MaterCare International, a Catholic medical charity working in sub-Saharan Africa, has produced a 25 minute film showing the primitive and dangerous circumstances in which hundreds of thousands of rural women give birth -- and often die. At least 85 percent of these deaths could be prevented, says Matercare, by access to essential obstetric services (not high tech) during pregnancy and delivery.

And yet these deaths are only the tip of the iceberg. For every woman who dies in childbirth, another 30 suffer damage from the complications of delivering a baby when the mother's plevis is too small for normal delivery due to malnutrition or chronic illness. “This results in the horrifying lifelong condition of a ruptured bladder and/or rectum, known as obstetric fistula, which causes shameful and permanent incontinence,” the film narrator says.

“Shunned by husbands, families and communities, these women become social pariahs, cast out to wander alone. Fending for themselves, some turn to prostitution for survival.” As many as two million young women may be living with the pain and shame of this disability.

This is all the sadder since obstetric fistula can be easily repaired with specialised surgery and nursing care. But there are few trained specialists to provide this service. MaterCare, founded in 1995 by Dr Robert Walley, has provided this service as part of a model of maternal care established in Catholic dioceses in Nigeria, Ghana and now Kenya. The model takes into account not only pregnancy and obstetric needs but the whole physical and social environment of the women.

The film describes in detail the system at Isiolo -- an isolated and very poor and conflict-ridden district 500 kms north of Nairobi -- and it is inspiring to see what has been achieved in only a year or so. If you want to do something for development in Africa, and particularly for mothers, this is a very attractive candidate.