Oxfam/Mumsnet trip to Malawi to highlight maternal mortality. Make your views known/ask any questions you'd like answered

[Carriemumsnet]

Hi there

Following earlier initiatives like the blanket squares and a couple of trips to Downing Street, Oxfam have asked us to go with them on a fact-finding/press trip to Malawi to highlight the massive problem of maternal mortality. The reason they've asked us to do this is because of your political clout and, as the election approaches, they're looking for ways of keeping this issue on the political agenda.

If you know/agree with the arguments about why healthcare should be free for women and children, and Western governments should be held to account over the promises they made at the start of this Millennium, then please sign up to the Million Mums Campaign (if you haven't already) and add a comment to this thread, even if it's just to say you've signed up. There'll be another call to action around Mother's Day in March.

If you're undecided or have specific questions you'd like to ask Oxfam, or DFID - the Department for International Development - then please post them here too. During the trip we'll be meeting people who have been directly affected by maternal death, plus midwives, Oxfam workers, the Minister for Health and a representative from DFID, so there should be plenty of opportunities to get questions answered.

In Malawi, on average 1 woman in every 100 will die in pregnancy or childbirth, that's around 14 women every day. In 2000 both rich and poor nations committed to reducing maternal mortality rates by 75% by 2015. In the last 10 years there has been no improvement, but the goal is completely achievable if there is sufficient political will.

The trip starts on Sunday and - computer access allowing - we'll be reporting back on what we've seen and who we've met - so watch this space and do please feel free to post comments and questions here.

Thanks,
MNHQ

Speedy, I think I may have misunderstood as I read Carrie's post before I read yours. Of course you're right. That is really shocking about the US having a relatively high maternal mortality rate. It all revolves around poverty though, both in the US and Malawi, but think more can be done on an immediate basis for the people in Malawi as it would be a matter of on the ground assistance rather than the labyrinth of political will.

Carrie, I'm fascinated by this, and I so wish I was going with you.

I lived in Malawi in 1992/1993, in fact I house-shared with a young English midwife at the time too, who was working voluntarily at the hospital at the bottom of the road. The stories were very sad sometimes.

Where exactly in Malawi are you visiting? I lived roughly between Zomba and Blantyre.

AIDS was an enormous problem too, the incidence is very high in Malawi. The fear, denial and ignorance of the subject meant it spread viciously. A friend of mine once spotted condoms for sale in a shop, the only time I think anyone ever saw them the whole time I was there. The price label had been STAPLED through the pack. It would be funny if it wasn't so awful. I wonder to what extent AIDS and HIV related illnesses are contributing to the maternal mortality rate. Several people I knew died of AIDS whilst I lived there.

Good luck with the trip. The people I met were generally happy, friendly and warm, despite sometimes enduring very difficult hardships. They call themselves "The warm heart of Africa".

From one who lives in Africa I am impressed to see MN getting involved.

As you mentioned Carrie, there is such a dearth of trained health professionals in these African nations. Often they train and then leave the country for more developed nations where they can get a decent salary.

Certain health sectors have been neglected over the years, both by governments and by donors. Mental health, the area I am working in, is one such area, another I feel is MCH (maternal and child health). A great amount of international funding has gone into HIV/AIDS programmes to the neglect of other basic health services.

I'd be interested in knowing what percentage of DFID's overall funding for Malawi is going into programmes reducing maternal mortality? Is it specifically for maternal mortality reduction or is part of their larger MDG health funding? Is the aim solely to reduce maternal mortality or are there strategies in place to deal with long term disabilities caused by pregnancy and childbirth, for example fistula?

Have signed up.

Agree with maragaritas about MCH often being neglected in favour of "sexier" diseases/ causes (that sounds ridiculous but ykwim).

The point about the US is important for "2nd world" or developing countries to note - I'm in Thailand, where they're working to a highly medicalised model of childbirth based on practice in the US (probably the US 20 years ago). It's ineffective as well as expensive.

I doubt that this is a problem in Malawi though, with 250-odd doctors. Would be interested to hear about how Oxfam is working, are they training hcp's? Is brain drain an issue, as margarita suggests? Often it makes more sense to train women with families than young single men if you're hoping they'll stay in their community, but then you can run into political/ cultural obstacles.

Hi Carrie

I live in Malawi (Lilongwe) and work in the health sector so if there's anything I can do to support your trip from here do get in touch.

I signed up for a millionmums a while back, and follow sarah Brown on Twitter who is an ambasssador for the charity

Have signed up a couple of months back. I am pleased that MN are using their political clout to do something to help other women who are not as fortunate as we are.

Have signed up

DH was born in Malawi, so I'll deffo sign up.

I've worked as a m/w in Eastern Africa so interested in this. When I was there I thought that lack of training/updating of the midwives was a big problem. They need better education.

A question - I'd be interested to hear from Oxfam how they link their work on maternal health to other MDGs in practice? I think it will be hard reaching the MDGs on maternal health if we can't crack the one of safe water and sanitation

(o - and all signed up here too)

Signed up.

verylittlecarrot I'm staying in Blantyre and Lilongwe and visiting Thyolo

Brain drain is definitely an issue - think someone said there are more Malawian nurses in Manchester than Malawi, but don't think you can blame people for trying to make the best living they can - agree though -and am sure Oxfam do too - that training hcp's is crucial. Education of girls also a massive topic....

Maswera - do let me know on email where you are in case we can come and say hello. I'm pretty much governed by Oxfam in terms of itinerary but may find we are in your area?

Oricella - good point - Its World Water Day on 22nd March.

Carrie - have you thought about approaching DFID for funding to make a proper film to spread the word? Also, get in touch with "Developments" the DFID magazine - they might contract you to write an article with photos for it.

Ethiopia is one of the poorest countries in the MCH stakes, but there is an amazing woman there, Catherine Hamlin now in her 80's, who opened a fistula clinic www.fistulatrust.org/fistula_problem.html in addis abbaba. Women will walk, literally, for weeks, to reach her and get help.

It ought to be noted that in some areas of Ethiopia (I don't know about Malawi) these problems are hugely exacerbated by the ongoing practice of FGM in baby girls. Educational campaigns to reduce this will have an impact in decades to come.

have signed up and passed onto all my mum friends too.

A while back I heard a radio programme about maternal health in Africa. The crux of the problem seemed to be suitable sanitation in schools as once girls started their periods they would stay home because of the lack of facilities at school. This led to girls being married and having babies very young (early teens)when biologically their bodies were not up to the job leading to terrible complications and in some cases death.

Whilst I am sure there are many far reaching reasons for maternal death in Africa this was a link I hadn't made before.

signed up. Good luck Carrie.

early marriage and lack of education is definitley key - tackling these is much harder than training midwives and/or providing sterile equipment but more likely to have a sustainable, long-term, impact. it's not about plugging gaps in healthcare - it's far more challenging than that.the change also needs to come from within, iyswim. time and again community-initiated projects have been shown to be far more effectve than things impsed from outside. carrie - i would be interested to know about how oxfam is ensuring meaningful community participation, and the extent to which they have their eyes on the long-term

and, if you fancy asking some detail, I'd like to know to what extent Oxfam uses the human rights framework to hold the govt of Malawi to account/work with the govt on MM. (Malawi is a state party to the key hr treaty, the International Covenant on Economic, Social and Cultural Rights. This includes the right to the highest attainable standard of health)

Have signed up

Brilliant MN work

I hope it makes a difference

I was interested to read some excerpts from this book - what do Oxfam make of these arguments?

Hatwoman - have you seen the girl effect campaign? It is about effecting change from within by empowering, educating and investing in women in developing countries.

www.girleffect.org/

There's some crazy statistic from the world bank "Women reinvest 90% of their income in their families and communities, compared with men who reinvest only 30% to 40% (World Bank)" , so the campaign is about using microfinance to get women into business themselves

Lady - not to pre-empt Oxfam or DFID's answers on Dead Aid, but here's a link to Duncan Green's discussion about it (he's Oxfam's Head of Research and has something interesting to say about pretty much everything).

Have signed up - very glad that Mumsnet is helping to promote this. Hope the trip goes well, Carrie.

According to this site, Canadian PM Stephen Harper (Chair of the G8 this year) has just announced that he's going to make MNH the G8's prime focus in 2010. He also mentions the importance of focusing on sanitation.