Kajiado girls betrayed at birth: Minors face Obstetric Violence, sky-high bills and brutal neglect

Kajiado is marked as one of the counties where maternal and sexual reproductive health violations and obstetric violence cases are rampant. As fate may have it, it is not a coincidence that 14-year-old Naeku and 15-year-old Pilanoi are victims of these vices; from child sexual abuse, structural violence, denied delivery services to being held in hospitals for not being able to settle maternal care bills.

We are welcomed by song and dance renting the air at Tinga village; and, No, it is not a wedding ceremony. It is the final push to mark the end of a two-week fundraising drive to help settle over Ksh.70,000 hospital bill arrears that Esther Pilanoi incurred at Fatima Mission Hospital in Rongai, Kajiado County.

Pilanoi spent five days in hospital after a successful Cesarean section (C-section) delivery. Naeku, on the other hand, suffered a still birth and then warmed ward beds for two days as she was unable to promptly settle hospital bills.

Both families endured hardship, as their young daughters Naeku and Pilanoi maneuvered bad roads for hours and gave birth after desperate, long and rough journeys to hospitals in Kiserian and Rongai respectively - over 70km away from their Tinga village. This after being tossed around by health facilities within their reach.

“At that time, Kajiado County health practitioners were on strike, I took my daughter to a private hospital but we were referred to a facility in Rongai, 70 kilometers away from home,” says Montoka Kipas, Pilanoi’s father.

As for Naeku, she suffered a still birth after laboring for over 24 hours. She had been turned away by four facilities for fear of attending to her due to her small body and young age; they feared that they may not have had suitable healthcare equipment in case of a bigger emergency during childbirth. Naeku and her mother, like Pilanoi, had to locate a faraway hospital where her baby was declared dead in the womb on arrival.

“We could not get help at Oletepesi county hospital, there was no midwife on duty and the labor ward was closed, that’s what they said. In the second private facility we visited, the officer we found told us that my daughter was too small and the baby she was carrying was too big for her to push, as such he referred us to Kiserian which is far away from where we live. I helplessly watched my daughter labor the whole night before we set out in search of a facility the following day,” narrated Esidai, Naeku’s mother.

Githunguri Member of Parliament Gathoni Wamuchomba described Kenya as a punitive country that believes that a minor getting pregnant is a crime, noting that sometimes public hospitals intentionally reject teen girls who show up to deliver.

As for Pilanoi, after giving birth, according to her father, the hospital could not allow her mother to help her with the young one.

“The doctor I talked to said that Pilanoi’s mother couldn’t be allowed to take care of her and the baby in the hospital as no one is allowed to remain in the ward to take care of the patients, because the hospital has so many nurses to take care even of the mothers who have delivered,” said Mzee Montoka.

Pilanoi narrated: “I was in so much pain, I suffered so much because even holding the baby was a struggle. The wound was hurting so much, I cried most of the time for the 5 days I was in the delivery ward, I wished my mum was by my side just to help me with the baby.”

More troubles awaited the two young mothers in the wake of their traumatic birth experiences. Naeku and Pilanoi’s families were unable to immediately pay their hospital bills.

Pilanoi needed to clear a Ksh.70,000 bill before her release, it took the intervention of a good Samaritan who secured her release on the strength of land as collateral. Naeku’s family, on the other hand, had to liquidate their property to get her home.

“I left my daughter in the ward for two days as I went looking for manual jobs and sold two goats, my only wealth, to pay her hospital bill to secure her freedom,” said Esidai, Naeku’s mother.

Mzee Montoka got perplexed with the bill he was handed when the family showed up to pick up Pilanoi from hospital.

“When we went to pick her up, I was handed a Ksh.100,002 bill. We looked at each other without comment, I almost collapsed. I didn’t expect it would be that high, we were not prepared psychologically to pay such amount. Looking back home, we didn’t even have goats to sell, I had 25 cows which unfortunately were all wiped out in the past draught,” HE narrated.

A heaven-sent neighbor, Sospeter Nkuito, would later come through for the family by offering a 15-acre land title deed as security to have young Pilanoi and her little baby released from hospital.

“I was touched when I saw the young girl cry in the ward. Instead of concentrating on her little one, all she did was crying out to have her mother by her side,” recalls Nkuito.

“I had not even thought of what if they would not be able to settle the hospital arrears, then what happens to my land, all I wanted was to help, for the girl and her baby to get out of the hospital.”

Pilanoi and Naeku’s stories reflect the plight many women and young mothers go through regularly during pregnancy, at child birth and during postpartum period in many Kenyan health facilities.

The government’s pledge on access to maternal healthcare through ‘Linda Mama’ remains in limbo with the teething problems experienced through the new Social Health Authority (SHA) covers.

Ruth Mumbi Executive Director, Women Collective Kenya, believes that the Kenyan government is not keen on protecting young girls and has not laid down regulations to cater for sexual reproductive health of the teenagers, especially when they get impregnated, as even the violators of the girls’ sexual rights go free.

“Our government doesn’t care for the health of the young girls whose sexual rights are violated and get impregnated and give birth while they themselves are children, that remains a huge challenge,” lamented Mumbi.

Wamuchomba expressed disappointment on the struggle she has had for over two years to introduce a motion in Parliament for the government, through Ministry of Health, to acknowledge OBV as one of the violations of gender rights.

“Every time it's just about to be read, it is pushed back. It's very unfortunate that in that National Assembly, we have a Deputy Speaker who is a woman…we have many other strong women elected on the platform of women representation…and such a motion can never be given a priority,” lamented the lawmaker.

While Kenyan law remain silent on treatment of forms of obstetric violence and handling culprits perpetrating the vice on women, the International Confederation of Midwives (ICM) categorizes OBV as a serious human rights violation, as well as a recognized form of gender-based violence which is supposed to be dealt with gloves off.