Women’s health has considerably improved over the last few decades. In the twenty-first century, a woman’s life expectancy at birth in more than 35 countries is upwards of 80 years, but in Africa it is only 54 years according to recent World Health Organization (WHO) statistics. Out of 99 per cent of all maternal deaths that happen each year, almost half a million occur in developing countries, many on the African continent. In fact, 66 per cent of maternal deaths happen in sub-Saharan Africa. The causes of such challenges to women’s health are the following, among others: the prevalence of poverty, economic dependence among women in certain African societies, lack of power and decision-making in the home and in communities, and control over sexual and reproductive lives. Women’s health in Africa is of extreme importance since the United Nations aims at reaching the Millennium Development Goals and in order to realize that, the health and wellbeing of women in Africa have to be worked on; it is the sine qua non for the achievement of that goal.
Challenges to women’s health
Women’s health was at the forefront of the decisions and measures that marked International Women’s Day this year, 8 March. Under the caption “Gaining Momentum”, the continental tragedy that women’s poor health poses in Africa was critically examined and the following diseases or health complications were listed as the principal hindrances to women’s well-being and, by extension, those diseases are a blockade to prosperity on the continent: poor reproductive health, the consequences of gender-based violence and discrimination, female genital mutilation, and all health conditions that contribute to the incidence of maternal deaths.
Recent data on causes of female mortality
The most recent report published by the United Nations, Trends in Maternal Mortality (1990 to 2010), indicates that although sub-Saharan Africa has witnessed a decline in maternal mortality of 41 per cent in the past 10 years, the figures are still unacceptable. One in 42 African women still die during childbirth, as opposed to one in 2,900 in Europe. On the African continent, mothers should expect to be able to stay alive after the birth of their children and to see them grow up to have children of their own, instead of simply hoping that their personal and family ambitions will be realized in the future. Initiatives such as the Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA), introduced in partnership with the African Union, are already providing much needed support on the ground at grass roots level in Africa to improve maternal health programmes. Yet, at a practical level, we must recognize that more needs to be done to provide improved access to basic health facilities and health workers for women. The latest WHO report, “Addressing the Challenges of Women’s Health in Africa,” highlights that the rate of cervical cancer among African women is twice the global average. In addition, the challenge of female genital mutilation is still a major health and societal issue in Africa. Although drastic measures have been put in place to eradicate that practice (imprisonment), it endures on several parts of the continent and the myths behind it are the following: it makes women faithful to their husbands, child birth becomes easy, and so on.
Obstetric fistula most commonly occurs in poor, rural areas of Africa where the women affected live in dirt-floor dwellings and lack access to running water and incontinence pads. It is an abnormal opening between a woman’s genital tract and her urinary tract or rectum and it is one of the major causes of maternal mortality: obstructed labor. The figure exceeds five cases/1,000 women in many countries including Uganda, Kenya, Ethiopia and Tanzania.
HIV/AIDS also claims lives among both men and women in Africa. In sub-Saharan Africa, adolescent girls and young women (aged 15-24 years) accounted for 25 per cent of HIV/AIDS infections in 2020, despite representing just 10 per cent of the population.
Besides causing death directly, COVID 19 also causes disruptions in essential health services that can result in death and in Africa, maternal deaths in health facilities in six of the 11 countries rose by 16 per cent on average between February and May 2020 compared with the same period in 2019.
Special medical condition: Woman with 2 wombs, 2 cervixes and 2 vaginas in Ghana
Medical history has recorded abnormal cases which can be cured or temporarily and regularly reversed through surgery and some of them are: babies born with both male and female organs, hypospadias which is a congenital condition in males in which the opening of the urethra is on the underside of the penis. In Ghana, a woman lives with a very different sexual condition, which has not been heard of before in the country and I wonder how known that condition is in other Africa countries or in the whole world. Elizabeth Amoaa is a 38-year-old Ghanaian woman with two wombs, two cervixes and two vagina canals and she is open about her condition.
Health science says Elizabeth has “uterus didelphys”, sometimes called double uterus, a rare congenital abnormality and it was when she was 32 that doctors figured out what was “wrong” with her. She said that she struggled with that unusual medical condition and spent years with crippling stomach pain that often stopped her being able to work. Ms. Amoaa even became pregnant and gave birth prematurely to a daughter in 2010 without being diagnosed. She was still having periods while she was pregnant as the fetus was growing in her healthier right womb. After multiple surgeries, scans and medication, she finally understood what was happening with her body in 2015. Ms. Amoaa now wants the world to know about her plight, so that other women with that body and health condition do not suffer.
She faced a backlash when she first went public on a Ghanaian radio station talking about her condition, but is determined to educate people. Elizabeth has set up a charity called “Speciallady Awareness” and has written a book, published last November, about her experience. “My advice to women going through my kind of condition is do not keep quiet, do not suffer in silence, seek early diagnosis and appropriate treatment” is her message to the world. The causes of “uterus didelphys” are not known, but it might have a genetic component since it often runs in families. Surgery is not always necessary; it can only help sustain a successful pregnancy in this case. Ms. Amoaa now lives in the UK and her condition is certainly of interest to medical history since much is yet to be known about it. This is a rare abnormality that adds to problems of women’s health. Ms Amoaa is vocal and has founded a charity. That shows her courage. She is not seeking sympathy and does not pose as a victim. This woman is fighting through her special condition.
Moussa Traoré is Associate Professor at the Department of English of the University of Cape Coast, Ghana.