The Zimbabwe Association of Doctors for Human Rights is deeply concerned that the lives of pregnant women have been placed in jeopardy by the closure of the only 2 government maternity hospitals in Harare. If these women develop complications and are unable to afford private hospital care, they will no longer have access to lifesaving surgical and other forms of emergency obstetric care. Inevitably, this will result in the unnecessary deaths of many otherwise healthy women and an even larger number of infants.

An average of 3000 women deliver per month in public hospitals in greater Harare and between 250 and 300 of them require lifesaving caesarian sections. Many more have deliveries assisted by forceps or vacuum extraction when their babies show signs of distress and a lack of oxygen. In addition, mothers who miscarry earlier in pregnancy require surgery to evacuate the uterus to avoid serious and often fatal infections and bleeding. Without access to these interventions a significant number of mothers will die. The risk to their infants is much greater as the majority of caesarian sections and instrumental deliveries are performed to rescue babies who are suffering from a lack of oxygen during labour. We can therefore expect a dramatic increase in the number of stillbirths and of infants who have suffer irreversible brain damage which will result cerebral palsy and severe mental retardation.

The Children’s Rehabilitation Unit at Harare Central Hospital has witnessed a 3 fold increase in infants presenting with severe brain damage from birth complications since 2004. This is a reflection of a general decline in obstetric care which has mirrored the economic decline. The current crisis could result in an immediate ten to twenty fold increase in the number of such infants.

For most mothers there is no alternative to the public maternity hospitals. The cost of Caesarian Section in private hospitals in Harare is in the region of US$1500, well beyond the means of the vast majority. While some mothers have attempted to access treatment at hospitals outside of Harare, enquiries have established that these are only a tiny fraction of those needing emergency care are accessing these hospitals. Marondera, the nearest provincial hospital to Harare, is no longer able to perform Caesarian Sections or any other form of surgery.

ZADHR therefore calls for the immediate establishment of a temporary facility at one of the main maternity hospitals in Harare capable of providing emergency obstetric care, including Caesarian Section, for the indigent population.