By Moses Bailey
Investigation conducted at maternal waiting homes in Liberia reveals that hunger remains a major challenge faced by pregnant women. These homes were constructed as part of Liberia’s effort to strengthen its healthcare system. It’s hoped that these facility will help augment the fight against maternal mortality. Liberia registers one of the highest rates of maternal mortality in the world. 1,072 women die out of every 100,000 live delivery. So, the homes are among steps taken to reduce pregnancy-related deaths and other complications.
With the hope of depopulating home-delivery, maternal waiting homes themselves are not very populated due to many factors. They are only built closed to a health center. For towns and communities without a health facility, pregnant women will either choose to deliver at homes, which many times come with huge risks; or walk many kilometres to reach the lone maternal waiting home available. For those who muster the courage to come over to the waiting homes, challenges abound, particularly including lack of food.
The lack of feeding is significantly affecting, if not defeating this purpose because many pregnant women would rather prefer delivering home under risky circumstances than to withstand hunger.
According to the investigation I carried out at 4 maternal waiting homes in Bong County, pregnant women at these facilities spend their days without food or on a single meal that hardly comes by. Because of distances and the rains, husbands and relatives of pregnant women hardly come to visit. This has been corroborated by a couple of similar investigations done by other health reporters; and confirmed by the health authority and partners.
Baby Tokpa is among seven other pregnant women currently at the Phebe maternal home in Suakoko waiting to deliver. Baby and the friends have to mobilize a cup of rice each plus fifty Liberia dollars to cook for the day. The single meal is not sufficient for these women, especially in an environment where everything else is strange. Hunger, accompanied by a minimum hope of feeding further complicate existing complications these women face.
Baby carries a twin, one of whom is in transverse position. To delivery safely, she needs a caesarean operation. The man responsible for the pregnancy died from illness over nine months ago just when the girl got pregnant. So, throughout these months, she has been fending for herself and unborn babies. Thanks to her mother, Mama Tokpa, who accompanied her to this maternal waiting home. Both mother and daughter will have to contend with the harsh reality of living without a father to the unborn babies in the days, weeks, months and even years to come.
Viola Markor is a certified midwife attending to these pregnant women. She also serve as main coordinator of midwifes assigned at waiting homes in Bong. Viola confirms that lack of food is a serious challenge. “The major problem we face here now is feeding. There is no food. These women have to put money and cups of rice together to be able to eat. The last time the county health team helped us with eight bags of rice. But that was not enough, even though we are grateful. Now, we are finding it difficult to cope without food. Some of them can’t even afford the one cup of rice and fifty Liberian dollars,” Viola says.
She wants support toward the direction in order to encourage more pregnant women to come over to the waiting homes so as to avoid home delivery.
The situation here is even better compared to other maternal waiting homes across the county. Here, there is farm of cassava, garden eggs, pepper that pregnant women can harvest to augment their feeding.
Bellemue and Zabay maternal waiting homes in Panta and Kpaii respectively, also have their own stories. Yamah Kollie is the certified midwife at the Bellemue maternal waiting home and clinic. Despite the challenges here, she wears a smiling face; acknowledging to herself that her work is helping to save lives.
In Zabay town, story is disheartening. For a long time now, not a single pregnant woman has visited this facility. This is not because women here are not getting pregnant. Bu they prefer staying home to deliver because the maternal waiting home cannot provide them food during their stay. Instead of staying or waiting to deliver, pregnant women just come in for check up at the clinic.
So, how come has food become the one sticky challenge for all these maternal waiting homes? Is this challenging going away anytime soon? Well, no, at least not now; as I gathered from George Toe, senior primary healthcare coordinator at Africare, an international NGO that constructed these homes. For Africare, providing feeding to pregnant women is not a sustainable way to run and maintain these valuable homes. They were not built to provide feeding for pregnant women. He says no NGO is funding feeding as part of running the waiting home. So, the women are still the responsibility of their husbands and communities.
The Liberian government also thinks so. Chea Sanford Wesseh is Liberia’s assistant health minister for statistics. At a training organized by Internews’ Information Saves Lives project in June held at Corina Hotel in Monrovia, minister Chea said the intent of the waiting homes is to help pregnant women who are at the verge of delivery, but not to feed them. He maintained that the homes should be owned by communities they serve.
So, the message from the Liberian government and its partner, Africare, is clear. No provision of food for pregnant women at maternal waiting homes.