Why isn’t Respectful Maternity Care taken Seriously in Uganda?
By Hanna Carr – Physician at Pediatric Health Initiative
It’s my 9th week in Uganda and I got to see some of the women’s health care at Jinja Regional Referral Hospital. Resources are not enough to meet the needs and the staff is working in headwinds. Going to work every day in a system that is rigged to your and the patient’s detriment, finding solutions where there are none, time after time. It deserves all the respect. And reminds us that what we have at home is worth fighting for!
On the Labour Ward, there are 26 seats in a large open room. The round goes like a tromb of white rocks through the hall. The hierarchy is obvious but clarified by mockery: the highest chicken points down. At the bottom lies the patient, defenseless. The health worker who was so kind to me just now pinches the woman in the bed in her arm and shouts: “Why did you braid your hair when you are about to give birth? And you say you don’t have money? ” I can’t interpret the context but I am ashamed.
So far in my career, I have compensated for lack of knowledge with proximity to soft skills (as well as being able to google), you will get a long way at home. Not on here. The mandatory vaginal examination is done in front of the entire room, sometimes with a flat screen with more holes than fabric. During the ongoing conference below waist height, I am questioned about something I, to my happiness, can answer but immediately feel ashamed of my satisfaction. I want to meet the woman’s look and show with mine that I am with her, like apologize for everything, sorry for the world!
She is looking away. I’m at a lost place. Moving slowly towards the main end. An ache comes and I get to grab a hand that still approaches mine. I’m taking a breath out.
When I’m presented to a woman who allegedly is in active childbirth I don’t understand. Has the labor stopped? Next woman, same thing. Lying still on the back, not a crooked toe reveals the pain, just the eyes disappear a little. A moment later, she heads to the Delivery Suite to push out the baby. I am just speechless. Sure, pain is situational, as well as individual/cultural, but – it DOES hurt to give birth?! Without the possibility of medical pain relief in an environment where you lack the right to decide over your body? A midwife explains: “Women believe that if they shout or act out during labour that it will bring bad luck for the baby. So, they fight to stay quiet.”
