Wamala died of a cause she worked tirelessly to stop

Jul 09, 2013

All seemed well when Remy Wamala drove herself to the hospital on the evening of Thursday, June 27. Little did she know that she would not come out of it alive. Her husband was excited to welcome a new member to the family. Unfortunately, it ended in a tragedy, Joyce Nyakato writes

 

All seemed well when Remy Wamala drove herself to the hospital on the evening of Thursday, June 27. Little did she know that she would not come out of it alive. Her husband was excited to welcome a new member to the family. Unfortunately, it ended in a tragedy, Joyce Nyakato writes
 
Every day in Uganda, it is estimated that 16 women die due to pregnancy or childbirth related complications, but Remy Wamala’s death on June 28 at International Hospital Kampala, a private hospital on the ill-fated day, has caused a public stir.
 
Her death was a topic of debate in one of last week’s parliamentary sessions. Florence Mutyabule, the Woman Member of Parliament for Namutumba district, who is also a friend of the deceased, moved the motion.
 
Wamala, the coordinator Uganda parliamentary forum for children and a member of the civil society committee on maternal and new-born survival. The parliamentary discussion was aimed at a nationwide probe into the slow progress in reducing maternal death, operations and efficiency of medical services in private health facilities.
 
 Many law makers seemed baffled at the suspected negligence that could have led to their colleague’s death.
 
According to her husband, Godfrey Wamala, she was 40 weeks pregnant and had attended all her antenatal check-ups at the hospital. He reasons that if she had any complications, they should have been detected because she went to hospital early enough.
 
Mutyabule talked to Wamala on Thursday as she planned to go to the hospital. She had complained about pain and decided to have it checked. The last time she had been at the hospital, she had been told that it was a false alarm.
 
This time it was real. She was admitted on Thursday after she was found to be in early labour. By the next morning on Friday, the labour pains had progressed. “I called Wamala at 10:00am and she did not pick up her phone. At 10:33am, she sent me a text message saying she was in serious labour and was confused.
 
Mutyabule then decided not to take any further action reasoning that her friend needed time with the doctor given the ordeal she was going through. “You would not want to bother a woman who is in labour.”
 
Later on, she got information from one of the volunteers at parliament that Wamala was unconscious. Mutyabule rushed to the hospital, but found her friend had already been wheeled into the theatre. Meanwhile, her baby had been admitted in the intensive care unit.
 
The deceased’s husband, who had been with her by the time Mutyabule called, heard his wife complain that the labour pains had stopped. 
 
“I proposed that she undergoes a caesarean section if the situation was getting worse. She assured me that her doctor had it under control and that he had given her medicine that would take effect in four hours.” He then left her at the hospital under the care of her mother.
 
 “I do not know what happened,” laments Wamala who was called at 2:00pm, to be told his wife was in critical condition. By the time he arrived there, he was asked by the doctor at the hospital to look for blood. After running around, he finally got blood from hospitals in Nakasero and Bugolobi.
 
After delivering the blood, he and other family members stood outside the theatre for about 40 minutes before they were called into the room to be given the sad news.
 
“I do not know if I will recover from this. On my part I count it as negligence,” he said while promising to seek legal redress. 
 
When New Vision talked to Wamala, the new-born was still under intensive care though he had him transferred to Nakasero Hospital, because of the emotional trauma he has experienced. He says he is yet to talk to the doctors to find out what exactly happened to the new-born.
 
However, an official statement released by International Hospital Kampala reveals that Wamala was admitted on Thursday in early labour, but developed complications on the second day, with a fast progressing labour.
 
“She developed seizures, but at no stage during labour, was she known or found to have high blood pressure,” the statement said. The patient had a normal delivery. However, at post-delivery, she started bleeding profusely because her uterus had failed to contract.
 
The hospital statement added that initial measures to control the bleeding were not successful, so the patient was rushed to theatre for surgery, in an attempt to control the bleeding. Sufficient blood supplies were mobilised from the blood bank at IHK, Uganda Blood Transfusion Services and other private hospitals. The patient received five units during the surgery, but she did not make it.
 
Maternal death in Uganda is not a rare occurrence, though it is said that most of the causes can be prevented if women sought antenatal services, report to hospital early in labour and are attended to by skilled attendants in a functional environment.
 
Private hospitals tend to be better facilitated because patients pay for the services, so when a woman dies in labour there, it raises concern.
 
The Gynaecologists New Vision contacted to explain this situation were only willing to speak on condition of anonymity because, according to them, this is a ‘sensitive issue’ and that they did not want their opinion to be used as evidence in court, should it turn into a legal issue.
                                                                                                                                                         Remy Wamala
 
One gynaecologist described over bleeding after delivery as the loss of greater than 500ml of blood. In Uganda, it is the most common cause of maternal death.
 
“The inability of the uterus to contract after childbirth may lead to continuous bleeding,” he said. Also labour induction increases the risk that the mother’s uterine muscles will not properly contract after she gives birth, which can lead to heavy bleeding after delivery.
 
According to the gynaecologist, medication used to induce labour, oxytocin or a prostaglandin, — might provoke too many contractions, which may diminish the baby’s oxygen supply and lower its heart beat rate.
  
Women who are at an increased risk for postpartum bleeding include those who have had a large baby, a prolonged labour, an augmented labour, those who had a previous postpartum haemorrhage and those attempting a vaginal birth after a caesarean section. The worst kind of bleeding to contain is from women who have blood clotting disorders.
 
Ideally, the best cure for postpartum haemorrhage is preventing the condition. After birth, all women receive care in order to prevent haemorrhage.
 
Her close associate, Stella Ayo Odongo, described the late s an harden campaigner for improved maternal health services. “Her motto was, no woman should ever die during child birth.
 
 It is ironical that Wamala died while giving birth,” lamented, Ayo Odongo, the executive director, Uganda Child Rights NGO Network.
 
She adds that the moment Wamala joined Parliamentary Forum for Children, through her zeal, passion and dedicated service, UPFC soon became a household name in Parliament.
 
Women at risk of postpartum bleeding
 
  •  Those whose uterus fail to contract
     
  •  Those who had a large baby
     
  •  Those with blood clotting disorders
     
  •  Prolonged labour
     
  •  Attempted vaginal birth after caesarean section
     
  •  Induced labour
 
 

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