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Last Updated: Monday, 17 April 2006, 11:55 GMT 12:55 UK
Helping the mothers of Benin
By Jane Elliott
BBC News health reporter

Inside the maternity hospital
Healthy twins born in the maternity hospital
Adakoun* lies brain-damaged in a Benin maternity hospital.

Only hours before, the young mother had given birth to her third child.

Her previous pregnancies were smooth and uncomplicated, but this time she was not as lucky.

Towards the end of her pregnancy Adakoun, who lives on the outskirts of the country's main city Cotonou, started to become drowsy and unable to talk.

Her body became swollen with retained fluids and her family started to worry.

Risk

Benin has just three ambulances for a population of 7.5 million, so the family knew they would have to get Adakoun to hospital themselves.

It took nearly two hours to get her to hospital where she was diagnosed with pregnancy-induced hypertension - high blood pressure.

Tests showed her blood pressure had soared to 180/120. A high reading is considered to be anything in excess of 140/90.

Dr Judith Hall
If we had the maternal mortality rate in Wales that they have in Benin people would be up in arms. It would be a national disgrace
Dr Judith Hall

Adakoun was slipping into unconsciousness and medics decided they must deliver the baby immediately.

Because Benin hospitals cannot afford to routinely carry the drugs needed for operations, the family was sent to buy the drugs Adakoun needed.

Luckily, the family were able to buy the drugs, Adakoun had a Caesarean, and the baby was delivered safely.

But her blood pressure was still too high, and Adakoun started to fit.

A simple drug called magnesium sulphate would have stopped the fits, but the family had now run out of money and all the medics could do was to leave her on a breathing machine.

Eventually the fitting stopped and her blood pressure dropped, but it was too late. Adakoun was left brain-damaged.

Sadly in Benin, Adakoun's story is not uncommon. A desperately poor country, the hospitals have little or no money, meaning that families must pay for everything.

Mortality

There are too few doctors. Benin has only nine anaesthetists and the maternal mortality rate is one in 50, although many suspect this is even higher as many women do not even make it into the hospitals.

Worried by these appalling death rates a Cardiff University lecturer and anaesthetist decided to set up the 'Mothers of Benin' charity to try and avoid unnecessary deaths.

Dr Judith Hall explained that her charity hopes to educate doctors, nurses and other carers in the mechanics of anaesthesia and to teach them about the warning signs when problems arise in pregnancy.

By teaching the locals she hopes to provide a long-term improvement in Benin.

Inside the maternity hospital
A patient just arrived in the maternity unit

"Adakoun's sad outcome could have been avoided if a lot of things had been improved.

"If her dangerous condition had been diagnosed earlier, then she would have arrived at hospital quicker. If her relatives hadn't had to go and get the drugs themselves, leading to a delay, that would have helped. If magnesium sulphate had been available, that could have prevented brain damage.

"This lady survived and her condition may improve over time, but many women don't survive.

"As an education charity, Mothers of Benin' can help by improving early diagnosis and treatment."

Dr Hall and another colleague have already been out to Benin to train up local staff. They plan to return this month as a four-person team, spending 10 days in the former French colony on the western border of Nigeria.

"The people of Benin are trying to help themselves by setting up a training school which will benefit not only them but the rest of Sub Saharan Africa as well.

"For us this is a long-term, sustainable commitment - we want to offer them education and knowledge for the future. The School of Medicine at Cardiff University has a lot to offer. We are good at training and teaching, it's what we do best."

Aid

Dr Hall said aid needed to be better distributed in the country, ensuring medics have the proper skills to use the available equipment.

"One western government delivered some equipment to help with pressure ulcers. It was worth a million pounds, but is under dust wraps because nobody knows how to use it. It is misplaced giving. What these people need is education.

"If we had the maternal mortality rate in Wales that they have in Benin people would be up in arms. It would be a national disgrace."

*Adakoun's name has been changed to protect her identity.




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