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 must say I don't know for sure that the follow on project isn't happening yet - but it's true to say that there is often a gap between one phase ending and the next starting up. If there is I guess it means it is a good time for the awareness-raising visit as there may be scope to campaign for certain things to be included/not forgotten in the next phase

oops! i am a bit late. i have signed up now!

I've signed up. Can we try and get this thread into "Most Active"?

Well Carrie also mentioned this:

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.

So why has the education for girls project been abandoned? Joyce Banda was very supportive for womens projects and empowering women and girls in general, I would very much like to hear what she has to say about that and what steps she is taking to ensure that these projects are getting the funding they need to carry on.

Signed up. Well done MN and Carrie.

I was in the maternity hosp in lilongwe too. There were crowds of pg women outside waiting to go into labour, or in early stages - no room inside.... the actual labor suite, if you can call it that - was a huge open plan room with 20 or so wooden benches for women to sit on while you were in final stages.

I was being shown around and had a male collegue with me, and they just took us straight in. !!!! The oddest thing about it though was that all the women were alone - you weren't alowed a companion becaue there was literally no room - and none of them were making any sound!

I was given a new baby to hold - I mean minutes old - the mother was off having a bath. They had no idea who I was really, as we'd just turnd up at the reception and asked to look around!

The saddest thing I heard ws in a rural clinic. The surgeon told me that babies routinely die because the mothers bring them in for malaria treatment too late.
Don't they recognise the signs - I asked.
He said they did - but they gamble with whether they can get through it without the drugs, because they can't really afford to make the journey to the clinic.

Now I am a mother, that upsets me more than when I first heard it.

How inhumane. How terrible!

Hi all and thanks to Maswera (who I met last night, and who is fab ) for filling in some of the answers.

Computer time is pretty restricted but I wanted to get back and fill you in briefly on the last couple of days.

We travelled to Lilongwe yesterday via a visit with one of Oxfam's partners to a family in the most remote rural area we'd visited so far. They lived in a hut, with no other huts in sight, surrounded by maize crops failing due to late rains. The mother, father and smallest child (of five) were HIV positive. The good news story in this otherwise bleak landscape was that they were receiving free ARV drugs, and since Oxfam had last visited they had all made a -literally - miraculous recovery.

The bad news was that they had to pay to travel monthly to the hospital to collect drugs, which often meant there was no money for food. The answer to our question of what would help them most was two goats. The lovely volunteer - who helped to look after them and the many other HIV-affected families in the five local villages -desperately wanted a bike to save her walking tens of miles a day. So an unashamed plug here for Oxfam unwrapped - and similar projects - who provide these things across the developing world.

...more to come, so bear with me....

(sorry... long... as they say..)

Today was the big meetings day. We'd had our whistle-stop tour of Malawi's maternal health situation and this was our chance to take our observations to the people in power.

After a few lessons in etiquette from the Oxfam local office, our first stop was the Minister for Health. An ex doctor and academic, he was welcoming and enthusiastic, grateful for the support Malawi had received from the UK and keen for us to take back the message that it was vital that this support continues.

He listened patiently to our concerns on midwife training and retention and better health care for the villages, but had no real reponse to why the training programme had stopped other than it was a project that had come to an end and needed evaluating. This didn't quite tie up with the story of students turning up to find their course unexpectedly unfunded but he had nothing else to offer and batted the ball into DFID's court. We said we'd certainly be asking them.

(more to come)

Slightly disheartened we met the fabulous Joyce Banda, vice president of Malawi, African Union's Goodwill Ambassador for Safe Motherhood and passionate advocate on all things women/health related. Raised in a village in her early life, her immediate response to tackling maternal mortality was to start with an education programme for village chiefs. Get the chief on board and you can start to affect what happens to a woman when she gives birth. In the first area where she had piloted this scheme, there hadn't been a maternal death since 2005. She now had chiefs from the initial pilot areas running workshops for other chiefs, a low-cost success story that made complete sense given the things we had seen and heard.

The things she wanted help with was - guess what - training for midwives. She was personally supporting some midwives who couldn't afford to continue their studies, but looked as bewildered as we were when asked why the government had stopped the funding so abruptly. She wanted to start a scheme whereby donors could sponsor students through training. We said we'd take this thought back to the UK.

The other desperate need she outlined, and this rather stopped us in our tracks, was for the construction of "holding shelters". Literally four walls where women could come for the month - yes month - before their due date, to ensure they got to the hospital on time. There was hard evidence that getting women to get themselves to the hospital a month ahead of time had significantly reduced maternal deaths in rural areas. But at the moment there was very little provision when they got there and they could end up sleeping in the open - she sometimes went round distributing blankets.

Until Malawi can train enough health care professionals to run rural health centres, this, apparently and almost unbelievably, is the best and only solution.

We handed over a sample of the blanket mumsnetters had helped to make for Oxfam, and just wished we'd brought more to fill the gaps until the shelters could be built.

more to come....

ok... last installment before I have to disappear for an Oxfam meeting...

Our last official meeting was with DFID. I wasn't sure whether to be impressed or anxious that my dashed-off blog of day 1 and 2 was printed out and highlighted. Our never ending quest to find out why the midwife training programme had stopped was destined not to be fulfilled. According to DFID - the Malawian government's biggest donors for health - they supply the Malawian government with a sum of money to spend on health (and a list of priorities) but ultimately it's up to the Malawian government to choose how they spend that money. There was much talk in acronyms (SWAP - sector wide approach is the main one bandied around) about the next phase of funding and we comforted ourselves with the fact that all the people we'd spoken to would be involved in that next round of negotiations, starting in March so maybe some of what we had been asking for would filter through.

(I lied - there's a bit more policyspeak to come, but that's it for local info)

Ok here goes... and hope I got this right from scribbled notes...

Finally, from what I could understand from the discussion, in terms of the UK election, the two main parties have both committed giving the promised amount of 0.7% of GDP to aid. But there's an anxiety that the money might get diverted to climate change (a valid area obviously but one that needs additional funds, not funds earmarked to reach the Millenium Development Goals) or even used to fund a stabilisation force using the military.

Despite being second to bottom in the hideous league table of maternal mortality, Malawi has made huge strides in the last six years thanks, to a large degree, to British aid. As decisions are made both in the UK and in Malawi in the next few months about the aid budget, I can only hope that the decision makers keep in mind the people whose lives they have the power not just to change but to save.

MNers personally sponsoring midwives in training could be a good one, no? (I know it's a sticking plaster on a large wound, but it would be lovely to know we were doing something concrete, and might help to keep interest levels up).

Well done Carrie, it must be exhausting and a bit upsetting!

I've signed up and shared the link on my facebook page too.

I'm visiting Northern Malawi in May as part of a community twinning and one of the things I'll specifically ask about now is midwife sponsoring. We already sponsor mosquito nets through www.againstmalaria.com/StNicholas4Malawi
and are looking at other health interventions, working with local health workers and hospital doctors.

Well done Carrie.

Only just read seen this thread and haven't read it all, but waht a good idea. I'm all for it.

So, heres a thought. There is an organisation called GoodGifts who enable you to buy a bicycle for a midwife, provide a delivery pack, or sponsor a child through university. They work with local charities in the areas, and what you buy is what gets delivered - unlike the Oxfam gifts where you are just donating to them.

We could ask them if they can find a partner in Malawi to arrange the logistics of sponsoring midwives who are committed to working locally afterwards. Also in funding the shelters at the hospitals.

It could generate publicity for MN and Goodgifts, and I'm sure between us we would manage a few bikes and shelters at least. The GG cost for a three year degree in Africa is 1250 pounds, a bicycle that is locally sourced (and of course then generates local income in maintenance etc) is 25.

I'll commit here and now to a shelter and blankets if we can do this. I like the idea of the support of women, by women.

I'm definitely up for the general idea of sponsoring midwives. I like Oxfam though, I'd be happy to donate to an Oxfam-organised scheme if such a thing was possible. If Oxfam doesn't have the right set-up for allowing us to sponsor midwives in a nominated area then I think CMOT's idea is a good one.

Agree - some sort of MN midwives scheme.

signed up

signed up

I just signed up and donated £50. Thanks for giving us this opportunity.

Ime of working in development, the problem with joined-up aid is often the lack of capacity to manage aid in governments esp in Africa, and other least-developed countries. I was involved in one project with Burundi, where it literally all hinged on the one single competent official we could find in a particular ministry. There was no one else. She was brilliant, but there came a point where she hadn't been paid for 6 months, we couldn't pay her because the project and donation rules didn't allow it, and she had to leave that job to be able to feed her family (brown-envelope solution was found, iirc). It's really hard when the government machine doesn't work.

Hi All

Back and just trying to catch up with everything in Mumsnetland (and indeed at home) but it's amazing to read this thread and it's so great that folks want to do something to support the women of Malawi. I know Oxfam will be monitoring this thread and were going to look into how best to organise sponsoring a midwife and indeed maswera, who is out there, has also emailed to say she would be happy to help out so I'm sure if there are enough folks interested we could make something happen.

Let me chat to the various folks involved and get back.

In addition there's some lobbying activity planned around Mother's day, so we'll certainly keep you posted on that.

Keep remembering more snippets from the trip. The vice president told a story of a woman who lost her baby because she made it to a primitive rural clinic but it was night time and there was no electricity, so the nurse couldn't see that the cord was round the baby's neck. The advice was now for all labouring mums to carry a candle on their trip to hospital in case they go into labour at night. Unbelievable.

Thanks again for all the support.