Alvine Kapitako
Opuwo-As children playfully minded their own business 22-year-old Uahironua Tjisuta was cleaning an animal skin at the rather quiet Omaoipanga village, some 15 kilometres from Opuwo.
The bright smile at the sight of visitors was Tjisuta’s way of saying ‘you’re welcome’, and immediately the health extension worker, Uaoo Tjiumbua, who accompanied New Era, explained the purpose of our visit. The mother of two gave birth two weeks ago to a healthy, bouncy baby girl.
Tjisuta insisted that we have our interview away from the playing children, in the Ovahimba traditional hut where her bundle of joy, Ramanovandu Tjisuta, lay under a mosquito net.
Like many Ovahimba women, Tjisuta delivered the baby at home with assistance from her grandmother who is known as a “traditional midwife”.
“I didn’t make it on time to the hospital because I was not in labour for long,” she responds when asked why she didn’t give birth at the Opuwo state hospital.
The bad terrain and lack of transport contributed to Tjisuta giving birth at home.
The Kunene Region has the lowest proportion of pregnant women delivering in health facilities, according to the 2013 Namibia Demographic and Health survey.
In Kunene, 72 percent of pregnant women deliver in health facilities. This is compared to the 88.7 percent national average and 97.6 percent in the Erongo Region, according to the survey.
Also, Kunene is presented with unique and compounding challenges that make access to healthcare facilities difficult.
Apart from having the lowest hospital deliveries, Opuwo has the highest rates of teenage pregnancy, according to statistics.
“I don’t have a house in Opuwo so I had to travel that distance for antenatal care but I didn’t make it on time to deliver,” she explained in Otjiherero.
In the “delivery room”, Tjisuta was assisted by her grandmother and a cousin. A blanket, pillow and animal skin were used to make the delivery process “comfortable”, explained Tjisuta.
While her grandmother sat close to Tjisuta’s legs to catch the baby when she popped, the cousin mainly assisted with Tjisuta’s back, by rubbing it and also ascertaining she was in a comfortable position to push the baby.
After a “painful” labour, the placenta was only expelled from Tjisuta’s body after at least three hours, she said.
“I gave birth in the afternoon but the placenta was expelled in the evening,” explained Tjisuta.
The final stage of labour takes place when the placenta is expelled from the womb. This stage usually takes place within 30 minutes of the baby’s birth, according to the American Pregnancy Association website.
“If the placenta remains inside the woman’s womb, the after-effects can be life-threatening, resulting in infection and even death,” according to the website.
“The placenta was buried in the hut. A hole was dug were it was buried,” Tjisuta said, explaining that according to tradition, “it’s dirt that shouldn’t leave the house”.
Tjisuta also related that a blade was used to cut off the baby’s umbilical cord. “In the olden days they used sharp stones to cut off the umbilical cord. Both my children were delivered at home.”
Even though Tjisuta’s baby girl was born two weeks ago, by Monday neither the mother nor the daughter had been seen by nurses or doctors.
“I kept delaying but I will go there tomorrow,” replied Tjisuta after the extension worker Tjiumbua stressed the importance of seeking medical attention immediately after giving birth.
Tjiumbua said part of her work entails encouraging women to seek antenatal services. “Because of that many are seeking these services,” said Tjiumbua.
Tjisuta further said that it is good that a maternity waiting shelter was built in Opuwo. The facility was named after the former governor of Opuwo, Angelika Muharukua, who died last year in October.
The facility will assist many women to give birth in conducive environments, she said. “Many women will now go and give birth in hospital because of that facility,” she added.
The Kazetjindire Angelika Muharukua maternity waiting room was launched on Tuesday at Opuwo. The facility is a stone’s throw from the Opuwo state hospital.
The health director of Kunene, Tomas Shapumba, said on Monday that the region is “one of the toughest” in terms of geographic terrain.
“Those things contribute to the delay of pregnant mothers seeking early maternity health services. There is no comparison between Opuwo and Khorixas because the terrain here is really bad,” said Shapumba.
Governor of Kunene Region Marius Sheya told reporters on Monday that health is “a challenge here”. Therefore, the maternity waiting home is a “step in the right direction”.
Meanwhile, the World Health Organisation (WHO)’s country representative, Dr Charles Sagoe-Moses, said at the official launch of the facility that it will make it easier for pregnant women in the region to access care at the time of delivery and after birth for themselves and their newborn infants.
This will improve health outcomes, noted Sagoe-Moses. “As Namibia strives towards the Sustainable Development Goals targets as well as the Harambee Prosperity Plan, it is critical that no one is left behind,” said Sagoe-Moses.
According to WHO, approximately 800 women die from preventable causes related to pregnancy and childbirth.
Most maternal deaths (99 percent) occur in developing countries and affect mostly women living in rural areas and among poor communities, stated Sagoe-Moses.
One target under the SDG 3 is to significantly reduce the deaths of mothers while giving birth.
The Kazetjindire Angelika Muharukua maternity waiting home was built with funding from the European Union through the Programme for Accelerating the Reduction of Maternal and Child Mortality (PARMaCM).