“He had mastered all the toddler stages of sitting, crawling, walking and was able to communicate quickly.
“As a mother, I could see a bright future ahead for my boy only for fate to take a cruel course.
“It’s like you planted a flower and someone plucks it out.
“Losing a child is so disheartening, but as religious people we are taught to believe that it is God’s will.”
These were the words of Tendai Hove (not real name) from Garai village in Bikita, a staunch member of the Johanne Marange Apostolic Church.
Fate, it seems, has been particularly cruel to her.
Hove, at the tender age of 21, lost her seventh born child in 2022.
The cause of death is unknown since a post-mortem examination was not done due to her religious beliefs.
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Hove remembers vividly how her son died.
“He was only a year old,” she recounted.
“One day he was playing with other children and I realised that he was not okay although his temperature appeared normal.
“At first I thought he had caught a cold since there was an outbreak of flue in the neighbourhood.
“He was very young and could not explain what was wrong.
“I, however, remember that he came home touching his neck and said ‘mama agaja’ (mom it’s painful ).
“I woke up the following morning ready to go to church to get a prayer so that he could be delivered from this sickness.
“Before I left my mother-in-law asked to examine the baby’s mouth. I then realised that he had mouth ulcers.
“My mother-in-law made a cooking oil and salt mixture and brushed his mouth using a feather.
“We then cooked some porridge, but he only had two gulps.
“He couldn’t swallow the third one and that was it. He died right before my eyes.”
All her deliveries were done with the assistance of church midwives at home.
Hove is, however, a dogmatic woman. She does not blame anyone for the death, as she believes it was God’s will.
She is, however, not in a club of her own as the Zimbabwe Statistical Agency census report of 2022 indicated that death during the first year constitutes the largest proportion of the total deaths.
The level of mortality for this age group is measured by infant mortality rate, which is the number of children dying before they celebrate their first birthday out of 1 000 born alive.
The census also indicated that the infant mortality rate was higher in rural areas than in urban areas.
In Masvingo Province, rural areas recorded 63 deaths, but urban areas recorded 56 deaths per 1000 live births.
Bikita had the highest infant mortality rate of 67 deaths per 1 000 live births while Masvingo urban had the lowest with 54 deaths per 1 000 live births.
Chiredzi recorded 67 deaths, Chivi 65, Gutu 63, Masvingo 58, Mwenezi 64, Zaka 58 and Chiredzi Urban 57 deaths.
Many villagers in Bikita believe religion has contributed to high infant mortality rates in the district.
Maximilan Chigumira, also known as Headman Chirobho of Chirobho village says most cases of child deaths are from members of the apostolic sects.
“We urge people to vaccinate their children so that when child killer diseases breakout your children will be immunised,” Chigumira said.
“We have the apostolic churches whose religion does not believe in going to hospitals and most cases of child deaths are coming from that sect.
“We have, however, come up with an initiative that If they do not want to visit the hospital we are going to have mobile patrols of health personnel visiting them at their churches.”
Around 43 million children below the age of five could die between 2021 and 2030 globally if government fails to urgently put in place measures to child mortality, United Nations Children's Fund (Unicef) has said.
Though in 2020 child and youth mortality was on a downward trend compared to previous year IMR is still high in rural areas.
There are many reasons for this.
This includes negligence by health personnel as well as low morale.
Renia Mupiyo had to bear the brunt of nurses and doctors’ strike at Ndanga Hospital in 2018.
“On October 24, 2018, I experienced labour pains in the afternoon and boarded a bus to hospital,” Mupiyo said.
“When I arrived, the nurses were on strike. I got in the labor ward ready to deliver but nobody was there to help me,” she said.
“There was only one nurse on duty. I would shout that the baby is coming, but the nurse would tell me I was not due to deliver.
“I had postpartum hemorrhage (PPH), that is heavy bleeding after giving birth, around 4am.
“When the doctor did his rounds, he realised that I had been due for a long time and the baby had low heartbeat.
“That’s when I was helped to deliver my baby.
“I had blood transfusion and my baby was put on oxygen, but she died around 6am.”
She said she was pained by the loss and believes her baby would be alive if she had received timely assistance.
Villagers in Bikita also revealed that inadequate health facilities were contributing to child deaths.
In some cases, villagers travel up to 30km to access health facilities.
Some expecting mothers face complications on the way to health centres while others have delivered before arriving at hospitals.
Silveira Mission for example offers services to people from as far as Gutu and Dewure.
Martha Zuva of Village 25 in Chinyika, Bikita, believes she lost her baby in 2014 due to failure to access medical facilities on time.
Zuva said transport is a problem and had spent six hours travelling to Silveira Mission.
“Where we live there are transport challenges, you can only board a commuter omnibus around 2am and get to Silveira Hospital at 8am,” she said.
“In my case, I had so much pain that I started hallucinating because of failing to get to hospital on time.
“When I got to the hospital, I thought I was going to die and cried while wishing that my parents were still alive so that they could take care of my child if I died.
“I felt the baby coming forcefully I didn’t even put any effort, it was the most painful moment I ever had in my life.
“I suddenly heard a baby cry and knew that my baby was out. I had 18 stitches.
“The whole night other babies were crying and breastfeeding but mine wasn’t.
“In the morning the babies had BCG injections, my baby didn’t cry that’s when I told the nurse that my baby is not feeding or crying like other babies.
“They took him and started feeding her with a pipe but the food was coming back through the nose, they tried to put her on oxygen that’s when I was told to leave the room, my baby had already died.”
Sheila Musavengana of Wanepi village in Bikita, who lost her child in 2016, says there is need for awareness since some deaths were caused by lack of information.
“I went to Mutikizizi Clinic to have a checkup, a lot of mothers were talking about their babies kicking in the womb, as it was my first pregnancy, I didn’t know how a baby kicks,” Musavengana said.
“I asked them how a baby kicks and they asked if mine wasn’t kicking and I told them that I did not even know how a baby kicks.
“I went back home but I started having a stomach ache.
“When I went to the toilet, I then realised I was bleeding and that really shook me. I then went to my aunt and told her.
“I then started having labour pains so we walked to hospital.
“It’s a mountainous area and we had to travel 6km to Silveira Hospital.
“We could not reach Silveira Mission Hospital as I had a delivered on the way.
“The baby was already dead and I believe she had died some time ago, because the environment was smelly.
“The baby’s skin was peeling off. We continued with our journey to the hospital where I had my womb cleaned.”
Masvingo provincial medical director Amadeus Shamhu says the state of health institutions in Masvingo is good, but concurred that there is need for more facilities, given distances between institutions.
“At the moment the state of our health facilities in Masvingo is good we are only having a challenge in some areas like Bikita District where we have new settlements along the conservancy area, which consists of Devule 1, 2, Odzi and Gava and it covers about 85km with one facility,” Shamu said.
“It means one will have to travel a distance of 20km and for pregnant women this delays one in seeking medical health.
“To curb high infant mortality rate in rural areas, government is rolling out highly trained personnel on health institutions, supplying of oxygen and oxytocin for the babies and mothers respectively, construction of pregnant mothers' shelter and grid power supply at every institution with back up.
“We have the Marange apostolic sect which is not adherent to our medical services.
“They are a closed community and we have encouraged our health workers in the grassroots to accomodate those who are coming forth but prefer not to be disclosed as this helps us in saving life.”
But over the years, however, Masvingo health institutions, including Masvingo Provincial Hospital — the biggest referral health centre in the province serving 1,7 million people, have been in the news for operating without basics.
These include oxygen and surgical blades. This has often led to delays in ceasarian operations, leading to avoidable deaths.
A human rights defender Munyaradzi Vengesayi said government should take action to halt the high infant mortality rate in the rural areas.
“In terms of section 29 (1) Constitution of Zimbabwe Amendment No 20, the State must take all practical measures to ensure the provision of basic, accessible and adequate health services throughout Zimbabwe,” Vengesayi said.
“The state should endeavor to build more hospitals and clinics in rural areas for easy access of health services during pregnancy, delivery and after delivery.
“Government should also carry out programs and awareness campaigns in a bid to teach women in rural areas about their rights, complications encountered during pregnancy and the importance of being checked up at local clinics.”
Zimbabwe Confederation of Midwives president Obert Nyatsuro urged government to strengthen some of its policies like the use of family planning methods and fund health care system as a measure to reduce infant mortality rate in rural areas.
“Government should also fund health care system so that they will be in a position to avail medication for the treatment of pre-existing conditions as these conditions will expose women to pre-maturity delivery or intra and ultra-growth restriction, those conditions that will affect the fetus whilst in the uterus such that when they are born they are not born in a compromised state,” Nyatsuro said.
“We are advocating for drills; we’re having midwives in the field to be kept sensetised on obstetric emergencies on the pre-natal care on how best we can prepare women for consumption so as to reduce infant mortality rate.
“We encourage the utilisation of family planning services and treatment of pre-existing conditions like Hypertension, Anemia, HIV and Aids and we encourage the vaccination of new borns at the appropriate times and the provision of information about baby care and the benefits of breastfeeding.”
He said negligence by health personal is debatable but with the exodus of staff there is inadequate staff members.
“The issue of negligence by health personnel is still debatable. With this exodus of staff, you will realise that we are having inadequate staff members on the ground.
“The nurse-midwife ratio is not favourable such that there is delay in accessing some of these services because of the ratios.
“In some cases, it's one midwife attending 10 women, so considering the time one will spend on one woman before moving to the other woman, we will actually have delays which actually bring in unfavourable results.”
*The story is published with support from the Voluntary Media Council of Zimbabwe (VMCZ) and the Embassy of Canada in Zimbabwe under the Investigative Journalism Fund Programme.
