A feminist interlude...

26^th March 2012

As anyone who has met me will know, I’m really interested in womens’ health. It was great, therefore, to spend my first day in the hospital in the maternity unit. Off the top of my head, I’m not sure of the maternal mortality rate here, but in countries as poor as Malawi it is usually staggering. The government are clearly trying to address this; the maternity unit at Mkope is government funded (unlike the rest of the hospital), and newborns get free treatment for the first week of life. As far as I can tell, Mkope has taken this funding and run with it, something which really seems to make a difference to maternal health. Every pregnant woman is seen 5 times during her pregnancy and given iron supplements, malaria prophylaxis and a free mosquito net. There is also a massive push for maternal education, both through public health campaigns and antenatal classes. I was able to watch one of the midwives give a class on the signs of certain dangerous conditions in pregnancy, something which is particularly important at a hospital in such a rural area. The whole thing was very different to the way things work in the UK. As the entire thing was in Chichewa, I didn’t follow everything, but it seemed much more didactic – in the UK, the paternalistic approach isn’t seen as appropriate any more. Personally, I found the ‘if your ankles are really swollen, come to the hospital’ approach quite effective.  The public health posters are quite similar in style. One that I particularly liked said ‘a good husband takes his wife to the hospital before the 4^th month of her pregnancy’, which I thought was a really important message, pretty much regardless of delivery.

The department, of course, has to deal with unbelievable shortages – women sometimes deliver on mattresses on the floor, due to lack of space. Despite this, several women that I saw in the antenatal clinic were invited to stay as inpatients because they were near term and lived far away. My admiration for the entire department was cemented on hearing that a woman who had presented with eclampsia (intractable seizures related to pregnancy) had been successfully treated and gave birth to a healthy baby girl.

Update on the mosquito bites – Dan now has two, which I’m sad to say makes me feel slightly better. As much as I don’t want either of us to get malaria, I was starting to feel as though this was some sort of plot by the makers of Anthisan to make me start buying it by the litre.

Danni