Africa's hidden war: Christian Aid's frontline fight to save the lives of women in childbirth

Nashoro Ndayia stares blankly into the distance as she tells me how she lost her daughter Sitting outside her simple mud and straw home in the village of Pusangi, in the south west corner of Kenya, the mother-of-eight, tells how the 19-year-old suffered complications during childbirth, but that without any healthcare services and no ambulance service, she died in the back of a car on her way to hospital.

She doesn’t cry. It’s too late for that. And besides, she has to be strong for her grandchildren – two of whom she now looks after.

Nashoro, 43, is already a widow, her husband having died from TB – another death which would have been easily preventable with proper health care.

“Semeyian was my fourth child,” she says, her lined-face full of despair.

“She was pregnant with her third child. One time she started having a headache and sickness. I talked to my late husband about taking her to hospital, but it was hard for us to agree, and he just ignored me.

“She was not married so it was her father’s decision.

“She was full-term, she had been in labour for two days by the time she gave birth. She was weak; she was exhausted.

“By 6pm she was bleeding very much. Around 8pm we started looking for a vehicle and we took her to the hospital. But she never made it. She died on the way.

“If we had a hospital here, I would still have my daughter today.”

The villagers of Pusangi are members of the Masai tribe. With their distinctive red cloaks, beaded jewellery and, for the men, carved staffs, clubs and swords, they are as majestically African as the lions, giraffes and elephants which roam the plains of the Masai Mara National Park, over the escarpment.

But behind what to the tourists is an idyllic image of Africa at its finest, is a bitter truth.

For the Masai, like so many others on that continent, are denied even basic healthcare – forced to rely on expensive taxis and motorbikes to reach the nearest hospital or clinic. Most can’t afford it so stay at home. And, all too often, die.

For poor women like Nashoro, life is precarious. And few things are more hazardous than the very act of giving life itself.

The figures make shocking reading. More than 14,700 women in Kenya die annually due to pregnancy-related complications – that’s 40 women a day. For every woman who dies it is estimated that another 20 to 30 suffer serious injury or disability due to complications during pregnancy or delivery – that’s as many as 440,000.

When world leaders developed the Millennium Development Goals to eradicate global poverty and human suffering by 2015, they set a target that 90 per cent of births should be assisted by a health care professional.

In Kenya it is just 44 per cent.

In Narok County, a lush but desperately poor rural province which includes the Masai Mara, less than 30 per cent of women have access to maternal and child health services. In remote villages like Pusangi, the picture is even worse.

Few of those tourists staying in luxury safari lodges a few miles away realise that something we take for granted at home is so cruelly denied.

Maternal fatalities account for 15 per cent of deaths among women aged 15 to 49, with 488 women dying per 100,000 births, compared to just 12 in the UK. That’s a bloodbath.

But it needn’t be.

Spurred on by stories like Nashoro’s, Christian Aid is working in the field to improve women’s and children’s healthcare. Through its partner the Transmara Rural Development Programme (TRDP), it is providing ambulances, mobile clinics and permanent health facilities staffed by professionals. And it’s working.

The village of Sitoka is just 11 miles away from Pusangi, but is a shining example of how the charity is saving lives.

Where before there was nothing, the inhabitants of this straggling village of mud huts, housing 2,000 people, are turning their backs on traditional home births, with all the risks they entail, and travelling to hospital in the nearest town, Kilgoris, 30 miles away, in a new four-wheel drive ambulance.

Members of the Mother to Mother Group in Sitoka

From this winter, they also have their own dispensary – a permanent maternity suite and pharmacy staffed by a nurse. In addition, Christian Aid funds a monthly mobile clinic dispensing immunisations, and has set up a mother-to-mother group – offering micro-loans to enable women to start their own businesses.

For the Masai women, who still live as second class citizens behind their men, it is empowering.

Elizabeth Ntunkosio, 28, has four children, ranging from 18 months to 11 years. She lost one daughter after two weeks. She said improved healthcare in the village was transforming lives.

“When I had my most recent baby, there was no ambulance,” she said. “So I went by motorbike and on the way back, hired a vehicle for around 20,000 shillings (£140) because it was raining. It was very costly.

“When I went on motorbike, heavily pregnant, it was very bumpy. Sometimes it can lead to miscarriages. There are pregnant women who fall off motorbikes.”

She added: “Now we also have the dispensary, it is going to help the community. We can go there any time, it doesn’t matter if it is night or day.”

And she had this message for Christian Aid donors in the UK: “Because of what you have done already, I thank you. Now I would ask you to look for other vulnerable places to help. A spot of light has been seen in Sitoka, but there are others now who need your help”.

Nashoro Ndayia with grandson. The child's mother died in childbirth

It’s a message echoed by nurse Margaret Nyachoka Omwenga, head of Maternal and Child Healthcare at the district hospital in Lolgorian, overlooking the Mara plains. She is exhaused after a long day seeing a steady stream of women and children, who come early and leave early “because they fear wild elephants”.

“I would encourage people in the UK to help the poor,” she tells me. “There is a lot of poverty here in Kenya. People are not able to take care of their health. I have seen many children who are orphaned by HIV.

“Many kids are left with grandparents who are poor and can’t take care of the children.

“You must help mothers get the services they need. The people here deserve the same services as those in richer countries.

“Every mother has to get standard healthcare. The quality of service must be the same – and every child also needs the same service. We cannot discriminate”.

RAISING VOICES TO SAVE LIVES

It's a long way from Oxfordshire to the wildlife rich plains of the Masai Mara, but hundred of school children in the county are tuning up to make a real difference to the lives of their young people in that remote corner of Africa.

For the seventh year running, Christian Aid in Oxford is working in partnership with the Oxfordshire County Music Service to put on the Big Christmas Sing.

Primary schools from across Oxford have been invited to sing some well-loved carols while raising money for Christian Aid’s Christmas appeal – which this year focuses on women and children’s health, by supporting partner organisations in the field, such as the Transmara Rural Development Programme.

Last year 19 schools took part, involving 250 pupils – including those from St Mary and St John Primary School, Cowley, pictured. This year the charity is hoping for an even bigger show of voices at the event at Oxford Town Hall on December 2 and 3.

In 2013, the Big Christmas Sing raised £2,600 pounds, bringing the total raised since the event started to nearly £10,000.

This year, supporters’ money will go even further, with the Government matching the amount raised.

Visit christianaid.org.uk

TALES OF HOPE

As part of his mission to improve the lives of the Masai, and other poverty-striken people in Kenya, Stephen Ngugi, from Christian Aid’s Nairobi office, is hosting an Advent Hope Service at Magdalen College Chapel, Oxford, on Friday November 28. The event features carols by candlelight with stories of hope in a beautiful setting.

Entry is free. For further details, call 01865 246818 or email oxford@christian-aid.org

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