CONCOURS GÉNÉRAL SÉNÉGALAIS
10 1 CGS 08 01 Durée : 5 heures Toutes séries réunies CLASSES DE PREMIÈRE
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Habibu is lying on matting on the mud floor of her hut. The contractions are coming thick and fast now. The pain is intense,but she draws comfort from the memory that, the previous three times, the agony gave way to the peaceful, exhausted bliss of holding her baby in her arms. Her husband’s mother is on hand to help; she has, after all, given birth many times herself and seen many more children born. Water has been brought from the pump and sits in two large bowls ready to be used – one to wash the baby and the otherto wash everything and everyone else ; pieces of old cloth have been gathered over the month before so as to soak up any blood and bodily fluid ; A kerosene lamp has been borrowed from a neighbor to cast any light needed on this dark west African night. The delivery itself seems to go well: a girl, Mama says, now to be heard crying. Habibu lies back and gives herself up to the pleasure of there nolonger being any sharp pain, only exhaustion and discomfort, and to the satisfaction of having brought another life into the world. It is a while before Mama realizes that blood is still pumping out of Habibu, forming a widening crimson pool on the mat and the floor. She uses the rags to try to staunch the flow, to no avail. There is no sign of the placenta being delivered, as would happen withinminutes of birth. Mama waits in hope for further precious minutes before realizing that the blood flow is not going to stop and there is serious danger. Alarmed now, she summons her son, who sets out on his bicycle to try to contact the nurse at the government clinic 12 kilometers away. By the time the nurse arrives, two hours have passed and it was too late for Habibu whose life has drained awaywith her blood. There is nothing the nurse can do for the woman. She tends to the baby, cursing under her breath the fees she has to charge for attending a birth at the clinic – fees that mean so many women opt to do it alone. She knows she could easily have saved her, an injection of Oxytocin, perhaps, or a manual delivery of the placenta, – but knows just clearly that this desperate experiencewill be repeated on many other nights and days over the months and years to come. The specifics of this story are fictional, though I name its victim Habibu in honor of a woman I knew in a Burkina Faso village who died at child birth. She had just married after years of hardship raising children as a widow and had been looking forward to cementing her new marriage with a baby. She could and shouldhave attended the nearest health center for antenatal checks and for her delivery – the last time I visited it, the maternity unit at that health center had yet to lose a mother during children. But she opted not to do so – in part because her previous children had been safely delivered at home, but also because such supervision costs money and even the smallest sums are hard to find in asubsistence farming family. Just one story – but one that is repeated an average of 1,500 times every day around the world, and with particular terrible regularity in Africa and south Asia. In other cases the complication might be not postpartum hemorrhage but an obstructed labor that demands, but doesn’t receive a caesarean section. In many such instances the baby will die along with the mother; inothers, the mother will survive but will have lost her child. In the vast majority of these cases, the deaths are eminently preventable. While the number of child deaths has consistently fallen – from around 13 million in 1990 to 9.7 million in 2006 – the maternal mortality toll has remained stubbornly similar. For decades, the international estimate of the number of maternal deaths each year has...
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