Pregnant women at risk of death in Kenya’s COVID-19 curfew

Veronica Atieno remembers feeling her way through the dark alleys between the shacks that make up Nairobi’s slums, picking her way past raw sewage and rusty, razor-sharp metal roofing with trepidation.

Her labor pains had crescendoed during Kenya’s coronavirus dusk-to-dawn curfew, and there were no public or private means of transport to the hospital where she had planned to give birth. Fears of heavy-handed police enforcement of the curfew kept possible helpers away.

With time running out, her only option was to reach the home of a traditional birth attendant nearby, Atieno said. But she was scared.

Kariuki reached out to companies and state organizations for support in providing free services such as transportation and medical personnel. The response was overwhelming, leading to the formation of Wheels for Life.

The Health Ministry, Nairobi University, taxi service Bolt and others pitched in to provide the free services.

“It is really amazing when you can see that people are willing to go beyond the economic gain so that they can help the less privileged in society, especially at a time of COVID when everyone is thinking about cutting costs,” Kariuki said.

Wheels for Life has a toll-free number which pregnant mothers call to be triaged and connected to a doctor. If a mother needs medical attention but it’s not an emergency, a taxi is dispatched to take her to hospital. If it’s an emergency, an ambulance is dispatched.

According to the United Nations’ Maternal Mortality Estimation Inter-Agency Group, maternal deaths in Kenya had fallen from 9,100 a year in 2000 to 5,000 in 2017. That translates to 13 recorded maternal deaths daily, down from 24.

Still, the East African country remains among the top 21 in the world for maternal deaths.

Louisa Muteti, chair of the Midwives Association of Kenya, fears that mother and child deaths during childbirth have increased under the curfew.

Muteti said 68% of mothers who give birth in Kenya have access to skilled personnel. Others give birth at home using traditional birth attendants or by themselves, and when deaths occur they are not officially recorded.

Transport and security are the biggest challenges under curfew, Muteti said, especially in dimly lit informal settlements.

“That’s why some mothers may die at home or struggle and go to hospital in the morning, only to die,” she said.

According to the World Health Organization, women die as a result of mostly treatable complications during pregnancy and following childbirth such as severe bleeding, infections and high blood pressure.

WHO emphasizes the importance of skilled assistance during childbirth, saying “timely management and treatment can make the difference between life and death for the mother as well as for the baby.”

Kariuki said Wheels for Life has handled 10,950 calls in the last 100 days while 890 women have been taken to hospitals for various issues with their pregnancies.

She envisions the service continuing beyond the curfew, targeting low-income residents and moving beyond Nairobi county. Most users are from informal settlement or low-income areas, she said.

“It’s just given me perspective of just how many women are in dire need out there even without the curfew,” she said. “Because if a lady tells you they have $5, curfew or not, they were not going to make it to hospital.”

Atieno, 23, knows how lucky she is to have survived the birth of her second child without reaching the hospital as planned. After eight hours of labor, she gave birth to a beautiful, healthy baby named Shaniz Joy Juma at the hands of the unskilled traditional birth assistant.

She continued bleeding after birth but managed to reach the hospital in time to treat it.

“Some things is just God’s will. I could have died,” she said.