“It’s like a hotel for pregnant women”

One in 13 women in Guinea-Bissau dies from complications during pregnancy – one of the highest death rates in the world, according to the UN Children’s Fund (UNICEF).



Kadiatou Barry, 21, pregnant for the first time, is seeking treatment at the government health centre in Gabu, a remote town 200km northeast of the capital, Bissau. The doctor says she has high blood pressure and anaemia, putting both mother and baby at risk.



But Barry may overcome these odds - she is one of more than 800 pregnant women referred over the past three years to the House of Mothers, a residential facility set up in Gabu’s health centre for women at risk of complications during pregnancy.



The House of Mothers is part of a wider project, Maternity without Risks, run by NGO Catholic Relief Services (CRS) with Guinea-Bissau’s Ministry of Health and the Catholic NGO network, Caritas. The project aims to reduce Guinea-Bissau’s infant and maternal death levels by having at-risk mothers cared for as early as possible before potentially life-threatening complications set in, according to project coordinator Serifo Embalo.



Regular check-ups and relatively straightforward interventions, such as providing treated bed nets and iron-fortified food, can keep mothers alive, says UNICEF.

 

But most mothers in Guinea-Bissau die because complications are diagnosed too late, said Guy de Araújo, Bissau-based representative of the UN Population Fund (UNFPA).





Photo: Felicity Thompson/IRIN
Idiatou Sadjo Diallo, 26, has already lost her first two babies. Pregnant with her third child, she is now being cared for at the House of Mothers

Early referral



Two-thirds of women in Guinea-Bissau give birth at home and do not regularly visit health centres until their problems are too far gone, says UNFPA.



Capacity for early referrals is still very low, given insufficient health-workers in rural areas, and the lack of free, efficient transport to health centres, according to government health adviser Antonieta Martins.



Maternity without Risks also runs a mobile clinic touring 16 villages to give pregnant women free consultations and train community volunteers to identify at-risk mothers for referral early on.



One of the most common problems is pregnancy complications caused by chronic malnutrition and resulting anaemia, according to UNICEF, which can lead to haemorrhaging.



“Think about a young girl who has been chronically malnourished. That means she is small, she has difficulties in pregnancy, she is anaemic. So she can easily die of haemorrhage,” says Silvia Luciani, UNICEF’s Guinea-Bissau representative.



At the centre, women receive three balanced meals a day, regular medical supervision and birthing kits. “It’s like a hotel for pregnant women,” Embalo said. “The sanitary conditions for giving birth in the village are not good. At the House of Mothers, everything is kept clean and sterile and each woman has her own bed with a treated mosquito net.”



Barry said she was enjoying her pregnancy at the centre: “You get a lot of support here.”



Together with its sister centre 50km away in Bafata, the House of Mothers aims to treat 2,000 women per year. When the centres are full, women are sent to Gabu hospital, which in June 2009 opened a surgical unit with help from UNFPA and the Portuguese government.



Survival rates improving



Provisional data already show higher survival rates in Gabu and Bafata among women who come from the House of Mothers compared with those who do not, Mawo Fall, CRS health project manager for Guinea-Bissau, told IRIN.



“The other women come very late,” said Gabriel Minkibam, head of Gabu region’s sole maternity ward. “They have had no supervision over the nine months of their pregnancy, so they arrive with too many complications. They are the ones who lose their babies.”



But at the government hospital essential medicines to induce labour, and equipment to perform emergency operations, such as caesarean sections, are still in short supply, he said. He pointed to a woman on a cot: “This girl may need an intervention, but I have no caesarean kits available.”



In the next room four women lay on cots, listless and staring into space. All of them arrived at the health centre with highly-advanced complications and three have just lost their babies.



At the House of Mothers, Idiatou Sadjo Diallo, 26, pregnant with her third baby, has high hopes. “I lost my first two babies. The first one I had an abortion and the second time I gave birth in the hospital but the baby came out dead. With this third baby I am worried, but I hope this time the birth will go well.”



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