Pain, joy of pregnancy amidst Covid-19 pandemic in Kenya’s informal settlements

Albright Amusala does not like to remember the pain she went through in May this year trying to get to a hospital when labour pains kicked in.

It was about a month after President Uhuru Kenyatta announced a dusk-to dawn curfew starting from 7 am to 5 am to stop the spread of Covid-19 pandemic. She was preparing to get to bed when the labour pains started. Under normal circumstances, she would have just called a taxi to take her to hospital but with the curfew in place no one was willing to risk their lives to take her to a medical facility.

“Pregnancy doesn’t know curfew. Labour pains can come any time. My labour pains kicked in at 10pm on a Friday. At this time, the country was already observing the 7pm to 5am curfew. I called the community health worker and she tried to call different drivers to look for a vehicle but she couldn’t get help,” she says.  It was at 12 midnight when an ambulance from Pumwani Maternity Hospital came for Amusala. She was staring at a possible complication.  Luckily she delivered her baby safely on May 29, 2020.

Covid-19 pandemic has affected almost all spheres of live but for pregnant women like Amusala it has adversely affected them, especially with the restriction of movement in most parts of the world. In Kenya, women from informal settlements are grappling with numerous challenges ranging from lack of transportation to hospital and the agony of getting to hospital after curfew hours.

Judith Shitambule, Community Health Worker in Lindi, Kibera.

Judith Shitambule, Community Health Worker in Lindi, Kibera.

Judith Shitabule, a community health worker in Kibera’s Lindi village says the challenge of the curfew has had an adverse effect on pregnant mothers. “I met a mother who was so traumatised to go to hospital due to the fear of contracting covid-19 and being caught up in the curfew hours. I had to take her through counselling and provided her with the right information,” says Shitabule.

In Kibera, pregnant women can now use a toll-free number -1195- whenever they have labour signs. “When the women call this number, they receive free means of transport to the health facility. In my community unit, two pregnant women have already benefited from this toll-free number,” she adds.

Besides the delayed access to health facilities, pregnant women and new mothers are also faced with the challenge of handling their newborns in the midst of the pandemic. Kenya’s Health minister Mutahi Kagwe urged young mothers to be extra cautious in handling their infants in order to protect them from contracting the deadly covid-19. “It is absolutely critical that you take care of the infants. I am also urging young mothers to wear masks, discourage visitors from coming to their homes and greeting the infants,” said Kagwe.

Zarika Adoyo, a new mother

Zarika Adoyo, a new mother

Zarika Adoyo, a Kibera resident, gave birth on March 18,2020. At this time the Ministry of Health had also introduced guidelines on prevention of the spread of the virus that has so far affected over 10,000 people in Kenya. Zarika, a mother of four, lives in Olympic area in Kibera. She had been attending ante natal clinics at St Mary’s Hospital in Karanja, about two kilometres from her home.

Zarika started experiencing labour pains at midnight on March 18. Although the government had not imposed a dusk to dawn curfew then, physical distance had been recommended in all places. Her husband accompanied her to the hospital. But he was not allowed to stay. Zarika delivered safely and was ready to go home the next day. “I called my friend to come pick me. She was, however, not allowed in the hospital compound as the hospital had put extra measures to avoid the spread of covid-19, especially at the maternity ward,” says Zarika.

Many pregnant and new mothers now fear going to the hospital for fear of infections. “Most of our hospitals have different kinds of patients and you can’t tell who has covid-19. As a result, I fear taking my child for clinics. But again, I know it is a requirement so I do it anyway,” Zarika has now taken her child for clinic three times.

Clinic sessions, she adds, are more than just that. “Now we are taught about covid-19. We are taught why we should not allow visitors or people without masks in our homes. We are also advised not to give our babies to neighbours as it increases the risk of spreading the pandemic,” she says.   Zarika, however, confesses that this a challenging directive to adhere to. “Here, we live like a family with our neighbours. In the past, we would freely leave our babies at the neighbours’ houses as we went to do menial jobs elsewhere. But now we have new rules to deal with,” she says.

Zarika, who used to do laundry work in people’s homes is now jobless as most households choose to minimise walk-in workers.

Agostina Mbwaya is a 33-year-old mother of two. She is a peer educator in Kibera. Between February 25 and 28 and March 17, she experienced premature labour between February 25 and March 17, 2020. By the time the country announced the first case of covid-19 early March. After several checkups in different hospitals, Mbwaya delivered in Nazareth Hospital after undergoing a caesarean section. At that time, the government had already imposed a 7pm to 5am countrywide curfew. She paid Sh2,500. Although she has already taken her baby for two clinic sessions, Bwaya says she fears contracting the corona virus disease from frequent hospital visit.

In May, the United Nations Children Fund said an estimated 116 million will be born under the shadow of Covid-19 pandemic and warned that the containment measures such as lockdowns and overwhelmed health systems were likely to put the lives of many mothers at children at risk. This could present a major challenge to pregnant women living in informal settlements are already face an uphill task getting medical care when they are expectant.

Although there is little research on pregnant women with Covid-19 a recent one by the Centre for Disease Control in the US on 8,200 women, showed that expectant mothers were 5.4 times more likely to be hospitalised, 1.5 more times likely to be admitted to the ICU and 1.7 times more likely to be put on a ventilator. The organisation, however warns that these results should be interpreted cautiously because these women may have had other underlying health issues that are not related to Covid-19.

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