Speaker: Ashley Muteti, Founder & Executive Director, Zuri Nzilani Foundation
We often hear the statement, “I wish I knew…” What is the most common sentiment women and family members express in your region?
Ashley Muteti: Hi, my name is Ashley Muteti from Zuri Nzilani Foundation here in Kenya. And one of the most popular sentiments that we hear from women is women starting their antenatal clinics late and that are very advanced age in their pregnancy. And when they do so, some of the challenges that they face is they come to the antenatal clinics when it's already too late for the doctors to do anything meaningful to save their life or the life of the baby. And that's where we advocate for preconception care and also once a woman gets pregnant, they should start the antenatal clinics immediately.
Women reported never hearing "preeclampsia" until the moment they were diagnosed. When have women learned about preeclampsia in your region?
Ashley Muteti: preeclampsia and other hypertensive disorders in pregnancy is a fairly new subject here in my country, Kenya. Not much education has been created about the condition and that's where here at Zuri Nzilani Foundation, we are very keen to create awareness about hypertensive disorders in pregnancy. This is because most of the women learn about it when it's already too late, whether it's a week, they have been told they have been diagnosed with it and been told about preeclampsia a week to um an elective C section, So most women do not know about it. They've lived with it, but now they know about it once it's already at a critical stage.
Do mothers in your region experience mental and emotional problems after preeclampsia? What is done for them or what do they do about it?
Ashley Muteti: women who have gone through preeclampsia, experience a lot of mental health challenges. And this is because the society has sidelined this particular type of women. As we know, women who have gone through preeclampsia can lose the baby so they can experience infant loss. They can experience pregnancy loss. They can also experience preterm, but and this can be sub sequent pregnancies. And due to this particular issues that affect the woman because of preeclampsia, the women are at a very vulnerable point in their lives where most of them have lost their marriages in africa and here in Kenya, Children are considered as a sign of wealth as a sign of continuity in the family tree. And so when a woman constantly loses the pregnancy or constantly loses a baby, an infant due to preeclampsia or gives birth freedom. Some people really considered these women as women who have been Bewitched, you know, so they associate these medical conditions with witchcraft and this in turn creates a lot of frustrations to the women. they are degraded in the society. Women do not want to be associated with them in the community. And so they leave them sidelined. And this creates a lot of mental health issues that these women need to deal with every single day.
Are the mothers in your region aware of preeclampsia's long term risks like heart disease? If so, what kind of care do they receive?
Ashley Muteti: Most women in Kenya are not aware of the lifelong risks associated with preeclampsia. If I can give an example, there's a lady who had hypertension in pregnancy and she did not know about hypertension in pregnancy or rather preeclampsia. And so she gave birth at 34 weeks thereafter when she was coming for when she was going for postnatal clinics, the nurse told her to stop her hypertensive drugs because she would be dependent on them. And this marked the start of a lot of problems that she endured. five years down the line. She got pregnant again and she got preeclampsia at a very early stage in pregnancy and she now has kidney injury as a result of very high blood pressure that was not controlled after her first delivery. And now she is on lifelong medication on high on blood pressure. And this goes back to there's not enough training also to the medical fraternity, especially in the rural areas on hypertension in pregnancy or pre eclampsia. And therefore women end up suffering life threatening um conditions as a result of preeclampsia in pregnancy.
What is the most pressing patient need in your country related to preeclampsia?
Ashley Muteti: One of the most pressing needs that women face here in my country is quality of care because it is expensive. It is expensive managing hypertension in pregnancy. The drugs are very costly, so women, especially in the rural area and even here in the city, they are gambling between buying food or buying medication, you know. So medication for hypertension is expensive and sustaining that, especially as a first line drug or a drug that will be effective to the woman is quite costly.