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When a child has a child

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Victoria Makhumba being comforted by a nurse

When she was growing up, Agnes Mateyu 17, wanted to become a nurse, to help the sick, heal, with her charming smile.

But instead of being in school, chasing her dream, Agnes, a standard 8 dropout is in pain recovering from birth complications at Zomba Central Hospital’s postnatal ward.

Agness married early, got pregnant and sadly, lost her child. The reality is that she will never give birth again because she lost her uterus to serve her life.

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She has since been in and out of operating theatres as her incision wound keep gaping and getting worse.

However, Agness is lucky because she survived when most of them die — a tragedy of many young girls in Malawi today.

According to UNICEF, in every 100,000 live births in Malawi, 807 mothers die as a result of pregnancy and childbirth related complications.

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Worse still, the younger they are, the much risk they are in.

For Agnes, a combination of several factors contributed to the death of her child and loss of her uterus. Distance from her home to the hospital and her age worsened the already bad situation.

“I failed to deliver at the health centre in the village. The doctors said the baby was too big. They referred me to Balaka District Hospital where I was operated on. The baby was removed but died minutes later,” she says.

Agnes’ mother, Kelita Fernando provides an even more chilling account of her daughter’s nightmare in labour.

In a classic example of the role distance plays in child birth poor, Fernando said after a failed labour at Kafumbata Health Centre in Ntcheu, with the head of Agnes’s baby almost visible, her daughter rode on a motor bike from the health centre to Senzani turn off where she boarded a minibus to Balaka District Hospital.

“At Kafumbata Health Center, I saw the doctor approaching me. She told me that Agnes was failing to push. She said a head of the baby was visible but there was nothing they could so I had to find a means of transport at to Balaka District Hospital. I was devastated. I did not know if my daughter could survive. They took something [Vacuum Extraction kit] and started pulling the baby out but it did not work.

“I later found some money and hired two motor bike taxi operators. One of them took me and our belongings to Balaka District Hospital where she was operated on. The doctors at Balaka District Hospital told me that the baby did not even cry. They said we stayed too long at the health centre and the baby died because of suffocation,” she said.

Fernando said her daughter started coughing and passing loose stool which forced Balaka District Hospital to refer them again to Zomba Central Hospital

At Zomba Central Hospital Agnes went straight to ICU before doctors removed her uterus to serve her life.

“The doctors told me that Agnes’ uterus was severely damaged and the only way to save her was to remove it. I said it was okay provided my Agnes gets better. I didn’t want to lose two people in a day,” she said.

While distance and poor referral system played a role in Agnes’s labour nightmares, the truth remains, she was too young, and her pelvis was not big enough for the baby.

Alinafe Chamveka, a midwife at Zomba District Hospital, explains the other reason that contributed to the death of the baby.

“Agnes’ situation is common among teenage mothers. Usually there is disproportion between their pelvises and the babies so they fail to descend. The labour was for too long and in the end the babies are asphyxiated (suffocation). That is why even the baby died,” she said.

Chamveka said child marriages and teenage marriages should be discouraged at all cost to protect lives of the girls and the neonates.

“There is a direct relationship between the age of mothers and the neonatal deaths. These teen mothers mostly do not understand what we tell them when they are in labour,” she said.

Agnes is not the only girl in the situation. Thousands experience what Ages is going through but very little cases are reported

Another girl, Victoria Makhumba, 18,also had the same experience like Agnes

But unlike Agness, her child survived. But she will also never give birth again because her uterus was removed to keep her alive.

Experts say the key challenge to ending child marriages in Malawi is entrenched attitudes that accept the practice. It is also closely linked to poverty, as often in rural areas girls will be married off very young to improve a family’s status.

Once upon a time, Malawi was a star performer reducing neonatal deaths from41 in every 1000 in the year 2000 to 23 in 2016 representing a 50 percent drop.

The neonatal deaths, however, remain high as the country has one of the highest rates of child marriages and teenage pregnancies in the world.

In Malawi, approximately 1 in 2 girls married by the age of 18 while 4 out of every 5 women who are giving birth are below the age of 18.

The fight against early marriages, teenage pregnancies therefore remains an answer to child survival.

United Nations Children’s Fund (Unicef) on February 20, launched Every Child Alive Campaign with the aim of giving every child in the world a chance of survival.

Sharlene Thopmson, Unicef Malawi’s Partnerships Specialist says Unicef believes that early marriages and teenage pregnancies have to be stopped by empowering young girls to be in school.

“We are lucky that Malawi has been doing great in ending neonatal deaths but we need to do more. We need to do more especially when we look at the issue of early marriages and teenage pregnancies. When a child has a child there are more complications. Usually the babies are born prematurely and also asphyxiated,” she said.

Senior Chief Kachidamoto made global headlines when she demonstrated how to stop child marriages in her area.

She broke over 1,000 child marriages and sent the girls back to school.

She asks the government to scale up the bylaws which she established in her area to end child marriages and teenage pregnancies on a national level.

The chief however places more responsibility of taking care of young girls on their parents.

“As chiefs we have authority over the girls as our subjects but the main responsibility lies with their parents. They are closer to them than we are and the girls will respect their own parents than how they would respect the chiefs. Every parent should make sure that his or her girl child is going to school,” she said.

The mother to Agnes admits her child was allowed to get married at a young age.

“She is too young. She should have not been pregnant at that age. Perhaps that is why she sustained all those complications,” she said.

For Agnes, this should not happen to another girl in the world.

She regrets that at early she got married and pregnant; she lost the baby and her dream of becoming a nurse.

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