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Archive for September 25th, 2011

It’s a tough life for single mums

Posted by Administrator on September 25, 2011

A girlfriend of mine is aghast about the behaviour of one of Nairobi’s top Christian primary schools.

They have rejected her son’s application to join the school. She has a great job and is very religious (she never misses Mass, tithes and fasts during Lent).

The unofficial reason given for the rejection was that the school does not look favourably upon single mothers because they do not reflect the desired poster image of perfect parenting that the school likes to promote.

This may sound bizarre in the 21st century but I know that a quite a number of us, and our institutions, harbour biases against the single mother.

To begin, there is an unspoken assumption that single mothers are gross violators of the Rules of Proper Conduct for Women.

They are women of no morals who got what they deserved. In some quarters, some feel that the woman who gets a child out of wedlock is a tart who would rather dispense sexual favours than swallow contraception.

Important details are forgotten – like the fact that there are many mothers who are single mainly because their once enthusiastic bedroom partners ran for the hills when they heard the trauma-inducing words, “We are late.”

For every single mother we have in our midst, there is also a father somewhere who bears no physical and societal stigma for the fact that he sowed some wild oats.

The single woman who elected to walk away from an unhealthy relationship fares no better.

She is often openly or secretly vilified for being selfish, and for rejecting the martyrdom gene that enables many women to put up with scrubs, good-for-nothings and cheaters, all for the sake of preserving the sanctity of the family unit.

So while she is trying to bring up balanced children on one income and one emotional and spiritual reservoir, some in society chose to view the single mother as a failure and misfit.

The single mothers who fare marginally better are widows, who at least get minimal sympathy since, after all, death is not a function of failed morals or failed contraception.

Society likes to place some rather funny requirements on single mothers. Once the babies come, the woman is supposed to dedicate herself to being both baba and mama and desist from any activities that show that she has either a heart or a crotch (or both).

A single mum who spends a lot of time enjoying a good drink or a good man (or men) is branded with a rougher brush than the child-free woman.

Then there are those men who like to believe that single women are ‘damaged’ goods who are only good for one night stands or for being the long suffering mpango wa kando.

Many men have claimed that it is against African culture for a man to raise another man’s child, while they overlook that they could be raising other people’s children even under the holy institution of marriage.

A greater dilemma for a single mum is what to do when she finds that man with whom she wants to have a non-platonic relationship. How to introduce this man to her child is usually a great problem.

Today’s children are not so naïve as to believe that the uncle who spends the night from time to time only does so because he happens to be homeless or an IDP.

Then again, if the same woman frequents those bed and breakfast facilities, she is labelled a harlot. When it comes to single mother dating and loving, you are damned if you do and damned if you don’t.

Most important, though, is that the poor woman takes all the blame for how her child turns out. In a marriage, one can safely blame the other side for all the foolishness and dysfunction that the child exhibits.

Should the child of the single mum have a weight problem, the mother is accused of having stuffed her child with junk to compensate for the absent father.

If he is the child who causes trouble in the open-minded school that accepts him, she is told that all discipline issues manifest the deficiencies of growing up in a broken down, one-parent family.

Simple things that do not bother other mums can prove to be a great headache for single mother. There are those who chose to put a big XXX in place whenever they are required to give the father’s full name.

This is because they know that the absent father might one day come and wave his magic male wand, and the legal system may just let her take away her child.

Some have to battle with real trauma from kids who are forever asking who their father is, and they engage in fruitless quests to find a father who would rather not be found.

Finally, and more unique to my tribesmen, is when the single mums exercise their rightful option to give their children their own names as surname.

So now we have many Moses Njeris, Joe Wanjikus and we all remember our famous, late Samuel Wanjiru.

One cannot imagine how vicious and cruel kids can be when it comes to harassing those who are different, let alone those who are boys with girlish names.

What is the other option for single mums? Is it to borrow names from their fathers, to impose the absentee father’s name on the child, or to possibly stigmatise her child with a girlish name?

For those folks who still harbour crazy hang-ups about single mums, just remember that they are trying to raise normal children in a rather abnormal environment while struggling to maintain their identity and femininity. It is a tough world! Cut them some slack.

Contact the author at njokikaigai1@gmail.com

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Elusive joy for mothers and babies as cartels run maternity down

Posted by Administrator on September 25, 2011

File | NATION Pumwani Maternity Hospital nurses stopped work earlier this year demanding increased allowances, additional staff, medical equipment and uniforms. A report on the state of the hospital lists low employee morale as a major hindrance to good service delivery.

File | NATION Pumwani Maternity Hospital nurses stopped work earlier this year demanding increased allowances, additional staff, medical equipment and uniforms. A report on the state of the hospital lists low employee morale as a major hindrance to good service delivery.

More than 1,000 children died at the crisis-ridden Pumwani Maternity Hospital in the past year as the City Council facility continued to sag under the weight of mismanagement, low staffing levels, corruption and the absence of equipment, a task force has found.

In the period from July last year to July this year, 13 mothers died in childbirth, while some 253 developed complications and 4,185 gave birth through by Caesarean section. Another 13,000 mothers gave birth normally and were discharged without complication, the report shows.

The task force’s report containing damning findings on the operations at Pumwani Maternity Hospital, and which is likely to shed light on the causes of the high maternal and child mortality at the facility, has been handed over to government authorities for action.

Under-secretary in the ministry of Medical Services, Mr Adan Adan, chaired the task force. Members included Dr Simon Mueke, Dr Izaq Odongo, Mrs Susan Otieno, Mr Manasseh Bocha, Dr Rachel Nyamai, Mrs Anne Njeru, Dr Robert Ayisi, Mr Sylverio Wanjira and Mr Karisa Iha.

Corruption, financial crisis, lack of critical supplies for mothers and babies, mistreatment of mothers, moral and ethical decadence, and absenteeism among doctors, are highlighted as some of the factors that have compromised the quality of services at the hospital.

For the first time, the report attempts to pinpoint areas that seem to have brought the hospital, the third largest and busiest provider of maternal services in Africa, to its knees.

Established in 1926 by the Lady Griggs Welfare League as Lady Griggs Maternity, the hospital caters especially for the poor in Nairobi.

The report brings to light the sorry situation at the hospital where poor expectant mothers go through major difficulties before and after delivery. Only one theatre works full time, resulting in up to 13 mothers who need immediate obstetric attention queuing for up to 24 hours to get emergency C-sections. Delay often leads to death.

City council

There is a shortage of necessary supplies required during and after delivery, and  mothers bathe in cold water after the boiler became non-usable, according to the Services at Pumwani Maternity Hospital under the Nairobi City Council, 2011 report.

Only one of the four autoclaves — equipment used to sterilise linen and theatre instruments to prevent infection — is in working condition.

Sometimes the hospital is forced to sterilise the tools at Kenyatta National Hospital to cope with theatre demands or when this machine breaks down.

Only a sixth of the required number of incubators for preterm babies is available, hampering efforts to increase child survival rates.

Workload is more than the 14 doctors and 194 nurses can handle, affecting the quality of services offered as staff struggle to attend to as many mothers and babies as possible. The hospital records between 50 and 100 normal deliveries and eight to 15 Caesarean sections every day.

Staff complained of burnout from the workload, which has had a negative impact on the quality of services delivered and the handling of women who deliver at the facility.

Corruption is also rife at the hospital, with the funds meant for the wellbeing of mothers and babies being misappropriated. Revenue collected from the hospital under the cost-sharing arrangement, for instance, is taken to City Hall for banking. The report says this creates an opportunity for  under-banking.

This procedure has affected the delivery and smooth running of services at the hospital, with those who manage it finding it difficult to run the institution without sufficient resources.

Two officers at the hospital who spoke to the Sunday Nation said the situation was so bad late last year that the institution was forced to sustain patients using daily collections.

These findings are contained in the  report by a 10-member task force formed after Prime Minister Raila Odinga visited the hospital in July and directed that an audit of the hospital’s operations be done following negative reports in the media. The Sunday Nation interviewed numerous staff at the hospital who corroborated the findings.

Battered image

The task force was mandated to, among other things, recommend ways of reducing maternal and child mortality and improving the hospital’s battered image.

Dated August 19, 2011, the report has disturbing findings that confirm Pumwani faces a crisis that needs urgent attention and action from the government and support from donors and well-wishers.

The report comes on the heels of admission by the government through a ministerial statement in Parliament early this month that 342 babies had died between January and July, raising questions as to what exactly is going on at the hospital.

Attempts to sort out the issues ailing the hospital remain a pipe dream due to serious financial problems. In the financial year 2011/2012, the hospital’s creditors are said to be owed over Sh60 million, with debts standing at over Sh5 million.

Sources within the hospital indicated that the City Council of Nairobi exacerbated the situation by failing to remit Sh2 million every month towards improving quality of  services at the facility. They claimed the hospital has been turned into a cash cow by some individuals at the council.

Some of the money collected from the hospital ends up in individual pockets rather than being used to benefit the women and babies who need it most. Some of these officials, said the sources, insist on controlling the hospital imprest and have resisted computerisation of the billing system.

Those who have tried to question the dealings have been sacked or transferred.

Another financial headache is presented by the National Health Insurance Fund (NHIF) whose refunds are infrequent and piece meal, making it difficult for the hospital to buy important consumables used during and after delivery.

Senior managers at the hospital say from early this year, NHIF was supposed to refund the institution Sh13 million, money accumulated since late last year.

“NHIF refunds come in small instalments, sometimes of half a million, which makes it difficult to pay suppliers,” said a source at the hospital who requested anonymity because of the sensitivity of the matter.

Affecting performance

The hospital is heavily polluted by dust from its surroundings and smoke emitted from vehicles plying on almost all sides of the hospital, affecting the performance of the staff and increasing the chances of infection of babies and mothers.

Besides the financial and environment concerns, the staff complained of a demoralising working environment — salary delays, inequitable remuneration allowances, non-payment of risk allowance for the past two years, lack of welfare benefits, lack of scheme of service, and use of abusive language by their seniors at City Hall. All these factors impacted on the quality of the services they offered.

The nurses blamed medical officers for failing to undertake adequate consultations and to communicate appropriately their decisions, says the report.

This situation is made worse because there is poor or no external supervision or monitoring of the health workers and their performance.

“Nobody is held accountable for the deaths of babies and mothers,” said a source at the hospital. One of the problems, the report and interviews with staff revealed, is the hospital’s poor management system.

There are parallel management systems with hospital workers reporting to different offices: some report to City Hall, others to the hospital’s superintendent, while doctors report to the Ministry of Health.

The hospital’s board is toothless. It does not “determine the staffing requirements for optimal operation of the hospital, and neither does it determine their terms and conditions of service,” the report notes.

Of concern also is the serious political interference especially when it comes to collection of fees and procurement.

Politicians, the report notes, significantly influence the hospital waiver system, sometimes making it lose a lot of money. Senior officers at the council claimed that the waiver is also being used to siphon the meagre resources from the hospital.

The politicians have also played a role in the grabbing of prime land belonging to the hospital, which was to be used for expansion and improvement of services.

Poor security and the porous hospital fence is another issue that denies the hospital resources as patients sneak from the wards without paying hospital bills. The task force has recommended additional staff and that the four theatres be fully operationalised.

Source: http://www.nation.co.ke/News/-/1056/1242274/-/10fd4s7z/-/index.html

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