"Dead mothers don't cry" notes from an event on maternal mortality – Enreca Health

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2009-05-11

"Dead mothers don't cry" notes from an event on maternal mortality

One of the gravest development problems is the high maternal mortality rate in low income countries. There are many ways to put focus on this issue, ENRECA Health chose to join the event "Kunsten at Redde en mor" jointly organised by Sex & Samfund, UNFPA and Danida with a high celebrity profile on the occasion of Mothers Day. By inviting Crown Princess Mary, the media coverage was far more intense than any other event with development on the agenda. That gave a new framework for the message that it is unacceptable that each minute one woman dies due to birth complications or unsafe abortions. These figures were put in perspective by the fact that the very same morning a new prince was born in Denmark, under the highest standard of care at Rigshospitalet. The stage was therefore set for a very captive princess who stayed longer than planned for, visited more stands than scheduled and grabbed the microphone to ask to which extent the newly developed policy of Chad also included women in the rural areas.

A visionary obstetrician fighting maternal mortality

Dr. Grace Kodindo is one of the many people fighting the war against maternal mortality. Based in the central African country Chad at a hospital in the capital, she has made maternal mortality a personal issue and her work on the maternity ward has been documented in the now famous BBC documentary "Dead moms don't cry". One of the patients in the documentary is a 12 year old girl hospitalised after attempt at an abortion who becomes one of the victims of poor health care in a country where the maternity mortality is 1 in 11.

Dr. Grace Kodindo was invited to Copenhagen to receive a torch to continue the fight toward the UN's Millenium Development Goal number 3: cutting maternal mortality with three quarters by 2015. Ms. Ulla Tørnæs, Minister of Development Cooperation, mentioned in her speech that as a mother of three daughters this was also a personal issue to her. One of the underlying causes of maternal mortality is the low status of women in many countries as well as gender based violence, lack of education and neglect of women's health needs. Ms. Ulla Tørnæs underlined that Denmark is fighting maternal mortality through partner programs in Mozambique, Ghana, Uganda, Kenya and Tanzania and through support to NGOs and multilateral organisations. Ms. Ulla Tørnæs also waved a female condom to show that we need more research in and promotion of female controlled contraceptive methods.

Grace Kodino gratefully accepted the challenge and said that awareness raising events like this can change things: after the BBC documentary, the government of Chad had initiated the development of a policy on maternal mortality and she herself has received many donations to her hospital from Europe and the US because people have seen the faces of the suffering women in the film.

Facility delays in emergency obstetric care

After the end of the official program, Crown princess Mary, Ms. Tørnæs and Dr. Kodindo visited selected stands at the exhibition, including the stands of Copenhagen School of Global Health and ENRECA Health. We had decided to perform a role play showing how training of health workers on ‘Advanced Life support in obstetrics' (ALSO) is conducted. It was a reality based role play, including bed, African clothes, a black pelvic mannequin, theatre blood and an impregnated bed net to avoid malaria. Only there was probably more staff (four trained persons) than in most cases. The role play was based on experiences by PhD student Bjarke Lund Sørensen, University of Copenhagen, who explained to Crown princess Mary, Ms. Tørnæs and Dr. Kodindo how he had conducted this training at Kagera Regional Hospital in Tanzania where hospital registers showed that five out of six maternal deaths happened because of no or delayed treatment in the hospital. At the hospital one out of three women were bleeding too much after delivery making it the most frequent cause of maternal death. After the two days courses the number of deaths was reduced with 50%.

The role play went well and the Crown Princess almost participated by grabbing the ‘baby' that was born. Then Flemming Konradsen, leader, Copenhagen School of Global Health, delivered the shortest speech ever on how research on the causes of maternal mortality can save lives and that the Danish universities are able to and willing to participate with the partners institutions in the South in Danish development interventions in this field. Finally, he gave the Crown Princess a deck of card, describing 40 activities that can fight maternal mortality.

 Lise Rosendal Østergaard

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