It was a sunny afternoon as most days are in Ethiopia in April. I was taking an individual tour of a large hospital in the middle of Addis Ababa where I got to talk to doctors, nurses, and see waiting rooms and even patients who were recovering from care.
I distinctly remember the room of women who had recently had abortions or were awaiting one. The room was eerily silent despite the number of patients in the large recovery room with few windows and no air conditioning. Personal effects were on all of the beds: blankets, purses, food, extra clothes . Some of the women had female visitors, others did not. While the Ethiopian abortion law on the books is considered “semi-liberal” by African standards, there is some pushback on abortion services although in practice if a woman wants an abortion she can most likely get one. This is mostly to help decrease maternal mortality rates and to curb the rates of unsafe abortions.
As I concluded my tour, the last room I saw was where the abortions took place with all of its machines and lone hospital bed. At that moment I was glad that despite the law, these Ethiopian medical professionals along with the hospital’s policy allowed women to have a choice about their own bodies and reproductive rights.
Experts explained that the U.S. resistance, although extreme, was nothing new. The United States previously demonstrated its allegiance to the formula industry by refusing to sign on to the World Health Organization’s Ban on the Marketing of Breast Milk Alternatives.
This U.S. stance, like its intimidation of Ecuador, flew in the face of near universally accepted medical and scientific research proving that breastfeeding saves lives. Perhaps even more surprisingly, both acts perpetuate an alarming racial divide in breastfeeding rates that leads to significant racial health disparities. American support of the formula industry comes at the cost of the health and lives of Black and brown babies, at home and abroad.
Both the resolution and the U.S. opposition to it stemmed from a decline in formula sales in the United States. The industry has sought to make up for its considerable domestic losses on the global market. The racial aspects of this local-global dynamic are hidden in plain sight.
PHOTO: Navi Pillay (third from right), UN High Commissioner for Human Rights, poses for a group photo with South Sudanese women from Jonglei State who shared stories about their experiences with human rights violations, including violence, child abduction, and forced marriage. UN Photo/Elizabeth Murekio
A woman was recently elected as a senior chief in South Sudan – a not unheard of, but very unusual occurrence. This surely a positive change in a country ravaged by civil war and attendant sexual violence.
Rebecca Nyandier Chatim is now head chief of the Nuer ethnic group in the United Nations Protection of Civilians site (PoC) in Juba, where more than 38,000 people have sought sanctuary with United Nations Mission in South Sudan (UNMISS) peacekeepers. Her victory is of symbolic and practical importance.
South Sudan’s chiefs wield real power, even during wartime. They administer customary laws that can resolve local disputes but also reinforce gender differences and inequalities, to the advantage of the military elite.
So could a female chief work towards changing this? Admittedly, even if the new female chief is determined to effect change — which remains to be seen — the odds are against her. The chief and her community are vulnerable, displaced persons, living in a sort of internal refugee camp, guarded by UN peacekeepers. Fighting and atrocities have continued outside, especially in the devastated homelands of the Nuer people. But the new chief has the support of the former head chief and a group of male paralegals, who have celebrated her victory as an advance for gender equality. Together, they might make a difference.
Caesarean sections have been lifesaving procedures for hundreds of thousands of women across the world who experience complications during labour.
Globally, it’s estimated that just under 20% of births take place via caesarean section – a percentage that’s gone up over the last three decades. This has raised concerns, particularly in high-income countries where generally too many caesarean sections are performed.
But in many African countries women who are medically required to have caesarean sections are not able to access them. This is due to several reasons, the most prominent being weak health systems and a lack of resources.
This needs to be fixed as women in sub-Saharan African suffer from the highest maternal mortality ratio in the world. Close to 550 women die for every 100 000 children that are born. This amounts to 200 000 maternal deaths a year – or two-thirds of all maternal deaths per year worldwide.
The more technology improves in low-and-middle income countries the quicker mobile apps will be invented and scaled to better people’s live. We already know that banking apps have transformed the exchange of money and have helped economies like Kenya’s thrive. Now, innovators are looking to create more and more mobile apps to transform health care and save more lives. Sub-Saharan Africa has some of the … Continue reading New Maternal Health Mobile App for Tanzanian Women Seeks Crowdfunding
During my visit to Haiti two years ago I had the privilege of visiting two hospitals: L’Hôpital Albert Schweitzer (HAS) in Haiti’s Artibonite Valley and L’Hôpital Sainte-Thérèse in Hinche, Haiti. Many of the patients at both hospitals, I learned, walked or took public transport over long distances for quality hospital care. As the poorest country in the Western Hemisphere, Haitians need many more hospitals and health workers to care after their sick. There are currently only six health workers for every 10,000 Haitians according to USAID. And, Haiti has the highest rate of infant, child, and maternal mortality in the Western Hemisphere. Most Haitians live on less than $1 a day and their life expectancy is only 64 compared to 74 for its neighbor, the Dominican Republic.
Quality health care in Haiti continues to be one of the country’s greatest problems. In fact, Haiti only spends 6 percent of its expenditures on health care and relies heavily on international funding.
After eight years of practicing obstetrics and researching childbirth in the United States, I know as well as anyone that the American maternal health system could be better. Our way of childbirth is the costliest in the world. Our health outcomes, from mortality rates to birth weights, are far, far from the best.
The reasons we fall short are not obvious. In medicine, providing more care is often mistaken for providing better care. In childbirth the relationship between more and better is complicated. Texan obstetricians, when compared to their counterparts in neighboring New Mexico, are 50% more likely to intervene on the baby’s behalf by performing a cesarean section. Nonetheless, Texas babies still have a lower survival rate than New Mexican babies.
I long assumed that our most puzzling American health care failures were idiosyncrasies–unique consequences of American culture, geography, and politics. But a trip to India for the 2017 Human Rights in Childbirth meeting led me to a humbling realization: when it comes to childbirth, both countries fall short in surprisingly similar ways.
Human rights in childbirth
I take care of patients in at a well-funded teaching hospital in Boston, where pregnant women seem well-respected and have clear, inviolable rights.
Every 28 days, millions of girls and women in developing countries miss school or work – up to 50 days per year – because they lack access to affordable menstrual products. And, it’s not just a problem in poor countries. Right here in the United States, women and girls who lack means often need both menstrual health education and reusable menstrual products.
The eight companies and organizations provide menstrual products in the United States and in Africa. Here are ways you can help them on their missions to provide women and girls with products that simply make their lives easier.
More than likely you have heard about the Global Gag Rule also known as the Mexico City Policy this week. You can learn more about it in a previous post: Why the Global Gag Rule Will Increase Maternal Mortality. To get right to the point, however, Planned Parenthood released this video: What is the Global Gag Rule that explains it succinctly. Continue reading Video: The Global Gag Rule Explained
Throughout my visits to clinics in Africa I have seen the work of Marie Stopes International in South Africa, Tanzania, Ethiopia as well as Zambia. They provide a full range of quality reproductive health services for women. I have always been impressed by the comprehensive care they provide. Now, their work will be hampered because of an imposed policy of the new administration.
Yesterday morning President Trump signed an executive order to reinstate the Global Gag Rule, or Mexico City Policy, that prevents international NGOs that accept USAID (taxpayer) money from advocating for the legalization of abortions, provide abortions, mention the word, or even refer women to health practionioners that provide safe, legal abortions.
The Global Gag Rule was instated during the Reagan admininstration in 1984 and since then there has been a virtual seesaw effect between Republican and Democratic administrations regarding whether the Rule is reinstated or revoked. According to the WHO, 78,000 women die every year from unsafe abortions. Under Obama’s eight year administration, that number was reportedly decreased by more than half. Now, that President Trump has signed this executive order reinstating the Global Gag Rule, the fear among the global health community is that that number will rapidly skyrocket again.