In the past three weeks, Saving Mothers’ Team members, Danielle Peress and Nichole Young-Lin, distributed a total of 40 birthing kits to comadronas (traditional midwives) in Guatemala. The program started off with a birthing kit distribution and training meeting on January 7^th. Fifteen comadronas attended the meeting and received Saving Mothers’ birthing kits, which contain the basic materials for a clean delivery.

Two weeks later, our team held another meeting to assess the comodronas’ reactions to and use of the birthing kits. Two comadronas used the birthing kits during previous week and were able to teach their fellow comadronas by  demonstrating how to use the birthing kits. These two comadronas expressed their satisfaction with the Saving Mothers’ kits. The comadronas also showed us their own instruments for delivering babies. Saving Mothers also distributed birthing kits to comadronas in a nearby village called San Juan.

Overall, the project has been extremely well –received and the comadronas look forward to the expansion of our birthing kit initiative in Guatemala.

Two comadronas demonstrate Saving Mothers' Birthing Kits

Meeting with the comadronas

This article from Nicholas Kristof for the New York Times explains how the lack of key micronutrients such as folic acid (aka vitamin B9), iodine, zinc, iron and vitamin A in developing countries is causing deformities due to neural tube defects, as well as brain malformation, anemia and blindness.  The good news is that micronutrient deficiencies is one of the cheapest problems to address, typically done by adding micronutrients to common foods. 

Read the article to learn more, and visit the websites of Project Healthy Children, Hellen Keller International, and Vitamin Angels.

A new article from the BBC examines how widespread rape has become in South Africa — and draws some truly tragic conclusions. Data collected shows that every girl born in the country has a greater chance of being raped sometime during her life than learning to read. That means that one in four will probably be raped before she turns 16.

The important thing to realize is that this is what the collected data reflects. This doesn’t account for the likely high rates of unreported rape. While laws against rape have been strengthened in recent years, as well as rape awareness campaigns, the numbers keep on climbing.

Accompanying the increase in women experiencing sexual assault, this type of violence against children has jumped 400 percent in the last decade, with the bulk of victims under age 12. This crime has only been exacerbated by a widespread belief that having sex with a child or baby can cure HIV or the AIDS virus.

The BBC article explores why this trend has continued despite efforts to combat it. Sexual discrimination plays a major role, stripping women of basic rights, and instilling mean with the belief that they are entitled to whatever they want from women.

Many have also attributed the problem to the violence fostered during apartheid. When it was still law, violence against women was often condoned and the criminal justice system was powerless to do anything. Only now has the government started to crack down on rape and other sexual offenses.

This shifting attitude has also spread to the medical establishment, where more doctors and nurses are being trained to administer rape kits and provide counseling services to survivors.

Data collected throughout the 2009 H1N1 (or “swine flu”) pandemic suggests that women who are pregnant or who have recently delivered are much more vulnerable to the disease than others. Health officials are now asking women who fall into this category to be extra vigilant about potential flu systems, and to see a doctor about antiviral medication as early as possible.

About 10 percent of the 1,088 people who were hospitalized or died from H1N1 this year were pregnant. They were about four times more likely to contract the flu than their peers, according to the California Department of Public Health. Frighteningly enough, six of these patients had to deliver while in the intensive care unit, and four of them were cesarean deliveries. Medscape today has more details on the data.

Pregnant and postpartum women are at greater risk because pregnancy changes regular cardiac, respiratory and hormonal rhythms. As a result, the Center for Disease Control deemed pregnant women as a priority class to receive vaccinations against the flu.

The study that produced these results looked at 94 pregnant women and 137 pregnant women. Out of those, eight died from the disease, two who were pregnant at the time and two who had given birth less than two weeks before developing symptoms.

This article from IRIN highlights the success of a program to distribute cell phones to health workers and villagers in Amensie, Ghana in preventing maternal mortality.  In the example cited by the article, an Amensie woman was able to call the hospital when she went into labor, who sent an ambulance to pick her up - in the past, 20 village women would die every year in childbirth because they were not able to reach the hospital or the village midwife.  Since the project began in 2006, there has not been a single maternal death.

In Ghana, 560 women die from childbirth or pregnancy related complications per 100,000 live births.  50% of women give birth at home with no skilled health worker present, and lack of access to equipment and skilled health workers is a principle driver of maternal mortality.  The distribution of cell phones  to attempt to improve communications and prevent these deaths was a part of the Millennium Villages project, in which development agencies target specific villages to lift them out of poverty and meet the Millenium Development Goals.  In 2006 mobile handset producer Ericsson teamed with mobile telecommunications firm Zain to install internet access and mobile phone coverage in the villages in 2006. They distributed free handsets to health workers and sold handsets to villagers for US$10 each.

Saving Mothers’ applauds the use of relatively simple and inexpensive technology to prevent needless deaths and hopes to see many more of these success stories in the future.

Today, Dr. Taraneh Shirazian presented Saving Mothers’ programs at the 19th FIGO World Congress of Gynecology and Obstetrics. This week, over 6,000 obstetrician gynecologists from around the world gathered in Cape Town, South Africa to participate in scientific lectures, presentations and workshops that covered an array of women’s health issues.

Dr. Shirazian’s speech stressed the importance of building sustainable and comprehensive global women’s health programs in resource-poor regions. The presentation also emphasized training medical students and residents along with the local health care providers and used Saving Mothers’ POWHER (Providing Outreach in Women’s Health and Educational Resources) program as a model example.

Saving Mothers’ team of obstetrician-gynecologists spent the past week in rural Guatemala, marking the start of Saving Mothers’ new POWHER (Providing Outreach in Women’s Health and Educational Resources) program.

On the ground, our team provided general obstetric and gynecological care to the women in the community. When a 44 year-old woman came into the clinic with vaginal bleeding, Saving Mothers’ obgyns diagnosed her with previa and immediately performed an emergency cesarean section. (See a clip of the video below – Warning: Graphic content. Viewer discretion is advised).

Had the woman delivered without trained medical professional help, she would have, suffered from life-threatening hemorrhage. The happy mother was grateful that Saving Mothers’ team was there to ensure her and her baby’s well-being, especially since the mother had lost her eight children to a severe mudslide in 2005.

The POWHER program goes beyond providing obgyn care. As part of the comprehensive women’s health program, Saving Mothers is incorporating its birthing kit initiative to address community health needs. Throughout the week, Saving Mothers’ team learned about local delivery practices through focus group discussions with over 10 comadronas (traditional birth attendants) in the community.

Saving Mothers will continue building upon the Guatemala POWHER program in January 2010.

This article from CNN tells the story of a 12 year old girl, Fawziya Ammodi, who died during childbirth after being forced into marriage in Hodeidah, Yemen.  Tragically, this is a common occurence in Yemen, where impoverished families often give up their daughters in return for dowries or simply to reduce the financial burden on the family.  According to UNICEF, which issued a statement regarding the child’s death, girls who give birth before the age of 15 are five times more likely to die in childbirth than women in their 20s.   Please take a moment to read the story and learn more about this important issue.

From May to July of 2009, Olivia Chang, from Mount Sinai School of Medicine’s Global Health Center in collaboration with Saving Mothers, traveled to Tanzania to launch Saving Mothers’ birthing kit initiative in Tanzania. Olivia writes:

“The research and service site is in the village of Nyakagoyagoye in the district of Karagwe in Northwestern Tanzania.  Nyakagoyagoye is a village of 1300 households.  Most of the children were born in the home, as access to dispensaries and hospitals is a huge barrier.  The closest dispensary is 1 hr by foot and the nearest regional hospital is 4 hr by foot.  Although it is recommended to give birth in health facilities, the location of Nyakagoyagoye does not always allow for adequate time and funds to reach a health facility.  In other words, the TBAs play an integral role within this community as their services are frequently needed.

36 traditional birth attendants, wakunga (in Swahili), were recruited from the village. The ages of TBAs’ ranged from early 40’s to late 80’s, and amongst them, the years of experience ranged from 1 to 50 years. During the training sessions, the TBAs were first trained to understand the purpose of individual items in the birthing kits.  Then, the TBAs were trained to utilize the content of the birthing kits in the correct order and for the right purpose.  The notion of early recognition of danger signs, such as hemorrhages, prolonged labor and/or convulsions, were introduced as well as the importance of early referral.  Lastly, the transmission of HIV/AIDS and self-protection for the TBAs during deliveries was emphasized.  Overall, all of the education topics were enforced with a test, which provided the opportunity to teach, again, at a one-by-one basis, for concepts that were misunderstood.”

Saving Mothers hopes to replicate the success of the birthing kit initiative in Tanzania in several other locations including Guatemala where we are currently building a comprehensive women’s health program.

Bolivia has just instituted a new initiative that would grant pregnant women $258 over the course of gestation contingent on them attending regular pre- and post-natal medical appointments. As it stands, two women die in the country every day due to pregnancy or childbirth-related complications. The government hopes the new measure will dramatically lower this mortality rate.

Named the Juana Azurduy mother-child subsidy, the payment is transferred to women in such a way that they must consistently interact with health services, making it much easier for the government to register and track pregnancies. In its first year, the stipend will be paid to about 550,000 women and children. Women receive $7 after each pre-natal checkup and $17 following their first post-natal checkup. The rest is divided into twelve payments of $17.70 guaranteed as long as the parents continue to bring the child in for regular doctor visits.

Bolivia has reported that its medical facilities are underutilized. It hopes that this program will encourage more people to take advantage of these facilities, helping them to strengthen their infrastructure and modernize at the same time. So far, the subsidy has fielded positive reviews from maternal health nonprofits.