Nairobi, Kenya – After Ana Khasakalla suffered two stillbirths in 2014 and 2015, she sought a solution that would provide better health care.
Friends told her that pregnant women in Kenya should pay bribes to doctors and nurses to escape the long queues of mothers waiting to surrender their babies.
"During my first pregnancy, I was excited to be a mother and I could not wait to salute my newborn baby in this world," said 34-year-old Al Jazeera.
"I registered for birth [the government-run] Pumwani Maternity Hospital in Nairobi. I attended all the previous observations at the hospital, I made an ultrasound scan and my baby was healthy.
"On my birthday I was disappointed with some women who came after me to a hospital [and] they handed their children before me. I experienced prolonged work for 18 hours from the moment I was admitted to the maternity ward of the building. In the end, the return was a stillborn daughter. "
Khasakalla earns $ 30 a month for selling fruits and vegetables on the streets of Nairobi.
Her second dead child was also a girl.
It represents some 34,000 Kenyan women who deliver stillbirths each year, according to the World Health Organization.
She now has two healthy children – both were transferred to the same hospital.
"Once I realized that most women pay bribes to avoid long queues, then I approached the famous gynecologist at the facility and negotiated a fee of 2,000 shillings ($ 20) to deliver my first child. He agreed and within 25 minutes , I had a normal birth and was home the next day after a maternity leave at night.
"The same is true of my second-born child, even though the parents are free in government hospitals, I did not want to risk more. There is no guarantee that you will be born safe, as many doctors are drunk while they are performing their duties, she said.
In the past few years, several doctors in Kenya have been charged – with some prosecuted – because they have been poisoned while working, and some cases lead to further injury or death.
|Cholera patients receive treatment and care in a special unit at the Kenyan National Hospital in Nairobi, Kenya July 19, 2017 [File: Thomas Mukoya/Reuters]|
Since 2013, the government of Kenya has provided free maternity leave services to state hospitals, including antenatal services until the child reaches the age of five.
This was part of a government program to prevent the rise in maternal deaths – 400 of every 100,000 live births in 2017, according to the WHO.
Neonatal mortality is 34 of every 1,000 live births according to the WHO, making Kenya one of the lowest sub-Saharan African countries for maternal health.
Pumwani Maternity Hospital, one of the oldest institutions in Kenya and founded in the 1920s, is currently under investigation for medical negligence and trafficking by the Medical Board and Dental Board (MPDB), a government agency.
"Yes, we have received reports of women who pay money when they do not have to do it just to give him life," said Daniel Yumbia, chief board officer on the board. "As a result, we canceled the licenses of some doctors, about 46 of them.
"We will soon send a motion to Kenya's parliament for new measures to punish doctors who break the law."
Yumbya said some women lost their lives, waiting to deliver babies through an emergency cesarean section to various hospitals.
He said the eight private maternity clinics were closed across the country by exaggerating their patients in recent months. Illegal contracts by doctors also killed pregnant women, he said.
"We are also investigating St. Mary, a Catholic hospital, to charge patients more than the normal amount of $ 50 for normal delivery. It's disappointing that a missionary hospital can do that," Yumbya said.
He said there was no latest bribe data, as most cases were not reported. But on the basis of regular complaints, he explained that the trend is worrying.
Excessive and underpaid doctors
According to Dr. Ouma Oluga, Chief Executive Officer of the Pharmacists and Dental Union (KMDDA), the government is to blame for the situation in hospitals, especially public hospitals. He said that doctors were being processed with limited resources and capacities.
"You can not fully blame the doctors and condemn them, for example, until recently, the maternity hospital in Pumani did not have a mortuary, and sometimes bodies have to be wrapped in polyethylene bags. It's a shame for the government that doctors and nurses flooded and insufficiently paid across the country. "
A spokeswoman for Pumwani told Al Jazeera that her staff members are trying to help the patients, despite being overwhelmed and that no doctor has ever neglected her duty.
Olga continued: "They are paid between 15,000 shillings ($ 150) to 40,000 shillings a month ($ 400). They are also busy, they work an average of 14 to 20 hours a day, making them very ineffective for the effective performance of their duties because of fatigue. "
He added that in the Roma hospital "Pumani" there are only six resident gynecologists for about 154 pregnant mothers.
"Many of these irregularities can be avoided if more attention is paid to doctors and nurses."
Larger investments in staff hospitals could, hopefully, lead to less stillbirths.
Reflecting on her first pregnancy, Hasakala said: "I cried and thought about suicide. My water began to burst only six hours before delivery, and doctors ignored my cries."