Agonising hour at the gate of Shinyanga govt hospital

By Lucas Lukumbo
12th July 2009

The entrance of Shinyanga Regional Hospital
.....If you have tears prepare to shade them when you reach the Shinyanga Regional Hospital gate during a clinic day for pregnant women. I shed mine on Friday morning.
A woman, in her 30s, struggled to step down from a bicycle after braving a whole hour of agony on a bumpy road from her village, Ndembezi, situated five kilometres away. Too weak to stand, she fell to the ground.
The cyclist Mwandu Richard said: “She asked me for help, and I just carried her on my bicycle free of charge which costs Sh1,000.”
I learnt later that cyclists in the area transport such pregnant women on bicycles because the region does not have an ambulance. People here have christened the bicycles “dala dala,” apparently for the good service they render.
More pregnant women arrived at the hospital by the same mode of transport, and like the first one, several more fell to the ground.
According to Richard, sometimes women come to the hospital on traditional cattle-pulled carts. On their way back the agony is the same. Distances covered can be as far as ten kilometres.
Near the hospital entrance, I saw a pregnant woman negotiating for the journey back home but could not raise Sh1,000 to pay the cyclist. She was desperate, saying: “There is nothing I can do. I do not have even a single coin.”
I rescued the situation. She thanked me, and off she went away to look for transport home with her newly born baby boy.
A driver who parks his vehicle near the hospital entrance Julius Justo, known by the name Molekos said, sometimes accidents occur as cyclists transport patients to hospital.
“Many of these cyclists from villages come to town because they have a patient to carry but have difficulties following traffic instructions,” the traffic drivers said acknowledging that cyclists are playing a very important role in transporting patients to health facilities.
There are times when the Shinyanga police arrest the cyclist sthey find in the municipality.
“When the police do that, they actually kill our mothers because they cannot hire taxis,” he said.
I witnessed at least 30 pregnant women entering the hospital gate in that one hour, out of whom 29 came on bicycles. Only one of them came by taxi.
A seat at the hospital gate which was being used by women and other patients to get a little rest after a long walk or ride bare nails, possibly to deter people from seating on it.
At 9am, I had to attend a meeting of all regional and district functionaries in the region. Heads of government departments from all the districts came to the meeting, organised by a Dar es Salaam based organisation, EngenderHealth, as well as others like the United Nations Fund for Population (UNFPA).
It was an advocacy meeting meant to instill knowledge to the participants to the meeting on this year’s World Population Day theme - Responding to the Economic Crisis: Investing in Women is a Smart Choice.
It provided space with policy makers, decision makers and community leaders in the region on the importance of investing in women.
I knew, after making some observations on how women travel to the regional hospital, I would make my contribution to the regional meeting.
At the meeting I was driven out by conscience that I should not divulge the matter to the regional authorities
There was a sign of disapproval from the chairman of the meeting, a retired brigadier general named Yohana Balele, who wanted to disapprove of my submission that Shinyanga region has no ambulance.
“Regional Medical Officer, please stand up and tell us if it is true that we have no ambulance at our regional hospital,” he ordered the Shinyanga RMO, Dr Fredrick Mlekwa.
The latter stood up and replied that it was true that the regional hospital does not have an ambulance. The meeting burst into laughter. I was the winner.
With regard to women’s health in Tanzania in general, figures on the maternal mortality have, remained virtually unchanged in the past decade; and pregnancy childbirth kills some 578 women per 100,000 live births.
With low purchasing power, there is a likelihood of a further decline in social services. This vicious cycle will exacerbate the negative impact of the current economic crisis.
The World Bank has reported that the economic crisis could lead to a cut in budgets, accommodating these issues, leading to more women and children dying, more girls dropping out of school, more women and girls being targets of violence and more women unemployed.
Progress in social and economic development goes hand-in-hand with gender equality.
There is not a smarter investment, with such high economic and social returns than investing in health and rights of adolescent girls and women.

SOURCE: GUARDIAN ON SUNDAY