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#CSW58-MDG 5: Promoting Maternal Health


When I reflect on the risk and sacrifices that women make in this world, it makes me wonder when, why and how it came to be that in many parts of the world, they are regarded as second class citizens. What am I saying?

According to the Zimbabwe Demographic Health Survey (ZDHS) of 2011, at least 10 women die every day due to pregnancy-related complications. Did you hear that, 10 women die every day while giving birth to children, some of them sons, who will then turn on their mothers, sisters, aunts, nieces and cousins and treat them as second class citizens. Isn’t that ironic?

Millennium Development Goal 5 is definitely one of the goals that Zimbabwe will not be able to meet. With maternal deaths estimated to be above 960 deaths for every 100 000 live births, the target of reducing maternal deaths by three quarters can remain an aspiration for now. Given that the 960 deaths are official statistics, which God knows how accurate they are, with the way our government is out of touch with the issues on the ground on so many levels, the rate is possibly even higher.

Let us assume for a minute that these statistics in fact are right, I am still perplexed by the worrying trend that factors such as education, class, location and age are no longer critical in determining who is affected. Uneducated and educated, poor and rich, rural and urban, and older and younger women are all dying in child birth. Clearly there are hidden nuances to the problem and successfully dealing with maternal health will needs exploring these. For instance, cases of celebrities who passed on in child birth, grabbed the headlines, raising the need for a more concerted effort into addressing the issue of maternal mortality.

What are some of these nuances?

  • We simply do not have enough trained health professionals to deal with the delivery of our babies. Our nurses left and we are not doing much to motivate those who remained behind to remain in our service and to be motivated at work.
  • The private health-care system has not been effectively regulated. Just in the past year I have had 2 friends and a relative who have had nasty encounters with private health practitioners. The first friend went to a reputable women’s health centre where she was told she had a growth in her uterus and needed to have her uterus cleaned. Fortunately for her, she chose not to do that and sought a second opinion. Guess what-the supposed ‘growth’ in her uterus was a baby. And to think these people have advanced machines for scans and all that other fancy stuff!!

Another friend elected to deliver her baby through a Caesarean and informed her gynaecologist of her choice. However, he kept pushing the dates for the performance of the Caesarean forward, in what she feared was an attempt to create complications in her delivery, leading to her increased stay in hospital and increased bill=more money for the doctor.

My other relative had had two babies, delivered through normal births without any complications. However for her third baby, the doctor dramatically chose to ‘induce’ her labour prematurely. She could not understand why he did so when her labour was not delayed and her pregnancy was advancing normally. Eventually she found out why when the bill came with a breakdown of:

  1. Costs for inducing labour
  2. Costs for delivering the baby
  3. Costs for doing the ‘stitches’ on the mother
  4. Costs of medication to clean the wounds

She also complained that the same doctor had developed a reputation of forcing women whose babies he delivered to have more ‘stitches’  or proclaim non-existent complications requiring caesarean delivery because doing so meant he would charge more for sewing them back together and performing the surgery. It seems the love for money far exceeds the observance of medical ethics these days.

What have we done well?

  • Our implementation of the Prevention of Mother to Child Transmission programme (PMTCT) has significantly reduced cases of HIV/AIDS infections in children at birth. HIV testing has improved and the responsibility lies with the mothers to choose life for their children.
  • The adoption of the National Campaign to Accelerate the Reduction of Maternal Mortality (NCARMM) directly corresponding with the African Union (AU) Campaign on the Accelerated Reduction of Maternal Mortality in Africa in itself is an important development as it affirms government’s recognition that maternal mortality is a serious problem that needs addressing.

What have we not done well?

Government admits that most maternal deaths are a result of time taken to seek healthcare because of ignorance or lack of funds to pay for hospital care; time needed to reach a healthcare because hospitals are too far and there is no easily accessible transport to and from the health facility or the cost to do so is high and unaffordable and time taken to access care at the health facility-where there is generally an air of neglect of women in health-care facilities by highly unmotivated nurses.

Generally health services are inaccessible particularly in rural areas where hospitals and clinics are not within easy reach and the transport networks to the major clinics and hospitals are not easily accessible. Increasingly, the service in hospitals, particularly public/government hospitals, has deteriorated and has become poor. Pregnant women suffer neglect in hospitals resulting in some avoidable losses and deaths. Socio-economic challenges, related with the current economic environment significantly impact women’s access to medical services as they cannot afford to pay the user fees. There has been reduced uptake of contraception for inexplicable reasons.

What more can we do?

  • We need to adequately fund all our health institutions. Although a government policy stating that women should not pay user fees exists, it is impractical. If clinics do not make women pay, then they will not have the gloves, medication and swabs to attend to the women at child birth. Until and unless government adequately funds these facilities then the assertions that user fees have been scrapped will remain what they are; mere rhetoric!!
  • We must address religious and traditional practices that deny women access to medical facilities or that delay until patients are in critical condition. Zvitsidzo (Apostolic sects’ version of maternal wards), located in bushes in the middle of nowhere, secretive and denying access to the public, are an example of how maternal care is being compromised. Because of the veil of secrecy that these sects throw over these spaces, it is not clear how many women actually die and whether there are any complications that women have to live with for the rest of their lives for failing to give birth in certified maternal health care facilities.
  • We must maintain our reliable supply of contraception BUT we must find out, through comprehensive research, why there is reduced uptake of contraceptives.
  • We must take measures to motivate our nurses to do their jobs effectively. Without the necessary incentives, women will continue to lose their lives in avoidable circumstances.
 

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#CSW58 Zimbabwe’s progress- MDG 1: Eradicating Extreme Poverty and Hunger


Over the past 15 years, Zimbabwe has not made great strides in achieving the goal to eradicate extreme poverty and hunger due to the economic decline that has persisted since 2000. Although efforts have been focused on improving economic growth, with our GDP improving from 5.4% in 2009 to 9.3% in 2011, the process of growth has not been inclusive. A comprehensive approach to ending poverty and ensuring inclusive growth, to me, would mean
1. the creation of decent employment;
2. the promotion of entrepreneurship through development of ICTs and other infrastructure;
3. the enhancement of access to and quality of social services;
4. a reduction in inequality between men and women and between social classes;
5. the promotion and implementation of a strategy to address the effects of climate change and the environmental hazards it brings

We still have a lot of our people living on less than $1.25 per day which is the global index measure of extreme poverty. Between 1990 and 2012 we only managed to reduce hunger by less than 10% while other countries such as Ghana, Congo, Mauritania, Malawi and Angola reduced hunger by a margin of 50% or more.

There is limited availability of loans translating into poor access to loaning facilities. This means more corruption by those who hold the reins to the finance, but of course in Zimbabwe that has a different name-it s called sanctions. The conditions of accessing the loans are extremely stringent for women, who predominantly are outnumbered by their male counterparts in owning immovable property that is required as collateral. If anything the last 15 years have seen increasing levels of poverty as our country has lost its middle class to create two classes, the poor and the rich. I am one of the poor. The majority of women-66% are in the informal sector, providing domestic labour and farm labour. Only 34 % are in formal employment.

What have we done well?

  • There is a marked decline in the number of underweight children under the age of 5 from 11+% in 2009 to 10% in 2012. This means that our fight against malnutrition in young children has largely been successful. I reckon the feeding schemes in schools and hospitals are what has paid off. I am not sure how these will be sustained since most are funded by donors (read western stooges and detractors).

What have we not done?

  • Our agricultural sector has not been performing well and we are being mocked, left right and centre as the classic example of a nation that turned from a bread-basket to a basket case. Food insecurity has also increased as a consequence of increasing concentration in commercial cash crop farming rather than growing food crops.
  • We continue to marginalise the people who till the land-the women- in land allocation processes. Only 20% of the beneficiaries of the land reform are women.

Photo

  • We redistributed land to poor peasants but have not followed up their ability to utilise the land through the provision of capital.
  • We have no data on how well we are doing. Most of the available statistics are outdated to 2011 [Is this a reflection on the incompetence of ZIMSTAT or are they just underfunded?]
  • We do not have gender disaggregated data [again this is an indictment on ZIMSTAT to pull their socks up].
  • We have not and are not adequately funding women dominated sectors of the economy including small scale farming and other small to medium enterprises (SME’s).
  • We have no comprehensive social protection services [and how could we when our National Social Security Authority (NSSA) is busy investing the funds workers contribute  in shady deals]

What more can we do?

I have a proverb that I like which says “Give a woman a dollar and she will either create another dollar or feed her family with it. Give a man a dollar and he will buy a beer.” Yes, this may sound stereotypical of men but the reality on the ground indicates this is true. The majority of women place the needs of their families and children above their own in almost any given circumstance. This is why a wise government should know that ending poverty is possible when we invest in our women. This is what I propose we do;

  • Our commitment through the budget to fund women’s projects must increase and extend to ensuring equitable, non-partisan distribution of the funds. This business of giving farming inputs to certain political-party-card holders should stop.
  • We need to increase women’s participation in both small scale initiatives and large scale ones, be it in mining, agriculture, fisheries or any other area.
  • We must recognise the informal sector as the current backbone of our economy and give better protection to the women in the informal sector through enacting the relevant legislation. Current labour laws are focused on regulating the formal sector with very little attention paid to the informal.
  • We must negotiate the inter-Africa trading space with women in mind. Our cross-border traders, who are predominantly women, need a friendly and safe working space to enable them to continue to provide for their families. We must never forget that had it not been for cross-border traders, Zimbabwe would have collapsed in 2008-2009. They brought us bread, mealie-meal, soap, cooking oil, milk and even eggs from across the borders.
  • We must have a land audit to ensure optimal utilisation of the land by repossessing all the land not being fully utilised and redistributing it with a focus on women farmers. We cannot afford to have idle individuals with big-fat behinds to claim ownership of land that they do not know how to till, do not till and does not produce anything meaningful except spans of grass and thorns.
  • We must increase our investment in women farmers as a means of increasing production, reducing hunger and malnutrition and increasing food security.
  • Our reliance on the rains (which are erratic) to sustain our agricultural sector is unsustainable. We must invest in irrigation. However this will also mean improving our electricity supply, which at the moment is nightmarish for the average urban dweller and totally gothic for the rural dweller.
  • We need to resuscitate our manufacturing industry, which used to provide employment to the majority of urban dwellers and whose closure has resulted in increased unemployment and poverty among our urban population. This business of grabbing productive companies and industries and turning them into rat-breeding warehouses must stop. Let those capable of running industries do so. If we want to capitalise from their hard earned productivity then let us create a taxation regime that gives the fiscus significant gains. Alternatively we should create a labour system that allows the employees of these companies to have share schemes and benefit from the huge profits we are sniffing after. We do not have to own companies to benefit from their existence in our country when we can’t run them profitably; although owning them and making them truly productive would be ideal.
 
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Posted by on March 11, 2014 in Development, Human Rights, Women, Zimbabwe

 

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Feminist Chronicles: Diary 11: Dr Fay Chung


Those of you who may have read the profile of Beatrice Mtetwa may recall that she is Swazi by birth but Zimbabwean by marriage. Apparently, there is something about Zimbabwe that breeds women of courage and integrity as integral members of our society. Dr Fay Chung is another one of these women. In her case, the circumstances are a bit different because not only is she Zimbabwean by birth but also a veteran of the fight for Zimbabwe’s freedom from colonial repression. When you take a look at her picture do not be perplexed, obviously, she is Chinese by descent, her grandfather having been a peasant farmer in Nanpan Village near Guangzhou in China but she is very much Zimbabwean in her heart and soul.

Dr Fay Chung

Her forte is education, the education of women and children being the hot embers that burn in her heart. Being an educated woman herself holding a first degree and a Doctorate in Education from the University of Zimbabwe
an M.Phil in English literature from the University of Leeds as well as BA in Economics from the University of London’s School of Oriental and African Studies, it is not surprising that Fay Chung wants the same for her fellow Zimbabwean woman.

Fay Chung joined Zimbabwe’s liberation struggle in the 1970’s and was instrumental in developing a Research and Teacher Education programme for Zimbabwean (then Rhodesian) refugee schools and guerrilla camps in Mozambique and Zambia.

After Zimbabwe’s independence was declared in 1980, she was instrumental in the setting up of the Zimbabwe Foundation for Education with Production, an organisation that provided education for war veterans and returning refugee children from Mozambique and Zambia. She served in various capacities in the Zimbabwe Ministry of Education including as Deputy Secretary for Administration in the Ministry of Education. The highest post she ever held was that of Minister of Education, Sport and Culture between 1988 and 1993. She resigned from this post following ideological disagreements with the government. During her tenure as Minister of Education Zimbabwe reached an unprecedented 95 % primary education rate, vastly improved secondary education and developed a progressive curriculum for teacher training institutions.

She has worked with the UNICEF as Chief of the Education Cluster in New York from 1993 to 1998.  She was also the first Director of the UNESCO International Institute for Capacity Building in Africa (IICBA) based in Addis Ababa, Ethiopia, a position she retired from in 2003. She served as an honorary special advisor to the Organisation of African Unity now the African Union.

In 2006, Fay Chung’s book “Reliving the Second Chimurenga: Memories from Zimbabwe’s Liberation Struggle,” was published. It was the first initiative of its kind by a Zimbabwean woman, chronicling her experiences and perspectives on the liberation struggle as well as the power struggles within the political parties of the day. Although this book has been discredited by some reviewers as being at odds with historical facts it still remains a necessary tool facilitating dialogues and reflections on the struggle for independence. Coming from a woman, she paints a vivid picture of the harsh living conditions in the refugee camps of Mozambique from a gendered perspective, and giving specific details on the challenges that children faced, something rarely reflected in post conflict literature.

Having noted the underrepresentation of women in tertiary institutions and recognising the need to cultivate progressive female leadership, Fay Chung cofounded, together with other Zimbabwean women, the Women’s University in Africa in 2002. She serves as the Chairperson of the Board of Trustees for that university. She is also a founder of the Forum for African Women Educationalists and the Association for Strengthening Higher Education for Women in Africa.

Her current preoccupation is the renewal and restoration of Zimbabwean institutions in her capacity as the Director of ‘Envision Zimbabwe.’ Envision makes use of research, discussion, policy and strategy development to address Zimbabwe’s multi-sectoral social, economic and political challenges. It also promotes good leadership and accountability at all levels.

Dynamite indeed comes in small packages!

 

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