A maternal health advocate for the UN Commission on Life-Saving Commodities forWomen and Children, a ‘Global Champion’ for the White Ribbon Alliance for Safe Motherhood, and a member of the Women’s Rights Division for Human RightsWatch advisory board.
How long do you think it takes for a woman to bleed to death? Minutes, hours or the agonizing lifetimes of the children left behind; their hopes, dreams of an education, well-being and survival. Every year, nearly 71,800 women answer this question as around the world, nearly 71,800 women bleed to death during pregnancy and childbirth. Postpartum hemorrhage is the leading cause of death amongst women, and is arguably the most preventable. Imagine, these mothers saved, their families left intact, countless children able to reap the enormous benefit from their mother’s care. The powerful and positive ripple effect of a mother’s survival benefits families, communities and nations.
As I write this, my three year old daughter - Azziza, which means precious or beloved - is singing sleepily behind me and tucking herself into my bed. Happy noises of early childhood that are all the more exquisite because immediately following her delivery, I suffered an Amniotic Fluid Embolism, a rare and catastrophic event. For 24-hours, my life hung in the balance with my doctors unable to predict if I would live or die. I was lucid for much of this time and have been fundamentally changed by the heartbreaking terror that I would leave my two young children and newborn daughter motherless. The horror of my experience has made me a committed advocate for maternal health. We will end preventable maternal death, and we know how to do it too.
Thanks to sustained political commitment, societal action and the dedicated work of global and national stakeholders in health, maternal mortality figures have decreased by 47 percent between 1990 and 2010. In 2010, the UN Secretary- General’s Global Strategy for Women’s and Children’s Health called on the global community to work together to save an additional 16 million lives by 2015, by increasing access to and appropriate use of essential medicines, medical devices and health supplies that effectively address leading avoidable causes of death during pregnancy, childbirth and childhood. This challenge has been taken up by the UN Commission on Life-Saving Commodities for Women and Children (the Commission), and is guided by the exemplary leadership of co-chairs Goodluck Jonathan, President of Nigeria, and Jens Stoltenberg, Prime Minister of Norway. The overall goal of the Commission is to increase access to these life-saving commodities in 50 of the world’s poorest countries. To do this, the Commission has identified and endorsed a list of 13 overlooked commodities that, if more widely accessed and properly used, could save the lives of more than 6 million women and children.
Three of the Commission’s identified life-saving medicines are at the heart of good maternal health care: oxytocin, misoprostol, and magnesium sulfate. For less than 50 cents each, these medicines have the potential to save lives and protect the well-being of mothers and their babies - whose health is inextricably linked.
Oxytocin and misoprostol are the recommended medicines to prevent and treat postpartum hemorrhage after childbirth. More than 8 million women each year suffer from excessive bleeding after childbirth. Magnesium sulphate is the most effective medicine to prevent and treat pre-eclampsia and eclampsia. Conditions caused by high blood pressure during pregnancy, which if left untreated can lead to seizures, kidney and liver damage, and death. These conditions claim the lives of an estimated 63,000 women each year, as well as the lives of many of their babies.
The challenges and complexities that face the Commission are vast. For the three identified maternal health commodities alone, there is an absence of robust data, low-quality products and weak regulatory capacity, inappropriate use, supply chain challenges, and funding gaps. And yet, 203 diverse groups and organizations have united because they know that by working together, identifying and battling the constraints, they can have a profound and sustainable impact. Mothers are the foundation and vital core of families and communities. When women earn an income, they reinvest 90% of it into their families. When a mother dies, enrollment in schools for younger children is delayed and older children often leave school to support their families. Children without a mother are less likely to be immunized and are more likely to suffer from malnutrition and stunted growth. The implication for girls tends to be even greater, leading to a continued cycle of poverty and poor health. Finally, every year, over US$15 billion in productivity is lost due to maternal and newborn death. Fifteen billion per year is a massive burden the world can little afford. In comparison, the Commission estimates that an ambitious scaling up of these 13 commodities over the next five years would cost less than US$2.6 billion.
Shrinking economies, increasing global crisis and needs are straining the demands on donors and governments. Issues related to maternal health will be marginalized and objectives unmet if the crisis is allowed to linger, and conversations stagnate in statistics, logistics and commodities. We need to touch people. We need to make it real. Women dying in pregnancy and childbirth, and the often uncounted millions of girls and women who survive but are left damaged and unable to fully participate in their family and community, need a voice. We need to reach leaders, so that they understand the pain of these girls and women and the impact their loss has on families, communities and economies. Leaders must take action now to put these insights to use to save lives, demonstrating the power of political leadership to exact change. Public and private sector leaders must also be encouraged to accelerate the use of innovative new partnerships, often with social entrepreneurs, to reach previously unserved communities.
With intense and sustained commitment of host country governments, donors, and other stakeholders to make these live-saving commodities accessible, affordable and available; we can make dramatic and sustainable improvements in the lives of millions of women, newborns and children.
My daughter is quiet now, fast asleep in my bed. Her arms flung up over her head, resting as only a baby can, knowing that her mother is there.