Cotton Tree woman, 20, is latest maternal death

A 20-year-old Berbician yesterday died in transit from the Fort Wellington Hospital to the New Amsterdam Hospital, following delivery complications, but at least one doctor knowledgeable about the case believes the woman could have been alive if she had gone to the hospital sooner.

Chitrawattie Ramjiwan of Lot 33 Cotton Tree Village, West Coast Berbice died some time around 10 am yesterday after giving birth to a healthy baby girl. Ramjiwan was being ambulanced to New Amsterdam since she developed complications during the delivery. Her husband, Lall Ramjiwan is angry that hospital officials continue to remain silent. Two maternal deaths earlier this year are under investigation.

Lall Ramjiwan, 28, told Stabroek News that doctors had listed the birth date of their baby at between May 10 and 13. He said after the baby did not arrive, they were given another week and until yesterday all was well with his wife.  Yesterday at around 4 am the woman began experiencing labour pains and they went to the nearest hospital — Fort Wellington.

Chitrawattie Ramjiwan

“The pain wake her up around 4 – 5 in the morning and we begin getting ready and so… We reached the hospital around 6:30 and the nurse took her to the room to check her and they come back and say she gat lil more time and she should walk around and suh. Up to then she been good just clicking the fingers because of the pain,” he explained. He said after some two hours elapsed, his wife informed medical personnel that she was ready since the pain had become more intense.

She was then taken to the delivery room. He said shortly after, the nurses rushed out to tell him that his wife had to be transferred to the New Amsterdam Hospital since she was weak but that she had birthed a baby girl. “Them seh that she was weak, that she didn’t have much strength to even push the baby out but she try and do and I got a girl. Then they bring her out and she bleeding bad and had to go New Amsterdam. But when I see her she look as if she faint away cause she wasn’t talking; just deh like if she blackout.”
It was on the journey to New Amsterdam that Chitrawattie stopped breathing. She was officially pronounced dead on arrival the New Amsterdam Hospital while her daughter was rushed to the Georgetown Public Hospital. Relatives said that the newborn was listed as in good health but was being kept for observation.

Chitrawattie, her husband and her child in happier times

Ramjiwan said when he asked for specifics on how his wife died, he was met with silence. He was later told by hospital officials that he would have to await the results of a post-mortem examination, which would be done on Monday.

Contacted by Stabroek News, one of the doctors who was part of the medical delivery team said that the woman bled a lot during delivery. He informed that there was no indication that her pregnancy was high risk since from her antenatal clinic card she was not suffering from any prior illness. “We tried our best and could not do anything else. Based on her charts, she had no prior complications so there was nothing to know that she would have bled the way she did,” the doctor said. He opined that the woman must have been feeling pain before yesterday morning as he confirmed her husband’s reports that she was taken to the hospital around 6 am. He said the hospital prefers women to go as soon as they experience labour pains and said that maybe if she had gone on Thursday evening she could have been better monitored and perhaps her life could have been saved. He said efforts were being made to have the woman transferred when she delivered the baby and that it was sad that she had died.

The Ministry of Health has come in for much criticism over the years for maternal deaths. During 2010, the country reported a staggering 19 maternal deaths. It was because of the high death rate that the United Nations had in 2011 stated that Guyana had made insufficient progress in curbing maternal deaths and was not on target to reach the 2015 Millennium Development Goal, much to the disappointment of then minister of health Dr Leslie Ramsammy.

Minister of Health Dr Bheri Ramsaran, who is currently in Geneva, had said “Every single maternal death has to be reported as per legislation in a timely fashion and analyzed by the Cabinet… It is a mark of your civilization how you treat your pregnant women and those who are found negligent will be held responsible and will be dealt with,” when he was questioned on two other deaths reported this year.

The two probes were initiated this year after an expectant mother from Linden, Tasya Joseph died in transit to the GPHC after being in labour at the Linden Hospital Complex for more than four days. The second death was that of Vanessa Roopnarine, whose dead foetus was left in her for days, apparently resulting in a stroke and subsequent death.

Joseph, 17, died on March 21 while being ambulanced from the Linden Hospital to the GPHC. Her relatives accused officials at the Linden Hospital, where she was a patient for over four days, of negligence saying they knew she suffered from sickle cell anemia and kept her in labour bleeding and without proper medical supervision. It was only after the woman’s condition worsened that she was transferred to the GPHC. Her baby also died although it was full term.

Roopnarine’s family accused the GPHC of neglect, since she was told at a private city hospital that she was carrying a dead foetus and it took too long to surgically remove it. She subsequently suffered a stroke as a result of gestational hypertension and died three days after with the dead foetus still in her.

“This is so unfortunate, more particularly for Linden, since last year Linden did not have a single maternal death and the previous year only one, which nonetheless had me hitting the roof,” Ramsaran said.

He added that while he cannot comment on the cases before a final report of the investigations has been given to him, he knows that the Linden Hospital is capable of dealing with high risk cases since it was equipped with relevant medical personnel and has a blood bank with the capacity of holding a minimum of 20 units of blood at a time. “Why should Linden hospital not be able to manage a sickle cell birth? Women with every ailment and sickness give birth every day. Women with cardiac problems, women with sickle cell, HIV, but we will wait on the report and action would be taken,” he said. (Marcelle Thomas)