Sylyvia’s Story: a look at maternal health in Uganda

image“First you have to dip the baby’s feet in the water. You don’t want to put his whole body in at once or the cold water might shock him, ” Sylyvia explains to me, holding her 3-month old baby, Cuthbert, above a plastic blue tub.

Sylyvia works in the Engeye laboratory, where she does everything from counting trophozites (the parasite present in Malaria) to performing HIV tests. Because Engeye provides staff housing right next to the clinic, however, she can take periodic breaks and check on her baby throughout the day.

Sylyvia is the kind of person who is constantly looking out for others. She frequently asks me how I’m doing and instructs me to change my gloves every few minutes whenever I’m working in the laboratory. And if I forget to follow through on something, I can always count on Sylyvia to remind me. She’s kind of like a nagging—albeit extremely funny and compassionate—mother.

So you can imagine that when Sylyvia learned she was actually going to be a mother, she sought out the best care for her baby. She received regular check-ups, requested a knowledgeable midwife and made sure all of the necessary preparations were in place weeks before her delivery.

Although I think it’s safe to say most mothers, regardless of their circumstances, desire the best for their children, Sylyvia and her baby underscore the value of a thorough education and proper resources when it comes to maternal and newborn health.

Sylyvia has clearly done her research.

And between Engeye’s assistance and her own awareness, she has had access to optimal care.

But Sylyvia’s story is not the typical narrative for women in Uganda (or sub-Saharan Africa, for that matter). As Nicholas Christoff writes in his book, Half the Sky, “The equivalent of five jumbo jets’ worth of women die in labor each day……. Overall in sub-Saharan Africa, the lifetime risk of dying in childbirth is 1 in 22. In contrast, in the United States, the lifetime risk is 1 in 4,800.”

And these aren’t just abstract statistics. These are staggering and unacceptable realities for women here, in Uganda, and, more specifically, Ddegeya. Sylyvia’s own aunt and nephew died a few weeks ago from complications during birth. “I wasn’t scared then [when I had Cuthbert],” she tells me, her eyes wide, “but I am now.”

When I ask Sylyvia what she views as the biggest obstacles to maternal health in Uganda, she offers a few short and direct explanations:

“Money. It is expensive to deliver babies,” she says. Sylyvia’s delivery alone cost 90,000 USH (the equivalent of $27—a negligible fee for most Americans, but a considerable price for most Ugandans). Although government hospitals in Uganda are—in theory—free, nurses or doctors will typically charge their own prices for any services. Many women seek out Traditional Birth Attendants (TBAs)—women with no professional training, who employ herbs and other traditional forms of medicine—simply because they’re cheaper.

Another big factor is distance. This is an issue that came up repeatedly in my other interviews as well—many women just don’t have access to proper medical facilities. Or they live extremely far away from the nearest hospital or clinic. As Sylyvia says, “Most women just go to TBAs because they can’t get transportation or something easy. Some women even deliver right on the road while they are waiting for a taxi.”

In addition, the medical personnel at government facilities or hospitals are often unfriendly and rude to patients (that is if they even show up—many staff at these places aren’t required to clock in or out and get paid regardless). And, to some extent, their attitudes are understandable. The hospitals are typically overworked and understaffed. “There are many women in the same room and the hospital doesn’t have the right medications available or clean materials,” Sylyvia notes, “Sometimes there are 3 midwives for twenty patients.”

All of this discourages women from going to hospitals or clinics for maternal care. But it’s also why a new maternity center at Engeye is such a crucial development for Ddegeya and the surrounding community; the center will give women an affordable, easily accessible place to deliver their babies. Not to mention, women will receive personalized care—a rarity in Uganda—and the staff are very friendly.

In the words of Sylyvia, “There is no better facility…they know we will help them.”

Sylyvia pulls baby Cuthbert from the tub. Once he is dry, she wraps him in a fuzzy polka-dotted blanket and rubs her nose against his. “There, all finished.”

To give to Engeye’s Maternity Project or learn more, please visit:


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