It's a recurring theme: "we did not have the money to reach the hospital, for this reason my son died".

In the small villages of Ntui, Mbangassina and Biakua, having access to health services is a matter of having disposable income or not.

We are in one of the rural villages of Central Cameroon , situated geographically close to the capital but only connected by a dirt road that in the rainy season becomes non-navigable.

“During the rainy season we are completely isolated, we cannot move from where we are”, says the Mayor of Ntui, “ all movement is complicated and not guaranteed, the road fills up with water and it’s impossible to pass through with any vehicle”. In these cases the role of health assistants become extremely relevant as they will be the ones who will visit each of these residents in order to check on their well-being and to ensure they have what they need.

In these areas surrounded by a dense forest, most of population live off agriculture and throughout the dry season don't have enough available funds to request a doctor and to visit or to make the long journey to the nearest hospital.

All they have is just enough to feed themselves, for this reason during this period of year moms are more likely to have home births instead of in hospitals, without any prenatal examination", says the Chief of Health services of the hospital of Bafia. "Hospital visits are higher during the harvest period when families can sell the products produced from their land, it’s only then when they use prenatal visits and deliver at the hospital, however during the dry season the numbers decrease and women take serious risks giving birth at home. It’s a matter of poverty “ reaffirms the director.

Falone Marie's home
Falone Marie is a young girl. One week ago she experienced her second abortion. Abortion rates are high among girls under their 20s, 14% of them did not take any antenatal visit and 40% of them delivers at home. Addressing issues regarding adolescent reproductive health, comprehensive sexual health education and youth friendly service delivery, will greatly impact the reduction of maternal mortality and HIV infection within this group.
Mom breastfeeding her new born baby in Mblamayo's hospital in Central Cameroon


Francis with his son Goodwill and his daughter Solange in front of their home. They lost their mom and wife Elisabeth during childbirth due to labor complications.

We met with the husband of Elisabeth, Francis in their home in the forest about 15 km from the closest village. When his wife was pregnant she received only one pre-natal visit and was never made aware that her public scare would have led to a mandatory caesarean operation. Once labor had began they decided to stay at home, as many parents do, and try to deliver the child alone. Unfortunately the baby was in a breech position and could not be delivered without medical intervention. Since they did not have the money to pay for a taxi, they needed to borrow money from their neighbours / friends and as a result arrived at the medical centre in Mbangassina hours too late. Upon arrival it was quickly apparent to the Doctor on duty that emergency surgery was required and this would only be available in the better equipped hospital of Bafia, 15 km from there. By the time they had left on an ambulance it was 4 am , a whole 12 hours since the beginning of her labour, they had to travel down a similarly dilapidated road which again adds to the already considerable journey time. This time, however, it was to long and by the time the had reached the hospital the poor child's time had run out.


Marie Madeleine with her two boys in front of their home

I met with Marie Madeleine and two of her children outside their home. She has given birth to ten children in total, two of which were stillborn and an other tree perished at young ages from undiagnosed causes. When asked which diseases had ended her children's lives, she replied that she did not know due to not being able to afford medical examinations in the first place . This put her in the terrible position of being left only with the hope that they could get better without medical care. She tells me that she wishes she had the money available to call a Doctor but without enough to even feed her family then how could she possibly afford this?

Marie Madeleine wishes she had the money available to call a Doctor and save her child, but without enough to even feed her family then how could she possibly afford this?


Colette and her six children in front of Ntui's hospital

Sometimes poverty forbids you from helping your four years old who has been unable to walk for two months due to his broken hip. Similarly your husband casts you way from your home with your ten children and the reason for this is because you spurn his sexual advances which would lead to another unexpected pregnancy. As a mother you realise that not a single one of your ten children will ever have the chance to go to school. When only the love of your sister, who takes you and your children into her already crowded home, offers you salvation even though she herself struggles to get trough another day, then you understand that lofe have a price that some, simply cannot afford to pay.

Colette is just thirty-five years old but her steely gaze and the harshness of life give her the appearance of a much older woman. I met her at Nui's hospital, where she met with six of her children to meet with the federal authorities, in order to denounce her husband who has never recognised them as his own. She doesn't have an I.D. card and has always lived in the forest where she has lived off agriculture and any occasional job she was able to find. “Every day is a battle to survive, but all of my children give me the strength to keep hoping, “even when it seems there is no way around it” she says with a hint of a smile on her face.

I asked her why her four year old does not walk and she replies: “would you treat you son’s fracture if you do not know how to feed him tonight? I just cannot help him”.


©UNICEF/Dominque Catton

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