ANDREA SEABROOK, host:
This is WEEKEND EDITION from NPR News. I'm Andrea Seabrook. For women in Africa, the chance of dying in childbirth is many times higher than in industrialized nations. Just getting the most rudimentary health care can be a substantial challenge. But for pregnant women in this tiny central African country of Burundi, that challenge eased this year when the government began offering free medical care. The challenge now for the impoverished nation is finding the funds to pay for the program. Michael Kavanagh reports from Burundi's capital.
MICHAEL KAVANAGH: The operating room floor of Rumonge Hospital is covered in dried blood. Just outside the OR, bloody gauze and a half dozen buckets of dirty water from the hospitals latest cesarean section are strewn around a steel sink. Dr. Innocent Ntamavukiro, one of only two doctors for the 120,000 people of Rumonge, says the generator at the rural hospital is broken and there's no water with which to clean up after operations. The faucets are completely dry, he says, not a drop. And they probably won't be fixed for another two or three months.
Rumonge hospital is overflowing with patients, especially newly expectant mothers. In May, the Burundian government began offering free health care to all pregnant women. Before the program, Dr. Innocent used to treat around 50 pregnant women each month. Now he treats almost 200. It's left the young doctor exhausted, so exhausted in fact that he admits that he's thought about joining many of his medical school classmates who now work in Europe or North America, where there's always water and power and where he'd do less work for much more money.
Dr. INNOCENT NTAMAVUKIRO (Physician, Rumonge Hospital): (Foreign language spoken)
KAVANAGH: But in the end, the young general practitioner says, it's better to stay in your own country, especially when the need is so great. At first, the free health care program was hailed by Burundians and the international health community alike. It used to cost about $10 to give birth in a Burundian hospital. For a cesarean section it cost about $200. It might not sound like much, but most Burundians earn less than $1 a day. Dr. George Guhungo(ph) is the director of Burundi's reproductive health program.
Dr. GEORGE GUHUNGO (Director, Reproductive Health Program): Even if they assure us there is a program, they don't have the money to go to the hospital. You tell them to give $10, they can't. They can't get the money, so they stay home.
KAVANAGH: In fact, before the initiative 84 percent of Burundian women had their children at home. Dr. Jondier Mirambu(ph) works for the World Health Organization, which advised the Burundian government on the policy.
Dr. JONDIER MIRAMBU (World Health Organization): (Through translator) There are many Burundian women who need a cesarean section and can't afford it, and who are therefore going to die. Just in terms of human rights, it's not acceptable. It's difficult to accept or to tolerate. So we must find a way to help them, whether they have money or not.
KAVANAGH: But the program is costing far more than expected. Foreign donors like the European Union will contribute around eight million dollars to the healthcare sector this year, but Burundi still needs millions more to restore its infrastructure and increase the pay of the country's 350 doctors, whose average salary is only $60 a month. Again, Dr. George Guhungo, Burundi's director of reproductive health.
Dr. GUHUNGO: We are calling all organizations that can help us - World Health Organization, UNICEF is trying to help us. I think that we have to come out with a solution very quickly.
KAVANAGH: But while the government waits for a solution, Burundi's mothers to be are still waiting for hours, sometimes days, outside the country's hospitals. At Prince Regent Charles Hospital in downtown Bujumbura, the line spills into the courtyard. About 30 women in brightly colored head wraps and dresses crowd around three small benches under a dusty bush.
Ms. RAHAMIAN NIZIZAMANA(ph): (Foreign language spoken)
KAVANAGH: Rahamian Nizizamana is 31 years old and nine months pregnant with her fifth child. I came here at noon yesterday, she says, and I've waited on this bench and still haven't been seen. She spent the night in the courtyard and had barely eaten in a day. Other public hospitals have had to turn patients away due to lack of space. And at least one woman has died while waiting outside a maternity ward. For her last child, Rahamian came to this same hospital and paid hundreds of dollars to have a cesarean section. But her husband recently died and she can no longer afford a private hospital. One of the women waiting next to her chimes in.
Unidentified Woman: (Foreign language spoken)
KAVANAGH: It was better before, she said. You pay and they'd actually see you. For NPR News, I'm Michael Kavanagh. Transcript provided by NPR, Copyright NPR.
