The HSE has issued an apology to the family of a 35-year-old woman who died after giving birth at University Hospital Kerry (UHK) last year.

The apology was issued at the opening of a resumed inquest into the death of Zimbabwe-born Tatenda Mukwata, who lived in a direct provision centre in Kenmare.

She died at 2am on April 21st, 2022, after giving birth six hours earlier to her fourth daughter, Eva, who was delivered by Caesarean section.

A pathologist told the opening day of the inquest in August that Ms Mukwata had died of haemorrhage and shock.

In its apology at the outset of the resumed inquest on Monday senior counsel John Lucey read an apology signed by Mary Fitzgerald, general manager of UHK, “for the failings of care afforded to Tatenda at this hospital on 20th and 21st April, 2022″.

“We fully accept that these failings should not have happened, and that earlier intervention would probably have prevented Tatenda’s death. An external review of the matter is nearing completion and as a hospital we will endeavour to ensure lessons are learned.

“We are deeply sorry that you have suffered the tragic loss of Tatenda. We wish to apologise to you unreservedly and offer our heartfelt condolences. We acknowledge the grief, stress, trauma, and suffering that you and your family continue to endure as a result of Tatenda’s death, for which we are truly sorry.”

In response, Dr John O’Mahony SC, on behalf of the Mukwata family, said the apology is acknowledged as appropriate., adding it came “very late in the day”.

Rutenda Mukwata (18), the eldest daughter of Tatenda Mukwata , told the inquest how on the night of April 20th at Atlantic Lodge direct provision centre in Kenmare her mother had called the ambulance service around midnight.

The previous day, April 19th, she had met her mother off the bus after she returned from a pre-planned medical appointment at the hospital in Tralee. Her mother was feeling tired and dizzy and felt she might have been kept at the hospital. The family – Tatenda and her three daughters – all slept in the same room in the direct provision centre. At around midnight she woke to hear her mother talking to paramedics. Her mother said she thought she was having contractions.

An ambulance arrived and Tatenda waved goodbye. “That was the last time I saw her in person,” she said. They texted each other and her mother told her she was going for a C-section.

At 1am on April 21st, the hospital contacted Rutenda and asked her to come to the hospital. “I said I had no way to get to the hospital and they sent a police car to come and get me,” Rutenda said.

“I still didn’t know anything was wrong and I was excited to see mom and the baby,” she said.

When she got to the hospital, “they told me my mom didn’t make it,” she said in her deposition.

[ Woman who died following C-section suffered ‘catastrophic’ haemorrhage, inquest told ]

Answering her counsel Dr O’Mahony, Rutenda said her mother looked fine and was still warm. “I just hoped she would wake up,” she said. She kissed her mother and was brought back to Kenmare at around 10 or 11am.

Rutenda was in shock and devastated. She phoned her grandmother Catherine and they agreed she would come (from London) and they would tell her younger sisters together.

Catherine Mukwata said at the beginning of the pregnancy her daughter was attending Cork University Hospital but public transport between Killarney and Kenmare was limited. It was decided by people in Cork to transfer her care to the Kerry hospital.

Tatenda had been HIV positive since 2009, and she would attend a HIV specialist in CUH and always took her medication. She did not want to be transferred to UHK because of being HIV positive. When she was transferred to the care of the Tralee hospital she told her mother how she overheard staff saying they had never dealt with her condition and giving birth with HIV.

“Tatenda was uneasy about this. She said to me, how can I feel confident with this?” This was around February 2022.

However, when Tatenda was told a team had been assembled by UHK to deal with this she felt more relieved.

Questioned by senior counsel for the HSE John Lucey, Catherine Mukwata said she was relieved to hear a team had been assembled who could deal with her HIV and be present when she was giving birth.

However Ms Mukwata said the team was not present when she gave birth.

Paul Hughes, then consultant obstetrician and gynecologist at UHK and now retired, said Tatenda was under the care of the infectious disease team at CUH. They were happy with her and there was regular follow-up.

Her scans were normal and there was good foetal growth.

She was keen to go into spontaneous labour, as she had done so in her previous pregnancies, he said.

The inquest before coroner Helen Lucey continues.

In Zimbabwe the ignorance wave seems to be everywhere like a spirit, especially when it comes to the characterisation of people who are assumed to be mentally ill as being ZIMCARE.

IT is, indeed, true that wisdom begins with the realisation that one does not know. Failure to acknowledge that one does not know is the beginning of arrogance and arrogance is deleterious to growth and development.

In Zimbabwe the ignorance wave seems to be everywhere like a spirit, especially when it comes to the characterisation of people who are assumed to be mentally ill as being ZIMCARE.

People who seem to have lost touch with reality in Zimbabwe are, unfortunately, labelled as ZIMCARE, but the question is: Does ZIMCARE mean mental illness or psychosis?

The panacea to the ignorance about the disease is education and it is the purpose of this opinion piece to tell apart the concepts of intellectual disability and mental illness and in the process walk through my Zimbabwean counterparts the ABC of ZIMCARE.

ZIMCARE is an abbreviation for Zimbabwe Cares. It is an organisation that educates and cares for children and adults with intellectual disabilities or challenges in Zimbabwe which in terms of institutional representation at national and subnational levels has 14 centres across Zimbabwe.

Of those 14 centres, 11 are for learners with intellectual disabilities and three are adult workshops for persons with intellectual disabilities who are taught daily life skills, practical and vocational skills like gardening, carpentry (e.g coffin making), pottery and weaving.

The 11 centres for learners with intellectual disabilities focus on imparting basic literary and numerary skills, social skills and skills in different areas of gifting in the sporting arena.

Both children and adults in ZIMCARE centres are not presented for any formal examinations because they will never be book-smart because of their condition of intellectual disability that will be unpacked anon.

The children and adults at ZIMCARE are taught to be street-smart, their street-smartness should stand out in their communities when they can embark on livelihood projects.

The history of ZIMCARE is identified with the merging of four organisations in 1981 and these organisations were SASCAM [Salisbury Association for the Care of African Mentally Handicapped], MAMSAC [Midlands Association for the Mentally Sub-Normal Children], Hopelands Trust and Sibantubanye Day Care.

These four organisations’ common denominator was that of educating and caring for the most vulnerable children and adults with intellectual disabilities in different geographical locations. However, what may need fleshing out is that the Hopelands Trust solely dealt with whites with intellectual disabilities.

SASCAM again is another erroneous classification for people who are assumed to be mentally ill in Zimbabwe, which is again wrong if we take into account the historisation of ZIMCARE and its constituent parts.

The focus now will be on distinguishing intellectual disability from mental illness. Intellectual disability by definition is what was traditionally referred to as mental retardation. Intellectual disability describes a person whose intellectual and adaptive skills are significantly below the average for a typical person of his or her chronological age.

People with intellectual disabilities are not homogeneous, but heterogeneous in outlook because the condition of intellectual disability exists in a continuum, that is from mild to profound. This type of disability may be due to pre-natal, peri-natal or post-natal factors.

Maternal and paternal factors are also said to have a hand in causing intellectual disability as scientific inquiry claims that women below the age of 20 and those ones above the age of 35 are at risk of giving birth to children with intellectual disabilities. Males whose ages are upward of age 55 are also at risk of contributing to the birth of children with intellectual disabilities.

Children and adults with intellectual disabilities may show some of the following physical and behavioural traits; sluggish physical and cognitive growth, difficulty in retaining information, inability to follow simple routines, changes in routine and coping with novel situations are usually confusing and upsetting, short attention span, inability to stay focused on an activity, limited communication skills, delayed development of vocabulary and syntax, lack of age-appropriate self-help skills, unawareness of surroundings or failing to tell a public space from a private space leading to engaging in activities that may be inappropriate for the public space like masturbation and rubbing their genitalia.

Developmental progress may be up one day and down the next and showing delayed social-emotional behaviours.

Intellectual disability usually comes with co-diagnosis, which is one primary condition co-existing with another condition.

For example, a person with an intellectual disability may also have cerebral palsy or a health-related condition like epilepsy.

The case for comorbidity (co-diagnosis) is also supported by wide scale research which reveals that 35% of persons with intellectual disabilities also have mental illness.

From the foregoing, it is necessary to split hairs now between intellectual disability and mental illness. Both intellectual disability and mental illness are neither ZIMCARE nor SASCAM.

Mental illness is not the same as intellectual disability, because the former is a disease of the brain which disrupts the emotional, psychological and social domains of a person and in the process disrupts how a person feels, thinks and acts.

The words mental and illness are often misunderstood. Sometimes people misuse the word mental to describe someone they think is stupid, bad or evil.

For the record, mentally ill people are neither bad, evil nor stupid; they have a disease and are in pain.

Essentially, mental illness speaks to mental health challenges which are often caused by personality disorders, stress, use and abuse of substances, anxiety, depression leading to visual, auditory and olfactory hallucinations.

Mental illness can be episodic, that is irregular in terms of its occurrence and its prognosis is favourable when a combination of intervention measures such medication, counselling and social support are considered.

While mental illness disrupts the way a person feels, thinks, behaves and acts, it has nothing to do with diminished intellectual functioning that is constant as is evidenced in people with intellectual disabilities.

Despite the fact that people with intellectual disabilities may have attention deficit hyperactive disorder, that may require medication to tone down their super-charged personalities, they have no disease of the brain.

The fact that people with intellectual disabilities may not understand private and public spaces and activities attendant to such spaces lead people to stigmatising and labelling them as being mentally ill.

The most important thing about people with mental illness which sets them apart from people with intellectual disability is that they are not mentally challenged (retarded); many of them are very intelligent.

In summation, this opinion piece has indicated that putting people with intellectual disabilities and mental illness in the same basket is like comparing apples with computers.

It is hoped that this article will help to change the attitudes of the so called typical (normal) Zimbabweans towards people with intellectual disabilities and mental illness, as both these categories of people are human beings who are equal to every Zimbabwean in terms of human dignity and rights.

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By Mark Adir | Bdaily News

TENDAI Murairwa, a former National Health Service (NHS) Sewing Room Assistant at Tickhill Road Hospital, Doncaster, has quit her job after taking part in York Fashion Week in May to launch her own fashion brand Teestyletribe and focus on her role as a freelance costume design trainee for film and television.

Tendai, age 44 from Stainforth said: “Being part of York Fashion Week in Spring as a speaker at an event for students reaffirmed my belief that there is huge potential in the world of fashion in the North and gave me the confidence I needed to leave my role in the NHS and focus solely on building my business.

“The support shown by the organisers was phenomenal and it provided me with the opportunity to network with fellow creatives and celebrate diversity within the industry.”

Following York Fashion Week, she secured a placement with Emmerdale, dressing some of the soap’s most famous stars including Mandy Dingle. Working in the costume department, Tendai was responsible for selecting relevant outfits for specific scenes and overseeing the issue of continuity on screen.

Before launching her own business, alongside her role at the NHS Tendai worked for Doncaster Homeless Services as a Project Assistant and was responsible for booking in homeless people, securing alternative accommodation for them and providing support.

But her creative journey was sparked by upcycling clothes which ignited her passion for fashion and led her to undertake formal training in Costume Design at Screen Yorkshire in Leeds.

Tendai explains: “I’m a firm believer that age should not be a barrier to pursuing your passion. And I never imagined that I would have the courage and conviction to switch careers. I didn’t learn to sew until the age of 40 which proves that it’s never too late to chase your dreams.”

Tendai, who was born in Zimbabwe, has taken inspiration from her African heritage to create a stunning collection of wrapskirts, kimonos, tote bags, headbands and headwraps. She continues: “With a clear vision for the future, I aspire to see high street shops globally offering African print clothing, accessories, and furnishings within the next five years.”

Looking ahead, Tendai has a strong desire to create more genderless clothing, reflecting her inclusive and forward-thinking approach to fashion. In addition to her creative endeavors, Tendai is committed to giving back to her community. She continues to support Doncaster Homeless Services and the NHS, using her skills to help improve the lives of others.

Tendia’s collection will feature in the Contemporary Fashion event on Sunday, October 1at Jalou, 2 Micklegate from 7.30pm – 10.00pm. York Fashion Week launched in 2018 in a bid to empower and champion grassroots and independent designers that are revolutionising the fashion scene to showcase their latest collections.