March of the Silent Tears
The scorching sun of Moroto District beat down relentlessly as I joined the line of marchers, each step heavy with memories that haunted my soul. Today wasn't just about raising awareness for postpartum hemorrhage (PPH) in the remote Karamoja region, it was a day to speak for the lives lost too soon, to mourn in the open for mothers who never made it back home. Today, August 29th, 2024, Moroto Regional Referral Hospital organized a grand Postpartum Hemorrhage (PPH) Awareness Day at Boma Ground in Moroto Municipality. The event was well supported by various partners.
The program began with a march from the Regional Referral Hospital across the town, involving a diverse group of participants, including health workers, NGO workers, and members of the community. The awareness day was a significant effort to highlight the dangers of PPH, a leading cause of maternal mortality, and to educate the public on preventive measures and the importance of seeking timely medical care. The active participation of healthcare professionals and community members demonstrated a collaborative commitment to improving maternal health in the region
My journey to this moment had been marked by countless painful memories. I marched to shed tears for mothers who arrived at our facility too late, their hopes pinned on a slim chance of survival that slipped away. One story that burned deeply into my heart was that of a mother from Kotido District, a grueling 130 kilometers away. She had been referred to us in desperation. Her district lacked an anesthetist, crucial for her emergency surgery. She had to endure a harrowing journey over rough, pothole-ridden roads. Her condition was dire, and the ride only worsened her suffering. By the time she arrived in Moroto, her uterus had ruptured - a catastrophic complication that left her gasping for air, her body barely clinging to life.
As we prepared her for surgery, the air in the operating room was thick with tension. The dilemma was excruciating: if we didn't intervene, she would certainly die. But if we tried, there was a slim chance we might save her. We decided to proceed, booking blood, mobilizing the team, and preparing for a battle against time. Yet, even as we fought with every ounce of our skill, her blood pressure collapsed. Despite the blood transfusions and a cocktail of medications, her body succumbed. She passed away, along with her unborn child. I carried her memory with me today, each step of the march echoing the weight of her lost life.
As I walked, my thoughts also lingered on a young woman after a brutal beating at the hands of her drunk husband, the young woman began to bleed heavily from her birth canal. Her cries grew weak as blood and thick, dark fluid began to ooze from her birth canal a ghastly sight that sent her neighbors into a panic. They rushed her to the regional referral hospital, the air thick with the smell of iron and fear. When they arrived, the midwife quickly assessed her condition, her face growing pale with each passing moment. An eight-month pregnancy was silent. The fetus had no heartbeat.
The midwife's eyes were grim. "Placental abruption," she muttered, knowing too well what had transpired. The placenta had torn away from the uterine wall, severing the unborn child's lifeline. The woman was in active labor, her body wracked with waves of pain as it tried to expel the lifeless child. With anguished cries, she delivered her dead baby into a world it would never know.
The hospital room was silent, save for the rattling breath of the mother who lay there, eyes glazed with exhaustion and despair. The relatives huddled in the corner, whispering frantically, while her husband stood by the door, his face a mask of indifference or perhaps it was something darker. The nurses looked at him with suspicion; something about his cold stare sent shivers down their spines.
That night, amidst the brightly lit ward, when the rest of the world slept, the husband made his move. He waited until the nurse on duty turned her back, then quietly crept to his wife's side. In a strange twist, with a speed fueled by desperation or perhaps something more sinister, he took her from her bed. His eyes darted around the room like a hunted animal. In the silence of the night, they vanished into the darkness, swallowed by the shadows beyond the hospital walls.
What happened to her after that, no one knows. They slipped away to some unknown village; a place buried in secrecy. When we tried to follow up, the neighbors all claimed ignorance. They didn't know where she came from or where she might have gone. It was as if she had been a ghost passing through a fleeting, tragic figure whose life had been erased from memory.
The march grew into a sea of faces, community leaders, health workers, parents, and children. The signs they held, reading "Save Our Mothers," "PPH is Preventable," and "No More Tears," were more than slogans; they were pleas for a better future. My own sign, trembling in my hand, bore the words: "For the Ones We Couldn't Save." Each step I took felt like a tribute to those mothers and a defiant stand against the preventable tragedies that had claimed their lives.
The pain of these memories fueled my determination. The names of mothers who had been lost, those whose lives were cut short by complications that should have been managed resonated in every chant, every song of the march. I remembered the frantic efforts in the operating rooms, the tightness in my chest as I watched lives flicker away despite our best efforts. These were not just statistics; they were real people, with stories and families left behind.
As we reached the heart of Moroto, the stage was set for speeches and discussions. Leaders from the Ministry of Health, local dignitaries, and healthcare workers stood ready to address the crowd. But I needed them and everyone here to truly feel the weight of the loss we carried. I wanted them to understand the personal stakes, the pain behind the numbers.
When my turn came at the microphone, my voice was thick with emotion. "Today, we march not only to raise awareness but to honor the mothers who lost their lives to preventable complications," I said, each word a testament to the grief I felt. "We march for those who died on their way to us, who fought valiantly on the operating table, and for those who never woke up despite a successful procedure. We march for the future where no mother's life is lost due to ignorance, delay, or a lack of resources."
The crowd listened in silence, absorbing the gravity of our message. The eyes of children, holding up their signs, reflected a mixture of innocence and resolve. In that moment, I felt a profound hope take root a hope that this march would ignite a change, that our collective pain and resolve would lead to better education, better resources, and ultimately, a future where no mother dies in vain.
As the march continued, I knew that this was just the beginning. The fight to save our mothers, to educate our communities, and to improve our healthcare systems would go on long after today's banners were folded. But today, we had raised our voices for the mothers lost, for the families devastated, and for every woman who deserved more than a story of tragedy.
With each step, I felt that our collective grief and determination were paving the way for a brighter, safer future. And so, we marched on through the dusty streets of Moroto Municipality, each step felt like wading through a thick fog of despair. I was almost counting every tragedy I had witnessed in my struggle to save mothers from the clutches of death during childbirth. The stories came rushing back, chilling my bones and tightening my chest. Each tragedy was like a specter, haunting my memory and whispering reminders of the cruel dance between life and death that plays out in the remote corners of our land.
One story stood out in particular - its horror clawing at my mind like a dark, menacing shadow that refuses to be forgotten. The story of a young girl, barely 16, a child herself but about to become a mother. She labored for hours, the cries of pain echoing through her small village like the wails of a tormented soul. The Traditional Birth Attendant (TBA) had taken charge, a woman whose pride in her ability to deliver every child that crossed her path bordered on arrogance. But this time, the situation was different. The girl's labor had stalled, her body too small and frail to bring forth life.
The TBA declared with an eerie finality that the girl would not survive this birth. Her voice was cold, almost as if speaking a prophecy, "No delivery defeats me; if it does, it dies." The words hung heavy in the air, wrapping the village in a shroud of fear. The TBA's verdict became a death sentence. No one dared challenge it. The girl's labor continued, not in the sterile environment of a hospital, but on the cold, unforgiving earth of her village home. Her screams pierced the night, mingling with the howls of distant animals, as if even nature itself mourned for her.
Her husband, barely a man himself, was taken aside by the elders. They spoke in hushed tones, their eyes dark with resignation. "If she dies, you will marry another," they said, their words like a death knell. But he loved her fiercely, and in his desperation, he decided to defy them all. He set off on foot, racing against time and fate, covering the seven kilometers to the nearest health unit. He ran like a man possessed, his footsteps pounding out a frantic rhythm on the dirt path, a rhythm that matched the racing pulse of his dying wife.
By the time she arrived at the health unit, the girl's fate seemed all but sealed. She was diagnosed with a contracted pelvis; her labor had been obstructed all along. The staff knew there was little time. She was loaded into a vehicle, and the race began again, this time to the nearest hospital where surgeons waited to perform an emergency cesarean section. But the journey had already taken its toll. She had labored for too long; the baby was gone, its tiny body limp and silent.
Death seemed to hover over her like a dark, spectral figure. Two days later, her condition took a turn for the worse. Sepsis had crept in, spreading through her veins like a dark curse. She was transferred to the regional referral hospital, but by then, her body was fighting a losing battle. Pus seeped from her incision, a foul, ominous omen of the infection raging inside her. It also began to seep through her birth canal, as if the very life was being drained from her.
When she arrived, we had no time to waste. We rushed her into the theater, the sterile lights overhead casting harsh shadows that seemed to bend and twist like dark figures looming over the girl. As we opened her up, a sickening stench filled the room. Her uterus was decaying, a rotten mass of tissue, blackened and putrid. The infection had devoured it from the inside out. There was nothing to salvage. It had to be removed to save her life.
But as we removed her uterus, a question whispered through the room like a ghostly wail: What would become of her? A child without a childbearing future. How would she face the torment of her own community, the whispers and the shame that would follow her like a phantom? Would her husband, who had defied the village to save her, still see her the same way? The thought chilled us, as if a cold wind had swept through the sterile theater.
And then there was another story, a darker tale that haunted me as I marched. A young woman, just recently married, who had convulsed from her home in the throes of a severe pregnancy complication. Instead of rushing her to the health center, her family, steeped in superstition, took her to a witch doctor. Instead of rushing her to a clinic or calling for help, the whispers began. "Evil spirits," they said. "She's cursed." Her body, still trembling with seizures, was dragged to the village witch doctor - a man whose face was as cracked and weathered as the parched earth beneath him. His hut was filled with the smell of herbs and death, a dark, suffocating place where the air itself seemed to writhe with malevolence.
They bound her wrists and ankles to the floor, and the witch doctor began his chants. Each incantation seemed to draw the shadows closer, wrapping around her like cold, skeletal fingers. Her body twitched and jerked as he smeared blood and ash across her forehead, believing he could drive the "demons" out. But the more he chanted, the more her life ebbed away. Her eyes, once full of pain and terror, began to dull. And then, with one final, agonized breath, she went still.
The silence that followed was heavy and oppressive, broken only by the crackling of the fire and the distant howling of a dog. The villagers stared, realizing too late that she wasn't cursed by spirits but was simply a young woman whose life could have been saved by the very thing they feared - modern medicine, it was too late. She arrived at the hospital cold and lifeless, the light in her eyes extinguished by ignorance and delay.
These stories are not just tales to frighten, but realities that demand change. They are reminders of the lives lost in the silent war waged in the remote corners of our land, where tradition, ignorance, and lack of resources conspire like a dark, unseen force.
This is why I marched, with every step, I shed my tears, not just for those lost but for those who could still be saved. I marched to bring light to these stories, to stir the conscience of those who can make a difference, and to challenge the specters of ignorance and apathy that hover over our villages.
As the march reached its culmination, the stories of loss and sorrow had painted a vivid picture of the urgent need for change. But acknowledging the pain was only the beginning; the next step was to translate our collective grief into concrete solutions that could prevent future tragedies. Here are strategies and solutions among others to address the critical issues we face in maternal health care:
1. Establish comprehensive training programs for healthcare providers, including midwives, nurses, and doctors, to handle complications like postpartum hemorrhage effectively. Ensure that these programs are accessible even in remote areas.
2. Improve the availability of essential medical equipment and resources in local health centers. This includes investing in anesthesia machines, surgical tools, and life-saving medications to ensure that critical care can be provided locally.
3. Invest in the development and maintenance of better transportation infrastructure to ensure timely access to health facilities. This includes repairing and paving roads in rural areas and providing reliable ambulance services. Transport vouchers to boda boda`s that support in transporting mothers to health facility.
4. Launch extensive awareness campaigns about the signs and risks of maternal complications. Utilize local languages and cultural contexts to ensure messages are understood and acted upon. Such messages should reach TBAs, so they can identify complicated cases early and refer to nearby health facility.
5. Train and deploy community health workers who can educate families about the importance of seeking timely medical care and dispel myths and misconceptions about childbirth and maternal health.
By addressing these areas, we can create a more robust and resilient maternal health system. The goal is to ensure that no mother has to face preventable risks alone, and that every woman receives the care she deserves to survive and thrive.
As we move forward, the stories of loss will continue to remind us of the urgency of our mission. But with determination, collaboration, and action, we can transform our collective grief into a powerful force for change, creating a future where every mother is safeguarded and every family is supported.
As the sun dipped below the horizon and the march came to a close, the stories we shared and the emotions we expressed were far from over. Our journey, marked by both profound sorrow and unwavering hope, is just the beginning of a broader mission to drive meaningful change in maternal health care.
The Village Doctor Initiative has been at the forefront of this mission, striving to bridge gaps in healthcare, educate communities, advocate for those whose voices have been silenced by tragedy and raising awareness of community experiences. Our commitment to improving maternal health, particularly in underserved regions, is driven by the real stories of loss and the urgent need for reform.
But we cannot continue this work alone. We need your support to amplify our efforts and bring more powerful stories to the forefront stories that have the power to change attitudes, influence policies, and ultimately save lives.
Here's how you can support The Village Doctor; donate to our cause, collaborate with us, share our stories, get involved or join us in advocating for policies that prioritize maternal health and address the systemic issues we face. Your voice can help influence decision-makers and drive the changes needed to improve healthcare access and quality.
The stories we tell are more than just accounts of tragedy, they are powerful catalysts for change. By supporting the Village Doctor initiative, you become part of a movement that seeks to turn pain into progress, grief into action, and loss into hope. Your support ensures that we can continue to share these critical stories, educate communities, and work tirelessly towards a future where no mother's life is lost to preventable causes.
Together, let's transform the narrative from one of loss to one of triumph, from sorrow to empowerment. Let's ensure that the stories of those we have lost lead to a brighter future for all.
Thank you for your unwavering commitment and support. With your help, we can forge a path towards a healthier, more equitable world. And so, we march on, united in our cause and driven by the hope for a future where every mother and child is safe, supported, and valued. And so, as we conclude today's march, let our resolve strengthen. Let the tears we have shed be the catalyst for the improvements we so desperately need. We march forward not only in memory of those we have lost but in hope for a future where no mother's life is lost to preventable causes.
With each step we take, we pave the way for a safer, more compassionate world. And so, we march on..................
Dr. Oloya Johnson Nyeko
Founder and CEO of The Village Doctor
Email: [email protected]
