Exclusive for the Daily Outlook Afghanistan
As we reflect on another International Women's Day and the progress made by women globally, it is painstaking to know that 1000 women still tragically die every day in childbirth or from pregnancy related complications. This statistic remains overwhelmingly confronting, especially when the vast majority of these deaths are preventable with skilled clinicians, drugs and equipment. Maternal death is an ongoing crisis, and an avoidable crisis that deserves our attention.
In December last year I was with Médecins Sans Frontières (also known as Doctors without Borders, or MSF) in Buin, a village in southern Bougainville in Papua New Guinea which remains isolated and poorly serviced due to civil conflict that ended eleven years ago. We had heard about a woman who'd recently died giving birth to twins so we went to check-up on the twins and found another woman, carrying twins. We transferred her to our hospital in Buin learning that she'd already had one previous stillbirth.
She then endured a difficult and protracted delivery but two healthy baby boys arrived into the world safely. What should have been a remarkable moment however turned into a medical emergency. There is a higher risk of bleeding after the delivery of twins, and the young mother started to haemorrhage, and probably lost over a litre of blood. We managed to control her bleeding with intravenous fluids and drugs, therefore preventing her from having further complications. She would have lost a lot more blood without this medical care and might not have survived.
The reality in most developing countries is that access to health care is limited and most women cannot get the emergency assistance they need during pregnancy and at the time of birth. In Bougainville that day, one woman's life was saved while another's was lost – the difference being that the second woman had practical medical solutions available to her that made death avoidable.
Access for all pregnant women to this type of quality healthcare may seem an impossible dream. As MSF, it is not our role to provide a global solution to the crisis of maternal mortality. It is the role of governments and development-focussed agencies to weigh in upon the issues of women's rights, education for girls and the improvement of health systems that are paramount in reducing maternal mortality in the long term.
While these kind of developmental strategies are critical, there are women dying today. We see it as our goal as an emergency medical humanitarian organisation to respond to this immediate need. I have witnessed firsthand the immense challenges women face and have had the privilege to provide care in places such as Darfur, Madagascar, Sri Lanka and Papua New Guinea.
In Afghanistan, MSF recently opened a maternity hospital in Khost province, which will help hundreds of women every month to deliver their babies in a safe environment. After seeing the direct impact that this care has, it unfortunately leaves me to wonder just how many women around the world are left without it.
In the countries where MSF works, our expectation therefore has to be relatively simple: to be able to concretely reduce the number of deaths we see in our clinics and hospitals by addressing the immediate needs of pregnant women in crisis situations. The medical approaches we use have been available for a long time, and it is abundantly clear from our experience in the field that maternal deaths can be averted.
It's a fact that 15 percent of all pregnant women encounter life-threatening complications during delivery, whether they are in Sydney, Port-au-Prince or Mogadishu. Women who are subject to conflict, health crises and displacement are rendered even more vulnerable – and complications for those living in a war zone are likely to be even higher when health facilities collapse.
To make an immediate difference, the focus has to be on the main causes – haemorrhage, infection, hypertensive disorders and obstructed labour – accounting for over 80 percent of all maternal deaths globally. In our emergency obstetric units, we can provide care for these complications in a range of high-risk settings.
Medical care and available resources are the key factors during these times of crisis. Time and again, we see that having access to emergency obstetric care will make the difference no matter where pregnant women are. Whether she is fleeing conflict, surviving in a refugee camp or living under plastic sheeting after her home was destroyed by an earthquake, all a pregnant woman who experiences complications in childbirth needs is skilled staff, drugs and equipment. This will save her life and that of her baby as it did for the woman we assisted in Bougainville.
A woman should not face an uncertain future just because she is pregnant. Today on International Women's Day, as on every other day, we must continually remind ourselves that every maternal death is an unacceptable and avoidable death.