Kigyezi Safe Motherhood: support pregnant mothers in Rukiga District

Photo: Portable ultrasound presentation to Mparo Health Centre IV, February 17, 2023

My letter about the disparity in healthcare access in Uganda triggered many responses from readers, the majority of whom agreed and shared their own experiences as patients or relatives of health care seekers. Quite a good number recognised their responsibility to contribute to solutions to problems in their own communities.

For avoidance of doubt, I should state very clearly that it is the responsibility of the central government to provide effective, safe, equitable, accessible, and modern health services to Ugandans. Citizens have the right to demand and to expect services that their rulers and political representatives enjoy.

So, lamenting about the problem is perfectly fine, indeed necessary, to draw the rulers’ attention to a community’s predicament. However, citizens also have a responsibility to themselves and to others through voluntary contribution to the improvement of healthcare and other social services in their communities.

A problem that cries out for help from volunteer citizens and other well-wishers is the high rate of maternal (mother) and neonatal (baby) death and sickness due to pregnancy and/or birth. Uganda’smaternal mortality ratio for women aged 15-49, reported to be somewhere between 336 and 375deaths per 100,000 live births (2022), far exceeds the United Nation’s Sustainable Development Goal(SDGD) to reduce the global figure to less than 70 per 100,000 live births by the year 2030.

Likewise, Uganda’s neonatal mortality rate of 19.2 deaths per 1,000 live births is well above the SDG to reduce the global rate to 12 deaths per 1,000 live births by the year 2030. We have previously discussed the multiple cultural, economic, and social factors that conspire to cause these largely preventable deaths. They need to be addressed together with the purely medical causes to move towards achieving the UN’s goals.

There is an 80-year-old health centre at Mparo, the headquarters of Rukiga District, which has the usual challenges of similar centres in the rural areas. It is the largest in that small district of 100,000 people. While it was once a well-provisioned health centre, it has had challenges, including nationally reported incidents of maternal and fetal deaths that appear to have been caused by lack of resources. This time last year, a young woman and her baby died because of a torn uterus (womb) and excessive haemorrhage (blood). We recorded that tragic story in this column.

One couple from Mparo chose to do something to help prevent recurrence of such tragedies. Upon learning from the doctors at Mparo that the absence of an obstetric ultrasound and lack of a refrigerator for storing blood for emergency transfusion may have contributed to the occurrence of the tragedy, the couple (who prefer anonymity) mobilised friends to come to the aid of the women of Mparo. They put together enough money to buy a state-of-the-art, portable colour obstetric ultrasound for Mparo Health Centre. The machine, worth UGX37 million (US$10,000) was formally handed over to the health centre on February 17, 2023.

Of note is that that ultrasound machine and its peripherals were purchased from Future Medical Equipment Ltd in Kampala after being evaluated and approved by Mr. Darius Orikiriza, a nurse and sonographer at Mparo Health Centre IV, who travelled to Kampala to ascertain its suitability. Mr. Orikiriza received training by the biomedical engineer at Future Medical Equipment Ltd. Buying the machine in Uganda was a wise decision, for it ensured local serviceability and warranties.

Obviously that donation was a tiny drop in an ocean of challenges that Mparo Health Centre faces. Much more needs to be done to bring the maternal-child health care services in line with international minimum standards. Whereas the health centre has very good doctors, nurses, technologists and other staff, the lack of basic things like reliable electricity supply, back-up transportation, and staff housing undermine their work and increase risks of potentially negative outcomes for pregnant women and their babies.

Recognising this, a team of like-minded people from Mparo have volunteered to form an organization through which they plan to raise funds for the sole purpose of supporting the government’s efforts to provide maternal and child health services at that Health Centre IV. The founders of that organization, which they have called Kigyezi Safe Motherhood Ltd, include Dr. Grace Mafigiri Kalimugogo, a retired medical doctor, Bishop Onesmus Asiimwe of North Kigezi, and Mr. Bruce Kwarisiima Kyerere, a senior lawyer in Kampala. These and other members of the team are all natives of Mparo.

The dreams of this team are: (1) To establish Kigyezi Safe Motherhood as an efficiently, transparently, and accountably operated volunteer charitable organization to provide support for the maternal-child health program at Mparo; (2) To fundraise for the purchase of other needed equipment; (3) To support the development of sustainable educational programs with local and international support for doctors, nurses, midwives, doulas, nutritionists, and respiratory technologists; (4) To support the enhancement of the current facilities with upgraded electricity supply, sanitation, structural and other physical improvements; (5) To support other efforts to attract and retain the best professionals at Mparo.

The team has been greatly encouraged by the support they have received from the political, administrative and health service leaders of Rukiga District. They are also working with an organisation that has been formed by friends of Mparo in Canada. The latter organization, called Mahali Salama International (Safe Place International), has a sole agenda to enhance, in partnership with local and international communities, a self-sustaining, comprehensive maternal-child health program in Mparo, Rukiga District.

This is the kind of volunteer collaborative effort that is needed in every district of Uganda. Ugandans are endowed with a healthy spirit of sharing their money with others in need. One is always impressed by the generosity shown during fundraising for weddings and funerals. Furthermore, the giving spirit of alumni of schools like King’s College Budo, Gayaza High School, and Nyakasura School, has been a pleasure to watch as they have continued to modernize their alma maters. It is comparable to the generosity of Canadians whenever there is a need to build, expand or renovate hospitals. When Canadians see a need in their community, they take ownership of it, and respond with great enthusiasm. They do not leave the responsibility to the governments.

It is in that spirit that I invite the sons and daughters of Rukiga District to prepare to join the volunteers who want to create a safe place for pregnant women and their babies, and a centre of excellence at Mparo that will supplement the efforts of the national and local governments. Replication of this effort in every district is worth considering by the sons and daughters of the land. Ultimately, we, the citizens, will be the beneficiaries.