Where's the will to reduce maternal deaths?

It is easy, when enthusing about family life, to forget that motherhood is a very risky and often fatal thing for hundreds of thousands of women in the developing world. Complications of pregnancy and childbirth kill more than 536,000 women a year, more than half of them in Africa, according to the World Health Organisation. Most of the deaths are preventable with basic obstetrical care, but there are shortages of hospitals, clinics, doctors, nurses, drugs, equipment, roads and transportation.

At one rural hospital in Tanzania, a trained medical assistant performs a Caesarean operation to deliver a baby after the mother has been in labour for two days. It takes the nurse 5 to 10 minutes of vigorous resuscitation to get him breathing normally and crying.

“There are many nights like this at the hospital here, 6 miles from the nearest paved road and 25 miles from the last electric pole. It is not uncommon for a woman in labor to arrive after a daylong, bone-rattling ride on the back of a bicycle or motorcycle, sometimes with the arm or leg of her unborn child already emerging from her body.”

For each African mother who dies, 20 other suffer from serious complications, according to WHO. “Maternal deaths have remained stubbornly intractable” for two decades, Unicef reported last year. In 2000, the United Nations set a goal to reduce the deaths by 75 percent by 2015. It is a goal that few poor countries are expected to reach. Why?

An obstetrician and university professor, Dr Siriel Nanzia Massawe, says that “the people in power” are not aware of the realities of maternal deaths. “Why don’t we have a global fund for maternal health, like the one for TB, malaria and AIDS?” he asks.

The women who die are usually young and healthy, and their deaths needless. The five leading causes are bleeding, infection, high blood pressure, prolonged labor and botched abortions. Maternal deaths from such causes were largely eliminated nearly a century ago in developed countries. In poor countries a mother’s death leaves her newborn at great risk of dying as well.

“Botched abortions” is a term covering some very dubious statistics, as an upcoming MercatorNet interview will show.

Experts say that what kills many women are “the three delays” — the woman’s delay in deciding to go to the hospital, the time she loses travelling there and the hospital’s delay in starting treatment once she arrives. Only about 15 percent of births have dangerous complications, but they are almost impossible to predict.

Among the cultural issues mentioned in the article is women’s lack of “information about birth control” -- a remedy that all too readily occurs to first world experts, and that would doubtless consume a good share of any global fund for maternal health.

Sadly, a universal tendency to “look after number 1” sees many of the local people trained to look after mothers deserting their posts to take up jobs in other (African) countries that pay more. Rev. Isaac Y. Mgego, an Anglican priest who is the director of the rural hospital mentioned above, says they have 16 staff, but:

“We used to have 34,” Mr. Mgego said. “People leave. We are struggling to retain them. They don’t want to live in villages. Some go without saying goodbye. Those who are committed, they are working tirelessly.” ~ New York Times, May 24


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