It’s a warm night in October at a remote village in Malawi, when a young pregnant woman suddenly goes into labour and rushes to a traditional birth attendant (TBA) to help give birth.
After some time, the now weak woman fails to deliver the baby because he is just too big. The TBA is not prepared for this complication. Efforts are made to rush her to the nearest hospital but there is no reliable transport or an ambulance. She is however lucky as a makeshift stretcher is used to take her to medical specialists for assistance.

Women are not always that lucky. Others have lost their lives and given birth on their way to hospitals, usually very far away from their villages. Worse still, some have been forced to give birth in the bush while on their way to the hospital.

Maternal health concerns

Maternal and infant health concerns have been a cause of concern for many years in many districts of Malawi and Mthumba village in Balaka has not been spared. Prisca Mandoloma, who is based in the village, and makes websites about challenges facing the area, in one of her posts on-line explains how getting pregnant women to hospital on time has been challenging and a nightmare.

While some women prefer giving birth with a TBA rather than in a hospital, lack of effective transportation is seen as a barrier preventing women from giving birth in health facilities. Other challenges on her website cited are food shortages caused by a lack of rain and not enough farm inputs like fertiliser and treadle pumps in an area with “poor soil which depends on fertilizer to produce high yields”.

The elderly have also been having it tough, especially during chilly months or nights hence the need for blankets to keep them warm.

Youth to the rescue

This is one of the reasons, Youth4 elderly, a non-profit organisation gave them blankets financed by Gerrie Bosch and Willem Bos, both from Holland but from different cities.

The youth group whose members include Grace Mbendera, Mark Chunga and Ric Hastings, has the core mandate of improving livelihoods of elderly people in Malawi. They also gave two bicycle ambulances to Mthumba villagers, hoping it could quickly help rush the ill and women in labour to the nearest hospital.

One is financed by Transport4transport and the other by the Koopman-Koornstra family in Holland who are getting married on February 17. Funds were sourced from church collections. Some plans were made through social network sites like Facebook and Twitter and on various websites belonging to the group.

Some view bicycle ambulances as an effective way of transporting pregnant women in need of medical attention hence hoping to effectively addressing MDG 5 to improve maternal health. Sad stories have been told of worse maternal and infant health outcomes especially surrounding home birth. Some Malawian women also wish to know that prenatal care was more accessible.

Besides also accessing postnatal care there, women faced challenges finding transport while recovering from labour and delivery. Mbendera, is of the view that the youth can do more to ease the plight of villagers in various parts of Malawi by trying to help them access basic necessities including easier transportation. On the elderly, she appeals to Malawians not to write them off as witches or wizards but view them as fountains of wisdom to tap valuable information from.

“Please lets help our elders and help those suffering. We need to improve the livelihoods of elderly people in Malawi,” she explains.

Some of 50 elders in random interviews, explained how their children living in town stopped visiting and assisting them. They appealed to other youth to not neglect their parents but instead show love and compassion. Among other things the mission of the Youth4 elderly group is also to inspire the youth to bring “breakthroughs to the elderly and help orphans living with the grannies realise their goals for a complete change of their lives.

Happy Chiefs

Traditional leaders in the area are happy with efforts of various youth groups to assist the less privileged and the elderly. Among them are Misomali and Mpoto who advises the elderly against selling blankets but to instead use them for keeping themselves warm. He also warned those stealing from the elderly risk being kicked out of the village.

An excited Villlage headman Mthumba also appeals to villagers not to accuse the elderly of witchcraft but instead feel pity for them these days as some are busy raising orphans, making them parents again. He plans to distribute the bicycle ambulances to two different areas to help save lives of the sick by easing transportation problems including for women in labour.

The World Health Organisation (WHO) website MDG 5 to improve maternal health among other things talks of reducing by three quarters the maternal mortality ratio, between 1990 and 2015. It also strives to achieve universal access to reproductive health by the same year, 2015. Up to 358 000 women are reported as dying in pregnancy and childbirth each year. “Most of them die because they had no access to skilled routine and emergency care. Since 1990, some countries in Asia and Northern Africa have more than halved maternal mortality.

“There has also been progress in sub-Saharan Africa. But here, unlike in the developed world where a woman’s life time risk of dying during or following pregnancy is one in 4300, the risk of maternal death is very high at one in 31.’ The WHO website adds that “increasing numbers of women are now seeking care during childbirth in health facilities and therefore it is important to ensure that quality of care provided is optimal.”

The way Forward

It remains to be seen if access to easier transport through bicycle ambulances can really help reduce further Malawi’s maternal mortality rate, by rushing those with complications quickly to the hospital. It is also a fact that some remote areas do not have enough good roads which complicates travelling during rainy seasons with tyres of various vehicles or even bikes getting stuck in the mud.

But for villagers in Mthumba village in Balaka where some consider a bicycle as being ‘valuable’ as a car, a bicycle ambulance is seen as one way of easing medical transportation difficulties and better than nothing.

Wednesday, 01 February 2012 12:37 Agnes Mizere