Maternal health must top agendas

December 22, 2007

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KAMPALA, UGANDA ✦A pregnant woman here in Uganda’s capital was recently beheaded by her husband. Maurine Ampire, 38, was a mother getting close to delivering number six.

It’s one picture of life here, and a comparable image to the lack of voice that pregnant women have worldwide. No voice. No choice. Just death, and often violently.

Some 525,000 mothers now die annually in childbirth, 99 per cent in the developing world. That’s 1,450 a day; or one every minute.

One in four simply bleeds to death. Millions of children then also perish.

Some of these moms are just girls with underdeveloped bodies, married young, or defiled. Others are forced to have so many children without child-spacing that they’re just digging their own graves.

Uganda is among 13 countries that share 70 per cent of all maternal deaths worldwide. In Africa, others are Tanzania, Kenya, DR Congo, Ethiopia, Nigeria and Angola. Outside, add Pakistan, Indonesia, China, India, Bangladesh and Afghanistan.

Incredibly, these deaths are virtually all preventable. But theycontinue due to lack of skilled birth attendants and emergency care at delivery, often fuelled by cultural myths and patriarchal attitudes.

It’s among the planet’s biggest stories. But you likely haven’t heard much about it; haven’t heard that from 1980 to 2000 more women — about 12 million — died in childbirth than of AIDS; haven’t heard that other crises, like say, in Darfur, pale in comparison.

In an information-soaked era, why not?

There’s plenty of talk about human rights and mutual respect and gender equity these days. Much came from world leaders at the recent Commonwealth Summit in Kampala, just days before Maureen’s head was taken off.

But we remain miles from even old maternal death targets, like the Safe Motherhood Initiative of 1987 to cut deaths by half by 2000.

While other global health indicators improve, the world’s poorest mothers just keep dying quietly. Hollywood icons or rock stars don’t campaign for them. Cheering for motherhood isn’t popular among Western feminists either, so they’re silent. So are religious groups. And governments. It’s all quite deafening.

I was just reminded of this after photographing Sarah Brown, wife of British Prime Minister Gordon Brown, during the Commonwealth Summit. In a breath of fresh air, she went beyond the rhetoric and social luncheons and visited Mulago Hospital, Uganda’s main birthing centre.

Then her personal aide forbade me from releasing the ensuing photos, strangely fearing Brown’s image would somehow be tarnished in the UK. Regardless, I released one for worldwide distribution through Reuters news, a little wiser of the silly challenges that confuse the real issues.

Here’s another example. Many Hamiltonians know the work of my wife, Dr. Jean Chamberlain Froese, a McMaster University obstetrician who is the founding executive director of Save the Mothers, a ground-breaking program based in Uganda.

In just two years, it’s seeing results because it trains a range of societal leaders. Four Ugandan MPs are among its current class of 55. As a result, maternal health is now on Uganda’s national budget for the first time. One of the four MPs, Sylvia Ssinabulya, visited Canadian parliamentarians in Ottawa this summer.

Too bad five requests for a Canadian official to visit this unique program, just 45 minutes from the Commonwealth Summit venue, failed. For its two invitations, the Prime Minister’s office didn’t even bother with a courtesy reply.

By the way, Canada spreads about $4 billion in annual foreign aid to some 161 countries, including 46 in Africa, in tiny allotments that, according to a Senate report, give no results anywhere. Ottawa is rightly streamlining the system.

One wonders, though, if it will ever learn to pinpoint aid to core issues, like maternal care, which, when stable, secures a country’s entire health system.

Few Westerners would say it’s acceptable that so many African women are dying on dirt floors in mud huts, alone, in bloody agony, any more than it was acceptable for African slaves to be chained to ships and carried over the Atlantic.

But, like during abolition, fundamental thinking needs to change. The broader public needs an awakening. And since dying mothers can’t, others need to speak for them.

As 2008 marks the 60th anniversary of the Universal Declaration of Human Rights, now is a good time.

 

 

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December 22, 2007 • Posted in ,
Contact Thomas at [email protected]

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