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Saving mother’s lives: the dedication of a doctor

© UNICEF/2009/Naser Siddique
Dr Emdadul Haque reviews the patient records of a pregnant woman who will give birth in his facility.

23 years ago, Dr Emdadul Haque lost a patient: a young mother who died because of severe bleeding after childbirth. Then a junior doctor, Dr Haque tried his best, but failed to save the woman. Plagued by grief and guilt, Dr Haque dedicated his career to ensuring safe childbirth and motherhood.

Now a specialist in gynecology, maternal and neonatal health, Dr Emdadul has worked for the last two decades as the obstetric specialist at Chowgacha Health Complex in Jessore, a district in south-western Bangladesh.

Award-winning health facility

Each year for the last four years, Chowgacha has won the Best Performing Award for Emergency Obstetric Care, a national award given to the twelve public health facilities that achieve the highest quality care. The award is sponsored by the Government of Bangladesh, Directorate General of Health Services and supported by UNICEF.

The prize recognizes the tireless efforts of Dr Emdadul and his staff to improve the facilities and level of care provided by their hospital. To qualify for the award, Chowgacha’s was judged according to the number of births taking place in their emergency facilities, the number of complicated cases, the numbers of cesarean sections and the overall mortality rate across all cases. Over 52 per cent of births in Chowgacha sub-district take place in the health complex, compared to a national average of only 15 per cent.

The hospital’s success is due in large part to a safe motherhood programme designed by Dr Emdadul. He and his staff devised a record management system, under which the health and treatment of pregnant women is properly monitored. “Pregnant women are given a card when they first visit the health center for tetanus immunization,” says Dr Emdadul. “This starts the monitoring of the health services they receive for the entire period of their pregnancy and post-delivery.”

Details specific to each pregnant woman are recorded on cards, ensuring that when they next visit the complex, the staff already have a good idea about what treatment they should be receiving. It sounds simple, but keeping track of all pregnant women in one sub-district is a lot of work.

‘The initiative was appreciated not only by hospital officials but also by local administration, representatives of local governments, the Ad-Din Hospital in Jessore and members of civil society,’ says Dr Emdadul.

‘The best part is that this is free. Women do not need to pay a single coin for our services. Under the programme, registered pregnant women receive four antenatal care visits, and advice about nutrition, health, family planning and the benefits of giving birth at hospital. Regular check-ups have helped us to significantly reduce the risk of maternal mortality in the area.’

UNICEF has also been working with the Chowgacha Health Facility to improve their ability to serve pregnant women and neonates.  Doctors and nurses are trained in emergency obstetric care and anesthesia. UNICEF has also provided equipment for operating theatres, generators to maintain power during blackouts and comprehensive equipment for blood transfusion.

© UNICEF/2009/Naser Siddique
The 17 dedicated emergency obstetric care beds are always full at Chowgacha Health Complex.

Community support is essential

However, as Dr Emdadul acknowledges, these material improvements would mean nothing without the support of the local community. ‘With community awareness, anything is possible. Without community support it is impossible to achieve anything,” he says.

To encourage women to utilize the health complex, UNICEF introduced a “women friendly hospital” policy which sensitizes staff to gender issues and the problem of violence against women - a significant problem that causes 14 per cent of deaths among pregnant women in Bangladesh.

Dr Emdadul believes that the improved care and services have boosted women’s confidence in the health complex.

Farida, 18, who has just given birth at the complex, said that the hospital and their staff have given her confidence in the health care system. She is grateful to the doctors who helped her give birth after a prolonged labour, a horrific experience that lasted seven days before her family consented to bring her to the doctor. Her mother-in-law also commented that she was very pleased with the services and would not hesitate to bring Farida directly to the complex in future. Mother-in-law often play a critical role in decision making.

As more and more women chose to deliver at the facility, real progress is being made in reducing maternal and newborn mortality rates.

Not only women, but the entire community has stepped up to support the obstetric care facility. Dr. Emdadul explains how a group of 500 community members have volunteered to donate blood whenever there is a need. The chairman of the local council supported their initiative by donating blood bags for use in the new blood transfusion unit.

Dr Emdadul is proud of his achievements. ‘If we want to reduce maternal and child mortality and morbidity rates and ensure quality services are provided to mothers and children, we have no alternative but to bring pregnant women to the hospital. This is the only way to save lives of mothers and newborn babies in rural Bangladesh.

 

 

 

 

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