Dr Jemimah Kariuki, the recipient of the 2021 Global Health Award from the WHO .

Helping women deliver babies safely in Kenya

When COVID-19 isolated expectant mothers, Jemimah Kariuki founded an ambulance service exclusively for maternity care.

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Interview subject
Jemimah Kariuki is the 2021 World Health Organization Global Health Award recipient.

She is a Kenyan doctor specializing in preventive medicine, maternal and child health.

During the COVID19 pandemic, she organized an ambulance service that enabled pregnant people to access maternity care.

She is a resident doctor of obstetrics and gynecology at Kenyatta National Hospital and the founder of Wheels for Life.
Background
According to Unicef, the mortality rate for children under five-years-old in Kenya has fallen from 102 deaths per 1,000 live births in 1990, to 43 deaths per 1,000 live births in 2019.

However, every year, 64,500 children still die before reaching the age of five, mostly from preventable causes. Three-quarters of these deaths occur before a child’s first birthday.

Only 16 percent of doctors and clinical officers prescribed the right treatment for neonatal asphyxia, even though 88 percent accurately diagnosed the condition. That’s according to a survey of 3,094 health facilities across Kenya. Less than half (43 percent) of health providers prescribed the correct treatment for post-partum hemorrhage while 90 percent gave an accurate diagnosis, the survey said.

About 9,327 newborns died from neonatal asphyxia within the first 27 days of their birth in Kenya in 2017, according to the World Health Organization. Severe bleeding during birth is the leading cause of maternal deaths, accounting for a third of them in sub-Saharan Africa.

In 2016 research evidence suggests a rise in reports of poor-quality delivery care with only 46% of health facilities in Kenya reported to have signal functions for emergency obstetric and neonatal care (EMonC) and delivery services. Poorer, unemployed, illiterate, and unmarried women often experience the lowest quality care.
 
Delivery by skilled health personnel has been established as an effective approach in reducing the risk of maternal and perinatal morbidity and mortality however its utilization is much less common among the women in Kenya with only 61.8 percent of deliveries being attended by a skilled provider.

The high cost of seeking maternity care has been associated with the low utilization of skilled care during pregnancy and childbirth.

NAIROBI, Kenya One day I read a story in the local newspaper about a woman who died in her house because she was afraid to go to the hospital as a result of government lockdowns and curfews.

As an obstetrician and gynecologist at the Kenyatta National Hospital, I wanted to do something to help women have safe deliveries during COVID-19.

I started a charity called “Wheels for Life” and have since received the World Health Organization’s Global Health Award.

Saving lives started with a simple tweet

I started my campaign and charity in 2020 with a tweet.

It read, “Hi any lady in this curfew and Covid time who feels they are unable to reach the hospital and they are in labor or have an emergency kindly reach out and I will do my best to intervene. #covid #letscreatesolutions #maternalhealth kindly RT that many can get help.”

I hoped that women in need of help, who were afraid to travel due to government curfews, would reach out instead of risking staying home and possibly dying. I went as far as giving out my mobile phone number on social media for people to contact me.

The first step included giving expectant mothers information and guidance for when their due date approached. I advised them not to panic when they experienced labor pains in the dead of night during curfew hours.

Still, fewer and fewer expectant mothers were coming to the hospital for deliveries. I wondered where they were delivering their babies and if they were safe. Did they even have doctors by their side?

Funding and public recognition strengthens the mission

It wasn’t long before I discovered the missing link. These pregnant mothers had no means of emergency evacuation nor a way to communicate with the available transportation options.

With “Wheels for Life,” I could send an ambulance to pick expectant mothers up from their homes and take them to the nearest health facility for safe delivery. I also set up a call center where mothers needing emergency delivery services could obtain help.

“Wheels for Life” offers free ambulance transportation for mothers experiencing labor during curfew hours.

In the early days of this campaign, I personally paid the expenses of those seeking help, but later supporters and financiers came on board.

Through public partners and corporate donors like the African Medical and Research Foundation (AMREF), Health Africa, and the Kenya Health Federation, we now reach more women in need.

The award from the World Health Organization has given me the motivation to soldier on with this work, together with my partners.

My efforts alone cannot reach every needy woman out there.

As “Wheels of Life” turns a year old, am hoping to see many more initiatives spring up, especially during this time.

This award may have come to me, but it is for all the expectant women in the world. It is a reflection of the smiles on the faces of the little angels born out of our efforts.

I want to believe that in this century of information and advancement, no woman should lose her life while trying to give life.

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Ronald Muya is a freelance professional journalist working in Kenya covering mostly topical issues and human interest stories affecting the society in his home country and East Africa.