Focus on Maternal Mortality in Tanzania

In our focus on the attacks on women’s health here in the United States, we often forget that women in developing countries have it much worse than we do. Take Tanzania for instance. A new article in Ms. Magazine explains that:

According to the World Health Organization, an estimated 13,000 women die each year in Tanzania due to labor and pregnancy-related complications, and more than a quarter million more suffer disabling conditions. The country ranks 21st highest maternal mortality rate among African nations. Like its neighbor Uganda, Tanzania is one of the world’s poorest countries, and 75 percent of its population lives in rural areas. Transportation is spotty and health-care facilities are often miles away from local communities, making it extremely difficult for women who experience pregnancy complications—which can include severe hemorrhage, infections, anemia and obstructed labor—to access skilled health care.

Belle Taylor-McGhee, the author of the Ms. article and a board member of EngenderHealth, a nonprofit aimed at increasing women’s access to family planning services worldwide, says that when she visited Tanzania and other sub-Saharan African countries to write the story for Ms., she was astonished by what she saw.

“I have worked on reproductive health care for some time,” says Taylor-McGhee. “My first trip to Africa was part of an EngenderHealth visit to Ethiopia. We were going there to look at women’s access to reproductive health care, the challenges health care providers face, and how those challenges are being addressed by the government and NGOs. The trip was a real eye opener for me. It was the first time that I actually met women who had experienced fistula. Most of the women at the fistula hospital we visited were quite young, under twenty years old, and some were as young as fourteen or fifteen years old.”

Fistula occurs when there is a tear in the vaginal area. Tearing can occur during childbirth, especially if labor is prolonged or there are other complications during childbirth. Fistula is very uncommon in developed countries, but it can occur frequently in countries where women do not have access to quality childbirth facilities. Vaginal tearing can lead to infections, and if this is left untreated, women can die.

Belle explains that when she was in Uganda, she met a woman who had been suffering from fistula for many years. “She didn’t know that there was anything she could do about it,” says Belle. “It was her first pregnancy, and her child died as a result of complications in childbirth, which is pretty common in fistula cases.”

According to Taylor-McGhee, this woman’s story is a prime example of the challenges women face worldwide, which is why the UN has set a goal to reduce maternal mortality by 75% by 2015 and achieve universal access to reproductive health care.

One of the primary challenges that women in developing countries face is geography. In countries like Tanzania and Uganda, most women live in rural areas. Taylor-McGhee describes taking a bumpy road full of potholes to get to one of the villages she visited in Tanzania. “The whole time I was wondering how women make this trek to get to the health centers.”

The lack of health centers, as well as skilled health care providers, is another challenge. As a result, women may turn to traditional birthing attendants in their villages. But these birthing attendants may not have access to supplies, medicine, and equipment to deal with childbirth complications. “It’s amazing what the health care providers in Tanzania are able to do with such limited resources. The delivery rooms there are small. There might be a gurney with stirrups, but there are very few supplies or medicine. It’s 180 degrees different from the United States. They need more doctors and nurses, more beds, more medicine. The need is so great, it’s hard to describe,” Belle says.

Lack of information is another issue for women. Belle explains that there is a lot of misinformation about pregnancy and childbirth. Some women believe that taking birth control can make you fertile. “Empowering women is not hard to do,” says Taylor-McGhee. “When women have the information, they know what to do with it, because they know their bodies.”

Women’s Dignity is an NGO that is working to empower women in Tanzania. The Tanzanian president has promised to increase the number of health facilities and to provide training for health care providers. Women’s Dignity will be hosting a summit in 2011 to keep pressure on the government, and remind the president that issue of women’s health will not go away.

Women’s Dignity helped arrange Taylor-McGhee’s visit to Tanzania. An outreach event was organized in one village, where community theater was utilized to help inform women about their bodies, and some of the complications that can arise during pregnancy. Taylor-McGhee says that over 200 people participated, and she explains that the event cost approximately $400 to produce. “Imagine what $400 could mean for another village,” argues Belle. “And $2000 could make a major difference for five villages.”

Taylor-McGhee wants Western feminists to get involved. “This is a human rights issue,” says Belle. “I don’t know how you can advocate for human rights for one woman, and not demand them for all women. Women are only separated by geography. Women around the world have many of the same issues, like childbirth complications. But these issues are preventable, and we can save women’s lives.”

Western women can get involved by putting pressure on the US government to provide funding for international family planning programs. The US should be a leader on this issue, in Belle’s opinion, and get other Western nations to work together to support the NGOs that are already doing the work, like Women’s Dignity. “Four hundred dollars is not a lot of money,” says Belle, “but that money can save women’s lives.”

Belle is hopeful about the progress that can be made in Africa. “Each generation of women is getting more information about how to plan their families and space their pregnancies. And they’re passing it on to the next generation.” Groups like Women’s Dignity and EngenderHealth are making a real difference, but more people need to get involved in order to meet the UN Millennium Development Goals.

Taylor-McGhee believes that most people in the West haven’t gotten involved on this issue of maternal mortality because they are simply unaware that the issue exists. “We have to tell these women’s stories,” Belle tells me. “I am just the conduit for that.”

Visit EngenderHealth’s website to find out how you can get involved.

Photo credit: Ms. Magazine