Africa

Ebola crisis: Pregnant women in Guinea still avoid hospital

Mamanata Soumah Image copyright Tamasin Ford

Guinea has been free of Ebola since June. But pregnant women are still afraid of the virus, avoiding hospital and giving birth alone, writes the BBC's Tamasin Ford.

Mamanata Soumah told me she didn't once see a midwife, a nurse or a doctor during her entire pregnancy and even as she entered the third day of excruciating contractions without any pain relief, she refused to see anyone.

I asked her why.

"I was scared of Ebola," she said.

This was back in March. Five months after this area had been declared Ebola free.

"I didn't have the courage to go for check-ups at the clinic because so many people died there," she said.

Ms Soumah told me she felt the baby moving in her tummy right up to the end.

"The baby just got too tired," she said with a blank look in her eyes.

"It was born dead."

Avoiding vaccinations

She is not the only pregnant woman who was too scared to go to hospital.

More than half a dozen women, cradling tiny babies in their laps, patiently waited outside the village chief's hut in Kalemodiagbe village to speak to me.

Everyone had a story to tell.

One was Ms Soumah's sister-in-law. M'mah Camara still refuses to take her baby to hospital to get vaccinated.

Like Ms Soumah, she also spent three days at home in labour, refusing to visit a doctor or a midwife.

Unlike Ms Soumah, her baby survived.

Image copyright Tamasin Ford
Image caption M'mah Camara refused midwives through her three days in labour

She gently tightened a green towel around her two-month-old baby.

The 27-year-old lost 13 members of her family to Ebola, including her husband.

After he died, following local traditions, she married his brother; the father of her baby.

"During Ebola people left to go to the clinic but they never came back. I'm scared to go now in case I don't come back," she said.

Nobody came back alive

It's the same story for the other new mothers and pregnant women in the village.

Even after Ms Soumah's horrifying experience, the fear of Ebola seems to outweigh the fear of anything else.

Fatoumata Camara is seven months pregnant but has no intention of using the healthcare system.

"Since my friend lost her baby, I'm scared of the birth but I don't have the courage to go to the clinic," she told me.

Her own mum, brother and mother-in-law all died of Ebola.

"I'm now scared to go to the hospital even though my husband wants me to go," she said.

Everyone, they say, who left the village during the time of Ebola to go to a hospital, a clinic or a health post, never returned.

In this village alone 43 people died of Ebola.

Empty wards

Kalemodiagbe is a good two-hour drive from the capital Conakry, and about 5km (3 miles) from the nearest health post, down a bumpy, dusty track.

Some 15km away at the district's main hospital in the town of Forecariah, there was an eerie silence in the courtyard.

During the Ebola epidemic, there was hardly space to move; triage tents occupied every space.

Wards were full.

But when I visited there were no queues in the waiting lounge.

Image caption Ebola treatment centres, like this one in Sierra Leone, now stand empty

Dr Mamamdou Cisse, the director of Forecariah hospital, put it down to fear and suspicion.

"The trust between the health system and the population hasn't been completely restored," he told me.

"And because of that lack of trust pregnant women are staying at home.

"They don't even come for their ante-natal appointments."

He told me that the hospital was running at around 30 to 50% of its normal capacity because people are just too scared to come.

Before Ebola, they would perform an average of 38 caesareans a month, now it's down to an average of 18.

The day I visited there were just 18 patients.

"Normally it's more than 50," he said.

Dr Cisse said his biggest worry was that if these expectant mothers are not coming to the hospital, then they may be dying at home.

Painful question

Before the Ebola epidemic, it was already a battle getting pregnant women to visit a clinic or take their babies for vaccinations; most instead chose to see a traditional healer.

Guinea is already in the worst 20 countries in the world to be a mother, according to the charity Save the Children.

One in 10 children dies under the age of five.

Women have a one in 30 chance of dying during childbirth.

But this was a battle health professionals say they were winning, until Ebola came and people lost their trust in mainstream health care.

As well as mums dying in their homes, doctors have seen polio and measles outbreaks because people aren't getting their children vaccinated, Unicef health specialist Dr Ibrahim Cisse told me.

Even though Guinea has been declared free of Ebola transmission, its aftermath will last for years to come, not least by Ms Soumah.

Back in the village of Kalemodiagbe, Ms Soumah looked around at the other new mums feeding their babies.

Her baby would have been around the same age now.

I asked the grieving mother the most painful question; what do you think would have happened if you had seen a doctor?

"During the pregnancy the baby moved lots so I think if I had have gone to hospital for the birth it would have survived."

More on Ebola

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How we lost control of the Ebola virus in 2014

Is this the tree where Ebola started?

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