Chicuque Rural Hospital Sees a Young, Pregnant Woman Through Malaria and Premature Delivery

A newborn fighting for her life. A burn victim. A caring nurse. A young man learning to walk for the first time. These are a few of the many faces of Chicuque Rural Hospital. Founded by a Methodist missionary in 1913, today the hospital provides health care to approximately 500,000 men, women and children in Mozambique, southeast Africa.

At 25, Paulina Antonio was pregnant with her second child and was due to deliver in March of the coming year. Paulina, who lived just two kilometers from Chicuque Rural Hospital (CRH), preferred the care provided by the hospital as opposed to the more common rural tradition of giving birth at home with the assistance of a midwife. Her first experience with the hospital came when she contracted malaria and was required to stay there for a week during her fifth month of pregnancy. As it turned out, the illness hospitalized Paulina four more times during her pregnancy.

Malaria is a parasitic disease that is transmitted through the bite of an infected mosquito. There is an incubation period of 7 to 14 days before signs of the sickness appear. Symptoms include fever, chills, sweats, cough, diarrhea, respiratory distress, and headache. If left untreated, malaria can lead to much more serious conditions, even death.

Beyond the danger that malaria presented to her unborn child, Paulina was plagued by the disruption that the illness caused in her daily life. At the time, her husband was away in France, receiving training in telecommunications. Left to care for her five-year-old daughter and tend to her small business, Paulina had to rely on others for assistance. Her mother was able to help her care for her daughter but there was no one to manage her shop-- a small hut near CRH where Paulina sells refreshments and snacks.

During the final two months of her pregnancy, Paulina went to the hospital several times for treatment. When she was admitted for an overnight stay, the expectant mother was placed in the maternity ward in a special division dedicated specifically to treating pregnant women infected with malaria. It is recommended that hospitalized patients remain under the protection of mosquito nets from dusk until dawn. CRH was able to provide Paulina with a net, a rare amenity for most hospitals in Mozambique-- Paulina did not even have her own mosquito net at home.

Most importantly, the staff of CRH were careful to provide Paulina with medication that would effectively treat her malaria but would not be harmful to the baby.

At 10:00 PM, the night before she gave birth, Paulina was home and began to feel sick, when her water broke. She immediately gathered her mother and sister to assist her to the hospital knowing that a water break in the 7th month of pregnancy was not normal. She feared for the health of her baby.

Paulina did not have access to a phone and was unable to call for the CRH ambulance. She did not have a car. Paulina, her mother, and sister had to walk the two kilometers on a dirt road to the hospital.

Luckily, Paulina did not begin to experience intense contractions until she was near CRH. Upon her arrival, she was assisted immediately by Mr. Baule, the primary OBGYN nurse at the hospital. Mr. Baule knew her well because of her frequent visits to the hospital during the past two months. According to Mr. Baule, premature births are particularly common at Chicuque with women who have been infected with malaria.

Paulina delivered twins. After just two hours, the first baby was born, a girl. Though Diandra Dabella only weighed 1.6 Kg, she was healthy. About 20 minutes later, Paulina delivered the second baby-- a stillborn boy. She tried not dwell on the loss of her son because Mozambicans believe that showing remorse for the death of one twin will sadden the living baby and bring misfortune.

CRH requires that babies weigh at least 2kg before being discharged. So, the new mother and daughter remained in the hospital for a total of 15 days. Paulina was lucky enough to have the support of her mother, sister, sister-in-law and church friends to help her at the time of Diandra's birth. They visited often, bringing Paulina sweets and fruits. They also laundered the baby's dresses and returned them later in the day. Members of her prayer group, who were praying for the safe recovery of Paulina and her new daughter, also came to see her.

Paulina is grateful to the staff of CRH, especially Mr. Baule, for their care. Mr. Baule visited with Paulina and Diandra Dabella every day during their stay at the hospital to ensure that both mother and child were comfortable and feeling well.

Diandra will celebrate her first birthday in 2003. She is a happy, beautiful and loving little girl who lets those who visit her embrace and coddle her. Paulina has resumed the management of her business and continues with her life.

Photos: 1. Paulina Antonio. 2. Paulina holding her daughter Diandra Dabella. Credit: Anya Nawrocky, 2003. Click on the photo to see a larger picture.