Rural women dying in taxis as they give birth

Perfect Daba was 23 years old when she died. Already a mother of two, Perfect lost her life after giving birth to her third child in the back of a car that was rushing her to hospital to deal with labour complications. This car was her makeshift ambulance, a vehicle procured in a panic 7 hours after her complications started. This car was her last resort, the only way to reach the nearest hospital 80 km away other than crossing the Kpone dam in a dugout canoe in complete darkness. This car was her downfall, better than the traditional motorbike used to transport women in labour from local clinic to larger hospital but still woefully inadequate. This car was her fate. Because in a broken medical system that overlooks most women like Daba, a perfectly healthy 23 year old in labour can be a death sentence.

Perfect is not the only victim of a labour gone wrong in her middling-sized town of Torgorme. Women in the town readily revealed to us that they are being careful not to get pregnant until the maternity care situation stabilizes. The problem is rampant and well known, enough to have permeated through pretty much every facet of life. Young women told us that in addition to good looks and a steady job, they now also search for a husband who lives in a town with a better clinic than the one in Togorme, in case they ever experience a medical emergency.

The clinic in Togorme is in state such that it is almost completely incapable of treating anyone effectively, let alone a woman in the midst of giving birth. Funded by the nearby Kpone Power Project, the clinic has no midwife, no fridge to store blood or other perishable necessities, no ambulance, a shortage of primary drugs and inadequate trained personnel. When we went to visit the clinic, the community health nurse stationed there was in Accra to take exams, leaving the clinic completely abandoned.

There was a nurse on duty on the night that Perfect Daba made the 100-meter journey to the Torgorme Clinic from her home with her husband. The lack of resources necessitated a transfer to the nearest hospital in Akuse, an hour and a half long journey by car. With no ambulance, no personal car and Perfect’s condition too far deteriorated to make the journey on motorbike, Perfect’s husband was forced to search desperately for a vehicle to make the trek to the hospital. When a car was finally available 7 hours later, Perfect began to bleed out and delivered in the car. Hoping to take the shortest route possible, Perfect’s husband sought to cut through the Kpone Independent Power Project, the only possible route with paved roads in good condition. However at the gates of Kpone, personnel of the plant refused to let the car through.

Deterred, the car continued on darkened unpaved roads, finally arriving at the hospital at 3am, 10 full hours after Perfect first began experiencing complications at 5pm. She died three hours later, leaving behind her husband and three children, including her newborn.

Since Perfect’s death, four children have been successfully born in Torgorme, all under the guidance of untrained traditional birth assistants; the town of 4000 continues to be overlooked by their rightful share of that National Health Insurance Scheme. Despite the happy news of healthy newborns and healthy mothers, there is one thing that cannot be ignored - that car. The car that delivered Perfect Daba to her death. The car that should be a reminder of how far we have to go.

Visit the Maternal Health Channel blog here.