While the southern African country of Lesotho isn’t particularly big, it is difficult to get around. There’s little of what you would call a road network and the harsh weather often cuts off the majority of people who live in rural areas.
This makes access to healthcare an ordeal – taxis are often too expensive and trekking for days is normal.
So, imagine being pregnant. None of this is ideal, less still if you take into account that once you arrive at your local clinic, you'll probably be referred to a bigger hospital even further away. In Maseru District, it’s easy to see why only 44 percent of deliveries are attended by skilled personnel.
Yet, at St Joseph’s District Hospital in Roma, one idea is helping. The concept is simple: rather than pregnant women having to travel back and forth, often at great cost and stress to them, why not offer them a place to stay?
They can then be looked after by medical professionals, right through to birth and beyond.
The Waiting Mother’s Lodge
The Waiting Mothers' Lodge, supported by Médecins Sans Frontières/Doctors Without Borders (MSF), was barely finished when I visited, yet was already full of pregnant women. Within minutes of arriving, I can’t get a word in edgeways.
I chat to Mapulumo Moeketsi. “I came here by taxi from Semongkong, it took around four hours. Without this lodge, I’d have to come back at least every Friday. It’s hard.” She’s very relaxed and happy about the medical care she’ll receive, especially as it’s her first child.
This is important. Lesotho has one of the highest maternal mortality rates in the world, and there is a real problem with HIV and tuberculosis (TB) being passed on to newborns. Sadly this also contributes to high infant mortality rates.
Risk of complications
According to the World Health Organisation (WHO), 15 percent of mothers can expect a complication of some sort during delivery. In Lesotho, ambulances can't always be counted on to reach mothers giving birth at home in time.
“I’m lucky," explains Mahlompho Malataliana from Nazareth, over an hour away, "it would be nice if these facilities were accessible for more women. If there are complications more women can be treated immediately, not after a long and stressful journey.”
Beside her, Mpinane Machachamise adds: “Some women have left this hospital okay, became sick as they got home and came back straightaway”.
Sadly, this sounds too common, but the lodge should help avoid this happening and the caring tone in Mpinane’s voice shows how much they care for each other.
Camaraderie and companionship
Sharing the adventure of birth is clearly fostering genuine friendships here; everyone seems positive and supporting. It’s a tangible bonus on top of the high quality, free medical care and reduced travel they benefit from.
“We all get along very well,” Mahlompho tells me, “the women who’ve had deliveries share their experiences, which really helps.” I find this reassuring, as some of the women in the Lodge look very young. I'm told many are expecting their first child.
Mpinane says they have a lot of fun, too: “We go for walks, we even try to run, and we all eat together. Sometimes we steal the TV from the nurses.”
The only bad point? “There are too many of us,” says Mpinane.
MSF’s simple and effective response
As I look around, I’m reminded that sometimes the simplest ideas really are the best.
Since MSF started to cover the costs of giving birth in this hospital (equivalent to 31 USD per delivery, including transport and accommodation in the lodge), 95 percent of babies in the catchment area were born in the hospital. This is an impressive statistic compared to the nationwide average of only 44 percent of births attended by skilled personnel.
Now it's a matter of having this idea catch up in the rest of the country.