It’s a cold evening in the small village of Molapowabojang. It’s an early winter and the blistering cold has ensured that scores of villagers are ushered into their houses or huddled around fireplaces to ward off the chill.
In one yard, an older woman is busy in a small compartment kitchen, preparing a supper of soup and dumplings for her two grandchildren. It’s difficult not to feel the eerie sad energy in the house as she hums quietly to herself, only ever looking up to gently reprimand the children who chase each other around the living room.
Pelonomi Kgotlaetsho* lost her only daughter a few months ago shortly after she had given birth to a premature baby. As if that was not enough tragedy, the little girl passed on a week later.
Young mother and child were robbed of their lives after a brief struggle on a cold hospital bed. Pelonomi sighs heavily when she recalls that incident.
“I don’t know what to say or think,” she says as she glares into the pot with tears welling in her eyes.
“She left that other child,” she says casually pointing at one of the two toddlers who stare back with beady eyes, perhaps curious about the topic of discussion.
“Although she wasn’t married to the father of her children, they loved one another. I think he is probably just as broken as we are,” she says.
Pelonomi explains that a few days before, her daughter, who was a teacher in Lobatse, arrived on her doorstop and informed her that she was certain she would give birth soon.
“I was confused as I thought she was due a few weeks later. She however insisted on staying and spent the next two days preparing for the delivery,” she says with a sigh.
Things however seemed suspicious when the young mother looked faint after her first contractions, two nights later.
“I called her brother who lives nearby and they rushed her to the nearest hospital, which is in Lobatse. When I managed to see her she was unconscious and struggling to breath. The nurses and doctors managed to resuscitate her. She gave birth but couldn’t hold on. She took her last breath a few minutes after delivery,” she says, low voice quivering.
Although the family was aware that the baby’s chances of survival were low as it was born prematurely the death still jabbed them in the heart. “I prayed that she make it through but only God knows why both had to leave us.”
This is one of the untold stories of women who lose their lives after child birth. Maternal and child mortality is a cause of concern in Botswana with many young mothers and babies who haven’t even lived beyond their toddler years losing their lives untimely.
The probability of a child dying between age one and five (child mortality) is at 25.90 (per 1000 lives) in Botswana, according to the Mundi index report.
In 2010, the maternal mortality rate per 100 000 births in Botswana was at 190, compared to 518.8 in 2008. Neo natal for under-five year olds is 38.
According to the ‘State of the World Population’ report of 2013 more than seven million girls under the age of 18 globally, give birth annually.
However, only one out of 10 of these occur within the confines of a marriage. It also points out that the physical development of girls at that age is still not strong enough to bear the exertion of child birth, while other factors like malnutrition, poor midwifery services, poor hygiene, infections and illness play a role in the death of young mothers.
It highlights the need to find new ways of tackling adolescent pregnancies by building girls’ human capital, protecting their rights and empowering them to make decisions that will improve the quality of their lives.
A total of 110 countries took part in a maternal health manifesto which was published in the Lancet journal. It emphasizes the need for universal access to reproductive and sexual health.
Although maternal mortality reduced by almost 50 percent since 1990, only 24 percent of developing countries are currently on track to achieve this goal by 2015.
Botswana is no exception. In accordance with the Millennium Development Goals, Botswana is faced with the mammoth task of reducing the numbers of child and maternal mortality cases across the country.
Number four of the Millennium Development Goal is to reduce child mortality and number five is to improve on maternal health. Botswana has adopted primary health care as a strategy for attainment of “health for all”, which aims to have a successful family planning programme.
The local Ministry of health stresses emphasis on prevention and healthy living.
However, there are still steps that need to be taken to address the large number of babies and mothers who lose their lives.
In January last year, over P100 million was allocated by the European Union (EU) to address maternal and child mortality in Botswana. This gesture of kindness is in line with the EU’s efforts to assist development partners accelerate progress in achieving the Millennium Development Goals.
Speaking during the event Minister of Health John Seakgosing indicated that strategies aimed at dealing with child and maternal mortality were a cumbersome challenge to the health sector.
“With current poor indicators of maternal health and mortality of children under the age of five, it is clear that the time has come to review and revise healthy delivery to address bottlenecks hampering desired improvements in childhood and maternal mortality indicators,” he pointed out.
Factors which have been pointed out as contributory to maternal and child mortality include HIV/AIDS related opportunistic infections, poor nutrition, complications during pregnancy and birth, poor hygiene and emotional distress.
Although not a direct factor of mortality, post natal depression is also a challenge that is often swept under the carpet in the social landscape more so that there is little knowledge and understanding of the condition. The assumption is that the mother will “get her act together.”
Post natal depression is a type of clinical depression which affects women after childbirth. The common symptoms include fatigue, sadness, a change in sleeping and eating patterns, crying episodes, irritability, anxiety and reduced libido.
While some women recover with treatment and support from their partner and family, others spiral out of control and require medication and constant observation by psychologists.
A worse form of this condition is post partum depression occurs the first few months after birth. Psychotic post partum is characterized by thought disturbances, hallucinations and delusions among others. However, in most cases, women who suffer this psychotic disorder often suffered from bipolar disorder or schizophrenia before the pregnancy and birth.
Unfortunately, it can be an undesirable situation as most such mothers exhibit an emotional incapacity show their children love, inconsistent childcare and they have poor coping strategies which may negatively affect their parenting journey.
With this in mind it’s clear that it’s imperative for the Ministry of Health and all Batswana to adopt a rigid and holistic approach to parenting, pregnancy, delivery, child birth and care.
