We live in the 21st century, we’ve sent humans to the moon and still every minute a women dies as a result of pregnancy. This video by the White Ribbon Alliance for Safe Motherhood highlights how a lot of these deaths could be prevented - simply by providing the much needed medical assistance. In the developed world a women is more likely to die in a plane crash, than in childbirth. We’re accustomed to births happening in hospitals, with sterile equipment and in the presence of doctors and midwives wearing clean hospital uniforms. I mean, there’s even a growing movement in America and Europe calling for “demedicalizing birth”!
All this makes the thought that millions of women give birth without ANY assistance almost unbelievable. And sometimes there’s a happy ending to an unattended birth - a healthy mother and baby. But too often their life is in danger, and this movie shows the multitude of reasons why women still don’t get medical assistance even when it’s a matter of life and death.
A lot of times the closest hospital is too far away. Cars are expensive but lack of means of transport to hospital are one of the reasons mothers and their babies die. Villagers in Pitala, Malawi (Southeast Africa) came up with the idea of bicycle ambulances - simple, cost-effective, and it works. Villagers in Pitala are lucky - the hospital is close enough for a bike-ride to be feasible. In a lot of places the closest hospital will be days away.
Sometimes the mother is hemorrhaging and losing a lot of blood - 1 in 4 women who die in childbirth die because of excessive bleeding. Something that almost never happens in the ‘global North’ because there’s a pill, available in every hospital, which can quickly stop the bleeding - Misopostol. It’s a low cost (less than US$2), off-patent, easy to administer drug with few side-effects, which dispensed by a trained birth attendant saves lives. It sounds simple (and it is), but a trained birth attendant with adequate supplies needs to be present. However, globally we are currently lacking 4.3 million health workers - that’s a New Zealand or Croatia worth of doctors, nurses and midwives the world really badly needs to keep women from dying while bringing life into the world!
Lastly, and maybe in some ways most tragically, women all too often die because their families are not willing to pay for their treatment, even when it’s as little as US$3.45. There are still frighteningly many countries, where girls and women are not valued equally to their fathers, brothers and husbands and their health isn’t a priority. This shows that for progress on MDG5 we also need to work towards gender equality - which we've written about recently through the stories of Jess, Exildah and Kakenya.
This is a touching movie which shows the devastating effect a mother’s death can have on her whole family and the well-being of her children. But it also highlights success stories showing that maternal mortality is a challenge to development which can, and should, be overcome (for more success stories check out: http://www.gatesfoundation.org/livingproofproject/Pages/default.aspx).
This clip also touches on the very important issues of adolescent pregnancies and family planning. Globally, complications from pregnancy and childbirth are the leading cause of death among girls aged 15 to 19. Additionally, 85% of teenage pregnancies are not planned. Providing family planning options could save millions of lives each year - not only of mothers and their newborns, but also those of older children who are much more likely to survive and thrive if their mother is alive.
The Guttmacher Institute, a New-York based reproductive rights organization, estimates that a third of all pregnancies worldwide are unintended - that’s almost 210 million pregnancies annually. This means there over 200 million women worldwide who have an unmet need for family planning. Providing them with the means to manage their fertility as well as some basic medical assistance can save 70% of the maternal and 40% of infant lives currently lost worldwide.
Women who cannot plan their family size and space their children appropriately are much more likely to die in childbirth or as a result of an unsafe abortion (74,000 women annually). Moreover, their children are more likely to be malnourished and less educated. Providing family planning empowers women and their families and allows them to make informed choices concerning their lives.
There are numerous organization worldwide working to meet the family planning needs of women worldwide (e.g. International Planned Parenthood Federation). Sexual health clinic workers save lives on a daily basis not just by dispensing AIDS medicine (ARVs) and condoms - although they perhaps gets the most media attention. A very important part of their job is providing contraceptives such as the contraceptive jab, or diaphragm. Although not highly publicized, this is an incredibly effective and cost-efficient way of saving women’s and children’s lives. It also gives women the time, energy and resources to invest in the children they already have and even take on a job outside of the home. Some governments (e.g. the current Canadian Government) are diverting funding from proven, long-running family planning projects in the developing world and still trying to convince the public they care about maternal health. We shouldn’t let them get away with it - family planning is absolutely essential for meeting MDG5!
I don’t know about you but I wouldn’t eat “eight thousand nine billion doughnuts” if someone paid me to do it, let alone because I wanted to. But apart from that I think the message of this movie is one everyone can agree on. As this video from the White Ribbon Alliance shows, Mums matter - no two ways about it!
Although the importance of a mother is universally accepted, MGD5 is lagging behind all other Millennium Goals and there are almost 400,000 deaths annually classified as “maternal mortality,” as we've noted previously. This means that a Miami or Manchester worth of women dies every year in childbirth (most often due to obstructed labor or bleeding) or as a consequence of an illegal, unsafe abortion.
Without a mother the world can be a scary place. Especially if you’re a child. Unfortunately, according to the White Ribbon Alliance this is the fate of 2 million kids worldwide every year. That’s more orphans than people live in Luxembourg and Qatar combined! 99,5% of these kids are in developing countries where there likely aren’t procedures or institutions that can make sure they are looked after. Traditionally families would care for a mother-less child, but due to the HIV/AIDS epidemic these traditional care-takers may no longer be alive or well enough to care for a child.
As Jill Sheffield, the President of Women Deliver, said “The biggest enemy of women’s health and rights is political indifference”. Even though we know how to effectively lower maternal mortality, taking action on preventing mums dying has never been high on politicians’ priority list.
The thing is, a little investment can go a long way. At least 80% of maternal deaths could be averted for US$24 billion. That may seem like a lot of money but to put things in perspective President Obama spent US$25 billion bailing out the automobile industry. Americans annually spend US$14 billion on Mother’s Day merchandise - that’s US$2 billion more than the current (inadequate) global spending on maternal health!
Statistically, every person contributes only US$2.50 annually to making sure women don’t die in childbirth. By making even a small donation to an organization that works to save mothers you can double your per capita impact!
In the worlds of Melinda Gates - “every birth is a cause for joy that holds promise of a better future” and we can work to make sure that nowhere is it regularly a life-threatening condition.
Most of us don't think twice about where we get our medicine from – the nearest pharmacy is bound to be close by, affordable and well stocked. Unfortunately, that's not the case for the many of the world’s poorest people. Big pharmaceutical companies are often targeted as a part of the problem – they have enormous control over which drugs are available and affordable and this can also make them a part of the solution. However, without some prompting from the public big pharma companies are unlikely to forego profit for the benefit of their potential, poorer clients in the developing world.
This is where the Access to Medicine Index steps in, which just published its second biannual report. The Index is a comprehensive database of major pharmaceutical companies which tracks their efforts to help improve access to affordable essential drugs in developing countries.
The Index looks at how much companies' spend on research and development, their management and patenting policies, as well as philanthropic activities. Research for the index draws on numerous sources and companies themselves are invited to verify the data while independent world experts review drafts of the report.
By bringing much needed transparency to the pharmaceutical industry, the index aims to engage private investors and pharmaceutical companies and to encourage collaborations.
Here's a story of how people's lives can be changed, when pharmaceutical companies do the right thing:
Every 30 seconds a child dies of malaria - even though there are drugs that could save their lives for less than a dollar. This movie shows how making these drugs available to those who need them most is possible and happening around the world. The public-private partnership between the government of Côte d'Ivoire and Sanofi-Aventis to provide a new, cheap and effective anti-malarial treatment is just one example of how governments are collaborating with the pharmaceutical industry in a bid to increase access to effective treatment.
Last year the head of GlaxoSmithKline made a pledge to drastically cut the prices of drugs in the developing world, reinvest profits into local hospitals and, importantly, share knowledge about potential drugs that are still patent-protected. Following through on that pledge has allowed GlaxoSmithKline to retain its top position in this year's Access to Medicine Index and gain wide approval from governments and non-governmental organisations alike. At the same time the value of GSK stocks went up by almost 7% in a year. This demonstrates that running your business more ethically obviously does not mean you'll need to give up on the idea of making a profit.
Much still needs to be done to ensure that people in the developing world can have easy access to the right drugs, at the right time and at an affordable price. It's comforting however to see we are making progress and the Access to Medicine Index is just one of the great new tools which are allowing decision-makers and consumers, around the world to make informed choices about which products they buy and what companies they invest in.
