An Oasis for Pregnant Women
By Lane HartillMuscuta Mané is having a baby. It's number 10. This is it, she says. No more.
But the truth is, Muscuta doesn't call the shots. Her husband does. Here, husbands dictate what their wives eat, how often they see a doctor and where they will give birth. Muscuta's fortunate. She's staying at the House of Mothers, a Catholic Relief Services-supported home for at-risk pregnant women. It's just a short walk from the delivery room at the state hospital. The birth will set her husband back $3.60.
It's a world away from where she had her first baby when she was 15 years old: on a bed in a musty hut in her village. Her grandmother squatted beside her, wiping the sweat off her forehead. She had lots of encouragement for Muscuta, but not a drop of medical training. After hours in labor, when the baby wouldn't come out, her mother and the other elder women made her drink a cocktail made from mango bark. "I sweated a lot and then the baby came," says Muscuta.
It sounds difficult, but Muscuta had it good compared with many women here. Some traditional cultural practices dictate that a chicken egg be placed in the birth canal during labor. Other times, a woman's child climbs a tree and insults his or her mother while she is in labor. Both practices are believed to help a mother give birth.
A Grim Reality
If you're pregnant, Guinea-Bissau is not the best place in the world to be. The country shares notoriety for dreadful health conditions and high maternal mortality rates with Afghanistan, Chad and Sierra Leone. A combination of poverty, neglect, dangerous traditional practices and a lack of education make giving birth here a life-threatening undertaking.
According to World Health Organization, only 40 percent of Guinea-Bissau's population is covered by the public health system. This number drops significantly in rural areas. Another study by the United Nations Population Fund found that among the 107 existing health structures in the country, only 3 offer complete quality obstetric care. Most worrying for women like Muscuta: Only two trained gynecologists work in the regions of Bafata and Gabú.
To make matters worse, forced marriages are common here. Teenage women have narrow pelvises, which can cause complications during childbirth. The Fulani and Mandingo ethnic groups also practice female genital cutting, which may cause hemorrhaging and complications during delivery.
Known for its cashews, military coups and cocaine trafficking, Portuguese-speaking Guinea-Bissau sits shoehorned and forgotten in Francophone Africa's west coast. It rarely surfaces on the international news. Its most recent cameo: Police shot and killed a counter-narcotics officer who was investigating the country's galloping drug-trafficking problem.
Corruption within the country and a series of uprisings have meant the health care system has been neglected for years. Dr. Augustino Mancabou, who studied for six years in Cuba, works in Gabú, the largest town in the east. He was only recently paid all of his back salary, dating to 2005. His commitment is startling, given that he says he is only paid $216 a month (midwives make $70 a month) and the hospital is dangerously underequipped. The worst part, he says, is that there has been no steady supply of electricity in Gabú since 1992. Mothers give birth on rusting delivery tables with very little medicine as midwives coax babies out by candlelight.
During the political tension in the 1990s that morphed into a civil war in 1998, much of the middle class fled and Gabú slid into decline. Bony long-horned bulls nose through garbage on the street; goats outnumber cars on the road; flies chew on dogs' ears; and the once-proud swimming pool at the end of town where lavish weddings were held is now full of dirt and Coke cans.
Muscuta, who thinks she's 36, never thought she would grow up to live in a place like this. As an only child, she spent her days making palm oil and soap, selling them in the village. "I was beautiful and lively when I was young," she says proudly.
Muscuta's childhood ended when she was 15 years old and her father pulled her out of school and forced her to marry. Muscuata had a plan—and a rebellious streak. She fled. But her father found her, and beat her. She still has the scars on her legs to prove it.
For the last 20 years, she's lived the life of a Guinean woman, always deferring to her husband, even when it came to where and how she'd give birth.
Hope at the House of Mothers
But she's now at the House of Mothers, where the women are treated like queens. CRS provides the food and also teaches the women through health and cooking classes. Women say they now know the importance of medicine. And what they should eat when they are pregnant. Simple things, to be sure, but lessons that could save their lives—and the lives of their future children.
The women feel so safe and comfortable here that soon the stories start to flow. Stories that would make most Americans run for the Kleenex box.
Take Nhima Sané, the soft-spoken woman in her early 40s with sad eyes who has given birth nine times. Seven of her babies died. She doesn't know if it's because of the hard work she did during her pregnancy or how she cared for them after they were born. At this point, it doesn't matter. She thinks about them often, but doesn't talk about their deaths with anyone. She says she cries alone.
The deaths of her children have taken a toll on Nhima. You see it in her face, how she moves. Smiles are rare and take effort.
Her husband, an older man in an electric-blue outfit, comes and visits her. He holds forth in front of the other women at the House of Mothers, joking that he wants six wives and 60 children. Nhima says not to listen to him, that he's just showing off.
She's just thankful to be here. She knows her baby's chance at surviving goes up by being at the House of Mothers. "I'll never forget this place," she says.
As for Muscuta, she says if she wasn't here, she'd be working right up until she had the baby. "If you don't work, you don't eat," she says. But eating mostly consists of rice and peanut sauce, a diet that leads many women to develop anemia. One 18-year-old woman said that prior to coming to the House of Mothers, she hadn't eaten meat in a month.
Muscuta loves it here. She's fed three times a day and always given meat, usually fried fish. She showers, washes her clothes and takes long naps. And at night, when the heat has lifted and the cool descends, she and the other women lay on their backs on the cool concrete floor, listening to the radio and talking about life. They all agree on one thing: They never want to have a baby in the village again.
Lane Hartill is the West Africa regional information officer for Catholic Relief Services. He has visited CRS programs in Burkina Faso, Ghana, Guinea-Bissau, Liberia, Nigeria and Sierra Leone. Lane is based in Dakar, Senegal.
