14 May 2012

Nigeria: Maternal Mortality - One Death Too Many

But for the few whose relations have cried out, quite a large number of women still die giving life due to sheer carelessness by health workers in the nation's health institutions, WINIFRED OGBEBO reports.

Mrs. Uloma Egbuchulam Anyanechi died on the theater table of the Federal Medical Centre Umuahia, Abia State on Thursday 24th November 2011.

She had given birth to a healthy baby girl under normal delivery inside the labour room of the hospital by 10.45pm on Wednesday 23rd November, 2011.

About an hour later, bleeding erupted but the medical officers could hardly stop it even after delayed blood transfusion. They later took her to the theatre for surgery but they failed to resuscitate her. So she died.

Also last year, another pregnant woman, 26 year-old Mrs Nana Lasisi was booked at the University of Abuja Teaching Hospital, Gwagwalada on the 21st of February at a gestational age of about 15 weeks. She was seen by the managing team regularly in ante natal clinic.

She was admitted at 41 weeks, two days for induction of labour on the 21st of July 2011, the indication being post date. She had cervical ripening with misoprostol and was transferred to labour ward on the 22nd of July when she was found to be in active phase of labour.

Lasisi who was hospitalised on the 21st July, 2011 for the purpose of delivery had her delivery period elapsed for one week and two days after being placed on induction for labour, a situation that complicated her delivery process.

She was taken to the theatre at about 11 am that day. While the scrub nurse and the nurse anaesthetist were preparing their trolleys and the surgeon went to scrub, the patient fell from the operating table and had a laceration injury on the forehead. Although a live baby was eventually delivered, she was to die four days later.

These are isolated cases. These cases came into limelight due in part to the parents and relatives who raised outcry over the issue.

The father of the diseased, a former broadcast Journalist, James Egbuchulam, who petitioned the Minister of Health, Prof Onyebuchi Chukwu for attention on the matter, described his daughter's death, as a very disturbing circumstance.

In a letter titled, "Our Nation, Our Hope," dated 32rd of April 2012 Egbuchulam averred that his daughter had given birth to a healthy baby girl under normal delivery inside the labour room of the hospital by 10.45pm on Wednesday 23rd November, 2011.

According to him, an hour later, his daughter started bleeding but the medical officers could hardly stop it even after delayed blood transfusion, adding, "they later took her to theatre for surgery but they failed to resuscitate her. So she died.

He observed in the letter that there was no blood available for her in the hospital's blood bank as it's the procedure for pregnant women due for child birth even though she registered at the hospital and attended its ante-natal clinics.

He said, "When I donated blood by 1.00am that night, it took a long time to cross-match and process the blood before transfusion could be effected. After my blood donation, the hospital waited and relied on few other sympathizers who donated blood between 2.00am and 3.00am. If there was effective blood bank in the hospital, my daughter's life could have been saved."

The father of the diseased also wondered why a young lady who gave birth to a healthy baby under normal delivery be operated on after bleeding for hours later, saying, "What was the reason for the operation when all products of child birth had come out?"

He also wondered among others why when the Medical Officers knew that they could not resuscitate his daughter after surgery, they drugged her to sleep with such high dose of general anaesthetic.

Pleading for justice, Egbuchulam said, "Honorable minister, the death of my daughter is tragic, painful and unbelievable. I have never witnessed such a calamity."

According to the former journalist, occurring when it did and how it happened raises an obvious question. "Was it not avoidable? Somebody who walked into the hospital healthy and normal should not have come out cold and dead. That such an incident happened in this age at the Federal Medical Centre Umuahia (supposedly a centre for excellence) dampens and deadens the hope of the citizen about medicare and maternal treatment."

Also, the Minister of State for Health, Dr Muhammad Ali Pate who was on a fact finding mission to the University of Abuja Teaching Hospital, Gwagwalada where Lasisi died, condemned the death of the woman, saying, "This is a case of maternal mortality happening in a tertiary hospital, it is really regrettable and unacceptable, and there is no reason for a woman to die on a normal physiological exercise of pregnancy case."

He said though things like this happen, it is not acceptable for a pregnant woman undergoing labour to fall off the table, develop puerperal psychosis and then go on to die in a higher level of care. "It is not acceptable," he said.

The minister said puerperal sepsis was something that could be treated especially in a tertiary hospital like the University of Abuja Teaching Hospital, saying, "I don't buy the idea of psychosis, let us not look into that, until the investigation is concluded."

Stating government's position, Pate told the management to speed up the investigation of the committee set up by the hospital to look into the matter before any sanction or decisions can be made.

Many people have attributed Nigeria's high maternal mortality rate largely to the lackadaisical attitude of health workers to women in labour in facilities of care.

Maternal health is a key indicator for global development. Maternal ill health and death impacts families, communities and societies and has far reaching effects across socio-economic strata.

Despite recent data showing a positive turning point in the battle to keep mothers alive through pregnancy and childbirth, 342,900 women die each year from causes related to pregnancy and childbirth in Nigeria.

Sadly though, since last year, up till the filing of this report, the findings of the committee has not been made public and efforts to get the brief from the Minister of Health, Prof Onyebuchi Chukwu, through his Special Assistant, Communications, Hajiya Rakiya Zubairu, has not yielded any fruit either.

The late Nana's husband, Lasisi, now saddled with the upkeep of his motherless son, has since rested his case in the hands of God.

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