Seeking Maternity Care in a Pandemic: Navigating Travel Restrictions
Reporting by Kasule Ahmed (Citizen Journalist), Asara Harriet and Tiko Jane (Advocacy Officers), from White Ribbon Alliance Uganda. 06/17/2020
Nakimbugwe Sharipher was three weeks away to deliver her first born when the COVID-19 lockdown was imposed in Uganda. When she visited the hospital as part of her antenatal care check-ups, she had to seek permission from local leaders to leave her home in Kampala. Across Uganda, the travel ban has created a complicated path for women to access maternity care. Without boda bodas, the motorcycle taxis abundant in the country, some women are walking long distances and risking their lives to travel for maternity care.
Twice, Sharipher had sought permission to go to the hospital from her local leaders, who provide stickers or letters for approved travel. Permission was always granted, but the travel was only authorized for the same day. Sharipher was concerned about how to seek permission if labour started in the middle of the night, when she could not seek permission in advance.
Sharipher’s concerns were realized as she went into labour during the night, unable to seek permission to travel. When labour started, a neighbour with a car came to her rescue. Under the circumstances, they did not have time to seek permission and drove straight to the health facility about 10km away. They were lucky to avoid security personnel that may have halted the journey to the hospital. Sharipher delivered a baby girl named Wendy via normal delivery.
In Adjumani District, Arach Scovia fears traveling for antenatal care, citing several instances of security personnel enforcing the travel ban with violence. Adiru Palma, a midwife at a health center in Yumbe District says many women walk long distances to reach health facilities. The difficult travel has impacted maternity services at her health center. She said; “In most cases, they arrive late for antenatal care and other services. Sometimes we cannot complete the mandatory tests that day due to limited time. Many pregnant women end up going back to their homes without receiving some services. Some don’t come back the following day”.
In response to these challenges, officials in Yumbe District have launched a new ambulance program for laboring women, training over 86 boda boda drivers in seven sub-counties in Yumbe, that are inaccessible by ambulances. To use the service, the State Minister for Primary Health Care, Dr. Joyce Kaducu, says “In case of onset of labor, at any time, [laboring women] call the boda boda, within the locality, the person comes and picks up the mother and takes her to the hospital.”
Adjumani District has employed similar measures. Idia Pauline, the In-charge of the Maternity Ward at the Adjumani Main Hospital said, “there is transport organized for pregnant mothers from the lower facilities in community to the higher-level ones. District ambulances are called to pick up the women and take them to higher facilities, but also take them back after delivery, which is a good thing.”
While women navigate the travel ban restrictions, they must also navigate securing provisions for both their newborn and themselves after delivery during the COVID-19 lockdown where shops and markets selling non-food items are closed and the women lack money to buy necessities due to closure of their small business. Sr. Idia said, “Several items are missing in the maternity ward such as masks, gloves, jik (disinfectant) and mama kits.” The health centre’s lack of supplies has placed an additional burden on expectant mothers, who must now provide some of the necessary items such as gloves. She went on to say, “Last week, a 16-year-old girl delivered at the hospital and didn’t have any baby clothes. The midwife who delivered her used a hospital bedsheet to cover the baby. Other mothers who were admitted in the ward helped her with other items. Expectant mothers who had not prepared earlier don’t have baby’s essentials and all shops are closed. The hospital has no mama kits to help them. Other mothers who live far and admitted at the hospital have challenges feeding themselves. Due to restrictions in movement, their relatives can’t bring for them food.”
In the What Women Want Campaign, women identified mama kits, medicines and supplies as their biggest need for quality maternal health care in Uganda. Listening to these demands could have alleviated some of the burden these new mothers are facing in an already uncertain time. The Global Respectful Maternity Care Council, convened by White Ribbon Alliance, launched the Safer Together campaign to help women, health workers and governments navigate this unprecedented crisis, together. Join the campaign, and help everyone stay safer, together.