Congo Confinement
(presenter)
They've got a man on top of her,
pushing down.
One foot is normal,
the other is a clubfoot.
That's such a shame.
The conditions are terrible if you have
to treat women and children.
I didn't hear anything.
She screamed the house down.
- Stillborn.
title
CONGO CONFINEMENT
04.03
VO
Congo is a lovely country, but don't have a baby there. One in thirteen women here die during pregnancy or labour. In remote villages it's even worse. There, a pregnant woman has one foot in the grave. One in five children die before they're five. In Belgium, that's one in 1,000.
We travel to Kasongo Lunda that lies on the border with Angola, in the southwest of Congo. We'll be staying for a week at the local hospital, looking for an answer to the high
mother and child mortality.
She's afraid.
04.54
VO
The pregnant Neza doesn't feel any movement in her belly any more. Nurse Willy listens for a heartbeat using a horn and an alarm clock.
I didn't hear a thing.
You didn't hear anything?
- No.
You don't feel anything?
I'm not sure. We're waiting for the
echography which will tell us more.
Why don't you do it right away?
Other sick people come in who
might also need an echography.
When we have three, four or five
patients,
we examine them all at the same
time.
To save on fuel.
If we always had energy, we'd do it
right away.
06.08
VO
They need the diesel generator to conduct an echography. It will only work tomorrow.
Neza will have to come back.
06.18
In the last decade, the health situation in Congo has only got worse. The government can't seem to get organised. There's no evidence of the international community's declaration to drastically reduce mother and child mortality. More mothers and children are dying than ever before.
06.42
We've come to Matamba Solo, 2 hours drive from Kasongo Lunda. Women in labour can never get to the hospital in time. Medical outposts have been set up for emergencies.
06.56
Claudine wants to have her baby here and not in her village, and certainly not on the road here.
How long have you walked to here?
- Perhaps six hours. Six hours.
Six to seven hours.
On foot? Just to get here?
Why did you come here?
First of all, because they have
midwives here,
and there are also doctors on hand.
If there are complications,
they have to help me.
The baby's lying in a difficult position.
The people in the village
do not know what they have to do
to get the child in a good position
so that it can be born properly.
You should realise that in cases like
that,
a lot of women in the villages die
because of the lack of medical skills.
07.53
VO
Next to her is a young mother who underwent a Caesarean a month ago. The wounds simply won't heal.
Where does it hurt? Here?
It hurts everywhere.
- It doesn't heal.
She's suffering. She's suffering.
This woman's really suffering.
She looks terrible and the baby's
covered in rashes.
Just look at that.
The conditions are terrible if
you have to treat women and children.
It's incredible, I've never seen
anything like it.
There's no proper window,
you can't scrub the floors.
There are animals everywhere.
It's so basic. The rain comes in.
Through that hole in the ceiling.
09.13
VO
Another step lower on the health care scale, Monganda, a medical post in a dilapidated hut. There's no doctor, just a live-in nurse with her child. And yet women give birth here daily.
There's no light here.
- No.
And no electricity either.
- No. There's only a hurricane lamp.
Even when I deliver at night,
I only have a hurricane lamp.
Is that sufficient?
- Not really.
Certainly if we have to carry out a lot
of examinations.
Sometimes the lamp goes out.
Especially when we have rain.
You'll see that it goes out easily.
Sometimes during a delivery.
10.15
VO
Traditional midwives deliver babies in the villages.
10.22
Willy, the nurse from Kasongo Lunda, introduces us to Ida, a traditional midwife. Her herbal mixtures should stimulate the woman's fertility, and eventually facilitate the birth. She doesn't use just any old plant, only medicinal plants.
What's that?
A vaginal suppository.
- Vaginal?
She's mixing.
When she's rolled it into a small ball,
she places it in the fire's cinders.
She takes it away after a few minutes.
That's not very healthy.
She washes her hands thoroughly
while she's doing it.
I see.
- She washes her hands well.
Once she's taken it from the fire,
she will give it to the mother.
11.19
VO
Willy finally admits she has her doubts about the alternative medicine.
It's risky.
Sometimes it can cause cervical
cancer.
I can well imagine that.
It's not hygienic at all.
I once assisted at a birth
where the woman went into labour.
After the delivery,
the child was apathetic.
Stillborn. The amniotic fluid
looked very green.
She admitted that she'd had an enema
with these leaves.
If you have an enema with these
during labour,
it can also stimulate labour.
However, if you're not quick...
It smells very bitter...
...the child will die.
It's poisonous, very poisonous.
12.12
VO
We're back in Kasongo Lunda. Ria, a Flemish sister, has been running this hospital for 33 years. Her pride and joy is the nurses' school she has set up. She's lost none of her drive
over the years.
Where does fertilization take place?
Where?
All of you, come on now.
12.37
VO
Sister Ria is the health care here. Without her and the foreign financial aid, there wouldn't be any medical personnel in the region.
12.47
VO
Mafwene has been in labour for days. Yet another young 17 year-old girl with an unwanted pregnancy. The father has disappeared. She's so young, her pelvis is too small for an easy birth.
13.09
VO
Mafwene has gone into labour. The midwives have their own ways of helping her.
13.29
They take turns pressing Mafwene's tummy, to no avail.
13.37
Manpower is needed.
They've got a man on top of her,
pushing down.
13.48
VO
She gives birth to a son, but it has difficulty breathing. Ria steps in.
That's not the right way.
Come on, quickly.
Cut the umbilical cord, hurry.
Can't you see the child's suffering?
Out of the way.
Out of the way, please.
I need a compress.
The child is deformed.
One foot is normal,
the other is a clubfoot.
That's such a shame.
And she can't afford to have the child
operated on.
That's why we don't show the child
to the mother right away.
They're still too emotional.
I'm going to try to put the foot in
plaster tomorrow, you never know.
15.05
VO
The next day, Ria takes us to the Mwana-Moymbo medical centre.
This child is sick.
- Look at its eyes.
They're so yellow.
You think she has Aids?
- Yes, I do.
She and her baby.
- Yes.
15.26
VO
She examines mothers and their newborn.
15.32
Justine has just given birth and is bleeding profusely.
She's very pale.
15.35
VO
Ria realises she's in an extremely critical condition.
The woman is far too pale.
- She needs a blood transfusion.
She can be dead tomorrow.
- She could die, really?
She's not bleeding much now,
just a little bit.
But she needs more blood.
Now you have to find a donor.
- Transfusions are not allowed.
She's worn out, she's absolutely worn
out.
What's she looking up?
- What it means.
What you saw just now,
is placenta praevia.
Take a good look at it.
A fourth time and the woman will die.
- That's terrible.
16.19
VO
Ria measures the haemoglobin in Justine's blood.
Six grams, as I said.
That's very dangerous.
- Oh yes.
What is it normally?
- Ten or twelve.
Can they give a transfusion
in Kingunda? Let's go.
Her mother and the baby will go,
and one or two people who can
give blood.
16.42
VO
Ria decides to ring the hospital about her emergency case. To warn them you're coming.
Actually, there's better reception
under that tree.
16.56
VO
You have to know the right spots.
- This should work.
No luck.
You're not far enough under the tree.
- Yes.
I have often tried phoning here yet.
He's switched off his phone.
- Let's leave anyway.
17.17
VO
We leave for the nearest medical post that gives transfusions. The road's in a terrible state. Without a 4x4 you're lost. Lorries can't pass through anymore. Transporting medical supplies is a huge problem.
17.38
We look for relatives who can give blood in Justine's village.
Apparently, the men are all in
the forest.
They're going to find them.
Seven of them will come.
To the mission post?
- Yes.
Her husband is a couple of
kilometres away.
They're going to fetch him too.
They'll all meet there.
They're going to walk 13 kilometres?
- It'll take 2 hours.
18.09
VO
The lack of any electricity means you can't preserve blood. Women who have to walk hours to a hospital, have little chance of finding a donor and still surviving the ordeal. Many die en route, or bleed to death at home.
If you tell someone at home about
this, they wouldn't believe you.
No one would understand.
18.38
VO
We've arrived. Now things have to go fast.
We need an urgent transfusion.
He's a former pupil. He'll do it well.
Look, her eyelids are swelling up.
If we hadn't got here, she would have
died by tomorrow.
18.50
VO
The trip has been hard on Justine.
Blood pressure is still good.
How much?
Five. You see.
- It's going fast now.
And when can a person die?
- Certainly when it's four.
19.09
VO
Once the blood group is known, a donor has to be found.
We need someone who's A-positive.
Do it right away.
19.21
VO
Luckily, they already find someone with the right blood group. However, there's a problem.
He refuses to do it. Hey, father...
That is my child.
I'm leaving with my child.
He's as drunk as a lord.
We don't have a donor any more.
That's it. Find someone else. Hurry.
20.00
VO
Justine's condition is deteriorating.
The palms of her hands are becoming
white. Do you see that?
They're much whiter now.
20.12
VO
It's already dark when a new donor is found. He needs to be tested. Difficult in the dark.
Rhesus factor A-positive.
That's very good.
20.43
VO
Our light allows them to do the test. Better than waiting for daylight. And then Justine's husband arrives.
I want you to listen to what I have
to say.
It might be a bit early, but I'm going
to say it anyway.
You have 3 children.
I'm Congolese enough to know
that having 3 children is not much.
However, listen to me. I'm telling you
3 children is the maximum.
She won't survive another child.
Do you understand?
21.10
VO
5 hours after we found Justine, she's given a transfusion. She and her baby have been saved.
21.26
We heard that Justine recovered, but that her child died 3 days after its birth.
21.42
VO
Willy holds antenatal classes. The way the women are dressed, clearly shows it's mainly the better-off women who attend. And they've come to sing, not to do exercises. They have to learn about possible infections, as well as understand what a hospital birth costs.
Having a child in hospital,
is not only buying some nice clothes.
You also have to pay money
to the hospital maternity department.
For the initial care you have to pay for
the gloves they use.
They are only used once.
You don't know how many pairs they
will need. It all depends.
It's 4,500 for giving birth to the child.
And the gloves and so on?
- They pay them themselves.
22.42
VO
At long last Neza can have her echography. The life of her unborn child has been hanging in the balance.
The age of the foetus.
This is a 27 week and
3 day-old foetus.
The result of our examination:
death in uterus.
23.15
VO
It's time to deliver Neza's child. It's unsure what her child died of. An infection, STD, malaria or simply hard work in the fields.
It was a girl.
Take her with you, then you can bury
her.
24.03
VO
This is the third child Neza has lost, but she'll get pregnant again. A large family is the only guarantee for the future.
24.26
VO
A woman comes in suffering from bleeding after a miscarriage.
I can't get hold of it yet.
The neck isn't wide enough.
Give me the apron.
Doctor, listen.
We need an emergency curettage.
The woman's bleeding too much.
I'll bring her to the operating room.
24.47
VO
She needs a curettage, a sort of cleansing of the womb.
25.03
VO
Tension mounts in the operating room. It appears the miscarriage is from a secret abortion, devoid of medical supervision, probably at her home. Abortion is still taboo here and forbidden by law, and yet many young girls take the risk. They often die, alone, at home.
25.29
Last month, 15 mothers died here of bleeding, infections, toxaemia, unsafe abortions, or during childbirth. Money is the main problem. Lack of money stops them coming to the hospital, and any help is usually too late.
There's no need to measure.
This is a Caesarean.
25.53
VO
A young girl from a poor family has arrived.
It's a very large child.
- It's also lying high up.
No, it can't come out.
26.03
VO
A Caesarean spells disaster for the girl's mother.The operation costs 120 euros. NGO Memisa's intervention will leave 44 euros to pay. Even that is too much for this family.
She wants you to try to deliver it.
- I'm not allowed to.
Because you can't.
- The child is much too big.
Her pelvis is small and so is the girl.
What if this happens in a village?
- They'll try anyway.
They push and push and then
the womb opens.
The child will die.
- They bring it here,
and maybe we can deliver the child,
and save the mother.
It all depends which artery has burst.
But a lot of the time we're unable to
save them.
26.55
VO
Life is more dear than money. Isha bears a beautiful son, Matondo.
27.17
VO
This is how it should be. The baby is carried festively to the village. The father waits expectantly at home. New life calls for a celebration.
27.29
Twelve babies were born during the week we were here. Three died.
Justine lived because we happened to be there.
The international community has six years to take action.
END