Lagging behind

Guyana’s dismal record on maternal mortality would have contributed to the near-fail the region received on this target when the 2013 Millennium Development Goals (MDGs) report was released on Monday in Geneva, Switzerland.

While Latin America and the Caribbean was referred to as one region for most of the report, the fifth goal—‘Reducing Maternal Mortality’—was one where there was significant disparity between what obtains in the Caribbean (Guyana included) and the situation in Latin America. The report said: “Maternal mortality in the Caribbean remains high, with 190 maternal deaths per 100,000 live births in 2010, and accelerated action is urgently needed to meet the MDG target of reducing the ratio by three-quarters. Latin America has a much lower maternal mortality ratio, with 72 maternal deaths per 100,000 live births in 2010.” While cumulatively, the Caribbean’s figure was 190/100,000, Guyana’s was much higher, stated as 280 maternal deaths per 100,000 live births in 2010. This is according to statistics compiled by the World Bank.

The maternal mortality rate is the annual number of female deaths per 100,000 live births from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes). It includes deaths during pregnancy, childbirth, or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, for a specified year.

Within Caricom, Guyana’s maternal mortality rate is second only to Haiti, which has a rate of 350/100,000. However, considering that Haiti has a population of 10.1 million, compared with Guyana’s 750,000, Guyana would be deemed to have a more alarming mortality rate in terms of its population density.

Part of the problem here is the reluctance by health authorities to even admit that there is a problem. What is typically seen is a circling of the wagons around those who may be responsible. There is usually an investigation, but no obvious determination of responsibility and disciplinary action, even when it is clear to a lay person that aspects of medical care might have been severely lacking.

Reports at the end of these investigations merely state the medical reasons for the deaths of these women and do not address the proactive approaches which were necessary but ignored and which may have seen a different result.

Former health minister Dr Leslie Ramsammy had made an impassioned proclamation of how “disappointed” he was with the health care system in 2010, when there had been a dramatic spike in maternal deaths (eight women had died giving birth between September and November in public hospitals around the country). But this, coupled with Cabinet’s criticism of him and then junior minister Dr Bheri Ramsaran, along with the announcement that the Cabinet sub-committee on health would look into maternal deaths, has not amounted to much.

Dr Ramsammy was removed from the Health Ministry following the 2011 elections and Dr Ramsaran was moved up into his place, but there has been no dramatic reversal in the maternal mortality rates.

In fact, since then, there have been several more deaths including those of Samantha Bruce, 17, and Chitrawattie Ramjiwan, 20, who died during delivery in May 2012 in Georgetown and Berbice respectively; 22-year-old Omadara Anthony who died in August 2012 and Kaimattie Sooknanan who died in October 2012 while being transferred to the city from New Amsterdam. Twenty-one-year-old Tushana Cameron also died in childbirth in October 2102 at the West Demerara Regional Hospital (WDRH). These women have joined the others as mere statistics, with not much satisfaction being afforded their grieving relatives.

It is only in the most recent case, that of 28-year-old Luan Rodney early last month, that the obstetrician on duty was sent on leave, following a recommendation by the hospital. And this was after outpourings by her husband and expressions of intense disapproval by the public—including a candlelight vigil held outside the hospital—regarding the way Mrs Rodney was treated and the fact that she was not monitored after being given a drug that could be considered dangerous if not administered correctly.

However, this does not answer the burning question as to what is being done to ensure that women are given adequate care during their confinement at public hospitals. If the reports into maternal deaths offer recommendations, there is no telling what they are or if they are followed. Surely we can do better than that. Lagging behind in the attaining of the fifth MDG notwithstanding, Guyana needs to and can do more to remove the spectre of death from giving birth.

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