Maternal
Problems in Kambia District |
Fatmata, a pregnant woman, told staff present at a meeting in
2004 at Kambia Hospital that there are maternal problems in
Kambia district:
What are the problems in Kambia District? Infant
and childhood mortality is high in Sierra Leone (170/1000), so women
are keen to have children to replace those who have been lost. There is little
incentive to use contraception and the use of family planning methods is
also very low in the district due to cultural beliefs.
There is no transportation for referral of emergency cases.
Late referrals to the hospital are due to late reporting and decision
making. There are no arrangements for women who are referred for operations.
Some operations are not done in Kambia because of lack of
appropriate medical personnel.
Women fail to seek medical help for many reasons: They
lack the money needed to pay for medical treatment. They
are used to being looked after by the elderly women around them
and Traditional Birth Attendants who have traditional ideas
and who are often illiterate and have little or no knowledge
of modern medical techniques and the necessary hygiene
precautions. Invariably, mothers are very frightened of hospital settings
which they have not seen or experienced before. Traditionally,
for many people in Sierra Leone, going to hospital only
happens when someone is going to die. Many women have had
little or no education, have limited reading skills and are ignorant
of how trained medical staff can help them.
The decision as to whether a woman needs medical help is
normally made by the husbands and male members of the family,
although pregnant women can gain access to health care through
Traditional Birth Attendants and friends.
If a woman dies because she did not attend the clinics, the children left behind will go out into the street to either beg or steal and this
is a further burden on the community.
The rural clinics also have problems: Kasoria
Clinic: The road network is very poor and the distance to
the hospital is far. There are only two nurses and one is not on payroll .There are no support staff .
The communication link is poor due to distance. A vehicle only travels along the route
between the clinic and the hospital once very week
The catchment area is large and people are far apart.
Konta Clinic: The road network is poor. Staffing levels are
inadequate. The distance to the hospital is far. Communication is
poor. There is a very large catchment area. There is no well.
Maselleh Clinic: This peripheral health unit is set away from the main
road, with a vast catchment area containing many villages. There is
only one member of staff and no staff living quarters.
Barmoi Bana Clinic: This clinic needs rehabilitation. The
well is not functioning. There is no communication link or transport
to the hospital How can the
situation be improved?
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Maternal health film being viewed
at Barmoi Clinic |
Attempts to improve the situation are already being improved through community
sensitization on maternal health. This is achieved through
films (see Maternal
Health Film) posters and songs which are used on a regular basis.
However, the people of Kambia District still need
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A special ambulance to
take pregnant women to the hospital.
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Communication facilities
at strategic points in the district to facilitate contact with the
medical staff at the hospital.
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More trained health
personnel, including doctors.
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Essential equipment to
combat maternal emergencies.
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Special arrangements for pregnant women with problems.
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Maternal health film being shown to
local people |
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Further information:
Childbirth in Kambia
Vesico-vaginal
fistula
Traditional birth
attendants
Training of Maternal and Child Health Aides
Visit to Kambia by midwives from Cheltenham
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