ARUSHA – Mathabo Ngomod lost a lot of blood after the delivery of her son in the rural district of Xhariep.
To save her doctors used blood donated by one of her relatives.
Unfortunately the donated blood that was meant to save her life killed her four years later due to HIV/Aids related illnesses.
Before delivering her child Ngomod was forced to test for HIV in order to protect her unborn baby. She was negative.
Ngomod’s husband James who is HIV negative blames medical staff for the death of his wife.
But the nurse who assisted Ngomod to deliver said shehad used all available resources to save Ngomod and the child including asking donors with the same blood group. Unfortunately there was no laboratory to screen the blood.
“I followed the guidelines and was aware that blood had to be screened first but there were neither resources nor time to allow for screening. However, I managed to save a life though it was for a short time,” said Grace Tshabalala, the nurse who assisted Ngomod.
The case of Ngomod is common in many African districts including Free State. There are no laboratories and enough resources to attend to emergencies which results in the needless loss of lives.
Ngomod is one of 35,000 women who died due to maternal complications in 2010 with her unborn child being counted in the825, 000 infants who die annually in the 14 East Central and Southern Africa (ECSA) Health Community member states.
Obstetric haemorrhaging was the second most common cause of maternal death, accounting for 688 deaths or 14.1 percent of the total. This is considered to be an avoidable cause of death involving bleeding during and after a caesarean section procedure.
Findings in a report compiled by the Saving Mothers campaign shows that almost 5 000 women died while pregnant or within 42 days of giving birth among ECSA member states between 2008 and 2010.
The report has revealed that 86.5 percent of deaths were attributed to non-pregnancy related infections (NPRI).
Most of these NPRI conditions were diagnosed before birth. Pneumonias (lung infection) contributed to two-thirds (67percent) of the NPRI deaths, followed by meningitis (12.9 percent) and gastroenteritis (5.2 percent).
Researchers noted that brain infection complications caused by antiretroviral therapy, although fairly rare, increased significantly in 2010, over 2008 and 2009. Liver complications and Stevens-Johnson syndrome were the most common.
Commenting on rural health workers Dr Ahmed Hingora said: “It is unfair to blame nurses who worked tirelessly to save a life for the death of Ngomod.
The nurse was not negligent; she knew the guideline and had only one option; either to watch a patient die from loss of blood or use the donated unscreened blood. If the laboratories were there it would be reasonable to blame the nurse for such deaths,” Dr Ahmed Hingora said.
Instead he blamed governments for lack of political will to improve the situation.
“The resources such as laboratories must be placed in the rural areas where people are vulnerable and prone to sickness. It is difficult to travel to town because most of communities in rural areas are not employed. Their lives could only be saved if services are brought close to their doorstep,” he said.
In Xhariep district the government has built a hostel for pregnant women living in the rural areas in an effort to reduce maternal deaths. Pregnant women are accommodated in this hostel during later stages of their pregnancies so that they can be close to hospitals where they can be treated immediately if ever complications of delivery emerged.
In an effort to reduce maternal deaths in Free State, the department of health is working closely with community based support groups and village health workers to equip with skills on how to react during an emergency.
“Community health workers serve as coordinators between patient and health centres,they are there to refer patients to hospital. However they have been trained in the best health practices although they can only react to emergencies such as when a pregnant woman delivers on her way to hospital or it is too late to take her to the clinics,” said Professor Noma French-Mbombo.
“Delivery of quality health to patientsdoes not depend only on skills and professionalone, the attitudealso counts.
“While some nurses have skills and competence to do theirwork, bad attitude towards patients outshines their work. As a result many patients prefer to be treated at home where they are taken care of with love.
“Therefore there is a need to empower the local community who had already formed some support groups and joined hands to take care of their patients,” the Cape Townbased professor Mbombo said while addressing a health directors conferences held in Arusha, Tanzania under the slogan “Accelerating and scaling best health practice.”