From the happiness of children

Author: Maximilian Glätzner

A look at World Almanac 2018 reveals that 82,668,000 people lived in Germany in 2016. Since 2015, the population in Germany has been shrinking by around 0.1% per year. A woman in Germany has 1.5 children on average. So birth rates are low compared to the rest of the world. In Germany, 99.7% of every 1000 infants survive their first year of life. It is now again 99.6% of these children who will reach the age of five; the children will then have an average life expectancy of 82 years.

What does this data tell us now? They merely reflect statistical realities that are of interest primarily in a demographic, economic and political context. However, the World Almanac reveals nothing about the actual reality of births and the processes. Numbers and dates cannot represent the experience of having a child. So what does it mean for a mother to have a child in Germany? Of course, this varies from mother to mother, and it would be best to ask a mother in Germany about this, but certain tendencies can also be observed in this way: In Germany, people generally talk about the happiness of having children - for most parents-to-be, having a child is good news and something fulfilling in life.

At first, pregnancy may come as a surprise, but very quickly joy spreads. Often the partner is informed first and then the own parents, who as grandparents-to-be are of course also looking forward to their grandchild. Young parents are now starting to pick out a name for their child and starting to shop for baby stuff. Everything must be thought of when the child sees the light of day: Clothing, food, bottles for milk, diapers, toys, cuddly toys and much more. Maybe you even start to decorate a nursery for the child, with the appropriate furniture, of course. Other parents may now also be considering moving and looking for a new home for their growing family.

In any case, there is a lot to do and it seems as if all the other components of life that were so important before - for example, one's own professional career - fade into the background. All that matters now is the baby and the family. Of course, the pregnant woman must visit the gynecologist more often to observe and accompany the development of the little embryo. For expectant mothers, there is probably no worse worry than that the child in the womb will not be well, but in most cases pregnancy proceeds without serious complications. The time comes when the nine months of pregnancy come to an end. It is not uncommon for people to attend classes to learn and practice handling an infant. Others read books about babies and parenting in early childhood, and still others ask their own parents for advice on what to look for in a newborn.

After all, you get an appointment for the birth and sooner or later you will go to a hospital - of course, there are exceptions, such as a birth center or the option supported by a midwife to have the baby at home. In the hospital, intensive care is provided and a number of medical options are available - should there be reason to believe that action is needed: Is the baby in the right position? Should a cesarean section be performed if necessary? Should the birth be induced earlier than planned or even delayed by means of medication? Of course, there can still be complications. In rare cases, the newborn does not yet have the ability to live independently and must be placed in an incubator and artificially ventilated and fed. For the parents, this is certainly not nice and associated with anxiety, but a team of doctors and nurses help parents cope with the situation.

However, the figures mentioned at the beginning of this article reflect the medical reality quite authentically: in the rarest cases there are complications and in most cases the parents can soon welcome their child home. At the latest then the name of the child should be fixed, when you write thank you cards for the numerous congratulations from relatives, friends and acquaintances. The child's happiness is now perfect. Even though there are always worries and problems associated with children and their growing up, there are few parents who regret having a child. Being happy about having children may seem self-evident here in Germany and we are often not aware of possible complications. However, the reality of pregnancies and births look entirely different in other areas of the planet. Ghana should serve as an example for us here, as I myself was in Ghana in the summer of 2017 and we have a focus of our work in Ghana with the NGO Healthcare Information Technologies for Africa e.V., or HITA e.V. for short.

In 2016, there were 28,207,000 people living in Ghana. The population is growing by 2% per year. This is mainly due to the high birth rates in Ghana: A Ghanaian woman gives birth to 4.1 children on average. On the other hand, there are also major differences in mortality rates. Of the newborn children, only 95.7% will complete their first year of life. Of these 95.7%, another 6.2% do not live to be four years old. In numbers, that's over 56,000 children a year in Ghana who die before they reach the age of five. But even the children in Ghana who live past the age of four have a life expectancy of only 61 years. That is more than 20 years less than life expectancy in Germany or other industrialized nations. These figures give an idea of Ghana's economic and medical reality. The country is still characterized by poverty in large parts and the medical infrastructure we know exists only for the privileged in the big cities. Ghanaians who live in the rural peripheral regions of Ghana (such as in Eastern Ghana, where we as HITA e.V. are active) will often never see a doctor in their lives. In fact, there is a massive shortage of doctors in very many areas, not to mention the lack of medicines and other equipment. Almost all health care in these areas is based on non-physician medical personnel: nurses, orderlies, and midwives.

The hygienic situation in the local "health centers" - these are wards and workplaces for nurses and midwives - is often catastrophic due to inadequate equipment, and the infection rate is correspondingly high. Especially in obstetrics, this leads to many fatal infections in the mothers. There are no incubators or ventilation masks for infants: if a child comes too early, he or she often dies without the chance of adequate medical care. Examinations during pregnancy are also far too rare and the quality of these examinations is poor: complications can therefore not be detected in time. Since there are also no trained specialists, it is also not possible to respond appropriately to complications. But what does all this mean for the people on the ground? What does this mean for the individual Ghanaian mother who is not concerned about all the numbers mentioned and only wants to bring her child into the world in good health? I can't really answer this question either, of course, but I remember very well the pregnant woman from a health center about 20 minutes from the eastern Ghanaian town of Ho.

There is also a maternity ward at this Health Care Center. In a dilapidated building there are three rooms separated by cloths. In one of these rooms there is a cold table made of precious metal, somewhat reminiscent of a dissecting table. On this table lay the heavily pregnant woman, half-naked only wrapped in cloths. There was no blanket or mattress on the table. She was very excited and very scared. I couldn't see any joy in her face, she didn't want to talk either. She will have thought and worried a lot. She probably asked herself, "What happens if something goes wrong and my child needs help? What happens if I die and my child has to grow up without a mother? What if my child is not born healthy, how will I be able to help him? How will I even feed the child?"

Of course, the midwife and nurses couldn't really calm her down either, they know themselves that giving birth in these areas of Ghana is very dangerous. Infant mortality rates are, of course, much higher in rural Ghana than in the capital Accra, for example. Whether the child was right-side up and healthy, no one knew at the time. How the birth turned out and whether the child was born healthy and the mother survived, I do not know. In any case, after a successful birth, she would have come to the small room next door to spend the next few days on one of the five beds - hoping not to contract an infection or get heavier bleeding. In any case, it is certain that a Ghanaian mother rarely has only one child. The risk of dying during childbirth is therefore correspondingly high.

Here in Germany, people talk about the happiness of children, but in Ghana, unfortunately, the reality for the people is too often rather a misfortune. Parents in Ghana, of course, still love and enjoy their children. But what may seem completely trivial to us is a privilege in other places in this world. We at HITA e.V. want to change that, we want having children to be a great happiness for the people in Ghana and in other African countries as well. To this end, we are trying to improve the healthcare system in the long term and are relying on IT structures to do so. Find out about our work and support us!

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