Guest post: "Across Africa, a new mother dies every three minutes"

[MumsnetGuestPosts]

As we sit together, shaded from the midday heat, I tell 20-year-old Pili Paulo how overwhelming new motherhood was for me. How common it is for UK women to find it hard to adjust to sleepless nights, the weighty responsibility and sudden lack of time for yourself. I wonder if she feels the same adjusting to life with her month-old daughter. But she looks puzzled at the question, "I didn't have time for myself before I was a mother so it's not that different. I'm just happy my daughter is here and I'm ok."

We are in Mbiki village in the Shinyanga region of rural Tanzania. On that morning's long drive, I imagined women travelling along this endless dirt road while in labour, painfully jolting towards an unfamiliar hospital. All the while not knowing whether they or their babies would live to see the end of the journey. Things are changing though, with the help of Amref Health Africa, whose projects I have come to see first-hand.

Amref Health Africa is Africa's leading health charity - saving and transforming lives in the poorest communities. A world that feels alien to me until six-month-old Clara topples over in exactly the way my babies would when learning to sit up. Then her mother Zena gives the baby her handbag to empty and phone to shake while we talk. I've done that too. When I ask about what women feel for their children I recognise the struggle to explain all that the answer contains. There are parts of this motherhood thing that we do share and then huge swathes I will never begin to understand.

Some birth stories I hear bear a striking resemblance to those of women I've worked with in the UK. Getting to hospital too early and being sent home. The kindness of midwives and the anxiety of partners. I meet a 17-year-old recovering on the postnatal ward three days after her caesarean. Her baby cries and she pulls down her dress and begins to latch the baby on. Two pairs of male hands shoot towards her to help. Before I know it I'm instinctively protecting her space, just as I would on a postnatal ward at home, and saying that it looks like she's doing pretty well on her own.

Tanzania has one of the worst maternal mortality rates in the world and across Africa a new mother dies every three minutes. Family planning is often viewed with suspicion - particularly by men. If a family's crops fail many will have no means of feeding themselves. Access to clean water is a pressing issue for many and some tribes practice FGM. Life appears tissue paper fragile. As I sit writing this, about 60 young African women have lost the chance to hold their babies. But the projects I visited are trying hard to stop this.

The projects take ill-equipped and understaffed local health centres and transform them in to safe places to give birth. Education projects compliment and support the work with community volunteers, local nurses and doctors working collaboratively to reach out to those nearby.

Amref Health Africa's upgrade of the health centre serving Mbiki means it now offers ultrasounds, provides caesarean sections, anaesthesia and a vital ambulance service. Instead of sending emergency cases four hours drive away, they can care for women in difficulty and stop them bleeding to death in transit. HIV clinics, laboratories, family planning and baby clinics are all now available on site.

This is changing the lives of women like 20-year-old Christina Paulo whose first baby, Johnson, was born by caesarean section a month before we meet. "I went through so much to have my baby but the nurses and doctors gave me such good support. I didn't feel scared. I knew I'd be fine here," she told me. Her caesarean scar had opened after she returned home. Without the facilities at nearby Uteshu she doesn't know how she would have survived the birth or whether she would have been able to afford the trip to hospital for repeat surgery.

But Christina and the mothers of Mbiki are still in the minority. We visit Lunguya village where it's a seven hour walk to the nearest health centre. Some women can't leave their families for a month to be safe and wait at the centre for labour to start. It's too late for some by the time their contractions begin. As we drive back through Lunguya schoolyard the little girls are smiling and waving - a bittersweet sight I'll never forget. I wonder how many will make it through the births of their children in ten years time, and know that without our support an unbearable number will not.

Photo: Joseph Were

This Mother's Day, Amref Health Africa is asking people to show solidarity with African mothers, whilst championing their own. To join the campaign, post a photo with your mother using the hashtag #savemothersday. View them at savemothersday.co.uk and visit Amref for more information.

[Claraoswald36]

We live such privileged lives in the west.

[SuburbanRhonda]

Thank you for writing this blog. It's so good to hear about the work being done to make childbirth a safe and happy experience for woman in Tanzania

[rosebudyblue]

Op thanks for the post because it's very insightful.

[rosebudyblue]

Hopefully the charity you work for or doing this will offer contraceptives to those who need it and don't want to have anymore children. A lot of women are coerced into having children that is both to a risk to their health and children. There are some health workers in Africa who are offering implants and UID contraceptives to women who don't want to have anymore children
but their husbands wants them to continue . Their are men refusing to use condoms and don't actually care about their wives health because they are replaceable. The scepticism about contraceptives and what they do to the body and the reasons for it being given to women is a big issue. It's a mind set that needs to change. They have had a lot of scares in the past couple of years with regard to Morden medicine and that is not an ideology which will die anytime soon.

In Africa the majority of people including men don't have issues with breastfeeding. To them if they were to write this article, the breast feeding bit would not have crossed their mind as something essential to include because that is how life is. They would have never looked at it as something other than what you use to feed your child at that moment in time. There is a rise in use of formula but the WHO discourages it because of fear that it will lead to even higher numbers of malnutrition cases. It's not because the formula is not good enough but because a lot of them might be over diluted with water. The other reason is the availability of clean water for mixing the formula.

[meditrina]

It is sad to see that the gulf between the rich and the poor remains entrenched.

[Nabanja]

You went to ONE African country, in fact a region of one country. You cannot roll out what you saw in this one corner across a whole continent of 52 countries. I wouldn't use what I witnessed in downtown Milan to describe problems of the whole European continent. Please respect our continent, and the names and borders our ancestors fought for. Please correct your article.

[RebeccaTheDoula]

Hi @nabanja. OP here. I'm genuinely really sorry you feel that way. I was very aware of trying hard not to generalise while writing this piece - hence being very specific about where I visited and who I met. I was also lucky enough to meet, interview and spend time with a number of the Amref Tanzania staff - all Tanzanian themselves - and had them to hand when fact checking.

If you can highlight the points you feel are disrespectful then I would be glad to see about changing them.

A note that I don't write the headlines, the copy about the campaign (at the bottom of the piece) and the statistic (every 3 minutes a new mother dies across Africa) was a key piece of the Amref campaign. If your concerns are with any of these elements then I'm sure Mumsnet and Amref Health Africa UK would welcome your feedback.

[Nabanja]

Hi RebeccatheDoula

1. Maternal mortality is never measured or represented in time based statistics eg every x minutes a mother dies. The data is often created by manipulating MMR (Maternal mortality ratios) to create an attention grabbing headline. It is inaccurate, misleading and does not represent the increasing percentage of survivors. If you got this data from Amref please put me in touch with the relevant people because I am keen to see how the managed to get a continent wide MMR as most epidemiological data stratifies their data into SUB-Saharan Africa and Northern Africa. Please see WHO, UNICEF, UNFPA and World Bank data.
   
2. Tanzania has seen huge improvements in Maternal deaths in the last 8 years. In fact a 55% reduction. This is not because of Amref but ofcourse since you are promoting Amref you wouldn't mention this. It probably helps the charity to create the impression that no progress has been made.
   
3. Your paragraph that opens by saying "Tanzania has one of the worst maternal mortality rates ..." continues to describe challenges women face but you remain ambitious as to whether these problems are unique to Tanzania or the whole continent by sandwiching the problems between two generalisations about Africa of questionable accuracy. Did you consult a maternal health expert to confirm that these were the reasons women were dying? Because several public health studies may suggest different reasons.

[Nabanja]

Meant to say "ambiguous" rather than "ambitious" in point 3

[Claraoswald36]

Nabanja -fascinating post thank you. Very curious now as after reading Dead Aid and Politics of Breastfeeding I'm super sceptical about western aid/interventions in developing countries, however well meaning.