The United Nations Millennium Campaign is launching a report this week on maternal mortality to coincide with International Women’s Day on 8 March. We are also joining with various national partners, UN agencies and governments in various countries across Africa in a month-long series of activities designed to draw attention to the alarming number of women who continue to die while giving birth or as a result of complications of pregnancies. Many of these deaths are preventable and their prevention is not costly in human and material terms to the families involved or society in general. The paradox of the situation is that millions of children in Asia and Africa now have a better chance of living beyond the age of five. If more children are living, why are their mothers dying in such scandalous numbers? Who is going to nurture and care for these children with improved chances of living beyond the age of five, facilitating their universal access to education and greater opportunities beyond 2015? Official statistics reveal a shocking trend of mothers dying in circumstances that are preventable. Despite the fact that some countries have invested in the provision of basic healthcare, in developing countries only 35 per cent of births are attended by skilled health workers. In sub-Saharan Africa, a woman has a one in 16 chance of dying in pregnancy or childbirth, compared to a one in 4,000 risk in a developed country. More than half a million women die in pregnancy and childbirth every year, and of these deaths, 99 per cent are in developing countries. Neonatal mortality accounts for almost 40 per cent of the estimated 9.7 million deaths of children under-five and for nearly 60 per cent of infant (under-one) deaths. Niger is one of the poorest countries in Africa and the most dangerous place to give birth with women facing an astonishing one in seven chance of dying. Nigeria for its part makes up 2 per cent of the world’s population, but accounts for 10 per cent of its maternal deaths. While statistics can educate and raise awareness, they remain statistics. We do not see human beings in them. Until they are humanised, we may not feel their impact directly. I have been banging on about MMR (measles, mumps and rubella) for quite some time now. But it hit me directly recently. A young sister of mine, Asmau (better known as Talatua) aged 33, died two hours after delivering her second child, a boy, whom she never held. Asmau was not an illiterate woman. She was a senior science teacher, while her husband is a college principal. Both fall far beyond the so called ‘ordinary man and woman’, as their income could ‘buy’ them better access to health facilities. My sister died in a ‘private’ clinic, one of many that have mushroomed in response to the crisis in the public health sector. Most of these ‘private’ clinics are owned by doctors and other medical staff ‘working’ in the public sector. So really the only dividing line between public and private is the ‘extra’ money that those who can afford pay in order to buy themselves extra care and time of overworked public professionals. But it is all a game of chance because many of these ‘private’ clinics do not have the requisite facilities and often fallback on the privatised sections of public facilities. So the closer one is to better public hospitals and other medical establishments like dedicated gynaecological, paediatric and other specialist hospitals like teaching hospitals, the better are one’s chances of buying off a slice of the public service for one’s health. Consequently, regardless of your economic status, your access to better public or private health facilities is predetermined by location. If you are closer to the big cities, your chances are better. In a continent where most of our peoples still live in rural areas, it is highly precarious that the health and lifespan of mothers and other citizens are based on such a random selection. It means that the majority of our peoples is condemned to inferior access to good medical facilities. Even in the capital cities, your residential area and economic wellbeing condition your access. Our people try to cope with every calamity, many of them avoidable, preventable and human-made, by insisting that ‘it is God’s will’. Since God does not protest and has no instant rebuttal department, everything can be blamed on him. 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 being penalised for doing what is natural to womanhood. It is unacceptable that governments that can find money for unjust wars, the private security of presidents and their wife, wives or concubines – not to even talk of ministers and other state officials – while ignoring the far greater needs of their citizens for these services. It is not about lack of resources, but lack of people-friendly public priorities. If the minister of health of a country goes abroad on the flimsiest of health reasons and the minister of education does not have any of his or her children in the educational services his or her ministry is providing, why should the public trust the services? It is not possible for the majority of a country’s citizens to privatise their way out of public services, whether in health or education. Therefore citizens’ pressure must be placed on governments so that public policy responds positively towards the better provision of these services. Enough is enough! While citizens must stand up and speak out to draw attention to the alarming speak number of women who continue to die while giving birth, governments in turn must develop national action plans for the reduction of maternal mortality that adopt a human rights approach supported by strong institutions, funding and accountability mechanisms. Special attention should be given to marginalised groups in health system strategies, and all efforts should be made to guarantee the meaningful participation of women and communities in the designing, development, implementation and monitoring of programmes and policies to combat maternal deaths. Most importantly, developing innovative strategies to rapidly increase access to skilled health workers for emergency obstetric care and comprehensive reproductive health services – including the expansion of responsibilities (and corresponding enhanced compensation) and greatly increased numbers of nurses, midwives and non-physician clinicians – is one of the few ways in which governments can demonstrate political will aimed at reducing the alarming maternity mortality rates. It is not morally or politically right and it cannot be acceptable that mothers die giving life. In memory of my mother who sacrificed everything for her ‘first child’ and other children, my grandmother who nurtured and loved me unconditionally, my great-grandmother whom I was privileged to know, my eight sisters who are now reduced to seven because of Asmau’s untimely death, and in honour of my two wonderful daughters, Aida and Ayesha and their mum, Mounira, and my numerous nieces, women cousins, sisters-in-law and all women, I have pledged myself to support the ‘Piga Debe’ campaign (‘to make noise’ or ‘to shout’ in Swahili) on women’s rights of the United Nations Millennium Campaign, with a particular focus on maternal health. Ends
