Reproductive Health

India's Ailing MDG Tied to 18th Century Cure

Sunday, September 19, 2010

Wendy Graham, a champion of Millennium Development Goal No. 5, says the starkest measure of the gap between rich and poor countries is that of women dying in childbirth. And the solution is as simple as cleaner birthing practices.

NEW DELHI (WOMENSENEWS)--With only five years to go until the 2015 deadline to achieve the U.N.'s Millennium Development Goals, which seek to eradicate global poverty, Wendy Graham says fear of failure should not hold anyone back from trying harder.

"Ever tried? Ever failed? No matter. Try again. Fail again. Fail again better," Graham, a professor of obstetric epidemiology at the University of Aberdeen in Scotland, urged 600 health experts from 55 countries.

The experts recently gathered here to focus on MDG No. 5, which seeks a 75 percent reduction in maternal mortality by 2015. The meeting, which took place Aug. 30-Sept. 1, was held as a warm up for the major U.N. meeting that starts tomorrow in New York to monitor progress toward global promises made by 189 member nations of the United Nations General Assembly in 2000 to improve worldwide living conditions.

"We have to understand that the F (failure) word is not so bad," Graham told the maternal health conference, which was organized by the Maternal Health Task Force at EngenderHealth, an international reproductive health organization based in New York City, and the New Delhi-based Public Health Foundation of India. "Health activists need to become 'connoisseurs of failure' if they are to learn from interventions that failed…If an initiative succeeds in one place, there is no guarantee that it will succeed in the next. We must consider the unique context of each setting where we work."

Graham, a proponent of crystallizing public health disparities in quantitative terms, often points to the gap between women's risk of dying from pregnancy-related causes in poorer counters (1:4) and in the richest nations (1:10,000).

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She contends this 2500-fold difference is the largest gap between the developing and developed world of all public health statistics. "The frequency of these tragic deaths in the 21st century is a global collective failure," she told Women's eNews.

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As is so often the case, there is a lack of understanding that we need an investment in nursing care. That is what is lacking here, not enough nurses or nurses educated highly enough to be able to provide the quality of care that would keep women alive through childbirth. Nurses are invisible because the "feminists" of the world think somehow that now that women can become physicians who really needs nurses anymore? But that's inaccurate thinking. Nurses are needed to deliver this care the author talks about, to educate women about how to stay well, and often, to deliver babies and teach them how to breastfeed, which is vital to staying alive in the developing world. But until there is a willingness by decision makers to find out what nurses really do to save lives and improve outcomes, we will continue to fail at reaching our Millennium Development Goals. If we want better health care, we should dare to find out what nurses really do--follow them at work! Ask them questions. Interview them for stories. Understand that they make the difference between life and death. Then we should strengthen the nursing infrastructure that will bring us better health care. At home and around the world, the problem is the same. Nurses are ignored because they are considered some sort of throwback--yesterday's girls--so their work is undervalued and underfunded, then patient care suffers, and people die. We must change how we think about nursing, or trying again to reach the same goals without learning something in the meantime will lead us to the same failed end.

Sandy Summers, RN, MSN, MPH, Founder and Executive Director, The Truth About Nursing, a 501(c)(3) non-profit working to improve public understanding of the nursing profession. Learn more at