We sleep hungry: How pregnant women fight for care

A pregnant woman. [Courtesy/GettyImages]

At around 3pm, we arrived in a village in Dukana area of Marsabit County. The sun had dipped past its highest point, the light had softened into a warm glow and long shadows stretched across the ground, which still radiated intense heat.

After five hours on a dusty road from Marsabit town, we stepped out of the vehicle into a wave of heat and the distant sound of women singing and ululating. Down the hill, through the glare, we could make out a circle of women dancing outside a Manyatta. We were told they were celebrating the birth of child, offering support, respect and honour to the new mother.

After greeting the women, radiant in their colourful kangas, we walked inside to meet the mother. Near the entrance, three women sat around the firewood, preparing food. Further in, past the partition separating the kitchen from the sleeping area, we found Talaso Jarso, the new mother, cradling her hours-old-baby.

Seated on her makeshift bed, wrapped in floral blue kanga, she looked up as we walked in, offering a faint smile, welcoming, yet carrying traces of exhaustion and pride. Outside, the women’s singing and dancing continued, their voices drifting steadily into the room.

Talaso says being pregnant in such an environment comes with countless challenges.

“It’s hard but for expectant mothers, it becomes even more difficult. You sleep and wake up without food, you feel dizzy and weak and when you are pregnant, you are also thinking about the child you are carrying.”

At times, she says, the struggle becomes overwhelming.” Sometimes you are so weak you cannot even get up from where you are lying.” Like many other women in the area, Talaso delivered her baby at home.

“I didn’t even try going to the hospital because the facilities are far and chances of finding a health worker there are very slim,” she says. When we step outside, weaving through the singing women, we meet Tune Mamo. She’s eight months pregnant.

We walk with her towards her manyatta, perched on a small hill near where we parked the vehicle. We sit outside as she explains how the lack of food drains her. “As a pregnant woman, hunger is my biggest challenge. Sometimes we sleep hungry and wake up hungry. By 10am, I am already feeling dizzy and throwing up. It’s hard.”

“The body is built with food. If we, as parents, feel this weak, it’s even harder for our children. My two children are fragile; they suffer a lot during the flu season because they have no immunity.”

Water, she adds is also a constant challenge. Tune says she walks for kilometres in search of the precious commodity.

Lactating Mothers

Down the hill from Tune’s home, we meet 21-year-old Teresa Buya, a lactating mother.

Teresa hopes that outreach programmes, where organisations visit remote communities to offer support and services will resume.

“We live very far from hospitals. Sometimes babies receive the BCG vaccine after one year. The measles vaccine, which is supposed to be given at nine months, some babies get it when they are already a year old,” she says.

Dr Supa Tunje, President of the Kenya Paediatric Association, explains that vaccines are given based on the earliest age at which a child is at risk of infection, as well as whether the baby has any protection passed on from the mother at birth.

“A baby may have some antibodies, but only up to a certain age. This depends on whether the mother has developed immunity to that disease, whether she was vaccinated, or whether she mounted an immune response if exposed during pregnancy,” she says.

Responding to Teresa’s concern that some babies receive the BCG vaccine late, Dr Tunje notes, “BCG is ideally given at birth because we live in an endemic area. Babies can be exposed from the very first days of life, that’s why the vaccine is given immediately.”

For measles, she explains, a baby receives some antibody protection from the mother. Normally, the vaccine is given at nine months, though in certain situations, it may be given as early as six months.

“If a child has missed earlier doses, catch-up vaccination is still possible. The schedule depends on exposure risk, how common the disease is in the community and the likelihood of falling ill if one hasn’t been vaccinated,” she says.

Donor funding

According to Bonaya Adano, the Chief Executive Officer of Kalacha Sub-County Hospital, the withdrawal of donor funding has had a major impact on remote areas.

Immunisation rates, antenatal and postnatal care, and skilled deliveries have all dropped sharply.

“The government is doing a lot to fill the gaps, but it is overwhelming. That’s why partners usually step in, helping us strengthen these essential service points,” says Bonaya.

Augustine Guyo, a nutritionist at Kalacha Sub-County Referral Hospital, says some of the ready-to-use supplements previously provided through partners included Ready-to-Use Supplementary Food (RUSF).

Francis Nalmalo, the Assistant Chief of Koya Sub-location in Laisamis, says malnutrition remains a painful reality. Many families go for days without food. He emphasises the need for continued sensitisation to prevent further livestock deaths, which worsen food insecurity.

“Donors and the government should come together and find a solution. Residents also need financial sensitisation, for instance, selling some livestock while they are still healthy and saving the money for emergencies, instead of waiting for the dry season when animals die and families are left with nothing,” he says.

According to Andrew Leinte, the Sub-County Water Officer in Marsabit, both the national and county governments need to conduct proper assessments.

According to The National Drought Management Authority, (NDMA) Acute malnutrition remains a serious concern. High levels were recorded in Turkana, Marsabit, Wajir, Garissa, and Mandera, with Baringo North specifically classified in Critical Acute Malnutrition (IPC Phase 4).

In total, about 741,883 children under five years and 109,462 pregnant and lactating women are acutely malnourished and in urgent need of treatment.