Maternal mortality rate in char areas still high

Lack of access to healthcare blamed

27 May 2010, 18:00 PM

Mahbuba Zannat, back from Shibchar, Madaripur

Reshma and her mother-in-law Rahela.Photo: STAR

The maternal mortality rate in many char areas in the country still remains high due to absence of healthcare facilities and shortage of family planning workers. The government officials admitted that they often fail to provide adequate healthcare services for the people in those areas because of poor health infrastructure and manpower shortage. One or two mothers die during childbirth here every month, said Abdul Malek Talukder, an elderly resident of Daliluddin Sarkarer Kandi village in Char Janajat union under Shibchar upazila. He recalls: “It was evening on a Monday this month when Sabina, 26, started groaning in labour pains. After her relatives failed to assist her in giving birth, a trawler could be managed to take her to a nearby healthcare centre. "At about midnight, the trawler left for Dhaka carrying Sabina. But at dawn we got shocked to see that it is coming back. When the trawler came close, we found Sabina lying dead. She died just because of lack of a skilled birth attendant," said the elderly man. Just a week before Sabina's death, Rojina, 22, daughter of Khabir Hawlader, died along with her baby after suffering from agonising labour pains for three days. Just because of the lack of access to comprehensive healthcare, women are dying from pregnancy-related complications without receiving minimum healthcare service, local people said. There are no healthcare centres, no maternal and child welfare centres, no skilled birth attendants and not even a family welfare assistant to visit and counsel mothers, they said. No family welfare workers bother to come to the village by crossing the river Padma and there is nobody except one health assistant to take care of health-related issues of some 15,000 people in Char Janajat union, said union Chairman Bazlur Rahman Sarker. "If there had been only an MBBS doctor in the union, the situation would have been different and the mothers would not have died young," the chairman said, adding that the union health and family welfare sub-centre is still under construction and out of the two community clinics here, only one is running partially due to lack of manpower. Unfortunately, the government health officials are quite unaware of the real situation in the char areas. "The maternal mortality rate in Shibchar upazila is zero," said Acting Upazila Health and Family Welfare Officer Motiar Rahman. "There are five or six family welfare assistants and health assistants in every union and they are locally appointed. So, there is no scope for them to remain absent," he said, adding that he is not aware of recent death of mothers in the locality. At another village Fazlul Sarkerer Kandi, popularly known as Bhumihiner Char, the mothers never received any antenatal care. Even they can't imagine a skilled birth attendant attending to them to ensure safe delivery. Harun Mollah's first wife died four years ago during childbirth. His second wife Reshma is now eight months' pregnant. But she has not receive any antenatal care so far, because there is no such facilities in the village. "It takes one and a half hours to go to the upazila health complex, the nearest health centre. So, I did not go there. My mother-in-law Rahela assisted me during my first childbirth. She also would do it this time," said Reshma. But Rehala had no training on birth assistantship. "Nobody taught me how to assist somebody in childbirth. I have to work as traditional birth attendants out of necessity. So far, I have helped mothers give birth to some 200 babies," she said. Director General (DG) of Family Planning Mohammad Abdul Qaiyum said there is acute shortage of family welfare assistants and family welfare visitors, the main workforce at grassroots level in the health sector. One family welfare assistant was supposed to work for 600 eligible couples in a locality in the 80's. Today the population has almost doubled in a locality, but the number of family welfare assistants remains the same. At present, some 650 posts of family welfare visitors are lying vacant and some of them are retiring from job every day. "There are many NGOs working on safe motherhood issues. But very few NGOs are working in remote char areas," the DG said. The government aims to reduce maternal mortality rate to 143 from 320 per thousand live births by 2015 to attain the Millennium Development Goal 5, he said, adding that but it would not be possible to do so without ensuring healthcare services for a large number of people living in char and other remote areas.