ON a sunny November 3 morning,Rudo (not real name), a Karoi woman goes to the Maternity Waiting Room (KuMatumba) along with her room mate at Karoi District Hospital.
She bemoans the poor farming yield they received as the sun burnt most of the crop.
Expecting mothers and their relatives at Karoi District Hospital dread being referred to Chinhoyi Provincial Hospital praying, hoping and keeping their fingers crossed.
The friend doesn’t talk much unlike Rudo who describes her experience kuMatumba.
Pregnancy related emergencies happen thus falling upon health workers present at a health facility to attend them with the urgency required to prevent maternal mortalities.
There are times when these health workers can avoid the maternal deaths or they cannot thus referring a pregnant woman to a more sophisticated hospital.
But to be helped comes at a cost or they watch you die. Zimbabwe’s has over the past five years been doing well in reducing maternal mortality rate to 462 per 100 000 live births from the previous 614 per 100 000 live births recorded in 2014, the latest Multiple Indicator Cluster Survey 2019 found.
In Zimbabwe’s rural hospitals are maternity waiting rooms where pregnant women get ante-natal check-ups, newborn care and identifying problems during labour. Maternity waiting homes are lodgings located near health facilities where mothers who are close to term can await delivery. These homes are meant to provide pregnant women with the option of planning ahead and travelling to health facilities well before labour begins.
At Karoi Hospital pregnant women get verbal requirements of what is needed at the hospital. There is nothing on paper.
“We meet our friends at the dam fetching water. We cook at this kitchen. Today is the checkup day they wrote for us in the maternity book,” she says.
Asked if they are supposed to bring their own food, she says they will be close by for the Hospital check up dates.
“When in labour, the midwife we stay with carries bags for us to the Maternity Ward. We just tell her we about to go into labour,” says Rudo.
The maternity waiting area is out bounds for visitors.
“They dont want people. They ask what the visitor is doing there. They dont want visitors inside. Visitors can get as far as stones over there. Even those who bringing us food, they have to surrender it to the midwives,” Rudo explains.
She says back then all the items needed when delivering a baby were easy to get and that the Hospital was not as corrupt.
“Nowadays its different. They just want money. If you find a midwife or doctor with a good heart, thank heavens,” Rudo says listing the items they should bring.
“Right now they tell us we should buy cotton wool, pegs to pin the baby’s navel, razor blades and candles. You would have brought with you preparation items.”
For emergency cases requiring referral to Chinhoyi Provincial Hospital, Rudo fears coughing up the ZW$200 as ambulance fees.
“When it reaches a situation requiring ambulance, they say ZWL$200 is needed to go to Chinhoyi.
“The ZWL$200 is for diesel. Should you get lucky, you will be helped by the Hospital’s doctor. It comes with luck. Many are told to pay ZWL$200 to Chinhoyi for operations,” she says.
All eyes are on one doctor for emergency cover at the Hospital.
“Fuel yekuita sei nayo? Ndiani akadaro? (Fuel for what? Who told you that?), says the doctor.
The doctor goes on to explain the emergencies pregnant women may face.
Alright here is the thing. Most of the times, should a pregnant woman go to the theatre let’s say the baby is not breathing well (perinatal asphyxia) or passes stool in the womb (meconium aspiration syndrome), if there is power, we just send her to the theatre there and if there isn’t, we just turn on the generator.
But now if it’s an emergency requiring referral to Chinhoyi Provincial Hospital an ambulance should take her there. Nowadays people have to pay for the ambulance,” he says without revealing the amount.
He adds that USD50 or USD100 should be set aside.
“But should the pregnant woman require theatre clinical interventions, as you can see with the doctors now on strike, bring with you even USD50 or USD100 otherwise the team will be on a go-slow, and at times I may not be available here, the doctor explains.
The doctor however says they prioritise pregnant women requiring emergency medical attention more than those who stab each other.
“You know getting pregnant is not a crime and we prioritise women in the maternity ward because we don’t want them to lose their lives, he says.
He explains that the ambulance expenses are to be met by the patient.
“There is no such thing as bringing diesel however the ambulance people need the money for fuel so that when other people want to use it, they find the tank filled. Before, people needn’t pay for these fuel expenses. We didn’t even bother looking at such issues,” says the doctor.
That pregnant women used to bring their own fuel for ambulance, the doctor suddenly admits.
“Otherwise haaa there was a time when we had a serious crisis. You know you will be seeing that this woman needs emergency care, but the theatre is not working, or we our blood stocks have depleted. Going to the theatre as a doctor you find there are many risks involved and recommend the patient for Chinhoyi.
“So, people would pool the money together. There were others who would take their relatives after finding their own transport. It was unfortunate for those who didn’t have the money, he says.
Bemoaning lack of motivation of health workers by government, he reveals that they just write prescriptions for patients.
“In this job action, we just want to highlight to the government and public at large that when you come here all we can do is to write your patients prescriptions and referrals for scans things that should be readily available at the hospital. The fuel would be there as well as the ambulance, the doctor says arguing that the single mother who raised him expects to be well looked after.
“Imagine my mum sent me to school to where I am today, and she expects me to look after her. Then you hear people talking about calling, yet did they tell my mother the same when she struggled to send me to school. But you see Government should address our concerns to sort this mess out.
For your own information, a hospital is easy to fix provided all things are catered for that is the equipment and human capital to an extent that as a doctor you will work satisfactorily,” he said.
However, the Health and Child Care Ministry quashed this report.
“Following inquiries with PMD and DMO Mash. West Province, @MoHCCZim would like to confirm the story about Mash West pregnant women being asked to bring own fuel for childbirth is not true and would like to hereby advise members of the public accordingly,” the Ministry Tweeted.
Results Based Financing initiative where the Health Ministry and donor partners pool resources to foot the medical bills of pregnant women and children under five. Through this, they are not required to pay a dime for medical care no matter the cost.
Of course, the health workers might not be well fed by their employer thus forced to resort to other means of income earning.
But it should not be a scenario where these health workers prey on the desparation of patients and their relatives.
