By Bobby Ramakant, CNS
“At the global level we don’t only have the issue of deaths of women and child, pregnancy and child-birth related situations, but it is the discrepancy between these deaths in the northern and more industrialized countries and in the developing countries. In fact, today as we speak we know that practically no woman dies in child birth in Europe or North America. But they do die in South Asia, Africa and Latin America” said Dr Frederick Torgbor Sai, an internationally recognized gender and reproductive health advocate from Ghana, who is the co-chair of “Women Deliver 2010” in Washington DC, USA (7-9 June).
Too many women and newborns are dying worldwide during pregnancy and childbirth. Every year, between 350,000 – 500,000 girls and women die from pregnancy-related causes. Almost all of these deaths (99%) occur in the developing world. Four million newborn babies die every year, also from causes that are mainly preventable and typically linked to the mother’s health.
“The causes of maternal death are not very different. The technologies and the approaches to do something about these deaths have been known for a very long time. So why is it that we continue to see them so very frequently in developing countries particularly in Asia and Africa. Recently we have seen that these deaths are coming down in Latin America and in many other parts of the world. Africa in particular doesn’t show that it is coming down too much” said Dr Sai in an exclusive interview to CNS.
Dr Sai was the moderator for the 1987 Safe Motherhood Conference which launched the Safe Motherhood Initiative and chairman for the Main Committees of the International Conference on Population in Mexico in 1984 and of the International Conference on Population and Development (ICPD), in Cairo in 1994. It was this last conference which produced the Programme of Action, emphasizing the centrality of women to all development programmes and called for world attention to the improvement in the status of women and for equity and equality between the sexes as the basis of all human relationships.
“When we met in Cairo in 1994 we decided that for reproductive health services the developing countries themselves should try to put in two-thirds and advanced countries about a third. Many of the developing countries have been keeping in money but the advanced countries’ money indeed failed to come and has been coming down particularly in the areas of family planning which are the number one prevention for these deaths. So we don’t think that the developed countries, the industrialized countries have contributed enough. The developing countries themselves too some of them have not, I suppose majority of them are in Africa, in Asia, in South Asia, haven’t put in commensurate with the size of the problem, they haven’t put in enough” said Dr Sai.
“I believe particularly in South Asia and parts of Africa, if the status of women can be improved, women’s education, quality education, can be given very more support, it would affect in improving the background for reducing these death rates very much, I think” said Dr Sai.
According to Dr Sai, to reduce the mortality itself, we need:
1) to have better facilities, better healthcare personnel trained for handling emergency obstetric care,
2) to have better treatment for women who are pregnant, improving care around the delivery itself,
3) to be prepared to have an emergency evacuation setup, that will link the site of delivery to any emergency centre that will be able to handle emergencies.
One of the problems with maternal mortality is that the major death rates don’t occur in people whom you can diagnose before they go into labour. The majority of deaths occur around the time of labour or immediately after the delivery. So these are true emergencies and the person assisting in the delivery should be knowledgeable enough to respond to these emergencies and know how to manage evacuation setup so that the individual can be sent to these clinics.
“Lack of the facilities and lack of trained healthcare personnel at the receiving clinic” are key impediments in saving women’s lives, said Dr Sai. “Sometimes the people go to these clinics and no one is present and there is delay right inside the clinic. So we are trying to reduce that period of delay in the clinics and expand the number of clinics that can handle emergency obstetric care. Also emergency evacuation services need to be organized” said Dr Sai.
“These are the things that can give confidence to the communities to bring the people to these clinics rather than them to think that people go to the clinics only to die” said Dr Sai.
“We have tried for so many years to try and wake up the consciousness of the world to what we consider as a major fight to save women’s lives. We have been successful only to a small extent. We want to think that this year 2010 is the beginning of the end of that battle – the battle we are going to wage now and will be taken on worldwide and we will save the women’s lives” said Dr Sai.
Dr Sai has earlier served as Senior Population Advisor to the Word Bank, President of International Planned Parenthood Federation (IPPF) from 1989 to 1995; was recipient of the UN Population Award in 1993.
Let us hope that the Women Deliver 2010 turns Dr Sai’s hopes into reality in saving women’s lives.
(The author is the CNS Policy Adviser, a World Health Organization (WHO) Director-General’s WNTD Awardee 2008, and writes extensively on health and development. Website: www.citizen-news.org, email: [email protected] )