Failing the expectant mothers
Every woman who dies in childbirth is a case worthy of investigation. Childbirth is one of the most natural things in the world. There may be complications and even in the most advanced countries people die. However, it is not by accident that the developed countries record fewer maternal deaths than the developing countries.
Similarly, babies born with complications have a greater chance of life if they are born in the developed world. And so we come to a recent statement by Health Minister Bheri Ramsaran that there is no cause for concern because the number of maternal deaths at this time is on par with the figure for last year.
Back in 2010, there was a spate of maternal deaths. The records would show that about thirty per cent of the women who went to the Skeldon Hospital to give birth died during the latter quarter of the year. This should have set off the alarm bells and it did. The government mounted an investigation, the details of which remain a state secret, probably of the damning finds. Although promised, the media are still to get any detail of that investigation.
Of what little is known from the reports out of Skeldon, the findings reveal that there were improper record keeping; nurses appeared to be among the least interested in the delivery of babies; patients were neglected because nurses slept rather than attend to the expectant mother and of course, the speedy presence of a doctor should a crisis develop was lacking.
Skeldon was not alone. Maternity cases came from Linden where the government spent millions of dollars to build a brand new hospital that would have been the main referral hospital in that corner of the country. However, it would seem that the hospital has not been upgraded to the level of a referral hospital largely because of the quality of staff that operates there.
The result is that maternity cases have had to be transferred to the city. Some died along the way. When the government examined the reports, and it must be noted that the first reports from the Linden Hospital were long in submission, the findings were no different from what operated at the Skeldon Hospital.
The government says that there must be monthly reports that should be forwarded directly to Cabinet. Knowing that Guyana is never big on enforcement, one must wonder whether these reports are routinely submitted to Cabinet. If that is indeed the case then the government is no nearer to ascertain the reasons for the spike in maternal deaths.
Dr Ramsaran does not see a problem once the figures are no higher than last year. But those figures were high enough, in fact, too high. If one were to examine the statistics as these relate to maternal deaths one may very well find that more women are dying these days. This may be an indictment on the quality of medical service on offer.
At one time, clinics were capable of determining the ability of women to deliver naturally. If they found that the women had developed ante natal diabetes or elevated blood pressure they were able to advise the mother on things like diet. We would like to believe that the older staff members at the clinics may still be able to do this but not all these clinics have these senior staff.
For example, one senior nurse must monitor clinics between La Bonne Intention and Paradise. East Coast Demerara. At the same time the government is boasting that its nursing programme is churning out more nurses than ever before. This statement has already attracted more than a fair share of criticism. Suffice to say that the training programme has been likened to preparing people for work in a killing squad. And mothers are dying.
Just two days ago there was a report that doctors at a private medical institution were called on to perform a hysterectomy on a woman who had given birth at the country’s main referral centre. Whether such cases are on par with last year and therefore reason for the Minister to exhibit no concern is cause for alarm.