At the Nyarugusu medical dispensary in north-west Tanzania, Eva Paulo, 23,
is in her 36th hour of labour. She paces barefoot in circles around the dusty
yard behind the delivery room, her narrow back hunched in pain. Apart from her
belly she is a slim woman with an angular face, her hair scraped back into rows
of tidy plaits. When a contraction grips her, Paulo leans hard into the nearest
tree, shuts her eyes and breathes silently as the sweat beads off her forehead.
“This is too much,” she says, as another contraction racks
her. “I don’t know why it’s taking so long. And the midwives, they don’t tell
me anything.”
It is, of course, the universal complaint of women in labour
the world over. But for many women in Tanzania, “natural birth” isn’t a
preference or an accomplishment – it’s
the only viable option.
Paulo is about to give birth for the fourth time in the most
basic hospital conditions imaginable. The dispensary is composed of two
unassuming cinder-block buildings in a jacaranda thicket halfway up a hill.
While the staff will do their best, Paulo will receive no pain relief, no
foetal monitoring and no medical interventions. The lack of doctors means
caesarean sections are not performed here.
Another problem – from which so many others stem – is a lack
of water. There is no running water for hand-washing, sterilisation or laundry.
Toilets are filthy, squat outhouses a short walk from the building.
Each morning, staff at the clinic buy 20 jerry cans of water
from a local vendor for 500 shillings (about 16p) each, for basic cleaning. The
money comes out of their own pockets, which is significant for nurses who earn
less than £200 a month. Because of this, pregnant women are required to arrive
with their own water.
Paulo’s water sits in the birthing room – three large vats
of murky liquid purchased from a shallow well near her house an hour’s walk
away..... read more here
News credit : The Guardian
Photograph: Sameer Satchu/WaterAid
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