Prevention of Mother to child HIV transmission treatment is central to care at the hospital. The obstetric and midwifery care provided at Bwaila Maternity Hospital is gradually improving thanks to new partnerships with international organisations.
The University of North Carolina-Chapel Hill, has commenced a partnership with Bwaila Maternity Hospital -They join The Rose Project Ireland and Freedom from Fistula Scotland, in an effort to improve maternal and infant health in Lilongwe the capital of Malawi.
Despite ongoing political unrest, Bwaila Maternity Hospital continues to look after the majority of the births in the Lilongwe district. Many missionary hospitals have had to close their doors due to the uncertain political environment.
Rachel Macleod - The Rose Project’s midwife representative at the hospital, continues to work with the Malawian team in an effort to raise the standard of clinical care in the labour ward.
The hospital has recently acquired a full time Kenyan obstetrician and also a full time fistula surgeon.
The challenge remains to address the high level of maternal mortality. Malawi has the highest rate of maternal mortality in the world, for a non conflict country.
The acute shortage of midwives and obstetricians is one of the contributing factors.
With 14,000 annual births and only one obstetrician this is a challenge-The National Maternity Hospital in Dublin, has 16 resident obstetricians - and 9,500 births.(2010).
HIV has had a profound impact on maternal and infant health. 30% of all new infections are the result of mother to child HIV transmission during pregnancy.
Additionally, Malawi is a predominantly rural country and access to antenatal care is extremely difficult for women. Long distance and poor transport being the principal problems.
Fistula Clinic at Bwaila Maternity Hospital (commenced 2010)
140 women have had fistula repairs at Bwaila Maternity Hospital in the past year thanks to the work of the Scottish organisation Freedom from Fistula who are funding a Fistula Surgeon.
Obstetric fistula is the most devastating and serious of all childbirth injuries. It happens because most mothers in poor countries give birth without any medical help. So many are young girls. Complications from pregnancy and childbirth are among the leading causes of death and disability for women of reproductive age in these places. Obstetric fistula was eradicated in the United States more than 100 years ago thanks to emergency caesarean section surgery.
After enduring days of agonizing, obstructed labour a woman’s body is damaged by childbirth. During labour contractions, the baby’s head pushes against the mother’s pelvic bone — causing tissue to die due to lack of blood flow to this area. The pushing creates a hole, or in medical terms a “fistula”, between the birth passage and an internal organ such as the bladder or rectum. A woman cannot hold her urine, and sometimes bowel content as well.
Her baby is unlikely to survive. If she survives, a woman with fistula is likely to be rejected by her husband because of her inability to bear more children and the odour created by the condition. She will be shunned by her community and forced to live an isolated existence. These women suffer profound psychological trauma resulting from the loss of status and dignity, in addition to suffering constant pain.
