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

I have now signed up and donated.

I went to Malawi 3 years in a row to deliver training in obstetric emergencies with a group of committed midwives and doctors who had previously gone there after fundraising. The Scottish Government then funded the project to continue further.

There is an amazing doctor there called Tarek Meguid and I am linking an article featuring him here

I visited Bottom Hospital and it was heartbreaking. There could be 30 women delivering their babies in one day with 2 midwives caring for them. The last time I was in Malawi the new hospital was under construction in Lilongwe.

Women were not allowed to be accompanied in labour - their relatives had to sit and wait on the ground outside. That is hopefully going to change/has changed.

It is beyond belief that women throughout the third world suffer as they do in childbirth, in this day and age.

for headcount purposes carrie i signed up (but didn't say so lower down, i don't think)

Signed up xx

I've signed up.

If I'd been in the 3rd world I would have died - am lucky to be alive even in the developed world. It had never occurred to me that childbirth could be a life threatening experience even with decent health care .

signed up

I've signed up too
Good luck Carrie
I would be blubbing too

I've signed up. Birth with no medical help is too terrifying to imagine.

maternity care in Malawi

Signed up.

Great work. I visited Malawi in the 90s, have fond memories of Lake Malawi!

signed

tried to sign but it kept saying error..will try tomorrow

signed up

Signed up. Good luck Carrie: but I can't think of a better justification for some emotional trauma.

I would like to ask Joyce Banda, as a woman who has experienced domestic violence and has overcome huge struggles to get where she is today - what are her future plans for the empowerment of women? And is it not an even bigger struggle when some of the very women you are fighting for, don't want to be empowered? When they have been brought up to believe that a woman's place is secondary to that of her hubands? How do you deal with challenges like that?

And what can we, in the West, do to help? As individuals and as a country as a whole?

Evening.

This is just to let you know that we've just heard from Carrie.

Internet connection is a bit dodgy where she is but she's managed to send us back a report on her first two days in Malawi.

We'll post it up in just a tick...

OK, here is Carrie on her first day:

"Day one was meeting local women (both pregnant and those who?d given birth recently) in a rural village about an hour outside Blantyre town.

"It felt strangely normal to be sitting with a breastfeeding, pregnant woman on a straw mat outside a very basic mud hut talking about the difficulties of making it to hospital when pregnant.

"It was the sort of conversation you might have on Mumsnet, with any mum to be (especially one with 3 children already)- the harsh and very real difference being that in Malawi there was a 1 in 100 chance that the mother wouldn?t make it through childbirth.

"Sitting in the sunshine in this peaceful, friendly village full of beautiful children with an entire Mumsnet-meet-up's-worth of vocal women this didn't seem to be a concern. They were happy with the monthly ante natal check ups they got in the village and pleased with the free healthcare they received at hospital.

"Getting to hospital was an issue (and the only main cost), but they seemed confident that when the time came, they would make it in a local public taxi, though we couldn't quite get out of anyone how on earth you got a public taxi if you went into labour in the middle of the night.

"The village was a good 2km away from the main road down a dirt track with no lights. It certainly put all my moaning about being driven through London in labour into perspective. Or so I thought..."

And Day Two :

"Day two's visit to an even more remote rural community added yet another layer of perspective.

"Meeting with community project volunteers we heard how difficult it is to access an ambulance in an emergency. Mobile phone coverage was unreliable and families would sometimes cycle to the nearest hospital with a letter requesting an ambulance ? the cycle ride was uphill on a road that made yesterday's dirt track look like the M1.

"The alternative, when it didn't have a puncture, was the bicycle ambulance ? a stretcher on two wheels pulled behind a very basic bike, with no seat belt.

"Although it took us about 20 minutes by Jeep, the journey to hospital was a three hour bike ride. The last person to use the contraption had died on their way to the hospital.

"After all the good news stories of yesterday, this was a horrific and sobering thought.

Chatting to the students and staff at our next stop ? a hospital with a nursing/midwife training college attached - was both inspiring and depressing.

"One trainee had witnessed two maternal deaths, one of them in the hospital closest to the last village we?d visited, both caused by getting to the hospital too late.

"Another student had been a beneficiary of the education for girls project, which offered free secondary school to girls, but which has now been abandoned.

"All had benefitted from a scheme to offer free places at nurse/midwifery school, in exchange for a minimum of 5 years service in state health care. Enthusiastic and committed to helping rural communities, these soon-to-be midwives are, from my brief experience here, exactly what Malawi needs.

"Sadly this scheme ended last year, and this year's intake will have to pay their own way ? around 130 UK pounds, a fortune in Malawian terms.

"None of the original candidates for the course had managed to raise the funds. Those that had finally taken their places were, in the words of both staff and students, never going to practise in rural areas: 'Any Malawian could tell you that just by looking at them.'

"We drove back to the hotel through driving rain, having promised to add their cause to the lengthening list of questions we have prepared for our meetings with DFID and vice president Joyce Banda later in the week.

"We, and the women of Malawi, can only hope that they have some answers."

So why are these projects being abandoned?

Re the scheme which gave free places at nurse/midwifery college in exchange for five years in the public sector, this is what I (think I) know about it... The scheme was part of a six year emergency human resources programme for the health sector in Malawi which was established in response to a massive crisis of human resources in health. It was one of a number of measures designed to increase the number of health professionals in the public sector - and was implemented for six years as (AFAIK) this was how long it was projected as necessary for the situation to move out of being a 'crisis'. That six year programme is now coming to an end and the last I heard a follow-on programme was to follow. It's true that the 'project approach' can mean that at the end of x years funds go elsewhere and good projects no longer have funding, but most donors in Malawi support the Sector Wide Approach, which is basically where all the donors and the government club together to follow one long term plan, rather than all donors doing their own thing and duplicating/contradicting each other. This also generally means there is a longer term view to things than just the 'we'll fund this for two years then find something sexier' approach. So I would assume the next phase of the programme will have some way of ensuring the numbers of nurses/midwives is maintained.