Dorothy Ngoma, the executive director of the National Organisation of Nurses and Midwives (NONM) in Malawi, cannot afford to lose hope, despite the many broken promises on the healthcare system she has dedicated her career to, because mothers in Malawi still cannot enjoy what others elsewhere take for granted: going into hospital and emerging a few days later with a healthy baby. Although there has been a notable improvement, the stark reality is that Malawi still has the worst maternal mortality rate of any non-conflict country in the world. Statistics show that 16 women die daily from childbirth and pregnancy-related complications.
"The situation is very bad," says the 55-year-old Ngoma. "In rural areas where 70% of the population live, I have visited nurses on night duty working alone and taking care of over too patients for a shift of 16 hours. This is too much--it is not humanly possible to have quality care that can save lives with this."
The situation is just as critical in hospitals in big cities. "You find that mothers may come early but they are not supervised closely enough. So we lose some because of our acute shortage of doctors, midwives and nurses who are usually busy with other health emergencies. So the mother has to wait," Ngoma adds. "At Bwaila Hospital in the capital Lilongwe for example, it is common for a single midwife to be attending to three or four deliveries in one go."
According to the World Health Organisation (WHO), health services should employ a minimum of 100 nurses and 20 doctors per 100,000 people. Malawi currently has 200 doctors, most of whom ate in management, and 3,000 nurses for a population of 14 million people. The heavy workload confronting the country's front-line medical staff continues to force them to emigrate to the West where they can earn good salaries in better working conditions. According to official figures, 120 Malawian nurses migrate to Britain and the USA every year, at a time when the demands of Malawi's health services have never been greater.
As a result, Malawian women continue to die at many levels; anti-natally during delivery because surgery is not performed early enough when complications arise; post-natally when there are no antibiotics and adequate follow-up care. The number one cause of maternal mortality is haemorrhage, which can easily be prevented with improved access to emergency obstetrics.
Ngoma has witnessed the devastating effects of the maternal crisis on communities in her 30-year career working as a nurse and midwife--hundreds of children orphaned and families destroyed year in and year out. …