Nov 2009: Sylvia Ssinabulya

Uganda is a country of 32 million in sub-Saharan Africa: a lush and beautiful land once called by Sir Winston Churchill “the Pearl of Africa.” But with more than two million orphans from civil war, AIDS and maternal death in childbirth, Uganda is also a place of heartache and challenges. While about a dozen mothers die annually in childbirth in Canada, an estimated 6,000 perish in Uganda. Ugandan Member of Parliament Sylvia Ssinabulya, who visited Canada in 2006 and 2007, has taken maternal health as her special interest to champion. A graduate of the Canadian-run Save the Mothers program at the Anglican school Ugandan Christian University, she recently spoke about her work with writer Thomas Froese, a Canadian in Uganda.

TAP: You almost lost a child in childbirth, and your sister-in-law did die in childbirth. How did these experiences impact your vision to save some of Uganda’s mothers?

S.S.: Two of my deliveries were breach; the babies came legs first. If I had delivered my babies with unskilled attendants, I could have lost them, but because I delivered at health facilities, I was assisted
and had them safe.

My sister in-law died while giving birth to her fifth child. The baby was a stillbirth, born “normally,” but one hour later the mother died! We learned she had some intra-partum bleeding. It was thought to be normal for a pregnant woman to bleed a little while pregnant! At the time, I hadn’t yet enrolled in the
Save the Mothers program, but since then I have advised people to never take any single incident lightly.

TAP: Just four percent of Uganda’s rural health units now have adequate emergency obstetrical care. And the nation’s health care spending -- nine percent of its GDP -- is well below the African Union target of 15 per cent. Why?

S.S.: It’s a matter of where the country’s priority falls. Until the government looks at women’s health as a priority and expenditure in health as spending that brings dividends to the economy, the expenditure on health in general, and emergency obstetrical care in particular, will remain below target. The government’s priority at the moment is not health.

TAP: There were riots in your home riding of Mityana regarding a recent maternal death there. What was the result?

S.S.: The riots were a show of outrage towards Uganda’s healthcare system and the general political leadership for not meeting patient needs in general, and mothers’ needs in particular. It has helped highlight how far Uganda’s healthcare system has sunk. But we have begun seeing positive action from the Ministry of Health, local government and the hospital workers.

TAP: It’s been reported that nine babies die every day in the maternity ward of Mulago Hospital, Uganda’s largest birthing centre. How can this number be reduced?

S.S.: Until we improve the entire health system to provide emergency obstetrical services for all women who develop complications, and until we make health centres attractive for mothers to deliver in comfortably, we shall never reduce neonatal deaths.

TAP: When you travelled to Canada, were you surprised by Canada’s development? Do you feel Ugandans can learn something?


S.S.: Canada is a developed country in the true sense of the word and I am not surprised when I look at its magnificent infrastructure. There are certainly lessons for Ugandans to learn; I sometimes wonder how much better we can be if the little money invested in health was put to efficient use.

TAP: You travel internationally. Do you feel the world understands Africa? Does having a black U.S. president help?

S.S. - I don’t think the world understands Africa and having a black U.S. president does not help. What can help is for Africans, both within and in the Diaspora, to do their best to love their countries and to sacrifice. It is only Africans who can make the world understand Africa. When an African moves to a foreign capital and castigates that country, how will it understand the good aspects?

TAP: Save the Mothers, the Canadian-based program of which you are a graduate, is just four years old in Uganda. What is its impact to date?

S.S.: The Save the Mothers alumni have become important advocates for maternal health at their places of work and in their communities. Like myself, some are engaged in community safe motherhood projects. Those in the media are giving safe motherhood a broader profile. We have managed to
show that maternal health is not only a medical issue, but a social issue.

TAP: What is your dream for Mityana, the district you represent?

S.S.: My vision is to see women empowered to make choices on when to start having children, how many to have, how often to have them and when to stop having them. This needs a functional healthcare system and a society where women and men are valued socially and economically as equal partners in decision-making.

TAP: How can the Ugandan church, largely Anglican, improve life in Uganda?

S.S.: Many churches are already doing this. But the church will only remain relevant if it aggressively helps its people deal with the daily challenges. Issues of HIV/AIDS, maternal and newborn deaths and poverty of their flock should be high on the church’s agenda.