Monday, June 29, 2009

Maternal mortality hits home

This Friday we hit traffic on the drive out to Robertsport, joining a 10 km-long train of cars that crawled past Duwala market, making an evening surf session an increasingly unlikely opportunity. My ladies at the Total station, who all have my number, told me it was the funeral of a "big man," led by a brass band and a line of mourners whose grief blocked the only road leading west out of the city for over an hour.

We passed the first checkpoint, and the traffic crawled so slowly that we could buy $0.30 of boiled peanuts out of the window without loosing our spot. It wasn't until we reached the first village out of town that we saw the funeral party peel off and slowly climb the hill to the cemetery in the distance, their black cars lining the road. We made it to Robertsport in time for a short evening session, by the way.

Yesterday, I wore my arms out surfing (more on this later) and walked back to camp. Alfred Lomax, our friend and Liberia's best-known surfer, and our well-intentioned but narcoleptic guard James were piling leaves into a wheelbarrow to fill a large hole someone mined sand from a few months back. Alfred made a few half-hearted trips to the hole, sighing and slouching a bit -- clearly something was wrong.

"My friend died last night after giving birth," he said, looking away and trying not to let his facial expression alter. "She had her baby, and at 3:00 am she died." I stood in silence for a moment, holding space for him as he told the story. "They took her to the hospital, but nothing. All of Robertsport is bereaved now."

We stood together for a few minutes, and as Alfred got ready to leave "to go sympathize with his friends and her family," we talked about Orita's life: her husband loved her, she has five other children, now there is no one to feed the baby.

With what many consider to be the highest infant mortality rate in the world, an estimated one out of every hundred Liberian women die giving birth. Being pregnant is one of the most dangerous things a woman can do. For Orita, it was fatal. Only for her, there will be no brass band, no stopped traffic -- only a man left to raise too many children on his own, and an infant who will never know its mother.

Nate and I are starting an NGO to address the needs of the Robertsport community, but what if the need of the half the community is simply to survive pregnancy and giving birth? How do we incorporate interventions for maternal mortality into our projects, even if it's just working with other local NGOs on health education to emphasize the importance of prenatal visits?

Ideas welcome.


  1. What a tragedy. I think what helped to reduce maternal mortality in El Salvador were trained community health promoters. They specially trained a few women health promoters to be mid-wives. They made sure they check and monitored the mothers prenatal and postnatal.

  2. We took the same strategy in Burkina Faso. The issue there was distance to the health center, lack of transportation, and limited understanding of the importance of bringing women to the centers. In Burkina the Council and UNFPA trained young women (who were already mothers, so they could speak with greater authority) and sent them in pairs. So they would speak to the family members, the gatekeepers, about developing a strategy for taking the woman to the center when she was about to give birth (making sure there was transportation and so on). And they were armed with vitamins for the pregnant women. I can send you more detail.

  3. MNS and Scrubness: this sounds like a great program we can run with the local health NGO that runs the community health center. I'd love to hear more. Email me with details!


Thank you for sharing your thoughts and comments! They help to inform my posts and are very much appreciated.