Maternal Mortality

By Anna Simula & Tea Tellismäe,  UN Millenium Development Goals course participants

When you think about maternity, what are the first things that come into your mind? Asking the same question from my close ones, I mostly received answers like pregnancy, preparations for birth, baby, happiness and other positive feelings and thoughts about the new family member. And why wouldn’t it be?

Questions such as how exactly should the women get to the hospital in time, is there enough healthcare staff, do they have enough skills to assist you in the delivery – none of these are likely to be on the worry list of an expectant woman. In the Northern Europe, we have many rules and strategies about how quickly the ambulance should arrive at the scene, or about the qualifications of the hospital staff, who are equipped and prepared for assisting in the normal birth and also ready for any abnormalities and emergencies, such as caesarean section, vacuum extraction etc.

To give you a better understanding and an overview what is happening in other countries and regions, I will share an example, which was given us during the lecture, by Teija Kulmala, Chief Physician at the National Institute for Health and Welfare:
“An example from Afghanistan, where it took too long to do a caesarean section. A pregnant woman came to the hospital. The midwife was not able to find baby’s heartbeat and called an obstetrician, a female doctor. She examined the woman and agreed, that there is a need for caesarean section. However, since she was a female doctor, she did not have the rights to carry out the operation. So, she had to call a male doctor, who then also examined the woman. Then it was finally possible to take the woman to the operating theatre. Altogether, it took about 2-3 hours, to start the operation, obviously it was too late for the baby to survive. The conditions, where the operation was held, were quite bad. For example, there was no electricity, and not enough needed medications. As a result neither the baby nor the woman survived.”

From this story, I learned that even if you do have qualified and skilled midwifes and doctors working in the hospital, it is still sometimes not enough to save a life. You may have the skills and knowledge, but if you can’t or are not allowed to use them, then..?

This leads us to the African countries, where people working in maternity wards, clinics have not gone to medical schools and yet they have really good skills and training for saving lives. I honestly wouldn’t imagine a situation, where people with no medical background, are doing the anesthesia and performing an operation on me. But this is every day life for people living in Mozambique and Malawi, for example.

In Tanzania, for example, the three delays that are crucial to mothers and infants survival; delay in decision to seek care and leave the house, delay in reaching care and delay in receiving adequate health care are fought against with a special program. Decentralization of emergency care and delegating even the challenging tasks to assisting medical officers and nurse-midwives has prevented both maternal and neo-natal deaths and in addition, fewer infants have born without damages often caused by delayed deliveries.

And the best part is, even without doctor’s diploma, they do these procedures perfectly! They also can’t count on different techniques that are widely used in here, such as CTG (cardiotokography), STAN (for fetus ST analysis), ultrasound etc. Instead, they use a Pinhard horn, a type of stethoscope. I believe that in our clinics, Pinhard horn is more like a decoration, it’s not commonly used, since there is so much other electronic equipment nowadays.

Because of all that, I’m again completely amazed and overwhelmed about these people. They don’t have much, yet they make the best of it. They don’t depend on electronic equipments. So therefore, I do believe, that instead of only thinking about how to make life better for them, we should also take a chance to learn from them.

The goal or purpose of this post is not to make people feel bad about the options and opportunities we have, but to appreciate and value it all.

As Staffan Bergström and Teija Kulmala suggested, the best way to help is to pack your backpack and go out there. Smell the poverty and learn valuable skills and lessons, which you can use and appreciate for the rest of your life.




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