TBAs continue to kill mothers

BY PAUL ARUHO SHEEMA: When Mercy Nuwagaba decided to seek the services of a Traditional Birth Attendant (TBA) little did she know that it would be the same time she would meet her death. A mother of two had conceived a pregnancy she never wanted at that time. She thought Manjeri Byesizibwa, 72, a reknown TBA in Buringo Masheruka sub county in Sheema district would terminate her pregnancy. Nuwagaba was wrong. She went through the whole brutal procedure but did not live long to take care of the two children she had already. At the hands of Ms Byesizibwa, she bled heavily and was rushed to Kigarama health center IV, where she died a few hours after her admission. Ms Byesizibwa known by locals in the village as a nurse she holds a certificate of attendance as a Traditional Birth Attendant and has been helping mothers to deliver for many years. Byesizibwa said that she has been doing this for years she does not remember, but in 1998, she was trained as a TBA. Although she is aware of that services of TBAs were abolished by the ministry of health, she has continued to make deliveries. “Women always come to me when in labour and I cannot leave them in pain. Some tell me that they don’t want to go to health facilities because when they fear to be operated on,” Manjeri who is now detained at Kabwohe after the death of Nuwagaba said. She confesses that she has been doing her job well until this incident on 7 April of Nuwagaba. She said that for every mother who come to her, she charges shs20,000. She also confessed to the police that she has been aiding girls and women to abort who come telling her that they fear to go to health facilities but sad “it is unfortunate that Nuwagaba died.” The Sheema district police commander, Ezekiel Emitu said that Ms Byesizibwa was going beyond what TBAs do. He said that investigations indicate that she has been carrying out abortions which are illegal in Uganda. “Residents call her a nurse for the work she has been doing. Her case is serious because we got shocked when we found a grave yard in her banana plantation where she says she has been burying the fetuses. She would just dig a few feet deep and bury,” Emitu said. Emitu refused to indulge in more details as he said that in Ms Bwesizibwa’s case, there are many local leaders involved and was not at liberty to reveal. When I visited Ms Byesizibwe’s home, there was a lot to wonder about. She has all it takes like a health facility. There was a labor ward with a delivery bed, an admission ward and a bathroom. There was a pit, which police suspect that there could be bodies of adults as police stopped opening it up as they didn’t have the gadgets. In her house, there are two patients who need her care. Her husband, Seezi Byesizibwa and a daughter only identified as Mauda are bedridden. Mauda has been in this condition for 30 years. Her step son, Hebert Matsiko 40, who stays in the same compound, said that he knew her step mother as a TBA but was not aware that she carries out abortions. He said that he has five children and his wife has never gone to hospital to deliver but instead enjoyed the services of her mother-in-law. “I got to know about this when I saw police coming to arrest her. I have known her as a traditional birth attendant and she is the one who helped my wife to deliver our five children,” Matsiko said. He said that as a step mother, he didn’t bother knowing her business saying that there was a time when he saw a sickly looking young girl in her house but when he tried to inquire, she was bitter with him. Matsiko said that since then, he has always kept a distance from what she is doing. Uganda National Health Consumers’ Organisation (UNHCO) has been running a Maternity health project in Sheema district. The Programs officer Mr Moses Kirigwajjo said that they had reported about the activities of Ms Byesizibwa but district leaders had not taken action. He said that this should be used as a yard stick to enforce the law of stopping on TBAs. “We have on several occasions reported the activities of Ms Byesizibwa to the district leaders but they have been reluctant to act. We had also agreed with them to meet all TBAs in the district, as she is not alone, but the meeting had not taken place and this incidence (of Byesizibwa) happens,” Kirigwajjo said. The Executive Director for UNHCO Ms Robinah Kaitirimba said that the mortality rate is going high in the country. She however said that such deaths are not recorded because women die in secret and no body bothers. She said that government should do research and find out why women have continued to go for TBAs when health facilities are in every sub county. “There is need to give much attention to the training of health workers. We have talked to women and they say TBAs are skilled and don’t abuse them. The death of a mother is costly and we must end this,” Ms Kaitiritimba said. She said that senstisation of women should be given a priority; to make them know that there are better services in our health centers and that TBAs are dangerous to their health. She said that TBAs should be put on a village health team such that the identify women who are pregnant and refer them to a health facility. Shunning contraceptives The Bushenyi district Reproductive Health Uganda (RHU) in-charge Stephen Karamuzi said people have continued to shun contraceptives making them to conceive unwanted pregnancies. Karamuzi said even young people must be educated on the use of contraceptives in order to avoid such deaths. “An abortion is as a result of a pregnancy you never wanted. Contraceptive uptake is very low and people have continued to get unwanted pregnancies. We must make information on contraceptives accessible to even young people such that they make informed choices,” Karamuzi said. He also said that lack of support from men has also resulted into these crude methods of abortion. He said start to blame their wives when the get unplanned pregnancy which force them to abort. The Sheema district health Inspector Mr Francis Mugume said TBAs have gone beyond their scope of operation. He said that they were not meant to aid women to abort which has claimed a number of lives. He said that it was disturbing to find Ms Byesizibwa inducing abortion. He said that police is involved because is a person dies, police has to come in. End item

Our Children, our future

Today, 6 April I appeared in a morning talk show on one of the radio stations in western Uganda. We were four panelists and a moderator talking about ‘Bringing up children’. All of us agreed that parents have continued to have a big challenge in bringing up children due to the current life styles and trends. We explored the need to earn in order to contribute to the economics of the family, where by both parents have to work. This situation has continued to keep parents away from home, making children more vulnerable to any unexplained situation. Parents have continued to leave their young children at the hands of house maids whose character is questionable. In Uganda, we don’t have companies that can train house maids such that one hires them. We instead bring these young girls from our villages, who are either school drop outs or orphans whose upbringing is also wanting. These are the type of house helps we bring in out homes to look after our children. There is an old saying that ‘it takes a whole village to bring up a child.’ But this used to happen long time ago when capitalism had not invaded our communities. These days, no one will seem to care about your child. Each family looks after itself and God is the one who is for us all. For us when we were growing up in 1980’s we respected our neighbor more than our own parents at home. It would be a serious crime for a neighbor to find you in wrong. We would make sure that we behave ourselves on the way to school because we knew someone was watching us. But to day things have completely changed. You meet a child on the way who hardly greets you and when you try to ask a few questions, you will be lucky if this child does not abuse you. In the past, everyone worked towards the wellbeing of every person in the community. These days we are seeing selfishness and the ‘I am not my brother’s keeper’ situation. I don’t know whether this trend can be reversed. There is another issue of boarding schools especially the private ones. I have one several occasions, on my visits to primary schools, seen children of 3 years boarding. This is a serious mistake parents we are doing. According to the chairman of Uganda National Examination Board and a consultant in education, Mr. Fagil Mandy, it is dangerous to take a primary level pupil to a boarding school. He says that this is the time a child needs the guidance of parents and to create a strong relationship with them. He asked parents to at least take make their children board when they join secondary school. In this, we have left our children at the hands of teachers who hardly have enough time for all the children in their care. Religious studies have for many years instilled discipline and respect in our children. While in school, there was compulsory prayers every morning. This could help us love our religious and God at it. Today, teachers no longer have these programs in our schools. They are interested in good grades, which the government puts them on pressure to, forgetting that this child needs morals. The government (leadership) has also not done enough in helping parents to bring up their children. They are more interested in telling our children about their rights for getting that these rights go with responsibilities. There is not effort in their budget to program for the young who takes the highest percentage in the country. Lastly, bringing up children should be a collective responsibility. Parents, teachers, the community and government should come up to disciplined and respectful children for these children are our future. As I said, “it takes a whole village to bring up a child”. I wish everyone good parenting.