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In the modest family home, the pain can be read on the faces. Aunts, sisters and neighbors flock to Astou Sokhna’s mother, who died on April 1ah April at the regional hospital in Louga, 200 kilometers north of Dakar. Maïmouna Ba holds in her hands an album full of photos of the young thirty-year-old and testifies to the twenty hours of torment her daughter endured. Nine months pregnant, she waited in vain and in great pain for a Caesarean section.
“Because of her severe abdominal pain and dizziness, she called the midwife many times but no one answered heroutraged the mother of the family. My anger is directed at the nursing staff for neglecting them. They don’t care about people. » The family filed a complaint against officials at Louga Hospital Center on April 7.
The tragedy caused great emotions in Senegal and became a symbol of the violence suffered by women in health care facilities. In the face of the outcry, Health Minister Abdoulaye Diouf Sarr had to publicly intervene on Thursday April 14. He conceded that Astou Sokhna’s death could have been avoided had there been one “good risk assessment and optimal monitoring” during her stay in the maternity ward.
An investigation was launched while the director of the hospital was removed from his post and the staff on duty during the death were suspended. These caregivers held a sit-in outside Louga Hospital on April 14 to deny the negligence thesis and point the finger at their precarious working conditions.
Their allegations include: the loss of an operating room, the reduction in reception capacity for pathological pregnancies and postoperative patients, sometimes resulting in two to three parturients per bed, the lack of staff (409 agents in 2022 for more than 25,000 consultations). Health workers also accuse the structure of not paying on-call and on-call services since September 2021.
For his part, Minister Abdoulaye Diouf Sarr insisted that this tragic death “does not reflect the current state of the healthcare system, which has made significant strides in recent years.” According to the World Bank, between 2000 and 2020 the infant mortality rate in Senegal fell from 6.7% to 2.9%.
This observation does not reassure the hundreds of protesters who marched in Louga on Friday April 15 to demand justice for Astou Sokhna, but also to denounce the recurring violence at the regional hospital of this small inland town. Many women shouted in the procession, despite the heat and fasting of Ramadan.
“This is the first time I see such a mobilization in Louga. Because each of these women was a victim of violence or abuse in the hospital.”says Mamyto Nakamura, member of the Justice for Astou Sokhna collective at the initiative of the march. Call for an online petition “End all forms of violence against women in Louga Hospital” reached nearly 85,000 signatures in less than a week.
The culture of fear of the gaze of others
At the end of the mobilization, Mamyto Nakamura submitted a list of demands to the region’s governor, including the improvement of the medical platform and equipment. The collective also wants to set up civil society monitoring centers in all hospitals in Senegal, because the Astou Sokhna case goes beyond the Louga case. “We have been accomplices for a long time because we have not denounced this violence and neglect. Today is an opportunity to try to win in this national battle.supports Mamyto Nakamura.
This Lougatoise feminist claims to have received hundreds of testimonies from women reporting cases of abuse since the tragedy. But most don’t want to talk about it “suture”which in Senegal describes the culture of discretion and fear of being looked at by others.
“I fight the Sutura because lives are at stake. If everyone had denounced this violence, Astou Sokhna would be with us today with her baby.”, Badiane Diop, 26 years old, rants. She herself did not dare to file a complaint when her baby died in Louga after giving birth in March.
“Despite the urgency, I waited more than five hours to receive treatment. I called the nursing staff several times but nobody took care of me. I was only asked to put on three sanitary napkins to prevent any blood or water leakage and was told it was normal to be in pain.”she testifies.
“A perpetrator is never named”
Her family opposed her going to court. “But I will never forgive what they did to me and my baby”In a bitter tone, she starts this young seamstress who has been unable to sleep since the loss of her baby. “But all pregnant women are afraid to give birth in this hospital They don’t have the resources to go to private clinical facilities.”She says.
According to some feminists, the silence of women can also be explained by the trivialization of the suffering during childbirth. “We are taught to give birth in pain. But how do you become aware that you are a victim of violence if you are conditioned to endure it? »outraged Khadidiatou Tida Dansokho, president of the collective Never Again That, which has been fighting against gynecological and obstetric violence since 2020. “We’ve had trouble getting people to dare to speak, but tongues are loosening and this Astou-Sokhna affair is an accelerator.”she admits.
The problems of abuse and neglect in public health facilities are not limited to maternity wards, according to Patients in Danger, a collective formed after the Astou-Sokhna affair. “Senegalese are victims of a failing system, but no one is ever blamed. impunity disgusts us”, explains Gahëls Babacar Mbaye, spokesman for the movement. This mobilization, she specifies, is not intended to stigmatize medical staff, but to propose reforms to the healthcare system.
The health department is aware of the problems. 3,000 nurses have been hired in two years, but that is not enough to compensate for the flight of specialists to private healthcare facilities. “Beyond recruitment, we must increase the training of health workers in ethics and deontology, while supporting them with income. But we also need to focus on sanctions to fear bad behavior.”says Ousmane Dia, director of public institutions in Senegal.
A new demonstration is planned for April 23 in Dakar to demand justice “Astou Sokhna and All the Other Victims” and claim “Quality and appropriate health care for Senegalese”.