COVID-19 affecting maternal health in DRC

Gabrielle Nina Mitch,

Kinshasa, 3 July: For many women who are pregnant during this time of corona virus this journey in their lives has been uncertain.

Arlette Mali Mungu Bahati, resident of Kinshasa city, is just a month away from the birth of her second child, but her anxiety has remained constant feature of her pregnancy since COVID-19 was reported in the Democratic Republic of Congo (DRC) in March. At one time when Bahati was feverish, she refused seeking medical attention owing to her anxiety and the risk of exposure to COVID-19 in hospitals.

Since March Bahati, who at the time was 5 months pregnant has witnessed several restrictions, including shutdown of the market where she makes an income from a clothing store. It was inevitable, her shop was located in one of the most frequented places in Kinshasa and government had to enforce social distance, an important protocol of curbing the spread of the virus.

With her livelihood affected, and her anxiety reaching new levels, Bahati says her pregnancy makes her more of prisoner than fulfilled.

“I have limited my outings because of the coronavirus, I hardly go out anymore for fear of being contaminated,” the expectant mother said.

She took even more drastic step. Afraid of being infected, Bahati decided to change hospitals. She could no longer continue to be examined by her usual gynaecologist at Ngaliema Hospital, with whom she had already established a good relationship since her last pregnancy. Her previous hospital located in Gombe municipality in Kinshasa City, the epicentre of Coronavirus, was one of 8 hospitals designated by the government to receive COVID-19 patients and she could not risk it despite assurances of care against contracting the disease. With the change, comes unavoidable financial consequences. She said the change is costing her dearly because while at her previous hospital prenatal consultations were free, but now she has to pay $10 per consultation in the new hospital and $20 whenever she requires the attention of a gynaecologist.

“At my former hospital, I was very used to my gynaecologist because he understood me better. I could call him at any time in case of discomfort but now I consult a general practitioner doctor just to check the evolution of my health. If I have to see a gynaecologist I must pay $20,” she said.

“It’s true that they’re all doctors and I trust them but the problem is that I’m not used to them and have to start all over again. I have a lot of self-restraint and I’m anxious because I don’t even know the health status of the doctor who consults me and the nurses who welcomes me, the situation is just complicated, but I trust God, he is in control, I will deliver my baby without complication.”

Coronavirus pandemic caught the world unaware, affecting all facets of human lives and motherhood is not spared. Fear, anxiety and uncertainty are disrupting this normally happy period for expectant mothers. Pregnant women are increasingly changing their places of consultation with a large number of them stopping prenatal consultations and care. Dr. Kabongo Kanyanya Jessy, Head of Program at AFIA MAMA, a non-governmental organisation (NGO) working on promotion of women’s rights and gender in Kinshasa city noted that pregnancy itself is a period of anxiety for women and COVID-19 has successfully multiplied it. He further noted that the government should put in place a policy to take care of pregnant women especially at this critical time.

“Fear is justified by the likelihood of inadequate care for the pregnant women by the health care staff. For example, if confronted with a pregnant woman who has malaria in this period, the pregnant woman will be received with suspicion once she presents these symptoms such as fever, cough, and cold. The government should develop a policy for the management not only of COVID-19, but also to consider other associated pathologies and above all to capitalize more on the follow-up of pregnant women because they are much more exposed,” he said.

Dr. Mukendi Richard, a gynaecologist at the University Hospital in Lubumbashi said, “although to date there is no scientific evidence to indicate that pregnant women are more vulnerable to COVID-19. Pregnancy is however accompanied by physical changes, and pregnant women may sometimes be more exposed to viral respiratory infections insofar as there is a physiological decrease in natural immunity during pregnancy to enable the pregnant women to support the father’s foreign cells present in the foetus,” he noted.

He, however, observed that social distancing is impossible in the management of delivery and this, alongside other modalities of clinical and paraclinical examinations of the pregnant women should be put into consideration in a country.

Despite the risks involved, consultations are conducted by healthcare workers in compliance with World Health Organisation sanctioned safety protocol for COVID-19. In spite of this, prenatal attendance has continued to decline with more pregnant women reportedly relying on home and traditional care.

“In fact, we are seeing a significant drop in the number of pregnant women attending public hospitals because of the fear of easily contracting the virus. But also because of the fear of being held in isolation in case of suspicious symptoms or a positive COVID-19 result,” Dr. Mukendi said.

While wearing a mask is recommended, Bahati, who is in her third trimester, finds it very inconvenient as it prevents her from breathing well but she feels obliged to wear one anyway. Local healthcare workers have also observed that pregnant women don’t tolerate wearing a mask including their non-pregnant counterparts.

Despite the preventative measures put in place by the authorities to reduce the spread of the novel virus, such as movement restrictions, partial containment, compulsory wearing of masks, disinfection of buildings, hand washing and mass awareness of barrier gestures, cases have continued to increase in the DRC. Within four months, the number of laboratory confirmed cases of COVID-19 in the DRC has exceeded 8,000 with Kinshasa recording 90 percent of cases. There are fears of rapid community spread of the disease throughout the country and pregnant women, just live other groups in the society, are left to either risk being infected or adhere to the safety protocols recommended by the World Health Organization. Either ways, one thing is certain and it is that the health care sector in DRC is over-stretched. The fight against covid-19 is hampered by the country’s poor health facilities and lack of infrastructure, but also by a population that refuses to believe in the reality of the virus

Gabrielle Nina Mitch,  is a journalist from DRC.  This story is part of the GL News Service Gender and COVID-19 series.