Shadows of Silence

Saving lives of mothers and new born babies. Tanzania SUMBAWANGA, Tanzania – Pregnant women in some parts of Tanzania are still at unacceptably high risk of dying in childbirth, despite the government’s promises to make emergency healthcare services available to women in their communities. But in a new drive aimed at re-doubling efforts to save the lives of mothers and newborn babies, the Tanzanian Prime Minister, Mizengo Pinda, will on March 15, lead the nation in marking the 9th Annual White Ribbon Day in Sumbawanga, Rukwa Region, one of the country’s worst affected regions. He is also expected to commission a new state-of-the art caesarean theater, donated to the community, by a non-governmental organization (NGO) affiliated to the White Ribbon Alliance, in a ground breaking ceremony in Mtowisa. The fully furnished facility worth $110,000 will serve as a model for other health centres in the East African country. The national event is aimed at urging the government and other stakeholders to accelerate their efforts and deliver on commitments to safe motherhood, officials said. “We are urging the government and all other stakeholders to re-double their efforts and deliver on commitments to save the lives of our Tanzanian mothers and babies who die needlessly due to avoidable deaths related to childbirth,” says Rose Mlay, coordinator of the White Ribbon Alliance in Tanzania. The theme of the event will be ‘Wajibika Mama Aishi’ – Kiswahili for ‘Be Accountable so that Mothers can Survive Child Birth.’ This is a follow-up to pledges the government made in the One Plan 2008-2015, a national roadmap to accelerate the reduction of maternal, newborn and child deaths, that 50% of all health centres will provide life-saving comprehensive emergency obstetric and newborn care (CEmONC). These would include caesarean sections, safe blood transfusion to pregnant women and qualified health workers. The officials called on the authorities to allocate a special budget with funds ring-fenced specifically towards the life-saving comprehensive emergency obstetric and newborn care in the 2014/2015 financial year. According to official estimates, more than 20 women die of pregnancy and childbirth-related complications every day in Tanzania. Medical experts say a woman suffering from obstructed labour, heavy bleeding or fitting from high blood pressure (eclampsia) may have only two hours to live. Most of these women live in remote rural areas where roads are extremely poor and medical services are limited or non-existent. One such region is Rukwa in southern part of the country. In this area, it would take five hours by boat to reach the nearest health facility, and it is over 100 km by road. “There are no health centers that provide comprehensive emergency obstetric care here,” says Dr. Jasper Nduasinde, a Tanzanian surgeon, who volunteers for White Ribbon Alliance, a global network of maternal health advocates. “This is despite the government’s pledge that at least 50% of all health centers will provide these services,” he adds. Death Can Come Easy Death can come easy here. Earlier this year, a schoolteacher died in childbirth in Rukwa Region. She bled to death due to lack of the emergency care the government promised. An ambulance arrived five hours later, but that was too late. The people were outraged. This is the situation in many poor countries in Africa and South Asia despite high level commitments of at least $40 billion for women’s and children’s health made at the UN in recent years. Despite the grim picture, some of these countries have achieved tremendous progress and the numbers of women dying in childbirth has gone down by half in the past decade, proving that it can be done. Many pregnant women and newborns with serious complications could be saved only if they had access to Comprehensive Emergency Obstetric and New-born Care (CEmONC). “The only way to avoid these unnecessary deaths is for pregnant women to have access to CEmONC in a facility near their home at health centers where, antibiotics and other essential drugs are available, and caesarean sections and safe blood transfusions can be performed,” says Theresa Shaver, a midwife and President of the global White Ribbon Alliance. Since 1990, annual maternal deaths have declined by almost half and the deaths of children have declined from 12 million to 7.6 million in 2010. In Botswana, Egypt, Liberia, Madagascar, Malawi and Rwanda, the rate of decline was on average 5 percent or more a year between 2000 and 2010, according to World Health Organization (WHO) estimates. A Helping Hand Against this background, the White Ribbon Alliance has been campaigning for more resources and the right of women to services which can prevent deaths in pregnancy and childbirth. The organization has been leading international efforts to hold governments and politicians to account for their promises. In 2010, UN Secretary General Ban Ki-moon launched a Global Strategy for Women's and Children's Health, an effort that has generated $40 billion in commitments to meet key goals supporting women’s and children’s health. These goals include more trained midwives, greater access to contraceptives and skilled delivery care, better nutrition, prevention of infectious diseases and stronger community education. For women in Rukwa Region in Tanzania, the implementation of these action plans would transform their lives and put an end to these terrible and preventable deaths in childbirth.