If you haven't ready Nicholas Kristof's new book (written with his other half Sheryl WuDunn) you probably should.  Half the Sky: Turning Oppression into Opportunity is interesting for many reasons, not the least of which is its analysis of maternal mortality alongside many other forms of oppression of women.  Kristof and WuDunn put a real face and a name on a maternal death (as well as maternal survival), something that statistics and public health journal articles can't do.  They spend two full chapters, six and seven, looking at maternal mortality and tracing the reasons that maternal mortality has been so difficult to reduce in many places.

 

There are two very difficult eyewitness stories that relate to maternal death and survival.  One story is about Prudence who was in a tiny hospital in Cameroon (Yokadouma)--she was suffering from obstructed labor and a ruptured uterus (due to a truly atrocious intervention by a traditional birth attendant).  The authors also tell the story of Ramatou, a woman with eclampsia who shows up at the Zinder clinic in Niger with convulsions and losing her sight.  One of these women is in an AMDD/UNFPA funded facility that is part of a pilot project--and though she appears to be very very sick, she lives due to the training and the care provided by the staff.  The other woman endures three days waiting in the facility in agony, the scorn of the staff for her poverty and lack of education and the withholding of live-saving surgery by a trained professional.  Both of these stories are frankly enraging and should spark a call to action, if they haven't already.  Even in the story with survival as the outcome, the AMDD/UNFPA clinic provided the tools for a cesarean section but for $42-- the family could barely scrape together the funds.  One has to wonder why the family is being asked to come up with the funds in this pilot project.  The authors asked the staff what would have happened if they hadn't come up with the money and the answer was clear: the woman would be left to die.  The thing that is so important about these stories is this:  these are women who actually made it to the health facility-- and from the sound of it the facilities actually had the ability to provide life-saving care, and yet the odds faced by these women were still incredibly grim.  So in light of the new numbers on maternal mortality just published this month, while progress seems to be made, whether a scenario featuring Prudence or Ramatou happens every ONE minute or every TWO minutes doesn't seem to matter for the moment.  The fact that it happens at all is a travesty.