Tuesday, March 19, 2024

When Giving Life Ends in Death: The Face of Maternal and Infant Mortality in Zambia

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Linda Kasonde
Linda Kasonde

By Linda Kasonde

I recently came across the story of a young African-American man, Charles Johnson IV, who is fighting for legislation to increase the quality of health care to reduce maternal mortality among African-American women. His own wife died after delivering a healthy baby via caesarean section. She bled to death because doctors at a very prestigious hospital in the U.S. ignored her haemorrhaging for several hours. Her name was Kira Dixon Johnson. She was very well educated and reasonably well-off and yet she became another statistic. In America, African-American women are 243% more likely to die to child-birth than their white American colleagues. Even wealthy, educated African-American women are still more likely to die in child-birth than white women. Earlier this year, tennis star Serena Williams revealed that she too had suffered a near-death experience following the delivery of her daughter due to post-delivery complications that her care-givers were not taking seriously. In America, black women are more likely to die in child-birth because of poverty and racial bias in terms of the quality of the care they receive. In Zambia, women are more likely to die in child-birth because of poverty and because of a lack of access to good quality health care.

When women get pregnant, they assume that their pregnancy will go smoothly and that nine months later both mother and baby will emerge glowing and “cherubescent” respectively. That is not the reality for hundreds of thousands of women across the world. In 2016, I was Kira Dixon Johnson. My pregnancy was complicated right from the beginning. I had placenta praevia (low lying placenta that covered my cervix completely). It meant that I bled on and off during my entire pregnancy. I would later learn that this condition is life-threatening as it meant that at any time the placenta could erupt causing me to bleed out in a matter of minutes. Added to that, I was gaining weight excessively (I later found out that it was due to fluid retention) and a few months on I began to experience shortness of breath.

My first doctor down played the seriousness of my placenta praevia and other symptoms insisting that I could more or less continue my life as normal. But because I was not satisfied with his lack of explanations and information; I was reading up on my symptoms on my own. I became so concerned at the lack of information that I was getting from my doctor that I changed doctors when I was about five and a half months’ pregnant.

My new doctor was great. She listened to me and answered my questions. On my first appointment my urine was tested and it was found that I had protein in my urine and my blood pressure was above normal, both indicators for pre-eclampsia – in addition to my placenta praevia. Eclampsia is a condition in which pregnant women experience unexplained high blood pressure. It is not stress related. It can lead to seizures and can affect internal organs either pre- or post-delivery. My new doctor put me on complete bed rest for the rest of my pregnancy which I strictly observed. There would be several occasions when I would be completely relaxed and having lain in bed all day only to be perplexed to find that my blood pressure was very high. My new doctor took a blood sample and ordered a supply of blood to match my blood type to prepare for blood transfusions in the event that my placenta praevia erupted suddenly. It proved to be a life-saving move. I was later to develop a very severe form of pre-eclampsia called HELLP syndrome which was also life-threatening.

At exactly twenty-eight weeks of pregnancy, my placenta praevia erupted and coincidentally my blood pressure was becoming uncontrollable due to the pre-eclampsia. I had to have an emergency caesarean section. My baby, Mazuba (sunshine) was born on 5th August 2016. He was small but perfectly formed. He was born underweight due to my condition at around 1 kg but fighting for his life. We both were. I was at one of the most prestigious hospitals in Zambia and yet its maternity wing did not have an infant respirator to help him breath. Mazuba died in the early hours of 7th August 2016. The fact that he was underweight had made his chances of surviving slimmer. It was one of the hardest things I have ever had to experience. I cried for hours until the next morning I was told to stop crying and remain positive otherwise I risked falling into depression which would aggravate my own condition. I had to suck it up. By then the HELLP syndrome had kicked in and my liver and kidneys were breaking down. I needed several blood transfusions.

I can point to the day I nearly died. I needed another transfusion and the hospital did not have enough blood. My mother, who is a medical doctor, managed to arrange for some more blood and that is how I survived. It took me two months to physically recover from my condition, which also included sepsis, a severe bacterial infection that I picked up at the hospital after my operation. The trauma of losing my baby and nearly dying led to me suffer post-traumatic stress disorder (PTSD) and post-partum (post-delivery) depression for a period of time. Contrary to popular belief, these conditions also affect black African people and are far more widespread than is accepted because no one wants to talk about it. I could not have gotten through it without supportive friends and family who loved and cared for me during what was a very difficult time. Like millions of mothers before me, I had to pull it together and life had to carry on.

I am alive today because I was educated enough to question my doctor, because I had enough money to go to one of the best hospitals in the country and because I was lucky enough to have a mother who is a doctor. Many thousands, if not millions, of Zambian women do not have those advantages. In Zambia, many women deliver babies at home or at health posts that are not staffed by qualified doctors and that do not have access to life-saving equipment. According to 2015 UNICEF estimates, the maternal mortality rate in Zambia is 224 deaths per 100,000 live births (a 2015 estimate). According to another 2015 UNICEF estimate, 36 babies die every day before reaching their first month. These are shocking statistics. And yet our government is paying for overinflated roads, fire engines, ambulances, cars and even jets while our women are dying trying to give life and our children are not being given a chance to live. That makes me very angry and sad – as we all should be.

December 12th marks Universal Health Coverage Day. I believe that health care should be affordable and accessible for all. I am not talking about politicised health schemes that will do little to improve the lot of Zambians. I am talking about adjusting our financial priorities by reducing expenditure and over-expenditure on non-essential items and increasing budgets for healthcare that will help increase the number of qualified doctors, medicines and facilities countrywide. We need to give our mothers and babies a fighting chance.

The author is a lawyer and civil rights activist. She is a 2014 Archbishop Desmond Tutu Leadership Fellow.

37 COMMENTS

  1. Guys don’t read this!!
    These are women affairs. I can’t wait to hear from Ba Sumaili, because this can’t be told in church.
    This is heavy my cousin Linda, mwatushikula.

    • @Nostradamus you are right. This is not for guys. It’s for real men who know that being a man is not just about d!ck measuring purposes!
      I, like Ms Kasonde, had a c-section Unfortunately I developed eclampsia. I survived because I had the best health care in the world.
      When I was discharged from hospital, it was just me and my wonderful Zambian husband alone with no help as we waited for my sister to come from Zambia to help us. My husband took great care of me. He bathed me, “ukunchina”, cooked and changed the baby’s diapers, and took the baby to her first doctors appointment. This was because I had terrible edema because of fluid retention, I was not allowed to bend from the waist. I was not allowed to do house work or to lift anything over 10 lbs.
      So, no this is not ukushikula. My…

    • @ nostra you are an under5 for real. This explains why your comments are childish. You jayjay and spaka should just join your fellow under5s at zwd
      You are lowering the bar for a once vibrant LT.

    • The rate at which our people die is unacceptable. Our children are dying for lack of clean drink water and yet our president can buy a Gulf Stream jet for $150 million dollars. How about investing in water reticulation and sanitation in compounds!

    • Oval head

      You are nothing but a PF dancing , sontaring stone thrower who needs to stick to ZNBC ……you bring nothing to LT but your lungu ar.se licking….you tounge must be brused by now…

    • @Nostradamus,
      We have already seen bigger things and worse things than what your cousin Linda is saying, a week ago ‘Kay Figo’ willing showed us stuff, even that other girl at named radio station went to work in a pitikoti, as if that was not enough, we were ‘gifted’ with a movie where a beer bottle was stuffed ‘inside’,,,,, awe shuwa lungu and PF need prayers

    • @Anonymous you see the consequences of loving d!ck. I feel sorry for your husband, that he has to go and impregnate some others.

    • Because some men you believe is taboos of the 18th century, that’s why you will never get lead of your stereotype. And you are the same men who make women pregnant. Bravo, Vundabar, Well done Linda Kasonde for voicing out on life issues.

  2. Maybe Linda LAZ Kasonde should stick to this. Certainly Law and LAZ and politics are not her fit, just look at the results of her joining LAZ to the futile Presidential elligibility case. A pure legal disaster and embarrassment, to say the least, that Linda Kasonde and her LAZ colleagues could fail to read and interpret correctly a simple law, and advise upnd and Trib.al Hacks accordingly.
    Mama Linda should stick to maternal health, seems like a good article though I have no time to read the whole thing or even half of it, just the LAZ legacy of the author puts me off … ……..kikikikikiki!!

  3. Am so sorry my sister for your Mazuba. Losing a child is the worst thing that could ever happen to anyone.
    Funny I just saw “Being Serena” the documentary on HBO. You would think complications like that only happened to lazy fat women but no.

  4. HH must understand there are so many things you can do in life to contribute to society. Look at Linda shr is no longer LAZ president

    6 times loses even with big names behind you. Dipark. Guy scot. Maureen. Milupi. GBM

    Its practically impossible to add value to this man because he can not think out side the BOX

  5. By the way, what is Trib.al Hacks doing this season? I mean after his street protest was postponed yesterday to July 2021? Jay Gay, please tell your trib.al not to forget to buy a Christmas tree and some goodies for his wife and children. And to celebrate Christmas freely, no need to hide in bunkers, this is a free country ……..
    kikikikikikikiki

    • Iwe chi whatever. Ayo wafumine nayo pakufyalwa aini? Keep your dirt mouth shut if you cannot comment sense. Linda Kasonde is speaking for the masses and you are vomiting for yourself. Leave Linda alone.

  6. Just checked the statistics and Zambia is down there in infant & maternal mortality rates. Only DRC and Zim have equally terrible numbers .Botswana = pretty good, South Africa =okay and Kenya = respectable.

  7. God is great because he takes care of him own whether rich or power.He has his own way that is why poor people survival.Remember in medival age when there no doctors .

  8. It’s sad reading from comments thus far…..someone is trying to bring up real issues to the foyer and people are down playing just because it’s “women stuff and been said by Linda Kasonde”…..Indeed we have lost it in this nation….and I blame it on the women……we can do better without these men I tell you…they are just good in what they know best….if at all they even know…coz now there are a lot of women caught cheating a sign that even there they have failed…..most men of Zambia are dimwits I tell you….lets rise as women and make things right for this mother Zambia….it’s mother Zambia for a reason….not father Zambia….I salute you madam Linda and I share your pain….it’s only a fellow woman who can live your trials…….and it takes real men to hold you and…

  9. Well articulated article Sister Linda. Health is a God given and human right for all. Knowing that life is sacred and precious, all health professionals should help by providing the best they can.

  10. Why are these challenges more common in women with similar lifestyles or groupings or behaviors? Does it say something about their sexual past, partner sexual behavior or lifestyle diet and habits?

    • placenta praevia is known to commonly occur in women who have terminated or aborted regularly. The point is appreciated, but let us also discourage abortions.

  11. To say that I am shocked at some of these comments is an understatement. Linda brings up pertinent and valid observations and seriously the vast majority of people on this blog go on a diatribe and you wonder why Zambia ranks low in healthcare, let alone other things. If not for you, think about your children and poor people in Zambia. Some of these men here have never seen the deplorable conditions of a labor/maternity ward in Zambia and have no desire to know, if only for a moment you would be human and humane enough to care. Linda kudos to you!!!!

  12. I lost young sister on Sunday the 25/11/2018 thru bleeding during child birth in southern province. Unfortunately the baby later died. So we lost both mother and child. Some of the issues you can only understand until it hits you as a family. What I worry is about someone presenting statistics in certain forum and possibly be interested in receiving funding for such statistics, but they forget the traumatic, emotions and feelings of the affected and unfortunately the money meant for improving health facilities may be diverged to other competing and “needy” areas leaving the poor mothers stranded with poor health care systems. Madam Linda you right and on spot. What I see is that Government is trying but more needs to done in this grey area.

  13. If she had not been anti Government she would have landed a top government post. Siding with tribal politics can be career limiting.

  14. This makes me sad: on the one hand these deaths are avoidable, on the other hand we can fix this! Through investment in healthcare and education there is a huge opportunity to make things much better for millions of Zambians. To my shame, I have never heard the call to train as a doctor or nurse, but I have huge respect for those who do and will do what I can to encourage people to consider the healing professions.

  15. Really!! Are people that numeracy ignorant? Well, she said 2 forty something per 100 000 (put in words in recognition of the high numeracy ignorance). Well, this pales in relation to other causes of death which many people died from in the same hospital she survived. According to the MoH, other death causes are measured per 100 or a 1000 population since they occur a 100 or 1000 times more frequently.

    When socialites or activists do their thing, they better put things in the right perspective. No wonder there are many comments sounding like the audience is not captivated by the speech.

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