each
wait
for
the
day
they
will
deliver.

Outside,
smaller
makeshift
rooms
house
24
other
pregnant
women,
waiting
to
deliver
their
babies.

Hilda
does
not
have
any
medical
qualifications
—
only
her
practical
experience.
The
51-year-old
says
she
started
to
help
women
from
her
church
give
birth
when
she
was
36,
after
experiencing
a
“calling”
to
do
this
kind
of
work.

“I
have
given
assistance
to
over
400
women.
As
a
rule
in
our
church,
we
do
not
go
to
the
hospital
for
deliveries,”
she
says.

Hilda
says
that
in
15
years
of
practice,
she
has
never
once
had
to
rush
a
woman
to
a
hospital.
“We
do
face
challenges,
but
I
always
get
a
voice
that
speaks
to
me
and
instructs
me
on
how
to
deal
with
each
and
every
situation,”
she
says.

She
adds
she
also
doesn’t
use
gloves
when
performing
the
procedures,
“as
per
church
doctrine.”
Members
of
this
church
are
known
for
distrusting
medical
practice
and
vaccines.

Dr.
Lucia
Gondongwe,
deputy
director
of
reproductive
health
at
the
Ministry
of
Health
and
Child
Care,
says
the
ministry
upholds
institutional
deliveries
as
the
standard
of
care.
“This
enables
women
to
get
a
comprehensive
package
of
care
required
for
childbirth
and
the
newborn,”
she
says,
adding
that
it
ensures
both
the
mother
and
baby
get
emergency
assistance
if
it’s
needed.

But
Edinah
Masiyiwa,
executive
director
of
Women’s
Action
Group,
an
NGO
that
advocates
for
women’s
rights,
says
that
institutional
health
care
has
only
worsened
during
the
broader
economic
decline.

“We
are
in
a
situation
where
the
public
system
is
requesting
women
to
bring
everything
needed
for
their
care
—
things
like
pads,
methylated
spirit,
cord
clamps,”
she
says.
“If
there
is
need
for
a
transfusion,
women
have
to
buy
the
blood,
which
is
more
than
100
[US]
dollars.
If
there
is
need
for
antibiotics,
they
also
have
to
buy.”

Madziyire,
the
obstetrician,
agrees
the
charges
are
an
issue.
“Making
the
facilities
fully
equipped
and
stocked
will
encourage
women
to
utilize
them.
Staff
must
be
well
motivated
so
that
they
handle
patients
well.”

Beatrice
Zindora,
a
resident
of
Hopley,
says
she
assists
women
in
dire
situations
to
deliver
their
babies.
Many
are
not
registered
at
local
clinics
and
hospitals,
and
some
do
not
have
baby
supplies,
such
as
clothes
and
diapers.

“We
are
in
a
situation
where
the
public
system
is
requesting
women
to
bring
everything
needed
for
their
care
—
things
like
pads,
methylated
spirit,
cord
clamps.”

EDINAH
MASIYIWA

WOMEN’S
ACTION
GROUP

“I
do
this
for
free
and
out
of
my
desire
to
help
women,”
Zindora
says.

A
few
days
earlier,
she
says,
a
woman
came
who
could
not
walk
or
talk
because
she
was
in
so
much
pain.
The
baby
was
coming
legs
first.
“I
had
to
insert
my
hands
inside
the
woman
to
bring
the
baby
outside.
The
baby
did
not
cry
for
a
moment
and
I
was
panicking,
but
later
he
cried.
After
the
birth
of
the
child,
I
encouraged
them
to
visit
the
hospital.”

A
year
ago,
Magnus
Kundanai
gave
birth
at
a
church
shrine
because
it
was
too
late
for
her
to
go
to
the
nearest
clinic
and
she
could
not
afford
the
transport
—
despite
the
fact
that
she
had
already
paid
25
US
dollars
in
advance
to
give
birth
at
the
clinic,
which
took
her
three
months
to
raise.
“Such
an
amount
is
hard
to
earn.”

Madziyire
suggests
that
the
Ministry
of
Health
and
Child
Care
train
and
certify
the
attendants
at
the
shrines
and
also
inspect
and
certify
the
independent
facilities
used
for
delivery.

Gondongwe
says
the
ministry
is
working
to
expand
health
facilities.
“It
is
the
ministry’s
desire
that
everyone
is
within
a
10-kilometer
radius
of
a
health
facility,
and
it
has
been
working
towards
the
achievement
of
this
mission.
However,
there
are
some
hard-to-reach
communities
which
had
not
realized
this
target.”

But
for
young
mothers
like
Mangwanya,
home
births
are
still
preferable.

“After
being
treated
well
at
the
shrine,
if
the
health
care
system
does
not
improve,
I
am
likely
to
return
to
Takaedza
for
assistance,”
she
says
with
a
smile.

This
story
was
originally
published
by
Global
Press
Journal


https://globalpressjournal.com/africa/zimbabwe/inside-makeshift-maternity-wards-harare/ 

Global
Press
Journal
is
an
award-winning
international
non-profit
news
publication
that
employs
local
women
reporters
in
more
than
40
independent
news
bureaus
across
Africa,
Asia
and
Latin
America.

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