One in eight

From the NYT Lens blog, “Showcase: from birth, death“:

Standing in the only operating room in the only medical hospital in all of Guinea-Bissau, Marco Vernaschi watched a nurse take an unsterile needle out of her pocket and, without anesthetic, suture a woman’s vagina after a difficult childbirth. The woman screamed. Mr. Vernaschi took a photograph. Moments later, she was required to walk out of the filthy room and go home.

The slideshow is not recommended for the faint hearted.

Amnesty International released a report today, calling the alarming rates of maternal and child mortality in Sierra Leone a “human rights emergency”, as one in eight women risk dying during pregnancy or childbirth.

According to USAID:

“Both maternal and child mortality rates in West Africa are among the highest in the world where outdated clinical, social, and cultural norms create obstacles to quality maternity services. It is estimated that for every woman who dies as a result of childbirth, at least thirty others are severely incapacitated from fistulae, chronic pelvic pain, and infertility. Poor sanitation and nutrition, along with inefficient health service management, put young children at risk of easily preventable illnesses.”

Gordon Brown is slated to announce millions of dollars of new funding to provide “free healthcare for millions more women and children in the developing world.” I wonder if this promise will go to rest in the great graveyard of broken promises. “Throwing money (with many strings attached) at the problem” has been the rich country M.O., requiring governments – like Sierra Leone’s – to spend inordinate amounts of time and resources proving to donors they can manage aid transparently. It takes months, years, for countries to turn around their public sectors and make their public health delivery systems functional.

Meanwhile, one in eight women in Sierra Leone faces the risk of death for becoming a mother – so how do we solve the “emergency” part of this equation?

One possibility could be training midwives and other pregnancy and child birth attendants in areas where access to clinics and health centers is limited. Many NGOs and agencies have the capacity to deploy such programs in a matter of weeks — pending funding. Africare was implemeting such a program last year in Liberia. I am cautiously hopeful that a renewed commitment to solve issues affecting women will create the political space necessary for emergency interventions to complement longer-term, more systemic efforts at improving the state of maternal and child health in West Africa.

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