Pumwani Maternity Hospital, Kenya – People Not Numbers

One million.

Can you visualize one million people?

The Kenyan population is growing at a rate of 1m people a year, and is in danger of slowing the positive development of the country. The effects of this population explosion is often told, but too often we concentrate on numbers and graphs, instead of on the human cost of this issue.

To put a face to the statistics, we travelled to the Pumwani Maternity Hospital in the East of Nairobi.

Dr Omondi Kumba told us a bit about the place. It was founded in 1926 and after Kenyan independence was turned over to the City of Nairobi. The hospital is a “referral hospital”, which means that health centres around Nairobi send patients who are at risk of complications to Pumwani. This explains the rather high proportion of caesarian sections carried out.

Each and every day between 60 and 100 babies are born in Pumwani every day. To put this into perspective, there are around 350 births a day in the whole of London in 2009/2010, including private clinics and homebirths. This hospital is only one of many hospitals in Nairobi, but the one that sees the complicated cases of the poor.

The Pumwani Hospital offers care for the poorest of Nairobi women. I was told that only those who cannot afford to go to one of the private providers go to Pumwani. The hospital has been hit by several scandals over the years, ranging from alleged baby switching and incompetence,  to not allowing women to leave the hospital if they have not paid their bills.

The hospital administration complained of lack of funding from the state government – a problem we are hearing everywhere as activists battle it out for the money available. Do you help those who live in the slums, finance HIV/AIDS prevention, assist young mothers … there is only so much in the pot (and a lot of what is there is funneled into other pots illegally and disappears).

When we visited we did not see evidence of the kind of allegations mentioned in the above articles. The staff informed us that women who were unable to pay are kept for 2 weeks then assessed by a Social Worker before being discussed by a committee. Then around 2% of the patients were released without charge.

It did make me wonder why they would keep the women for an extra two weeks when they would surely know that the poorest women from the slums would not be able to pay even the KES 3000 (around $35/GBP23) for a normal vaginal birth.

The past scandals would certainly explain why the hospital has found it difficult to find private sponsorship or donors from abroad.

We were shown around the hospital. I found it rather regimented and cold, the women lined up on a bench breastfeeding their babies. The women and the children seemed to be well cared for, if only physically. One woman sat with her back to us, crying softly. When one of the organizers of the trip spoke with her, she explained that she was waiting to leave after having lost a baby. She was sharing a ward with women who had just given birth and who were cuddling their babies.

The staff were very conscious of the dangers of infection, giving us cotton shoe covers to wear while visiting the baby unit. We saw them washing down the cots and preparing them for new arrivals.

Some of the women consented to speak with us, and allowed us to take photos. They proudly presented their babies, smiling as they told us names and birth weights. A familiar ritual, that I have seen many times with our children and those of family and friends.

The mothers will be going home with their babies soon. Some will continue to attend the Pumwani Antenatal Clinic to have their children vaccinated and their weight monitored. We met a little 9 month old girl called Fatima whose mother was given a food supplement.

In the antenatal clinic, women have their stitches from the CS removed and make arrangements to see the family planning clinic. Many women in Nairobi slums would like to access contraception in order to space out the births of their families better. It is a constant struggle to reach all of these women.

For many years the discussion about family planning revolved around the issues of over population, but as we have seen this week, the real losers are the women.

Having several children within a short period of time puts a huge stress on the body of these women. They are unable to properly recover from one birth before they are pregnant again. They are at much higher risk, and the risk to their children is much higher. The maternal mortality rate in Kenya is high, due to unwanted pregnancies, unsafe abortions and complications thereof.

In order to help these women, we are drawing attention to the issue this week. Women in Kenya and around the world should be able to access family planning services when they wish to limit the size of their family, or space the births of their children out.

The more educated women in Kenya do this. The poor women from the slums cannot.