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MNHQ

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

14 replies

Carriemumsnet · 25/01/2010 17:11

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

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MNHQ

Carriemumsnet · 25/01/2010 21:48

Hi all

Sorry meant to sticky - will do so now.

lljkk - the rich countries of the world committed (in 2000) to increase aid spending to 0.7% of GDP by 2015 and to act urgently to meet the global financing gap for health (estimated at US$37 billion, including US$10.2 billion of it to scale up maternal, newborn and child health interventions). This is currently not happening.

The current UK government has actually provided fantastic support to Malawi in recent years with positive results. A new health plan for Malawi is under development and Oxfam think there's a risk that if the UK lowers its support in the future, important gains will be lost. So they want the UK government to recommit to high levels of financial and technical assistance to the Malawi government to help them achieve health care for all.

BradSplit. I am going on behalf of Mumsnet

LeninGrad thanks for signing up and for the link. It's incredibly powerful and I'd urge anyone wavering in their support to watch it. Not sure how much use I am going to be out there as just blubbed my way through it.

MNHQ

Carriemumsnet · 25/01/2010 22:29

Speedy - may have something to do with lack of access to free healthcare for mothers and children. Don't know heaps about the US system but do know you can really suffer if you don't have insurance. Agree it's unbelievable and one of things that struck me when we went to Downing Street with pregnant women. Oxfam were talking about 6 new countries in third world aiming to offer free health care. There were a couple of Americans with us and they were so full of praise for the NHS it made you feel bad moaning about it (though of course we still did )

LeninGrad - will certainly do my best to ask what I can. The first day's activities currently stand as: "the team will visit and interview a family that has experienced a maternal death, an orphan (as a result of maternal death), a mother who lost a child in child birth. If I can still speak after that I will ask what I can.

One of the stats is there are only 252 doctors for the entire population of 13 million, with fewer health workers per person than Sudan. So think provision of trained health care professionals is obviously key.

Bibbity - think Malawi is particularly bad, but has had some success with the resources it has had and the Gov is trying hard, so think they want to show what can be done - but will certainly ask them and report back. Thanks for good wishes.

MNHQ

Carriemumsnet · 25/01/2010 22:51

Am trying to make my daughter's flip camera work at the moment - family vid camera not cooperating and not sure how easy it would be to keep it charged up... Oxfam also taking a flip camera and think there will definitely be an official photographer on some of days, so hope to be able to have a record if it all.

Thanks for signing up - and do please encourage as many folks as possible to do the same. It costs nothing to sign.

MNHQ

Carriemumsnet · 26/01/2010 12:14

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?

MNHQ

Carriemumsnet · 27/01/2010 21:17

Hi there

Thanks so much for all the comments and for signing the petition. As well as helping the White Ribbon Alliance to reach their million mums target it's also useful ammunition when we want to show that MNers care about this issue. It would be great to have 1000 people on the thread saying they've signed the million mums campaign - heck we should be able to get them their million just from Mumsnet - so please encourage anyone and everyone to sign

Have just heard from Oxfam that we might be meeting Malawi's vice president Joyce Banda, so they've suggested that it would be good to have some questions ready for her if you have any.

Agree with all those who've said far reaching changes will be needed - am sure the aid agencies know that, but it can't harm to keep reminding those in power.

Thanks again and keep the comments/ questions coming.

In case folks need another reminder, here's the link to sign up

Thanks

MNHQ

HelenMumsnet · 02/02/2010 22:25

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...

MNHQ

HelenMumsnet · 02/02/2010 22:28

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..."

MNHQ

HelenMumsnet · 02/02/2010 22:31

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."

MNHQ

Carriemumsnet · 04/02/2010 14:38

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....

MNHQ

Carriemumsnet · 04/02/2010 14:58

(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)

MNHQ

Carriemumsnet · 04/02/2010 15:23

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....

MNHQ

Carriemumsnet · 04/02/2010 15:49

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)

MNHQ

Carriemumsnet · 04/02/2010 15:56

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.

MNHQ

Carriemumsnet · 08/02/2010 10:59

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.

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