whispers. She should have gone to hospital at the slightest fever but there is none on the island. A kilometre or so from Achans home, I find Jessica Aarakit who is six months pregnant. Not once has she gone for antenatal check-up, it is a luxury. It takes about sh2,000 (less than a dollar) by boat, then another sh3,000 by motorcycle to get to a health centre in Ongino. So I am waiting to save more money so that I can go to the mainland early enough, Aarakit confesses. The island, whose occupants are largely peasants, charcoal burners and few fishermen, live in abject poverty. When you give birth, you need at least sh30,000. So I am saving sh1,000 every week until the last month, the young mother says. It was such practice that caused Achans son to be born pre-term and it is the same reason Helen Atyang, who lives a kilometre or so away from Aarakit has had three miscarriages. In the morning, you suddenly get feverish, by afternoon, it is a miscarriage and you do not even know why, Atyang confesses. Perepetwa Ibere, a village leader, says that many women have died during childbirth or due to over bleeding from miscarriages. I cannot forget a lady called Liman, the wife of Opio. She gave birth from home, but it was a complicated delivery so she bled a lot and died before we could even reach the boat, She says. Ibere swears that nearly every woman on the island has lost a child either after they are born or through a miscarriage. Many of these children are born and die without any single record of their existence, unless born in a hospital. Harriet Dikili, a mother of six has children with nicknames as interesting as Atitipu a Teso word for ant-hill. I have six children; two were born in my compound, two near the hospital and the other two near anthill, she says. She says labour always got her unprepared because sometimes, she barely knew how advanced the pregnancy was and at times she got the months mixed up. But even when these women labour in the bushes, Ibere says there is not a single glove for those who might want to help. Once, a young girl delivered on a boat, in the dark and I used
Adikili gave birth on an anthill
Omongot and his wives
show some of their childrens graves a polythene bag, as a glove. This exposes us to HIV! She lamented. The 2013 State of Uganda Population Report states that, all women face some level of risk during delivery. Quite often, 40% experience pregnancy complications, whilst 15% are in need of obstetric care. Delivery is a matter of life and death. There should be a trained person to ensure that death does not occur, Hellen Namaganda, a senior midwife at the Soroti Regional Referral Hospital, says. Child mortality The people of Tisai have lost count of the children who die on the island either at birth, before birth or a few years into the world. If the child is not a grown man or woman, just prepare for the worst, Ibere says. She further says if these children survive, Immunisation is a luxury their parents can barely afford. Jessica Adiochi, who has eight children with four born at home and have never been immunised says: If you give birth successfully, you wait until you get money to go to the mainland. Sometimes, this could take close to a year! she says.
The hut in which the writer spent the night.
But even when the
women labour in the bushes, there is not a single glove for those who might want to help At the island, the bushes are littered with human waste. When it rains, it is washed into the lake. Sadly, this lake is the only source of water on the island. During day, you will see little boys on tiny canoes going to fetch water. Ibere confirms that most of the deaths are from malaria-like symptoms and diahorrea. My baby died at 10 months. He had a fever and a running stomach and by evening, he was dead before I could even leave the Island! she says. Stella Akiteng, had 10 children but sadly, only five are alive. It was malaria, the child would
sweat or start shivering and die
shortly afterwards, she says. Agnes Kedi says she had to start all over again after all seven of her children died. When one clocks one, he/she dies. Another reaches two, he dies. Another one is still a newly-born baby, he dies, she says. A report titled Ending New Born Deaths by Save the Children early this year states that 10% of all newborn babies require help breathing on the first day. According to Aaron Kugonza, a doctor with Child Health, anything can go wrong before or after a child is born. Until the body learns how to defend itself, a child is always delicate and that is why their first 1,000 days should be monitored, he said. John Francis Oluka, the health inspector of Ongino sub-county, revealed that Tisais problems are far from over. We had a plan to drill a well but the contractors said the nature of the Island does not work well with the hilly Island. But we plan to dig a latrine this financial year at the school, he said. Maternal and child health, which are the most wanting of services on
A young boy goes to fetch water on the lake
Achans newborn was
eaten by wild pigs this island, are nowhere in the plan. MP Oboi says the biggest obstacle to development for the island has been poor transport. Though a bridge at the narrow part of Lake Opeta could connect the islanders to the mainland, it is still a long way to go. We need over sh1b yet we have less than half of that money. If only this road could be repaired, maybe we can entice some health workers to the island, he said. Can Tisai benefit from Government's new promise? The UNFPA 2012 annual report states that at least 16 mothers die every day during or after childbirth in Uganda. This means the country has failed to meet the fifth Millenium Development Goal (MDG) of reducing maternal deaths to 131 per 1,000 live births. The UNFPA report also states that 454 mothers die every year per 100,000 live births. According to the House Hold Survey Data and Modelled Estimates, approximately 200,000 children in Uganda die before their first birthday. This contradicts MDG 4, which seeks to reduce child mortality towards zero by 2015. So as we enter the post MDG phase, the Ugandan Government has recommitted to achieving these goals. In alignment with the countrys Vision 2040, the Reproductive Maternal Newborn Child Health Sharpened Plan with the theme A Promise Renewed has been rolled out by the health ministry and partners. This, together with the United Nations Proposed Sustainable Development Goals to be attained by 2030, should erase maternal mortality by 2040. But will the mothers and children of Tisai island benefit this time round? As I left the Island, they had but one plea, Please President Museveni, do not forget us!