Ugandan women shunning hospitals to give birth traditionally

Kampala - Milly Nalwadda believed that when she checked into a hospital in Uganda instead of using a traditional birth attendant, she was doing the best thing for her unborn child. But Milly's decision backfired when the attending nurse accidentally killed her newborn baby. 'Two hours after delivery, I requested to see my baby but she was dead because the nurse had laid her face-down,' the 39-year-old mother of six said. 'She apologized, but I was left in tatters.' 

Despite the tragedy, which came in 2005, Milly returned to a maternity clinic when she became pregnant again, only to face abuse from nurses who told her she was too old to have a child. She gave up on modern medicine and turned instead to a traditional birth attendant, who administered a course of herbs and delivered her child safely. 

Milly's case is not an isolated incident. Hundreds of thousands of Ugandan women, distrustful of the dire healthcare system, are relying on traditional birth attendants, leading UN officials to warn that child mortality reduction targets are in danger. Officials say that poor medical facilities in hospitals, badly trained and rude medical staff, poverty and the long distances from rural areas to medical centres are contributing to the trend. 

An average of 1 million babies are born in Uganda every year, but government and UN officials concede that while the majority of mothers visit antenatal clinics during the first months of pregnancy, they opt to stay away at the moment of birth. 'Antenatal care for Ugandan women is over 70 per cent, but only 40 per cent deliver in hospitals,' Deputy Health Minister Emmanuel Otala said. 'The reasons for this are many ... there are delays in the delivery of services, there are negative attitudes towards the patients.'

A government study in 2006 found that more than 370 children under the age of 5 die in the country per day, of which 25 per cent are under the age of 1. 
The death rates are decreasing at a rate of 1 per cent per annum, but this is far below the target of a 13-per-cent annual reduction, the United Nation's children's agency UNICEF says. According to the agency, there is a direct link between the deaths and mothers giving birth away from health centres. 'It is absolutely clear that there is a connection (between the deaths and mothers staying away from antenatal clinics),' UNICEF's spokesman in Kampala Hyun Chulho said.

'There is also a connection to where the child is living, household incomes, the level of antenatal care and the educational level of the mothers,' he added. The traditional birth attendants are seizing the opportunity left by yawning gaps in the healthcare system and have organized themselves into a registered association, which is busy wooing the expectant mothers to their side. 

'Pregnant mothers normally seek services from us because we have experience in handling them,' said Musanje Kyabaggu, the secretary general of the National Traditional Healers and Herbalists Association. Members of Kyabaggu's group, which numbers around 60,000, charge around 10 dollars for each expectant mother, compared to more than 50 dollars charged for the services in the established health centres. 'Expectant mothers are running away from nurses because the nurses are young, inexperienced and abusive,' Kyabaggu said.