Posted on March 15th, 2012 in
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Highlights
To help reduce maternal mortality, a U.N. Millennium Development Goal for 2015, OCHAN has opened a modern maternity ward at Ocan Community Clinic (OCC). The event attracted 120 women, clinic staff, and Ocan Agenne (local NGO) officers, along with Dr. Acepa (consultant OB/GYN), local and regional elected leaders. By presenting to the women services newly available at the clinic through donors’ generous gifts, OCHAN hopes to spread information that encourages women to consider the clinic as a safer birth option than home delivery. At this event on the clinic’s veranda, OCHAN presented major gifts from U.S. donors, including a solar fridge for the safe storage of vaccines and free delivery kits which drew loud applause from the women. In Uganda, women have to provide their own supplies for the clinic attendant to use during delivery: cord clamp, cotton wool, sterile gloves, sheeting, etc. These kits cost the patient the equivalent of $13 and have been an economic barrier to giving birth in a clinic.

Dr. Tom prepares a volunteer to hear her unborn's fetal heartbeat using a battery-operated machine held by the clinic's medical officer.
Dr. Tom Boto demonstrated his gifts to the clinic, including a fetal heart monitor. He explained its role in monitoring the health and growth of the fetus; in so doing, he encouraged the women to attend prenatal sessions. The women leaned forward in amazement to hear for the first time ever the tiny heartbeat of the unborn inside a volunteer’s womb.
Because inadequately trained Traditional Birth Attendants at home deliveries have been considered part of the cause of high maternal mortality, the Uganda Government is phasing out their services in the communities. The women, having to turn elsewhere for a safe, affordable delivery, look to local clinics for assistance.

First baby to use resuscitation bed for a short while after birth
Among the generous gifts from St. Margaret’s Church, Annapolis, are three custom-made beds–for delivery, examination, and baby resuscitation. In addition, their funding of the delivery kits is a strong inducement for women to choose the clinic. A church in Baltimore County, MD, has augmented this wonderful gift by adding a small layette and something refreshing (ex. a bar of scented soap) for the new mom. Members of St. John’s Episcopal Church, Glyndon, are currently raising money to fund these “Mama kits” as a further inducement for women in Opac and surrounding communities to consider OCC for their deliveries.
The gifts mentioned above, all of which have had a stunning multiplier effect on women’s reproductive health in the community, fill the hearts of the women and OCHAN with gratitude. Being able to provide inoculations now at the clinic saves mothers with infants a seven-mile walk or bicycle taxi to a vaccine facility. Now, women from an ever widening geographical area come with their babies to the monthly vaccinations offered on the clinic’s veranda. The number of attendants at each of these sessions is about 80. We hope attendance will continue to increase.

October 2011 vaccine session for children on the veranda of the clinic. Mothers hold the vaccine record cards. Mr. Acuma, the medical officer, is at right administering a vaccine.
The Problem
Maternal mortality in Uganda is stalled where it was last year at 435 deaths per 100,000 live births. (In the U.S. there are 20 deaths for every 100,000 live births.) This grim situation is the focus of several recent news articles as summarized below:
“Maternal Deaths focus Harsh Light on Uganda,” by Celia W. Dugger, The New York Times, July 30, 2011, narrates the experiences of two women in labor who, left unattended, bled to death in different clinics in Northern Uganda. The stories of Jennifer Anguko and Ms. Nalubowa heartbreakingly underscore the state of reproductive services in rural Uganda.
Facts from “Activists Take Maternal Death fight to Court,” by Evelyn Lirri, Saturday Monitor, June 11, 2011, informs the readers in Uganda on critical aspects of the issue including the following: 1) Causes of maternal mortality; 2) key issues in petition to the Constitutional Court (of Uganda); 3) key maternal indicators (which includes hemorrhage as one of the key causes of death along with frequent births previously and lack of skilled birth attendants); 4) a critique of the Traditional Birth Attendants.
“Maternal and infant mortality, morbidity unacceptably high,” by Dr. Imelda Namagembe, New Vision, August 25, 2011, includes some disturbing facts and trends in Uganda: 1) 32% of all infant deaths are neonatal deaths. The highest risk is within the first 24 hours after delivery; 2) The number of skilled birth attendances needed is still below 42%; 3) a sizable number of Ugandan women face advanced cancer of the cervix, which is preventable; 4) Gender-based violence is on the rise; 5) Commitment is needed in several areas including addressing the issues of human resource staffing in the rural health facilities and equipping them.
Good news from the clinic

Helen Abua, gave birth to baby Amony, a girl, at OCC in October 2011
OCC in Opac Village should be able to provide pregnant women and newborns improved, safer care not only when specific equipment and staff are in place but when safeguards are available to protect the lives of mother and her baby during/after birth. As of the end of January, 20 women had given birth in the clinic since the maternity ward opened in late August. OCHAN thinks this rate will increase with the prospective hiring of a female midwife with whom women’s cultural shyness will not be an obstacle.

Agnes Auma with her baby boy, Omara, born in the clinic 8 hours earlier in February 2012
Joseph Kony will not have the last word
The appalling condition of maternal/child health in Northern Uganda necessitates urgent action. Though Joseph Kony destroyed the entire healthcare service during the 20 yr war, his reprehensible acts should not be the finale. There is a saying that the best revenge (against an enemy) is to live well. OCHAN is helping the Opac community do just that through several resettlement projects as discussed in other posts. In this writing, rescuing women’s health is the focus. The community needs access to counseling on family planning, reproductive health, prenatal care, and trained, well-equipped attendants for their deliveries. OCHAN will continue to report on this issue and, hopefully, on obstacles that have been overcome to make OCC a safe haven for women during their reproductive years. In 2009, the leaders of the women farmers had listed locally accessible modern health care as a critical need, because most of the women farmers were still of child-bearing age with no adequate services available in reproductive health–clinics having been looted, their staff having fled during the war years. Dear reader, your kind donations are translating into a tangible safety net for women. Please keep the clinic in your prayers as it ramps up its capacity to serve the true engines of economic development, the women of Opac. Better healthcare for the women of Opac and their families will be the last word.

The Nile River squeezes through a narrow gorge at Murchison Falls before continuing its epic journey north.