NAIROBI, Kenya (WOMENSENEWS)–I have been aware of the dangers associated with delivering children most of my life and always believed it was part of some “natural risk.” But campaigning on the issue of maternal mortality changed that. It hit me more directly last month, when my younger sister Asmau (better known as Talatua), age 33, died two hours after delivering her second child, a baby boy whom she never held.
Asmau is among the 500,000 women who die each year as the result of childbirth and pregnancy; it’s the No. 1 killer of women of childbearing age in the developing world. The vast majority of these deaths are preventable and their prevention is definitely less costly than death, in both human and material terms, to the families involved and to society in general.
To show you how much surviving pregnancy is a matter of privilege, consider this fact: The risk of a woman dying as the result of pregnancy in a developed country is 1 in 7,300. In Africa, it is 1 in 26.
Yet while statistics can educate and raise awareness, they remain statistics. Until they are humanized, we may not feel their impact directly.
Let me tell you about my sister.
Asmau was far from illiterate. She was a senior science teacher in a secondary school and her husband is a college principal. In income terms, both of them are not the so-called “ordinary” man and woman. Their income could “buy” them better access to health facilities. My sister died in a “private” clinic in Funtua, a small town in Nigeria. The clinic is one of many that have mushroomed in response to the crisis in the public health sector in Africa.
Most of these “private” clinics are owned by doctors and other medical staff working in the public sector. The only dividing line between public and private is the extra money that those who can afford to do so pay, for extra care and time from the overworked public professionals.
Game of Chance
But it is all a game of chance because many of these “private” clinics in Africa do not have requisite facilities and often fall back on the privatized sections of public facilities. So the closer one is to better public hospitals and other medical establishments–such as dedicated gynecological, pediatric and other specialist hospitals like university teaching hospitals–the better one’s chances are of buying off a slice of the public service.
In my sister’s case the main reason she bled to death was because the private clinic did not have competent professionals to attend to her post-natal emergency. For many other women, death could result from being too far from health facilities, lacking appropriate transport in an emergency and inability to obtain adequate and timely professional intervention.
In Africa and Asia, where most people still live in rural areas, the health and lifespan of mothers and other citizens is based on the random selection imposed by our limited facilities. Even in the capital cities, your residential area and financial ability determines your access.
Annie Raja, general secretary of the National Federation of Indian Women, says that in India, the country with the world’s highest number of maternal deaths, “Many prefer to use God’s anger as the reason for death rather than the non-availability or failure of medical care.”
The same is true in Africa. Since God does not protest and has no instant rebuttal department, everything can be blamed on him.
It’s Political Will, Not God’s
But it is not God’s will that children should be brought up without their mothers. It is the way in which we plan our society that leads to women dying like this.
The U.N. Population Fund reported that in 2007 donor spending on reproductive health was $1.28 billion, while $6 billion is needed to combat maternal mortality.
But this is not simply an issue of lack of resources. This is also a matter of unfriendly public priorities.
If the minister of health of a country goes abroad for treatment on the flimsiest of health reasons and the minister of education does not have any of his or her children in the schooling his or her ministry is providing, why should the public trust their services?
It is unacceptable that governments can find money for unjust wars, the private security of the president and his wife, or concubines–not to talk of ministers and other state officials–instead of providing for citizens who badly need services.
It is not possible for the majority of citizens to privatize their way out of public services, whether in health or education. Nor is it possible for aid money to magically solve the problem. The citizens of Africa and Asia must exert pressure on their own governments for public policies that serve them better.
MDG Year 2015 Coming Up
In the year 2000, world leaders from 189 countries, rich and poor, pledged to achieve the Millennium Development Goals, a set of eight benchmarks to eradicate extreme poverty, improve health, education and the environment, as well as create a global partnership for development by the year 2015. The fifth of these goals is to reduce maternal mortality by three-quarters. But this goal has had the least progress and is unlikely to be achieved unless urgent action is taken now.
Jemima A. Dennis-Antwi, a midwife in Ghana who works with the International Confederation of Midwives, notes that women of reproductive age in low-income countries still die from preventable complications.
“This situation must be rejected by stakeholders with an interest in improving maternal health,” she says. “Sub-Saharan Africa and other developing countries within Asia and Latin America especially must rise up to the occasion and aggressively address the problem through the adoption of culturally sensitive and medically approved approaches. The midwife is pivotal to success.”
As I’ve discussed, adequate health-care infrastructure and personnel are two pressing areas of need. But pregnant women also need secure sources of food, water and sanitation to ensure proper nutrition and hygiene. They need roads and bridges to get to hospitals in time if necessary, and electricity so they can be treated properly when they arrive. They need access to education, which helps women better plan and space their children. They need their governments to curb malaria, a major cause of maternal mortality because pregnancy renders women more vulnerable to the disease. Leaders of poor countries must urgently marshal domestic resources to meet these needs.
On March 25 at 10 a.m. Eastern Standard Time, Dr. Jemima A. Dennis-Antwi, the International Confederation of Midwives’ Regional Midwifery Adviser for Anglophone Africa, and Annie Raja, mentioned earlier in this essay, will discuss ways to boost progress toward Millennium Development Goal No. 5 in a live online chat organized by Women’s eNews and the United Nations Millennium Campaign.
Tajudeen Abdul-Raheem is deputy director for Africa at the United Nations Millennium Campaign, which supports citizens’ efforts to hold their governments accountable for achieving the Millennium Development Goals. He has been engaged with civil society organizations and social movements across Africa and in the diaspora for more than two decades.
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