The practice by government officials to make grandiose pronouncements on issues around the time of national or international observances of said issues has been so overdone that it has become expected. It was therefore unsurprising that Minister of Public Health Dr George Norton was quoted as stating that six months maternity leave would soon be legislated in Guyana to promote and support exclusive breastfeeding of babies for that time period. Nor is it the first time the six-month maternity leave idea was floated. Similar pronouncements were made last year by Minister of Social Protection Volda Lawrence, at a consultation held to address the issue of women in paramilitary and military organisations being fired because they became pregnant ahead of a time period stipulated by those organisations. And earlier this year, both Dr Norton and Ms Lawrence vocally supported the extension of maternity leave, which would bring Guyana in line with PAHO breastfeeding guidelines.
The health benefits afforded to both the mother and child through exclusive breastfeeding are well known and well documented. All the available evidence shows that this is no gimmick; exclusive breastfeeding, among other things, prevents the contracting of diseases that would otherwise plague infants. And even if this were the only benefit, it should definitely be championed. There are a few rare cases where, for health reasons, mothers are unable to or should not be allowed to breastfeed. There are also instances where mothers choose not to breastfeed and these are the cases where the Ministry of Public Health and the pro-breastfeeding lobby would have much work to do.
The actual enactment of legislation to extend the current three months of maternity leave to six months, however, falls under the purview of the Ministry of Social Protection as it is in fact a labour issue more than a public health one. And it is significant enough to warrant wide consultation among employers, employees and their trade union representatives prior to legislative changes being made.
The Ministry of Public Health, therefore, should place more focus on ensuring that the environment at all hospitals, and particularly public institutions, is conducive to the safe delivery of pregnant mothers and that babies actually have a greater chance of staying alive.
The incidence of maternal mortality at local hospitals has been pegged by a joint World Bank, World Health Organisation, UNICEF and the United Nations Population Division report in 2014 at a horrific 250 deaths per every 100,000 live births. This was the second highest rate in Latin America and the Caribbean, the highest being that in Haiti. Meanwhile, the infant mortality rate was placed at 32 per every 1,000 live births by statistical data obtained by the World Bank in 2014. And because the local data collection is patchy, there is every chance that both figures are higher than quoted by these international organisations.
What is not inconsistent though is the common thread running through the stories of loss and grieving linked to these statistics. The prevalence of women who need but are denied life-saving Caesarean sections; those whose gestational hypertension and other risk factors are ignored or not monitored; these are the horror stories that produce the statistics. But one supposes that all of these protestations about the lack of care must be wrong. Because of all the endless investigations conducted into maternal and infant deaths, both by this administration and the previous one, no medical professional has ever been sanctioned—at least not publicly—for failing to perform his/her duties.
Women who survived while their babies died, can and have spoken about the hostility and lack of empathy towards their condition by nurses especially. They do not lie. Others with known complications whose children have lived speak glowingly of those medical personnel who do their jobs well and have also gone beyond the call of duty.
Championing exclusive breastfeeding is commendable; it is also a relatively easy way of scoring brownie points. Ensuring that a high standard of care is exercised across the board at all medical institutions appears to be much more difficult. But this is the crucial issue that the Ministry of Public Health must grapple with head on and formalize. Surely, saving lives goes beyond the rhetoric.
