African Activists' Struggle to Improve Maternal Health

Activist Juliette Compaoré says the MDG summit will have an impact in Burkina Faso © Amnesty International

New UN statistics released last week show that world leaders are struggling to keep their promise of cutting the maternal mortality ratio by 75 per cent by 2015. For activists in Sierra Leone, the slow progress is no surprise.

Many people don’t understand that maternal health is a human rights issue and so many other factors contribute to these deaths. Discrimination, lack of facilities, domestic violence and poverty… if these underlying issues aren’t addressed, it will undermine the good work that is being done,” says Victor L Koroma, an activist based in the capital Freetown.

Koroma’s small organization, the Campaign for the Promotion of Health and Human Rights Activities, campaigned to abolish medical fees in Sierra Leone. In April, the government took the landmark step of introducing free healthcare for pregnant and breastfeeding women.

However, Koroma warned world leaders gathering this week in New York to discuss progress on the Millennium Development Goals (MDGs) that more still needs to be done.

“We need to go beyond free healthcare because there are lots of problems. Many midwives are not properly trained and drugs and blood are not available. Nutrition is completely ignored. Drugs are unevenly distributed and there is discrimination – whether on the basis of tribe, gender, social status or political affiliation.

“World leaders, donors, the UN and the World Bank all need to do their bit if a country like Sierra Leone is to be saved from the ravages of pregnant women dying every day.”

Koroma paints a harrowing picture of the scale of the maternal health crisis facing MDG decision-makers.

“Sexual and gender-based violence is rampant; women and girls as young as five are being raped. Many then become infected with HIV. Yet the government does nothing. In the last year only two people have been sentenced for violence against women out of probably thousands of cases,” he says.

The UN statistics show an average annual decline of 2.3 per cent since 1990, falling way short of the 5.5 per cent decline needed to reach the 2015 target. Although a woman is no longer dying every minute, the new statistics show that one woman is still dying every minute and a half.

Severe discrimination and the low social status of women also fuel the high rate of maternal deaths in Sierra Leone, where women’s health needs are given low priority by their own families and community leaders.

Most maternal deaths in Sierra Leone take place in rural areas cut adrift from hospitals. Most women die in their homes. Some die on the way to hospital; in taxis, on motorbikes or on foot.
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Speaking Out for Maternal Health in Detroit

On April 17, Detroit hosted the second stop of the maternal health speakers tour. In this post, Reuben Metreger, a law student at Wayne State University and Amnesty International state legislative coordinator for Michigan, looks back on the event.

As I reflect on the Deadly Delivery Detroit event I am reminded of what long time Detroit co-group 78 leader and new area coordinator Ken Grunow said. In Detroit we will all need to become midwives and mid-husbands to deliver the rebirth of our city. Amnesty International leaders from around the world gave us a good first push. As we begin to demand dignity and take on poverty it seems clear that a common problem is inequality for women and minority groups and that it is people power, not technology that will make it happen.

As if on cue the technology failed us. The sound system went out, but our leaders did not skip a beat. They were able to communicate the old fashioned way, from the heart.

Larry Cox, executive director of AIUSA, told us that although we are the richest country in the world, we still rank behind forty other countries in terms of lifetime risk of dying in pregnancy or childbirth.

Silvia Rosario Loli Espinoza, executive director of AI Peru, told us through her interpreter that although her country is considered a middle income country, they are the third worst in Latin America when it comes to maternal mortality. Unfortunately, there is still a lack of resources and women are not even provided with basic needs like food and transportation. Other problems have to do with discrimination against indigenous people and women in the country which contribute to poor outcomes. She described a technique called vertical delivery where women give birth while standing; indigenous women often prefer vertical delivery, but too many Peruvian health professionals are unable to facilitate the technique, or even actively discourage it.

Yves Boukari Traore, executive director of AI Burkina Faso, told us that his country is one of the economically poorest in the world. Poverty is a leading cause of maternal mortality, yet the problem is more than a lack of resources — it is a lack of will. We watched an inspiring video of women on the Amnesty International caravan delivering the message that maternal mortality is a serious problem and that when the community joins together to demand dignity, the government will have to respond.

The most hopeful news of the day came from Brima Abdulai Sheriff, executive director of AI Sierra Leone. Although he told us that Sierra Leone facing many of the same challenges as Burkina Faso, his government has announced that health care will be provided free to pregnant women in his country!

It was inspiring to get to see first-hand Amnesty activists from around the world and to recognize that our problems have much in common. We all need to come together to join Amnesty International and demand dignity for all people! As Ken said, we all need to help support pregnant women to ensure that birth is a joyous occasion that we can all celebrate.

Speaking Out for Maternal Health in San Francisco

This post is by Cecilia Lipp, AIUSA San Francisco Organizing City Activist Leader.

L-R: Larry Cox of Amnesty International USA, Maddy Oden of the Tatia Oden French Memorial Foundation, and Yves Boukari Traore of Amnesty International Burkina Faso

L-R: Larry Cox of Amnesty International USA, Maddy Oden of the Tatia Oden French Memorial Foundation, and Yves Boukari Traore of Amnesty International Burkina Faso

San Francisco hosted AIUSA’s maternal health speakers tour at the San Francisco Public Library Wednesday night. Amnesty International executive directors from Sierra Leone, Burkina Faso, Peru and the United States presented the findings of AI’s reports on maternal health in their respective countries, and outlined their campaigns to make every birth safe.

The panel discussion, moderated by Diana Campoamor, president of Hispanics in Philanthropy, took us through from the international to the local level. The statistics at every level are shocking. But what stays with me most are the stories of individual women denied access to lifesaving health care.

L-R: Yves Boukari Traore of Amnesty International Burkina Faso, Brima Abdulai Sheriff of Amnesty International Sierra Leone, Sameer Dossani of Amnesty International USA, and Silvia Loli Espinoza of Amnesty International Peru

L-R: Yves Boukari Traore of Amnesty International Burkina Faso, Brima Abdulai Sheriff of Amnesty International Sierra Leone, Sameer Dossani of Amnesty International USA, and Silvia Loli Espinoza of Amnesty International Peru

Maddy Oden, founder of the Tatia Oden French Memorial Foundation, shared the intimate story of the loss of her daughter, Tatia, after an induced labor at a respected San Francisco Bay Area hospital. Tatia’s daughter Zorah passed away as well. Before speaking, Maddy lit a candle to honor the spirits of the women who have died while giving life.

In a room filled with midwives, local elected officials, our local human rights organizations and people who are all parents and children, it was so important for us to be brought back to the fact that the issue of maternal mortality is not just a question of abstract statistics or lofty human rights ideals. This is a concrete, flesh-and-blood issue that affects every person in the room, and the inspiration for this work lies in the fact that this is a crisis we can fight! These deaths, like Tatia’s, are unnecessary and preventable, especially in the United States, where geography and infrastructure do not pose a problem in the way that it might in rural Burkina Faso.

L: Silvia Loli Espinoza of Amnesty International Peru

L: Silvia Loli Espinoza of Amnesty International Peru

We looked at solutions in our community, such as the bill for single-payer health care in California championed by Senator Mark Leno, supported by partner organizations including OneCare California. We, as a community, can also look to support education solutions that the Tatia Oden French Foundation proposes including increasing women’s awareness of their rights within the health care system, including the right to refusal. It’s imperative for our community to ensure that all women get everything they need to be fully informed participants in their care.

This event was a call to action: to come together in solidarity with one another and protect the life of every woman in our global community who chooses to give birth. Let us make sure every woman knows her rights, let us hold the medical community accountable (not culpable, but responsible), let us support the practice of midwives and doulas to support women in birth, let us ensure that women are visited by doctors and community members before, during and after their birth.

L-R: Maddy Oden of the Tatia Oden French Memorial Foundation (hidden), Yves Boukari Traore of Amnesty International Burkina Faso, Brima Abdulai Sheriff of Amnesty International Sierra Leone

L-R: Maddy Oden of the Tatia Oden French Memorial Foundation (hidden), Yves Boukari Traore of Amnesty International Burkina Faso, Brima Abdulai Sheriff of Amnesty International Sierra Leone

We have our work cut out for us, but I became convinced this week that we can make this change in our community here in San Francisco. Could you do the same thing in your community? Will you work for a crucial national solution — an Office of Maternal Health? I will remember the life of Tatia Oden French and the other women just like her who die every day within the United States alone. Let us stand together in solidarity and transform this unnecessary and heartbreaking reality.

Maternal health is a human right. Motherhood and birth deserve dignity, so let us demand dignity for ourselves, our sisters, our daughters, our partners.

Giving Life, Risking Death in Burkina Faso

Safiatou (not her real name), 26 years old, married her cousin Hamidou when she was 14. They lived in a village in Burkina Faso, about 100 km south of Ouagadougou, where they farmed livestock. Safiatou had already had four children when she got pregnant again in 2007.
Safiatou’s husband told Amnesty International: “The day of her delivery, she was in good health and worked all afternoon as usual without any problem. She prepared tô [a local dish made from maize flour] for her children and went to get the hay for the animals. In the evening, when her labor began, she left for her mother’s home. Her mother came to warn me that she was not well, that we had to take her to the clinic. I do not have a motorcycle, so I had to go and get one. That made us lose time.” Hamidou added that he “did not know that she should have delivered at the clinic. When I came to fetch her at her mother’s house, she had lost consciousness.”
Hamidou borrowed a small motorcycle from his neighbor, but it didn’t have any fuel. The closest gas station was 10km away. Safiatou ended up delivering at home, but there was placenta retention and serious haemorrhaging. Her husband asked a friend to help him take Safiatou to the local health center, but she passed away on the motorcycle on the way there — 4km away from the facility.
Safiatou left five boys, ages 11, nine, seven and four, and the newborn baby.
The story of Safiatou is one of the 50 cases that Amnesty International’s researchers investigated in-depth for “Giving Life, Risking Death,” the new report on women dying in pregnancy and childbirth in Burkina Faso. The report launched today at an event ??? in Ougadougou.
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Maternal mortality in Burkina Faso Safiatou (not her real name), 26 years old, married her cousin Hamidou when she was 14. They lived in a village in Burkina Faso, about 60 miles south of Ouagadougou, where they farmed livestock. By 2007, the family had four children. Safiatou got pregnant.

Safiatou’s husband told Amnesty International:

The day of her delivery, she was in good health and worked all afternoon as usual without any problem. She prepared tô [a local dish made from maize flour] for her children and went to get the hay for the animals. In the evening, when her labor began, she left for her mother’s home. Her mother came to warn me that she was not well, that we had to take her to the clinic. I do not have a motorcycle, so I had to go and get one. That made us lose time.

Hamidou added that he “did not know that she should have delivered at the clinic. When I came to fetch her at her mother’s house, she had lost consciousness.”

Hamidou borrowed a small motorcycle from his neighbor, but it didn’t have any fuel. The closest gas station was six miles away. Safiatou ended up delivering at home, but she suffered placental retention and serious hemorrhaging. Her husband asked a friend to help him take Safiatou to the local health center, but she passed away on the motorcycle on the way there — two and a half miles away from the facility.

Safiatou left five boys — ages 11, nine, seven and four, and the newborn baby.

The story of Safiatou is one of the 50 cases that Amnesty International’s researchers investigated in-depth for Giving Life, Risking Death, the report released today about women dying in pregnancy and childbirth in Burkina Faso. SEE THE REST OF THIS POST