As part of Mom Blogger’s for Social Good (a global coalition of over 3,000 mom bloggers), I have received an advance copy of the inspiring new book by Betsy Teutsch called “100 Under $100: One Hundred Tools for Empowering Global Women”, for review. All opinions below are my own take on the book.
“Do your little bit of good where you are; it’s those little bits of good put together that overwhelm the world.” – Desmond Tutu
In the field of international development, it is a well-known fact that women are powerful agents of change and development, and it is only by empowering women and girls that the world will be lifted out of extreme poverty. Yet despite this easy assertion women and girls continue to be the most impoverished, most vulnerable and most neglected human beings in the world.
There are many reasons why women and girls continue to suffer the most. Cultural beliefs and norms, war and violence, poverty, lack of infrastructure and education continue to play a significant role in women’s empowerment and rights. However, despite some of these challenging, long-held beliefs, traditions and obstacles, there are proven, cost-effective ways to change the lives of billions of women and girls living in extreme poverty.
Two young girls pose for me during a visit to one of Delhi’s many unauthorized slums. Despite their poverty, they were enrolled in a program sponsored by Save the Children to improve their lives.
For over three years, I have been a part of World Moms Blog, an amazing group of women writing about motherhood around the globe. These women have become some of my closest friends and I have been incredibly honored to work with them as a part of World Moms Blog, ONE Women and Girls, and Shot@Life. This week we are supporting CleanBirth.org, an organization started by one of our contributors, Kristyn Zalota,to make birth safer in Laos, one of the worst places on earth to give birth.
In the rural areas of Laos where almost 70% of the population live, access to life-saving health care is sparse and many people live in remote, mountainous areas that are hard to reach posing challenges for expectant mothers. Per the World Health Organization, Laos ranks 21st out of all countries in the world in terms of the highest maternal mortality rates. The 2010 statistics are 470 maternal deaths out of 100,000 live births which is worse than Afghanistan. Infant mortality rate is not much better. Laos comes in as the 33rd highest with a rate of 54 deaths out of 1,000 live births (2014).
Mother and child in Laos. Photo Credit: Kristyn Zalota
Shouldn’t a child be given the same shot of life no matter where he or she is born? I believe that children everywhere deserve the chance to live and reach their full potential. The availability of life-saving vaccines for every child is critical.
For those of you who have followed my blog for years, you know that besides blogging I am also an active advocate and activist for a number of important causes. I advocate for the ONE Campaign to eradicate global poverty, ONE Women and Girls to help elevate the status and well-being of women and girls around the world, RESULTS (another advocacy group that works to advocate with our members of Congress to affect policy on ending poverty) and the UN Foundation’s Shot@Life Campaign, a grassroots organization aimed at providing global vaccines to the developing world. All of these causes are truly important to me and I am amazed how much I’ve personally grown by being a part of each organization and using my voice to effect positive change.
As an advocate for global vaccines, I’ve worked hard as a Shot@Life Champion since the campaign launched almost three years ago. Working with Shot@Life has taught me many things about the value of vaccines and the importance of their availability around the world in saving lives. Before I joined Shot@Life, I had no idea that every twenty seconds a child dies from a vaccine-preventable death. Every twenty seconds!
The tragic statistics combined with the reality that this is a fixable, solvable problem that truly does not cost much, invigorated me to join the cause and fight for funding of global vaccines.
Young girls in Mozambique show off their newly updated vaccination card. Shot@Life–UN Foundation, Mozambique, Wednesday, June 1, 2011 (Photo/Stuart Ramson)
This January, world leaders are meeting to discuss the replenishment of the GAVI global fund for vaccines. This meeting comes at a critical moment in time. A time where we have seen amazing progress in the reduction of under age five deaths thanks to the provision of global vaccines.
At the meeting, global leaders and private donors will make commitments for the next five-year plan of GAVI’s funding (years 2016-2020). The goal is to achieve 7.5 billion, and the United States, one of the top four funders of the GAVI Alliance, is being asked to commit to 1 billion dollars. It is an ambitious and reasonable goal. (In case you are wondering, the top donor last year was the UK, followed by the Gates Foundation and Norway. The US came in fourth).
We have made significant progress in combatting preventable deaths in children under age 5 by providing access to vaccines. Photo credit: Gavi Alliance
Before I dive into GAVI and their great work, I’d like to tell a story. In early September I had the opportunity to meet Dr. Namala Patrick Mkopi, the Secretary General of Tanzania’s Pediatric Association. I met Dr. Mkopi for lunch and he shared firsthand stories about what he has seen as a pediatrician in Africa. The two leading killers of children under age five are diarrhea and pneumonia. Together they kill one in every four children in the world, and both are preventable by vaccines.
“In order to fight against poverty, you have to attack it from many different directions and then pluck it out, ” said Marta, co-founder of Project Mercy, as she described their Community Development Model. “We cannot educate children if the only outcome is to make them discontented with the limited job opportunities currently available.”
A beautiful flower within the gardens at Project Mercy
Back in June, when I was in Ethiopia as a fellow with the International Reporting Project I spent my last full day there visiting Project Mercy. Project Mercy is a special not-for-profit organization as it was created in 1993 by two Ethiopian exiles, husband and wife team Demeke (Deme) Tekle-Wold and Marta Gabre-Tsadick. Deme and Marta left Ethiopia and repatriated to the United States during the heart of Ethiopia’s repressive government. Wanting to help their fellow countrymen at home, they established Project Mercy as a way to help Ethiopians rebuild and lift themselves out of poverty.
Today, Project Mercy is run by Desalegne “Lali” Demeke , Marta and Deme’s son who manages the 52- acre compound that houses a school, a home for orphans, volunteer housing, a hospital, a new Health Science College and agricultural, cattle breeding and handicraft training services, to help empower the local community and improve their lives. Project Mercy is an incredible organization and I was excited to visit it in person.
Getting to Project Mercy was half the fun and required a land cruiser, a driver and a full day of adventure. We left Addis Ababa early in the morning heading for about three hours south into the heart of the Yetebon to arrive at the bumpy, gravel road that brought us to Project Mercy. Continue reading →
“Recognizing and addressing the world’s malnutrition problem as one of the major underlying impediments to eradicating global poverty and economic growth will not only save lives, it is critical to the success of the U.S. government’s ability to advance our global development objectives.” – Edesia
A dear friend of mine and fellow social good blogger, Elizabeth Atalay (documama.org) is a mother of four, living in Rhode Island and is following her passion to help mothers and children around the world through advocacy and using her voice as a blogger. Elizabeth recently began working with local Rhode Island non-profitEdesia whoproduces a nutritional paste called Plumpy’Nut that is used globally by the World Food Programme, USAID and UNICEF to treat severe malnutrition.
Severe malnutrition impacts millions of children around the world and is highly preventable.
According to UNICEF, there are at least 51 million children in our world under the age of five suffering from acute malnutrition, a condition directly responsible for at least 1 million young child deaths each year.
Stunting occurs in children who have access to food but for whom nutrition and hygiene are inadequate; 165 million children are stunted and will experience lifelong cognitive and physical deficits that cannot be overcome. The irreversible stunting that occurs in children as a result of prolonged under nutrition, causes children to underperform in school and have lifelong health problems, furthering perpetuating economic loss and the cycle of poverty for families, communities, and countries.
Malnutrition contributes to an estimated 45% of all child deaths as it makes a child more susceptible to other life threatening diseases and illnesses. Malnourished children are 9 times more likely to die from diarrhea and 6 times more likely to die from pneumonia.
Malnutrition is called the silent killer because often it goes unnoticed until it is too late.
The economic toll of malnutrition costs countries millions of dollars each year.
Proper nutrition in the first 1,000 days of life – from conception to two years of age – is critical to a child’s healthy development and future productivity in society.
Children in Burkina Faso who have benefited by Plumpy’Nut nutritional paste. Photo Credit: Edesia
Children in Burkina Faso who have benefited by Plumpy’Nut nutritional paste. Photo Credit: Edesia
Children in Burkina Faso who have benefited by Plumpy’Nut nutritional paste. Photo Credit: Edesia
Children in Burkina Faso who have benefited by Plumpy’Nut nutritional paste. Photo Credit: Edesia
Navyn Salem began her journey in helping malnourished children in 2007 as a stay-at-home mom of four young girls. Horrified by the growing numbers of malnourished kids around the world Navyn decided to do something about it. She began with operations in her father’s homeland, Tanzania, and worked with the government and the French company Nutriset to produce Ready-to-Use Therapeutic Foods known as RUTFs. A factory was built in Dar es Salaam, Tanzania’s capital and today they provide RUTFs to nine neighboring African countries.
EngenderHealth works to improve access to maternal and reproductive health care in more than 20 developing countries. At the end of September, EngenderHealth launched their new campaign, “WTFP?!” (Where’s the Family Planning?!) to raise awareness among Americans of global access to contraception.
Although for many Americans, access to contraceptives is relatively easy, around the world, this is not the case and there remains a huge, unmet need. In fact, over 220 million women in developing countries want contraception and family planning but lack access. There are a variety of reasons regarding why women do not have access – poverty, lack of education, lack of health care facilities, culture and religion – however it is proven that when women have access to contraception they are more likely to survive childbirth, have healthier children, and go further in their education.
Water is essential to life. Without water, humans and our world would not survive. Yet, 11% of the world’s population – 783 million people – do not have access to safe water. Although many people living in the western world including myself often take water, sanitation and hygiene (collectively known as “WASH”) for granted, there are millions of people around the world who do not.
In fact, the figures are shocking:
2.5 billion people – almost 35% of the world’s population – do not have access to adequate sanitation. (WHO/UNICEF)
More than 500,000 children die every year from diarrhea caused by unsafe water and poor sanitation – that’s almost 1,400 children a day. (WaterAid 2012/WHO 2008/The Lancet 2012*)
The weight of water that women in Africa and Asia carry on their heads is commonly 40 pounds, the same as an airport luggage allowance.
Providing water, sanitation and hygiene together reduces the number of deaths caused by waterborne diseases by an average of 65%. (WHO)
When I was in Ethiopia this past June, I witnessed firsthand the drastic unavailability of water and sanitation services. It could be seen every time I left the nation’s capital, Addis Ababa, and headed out along the roads leading to the rural population which make up 90% of Ethiopia’s 90 million people. Woman walking for hours with yellow jerricans on their backs. Mule carts loaded with empty and full jerricans. Even children carrying jerricans and walking miles in search of safe water.
The 5th Annual Social Good Summit was held this year at 92nd Street Y from September 20-22, 2014 and streamed around the world in multiple languages.
Last night I returned home after attending my third Social Good Summit in New York City, this year as a United Nations Foundation Social Good Fellow. The Social Good Summit is a unique convening of world leaders, new media and technology experts, grassroots activists and voices from around the world that come together for a two-day conference coinciding with the United Nations General Assembly meeting held during UN Week.
“Social media is one of the most powerful tools in creating social change” ~ #JimmyCarter #2030Now
The theme of this year’s summit – #2030NOW: Connecting for Good, Connecting for All – challenged speakers, participants and a growing worldwide community to explore how technology and new media can be leveraged to benefit people everywhere, to spark discussion and ignite change in creating a better world for all by the year 2030.
On one of my last days in Ethiopia as a fellow with the International Reporting Project we visited Project Mercy, a not-for-profit relief and development agency that provides services to help alleviate human suffering and overcome systemic poverty in Southern Ethiopia. The visit ended up being one of the most enlightening moments of our entire trip.
In order to combat Ethiopia’s high maternal and newborn mortality rates, Project Mercy opened a “Lie and Wait” home for rural woman to come to stay before delivering their child at a nearby hospital. In a country in which an estimated 90% of women deliver at home with little or no trained birth assistance, a Lie and Wait house ensures women from the far away, remote villages will come to wait to stay and deliver at a hospital with a trained midwife or doctor. Lie and Wait houses have saved many lives of both mother and child.
Many of these expectant mothers walk miles on foot on various terrains and topographies to reach a Lie and Wait house. At Project Mercy in the Yetebon community of Southern Ethiopia, pregnant women can walk hours through rugged, mountainous terrain to reach the Lie and Wait home. It is a true test of endurance to walk on foot carrying almost a full term baby.
Reaching the Yetebon community on rough gravel roads that end when they hit the mountains where most of the population live.
Before I travel to a new place, I make it a habit to read a couple of books on the country I’m visiting in order to get an overview of a country’s history, culture, politics and other pertinent issues. When I was selected to go to Ethiopia as a fellow with the International Reporting Project where I’d be learning about newborn, child and maternal health I found several fabulous books highlighting these issues.
One of the most powerful non-fiction books I read before I left for Ethiopia this past June was “There is No Me Without You” by award-wining journalist Melissa Fay Greene.
Greene’s moving book chronicles the life of one woman’s fight to save Ethiopia’s AIDS orphans during the height of the AIDS epidemic in Africa. Before reading the book, I honestly had no idea that Ethiopia was the second most impacted country in Africa by HIV/AIDS. Greene herself was unaware of the severity of the AIDS epidemic until she came across a New York Times Article in the summer of 2000.
On page 20 in her book, Greene writes:
Per the United Nations, in 2000 Africa was “a continent of orphans.” HIV and acquired AIDS had killed more than 21 million people, including 4 million children. More than 13 million children had been orphaned, 12 million of them in Sub-Saharan Africa. 25% of those lived in 2 countries: Nigeria and Ethiopia. In Ethiopia, 11% of the children were orphans.
Greene realized she could not turn a blind eye to this horrible tragedy and spent the next several years researching the origin and history of the HIV/AIDS, the development of antiretrovirals, the impact of AIDS in Africa and the plight of an entire generation of AIDS orphans. Her research resulted in her powerful book “There is No Me Without You” which is all shown through the eyes of one woman, Haregewoin Teferra, who dared to rescue these children, deemed untouchable and tragically left behind in the aftermath.
A book written on Amelezewd’s life.
It was within this mesmerizing, heart-breaking true story that I learned about Amelezewd and AHOPE for Children. Amelezewd Girma and her two younger brothers were AIDS orphans living with Haregewoin when it was discovered Amelezewd and one of her brothers were HIV positive and too sick for her to care for.
At the time, Ethiopia was overwhelmed with HIV/AIDS orphans (there were over 1.5 million in Sub-Saharan Africa by 2005) and Haregewoin searched desperately for a place that she could send Amelezewd and her brother to be properly cared for. Through Haregewoin’s search, she found Enat House for HIV-positive children which later was renamed AHOPE for Children, and Amelezewd and her brother Michael were placed there.
Sadly, it was too late for young Amelezewd who as a young teenager dreamed of getting an education and becoming a professor someday. Life-saving anti-retrovirals (ARV) that were widely available in the western world were still unaccessible in Sub-Saharan Africa where they needed them most. ARVs were not available in Ethiopia until 2005. Amelezewd passed away leaving behind a legacy of heartbreak and hope while her younger brother Michael survived thanks to the availability of ARV treatment. AHOPE meant that there was finally a hope for HIV positive children and they were no longer being sent to a place to be cared for before they died.
It was against this backdrop that I contacted AHOPE for Children and scheduled a site visit to meet with the director Mengesha Shibru during my reporting fellowship in Ethiopia this past June.
This past June, I visited Ethiopia as a fellow with the International Reporting Project with the primary goal of examining the impact of Ethiopia’s success at achieving Millennium Development Goal (MDG) 4 – reducing child under age five deaths by two-thirds – well before the 2015 MDG deadline. Granted it is a stunning achievement that has put the spotlight on Ethiopia, it can also be argued that Ethiopia as well as many other countries around the world are failing to reach critical milestones for other MDGs such as maternal health. MDG 5 – to reduce maternal deaths by 75% and achieve universal access to reproductive health – is trailing way behind the other goals coming in near the bottom.
According to a recent article published in The Lancet*, only 16 countries out of the 189 United Nations member states who committed to the goals are expected to meet MDG 5 by 2015. The consequences of this are devastating to women and their families.
The tragic facts about maternal deaths
Every day, 800 women die from causes related to pregnancy or childbirth.
When a mother dies, the risk of death for her children under the age of five increases by 50%.
The number one killer of 15-19 year old girls worldwide is pregnancy and childbirth. Every year, 70,000 young women die as a result of pregnancy and childbirth – over 70% of these deaths are preventable.
Access to universal reproductive health, the other piece of MDG 5, is also lagging behind. There are millions of women, mostly poor and rural, who have no access to family planning and are unable to space or plan their children. Furthermore, this year alone it is estimated that nearly 22 million unsafe abortions will take place around the world resulting in millions of preventable maternal deaths and longterm disabilities.
Ethiopia, the second most populous country in Africa, is one of the five most dangerous places to be a mother in the world. One in 27 women die from complications of pregnancy or childbirth (25,000 annually) in Ethiopia.
With a population of 90 million, it is estimated that anywhere from 80-90 percent of mothers give birth at home with no trained assistant. In rural areas, where over 85% of the population live, it is even worse. Only an estimated 5% of mothers give birth in a health center with a trained delivery assistant. The chart below illustrates where Ethiopia falls compared with her neighbors:
How Ethiopia fares compared with her neighbors. Source: Marie Stopes International
This means that Ethiopia’s maternal mortality rate is estimated at 420 per 100,000 live births (2013 WHO/UNFPA) which lumps Ethiopia along with India, Pakistan, Afghanistan and Nigeria, as the top five highest maternal mortality rates in the world. As the population continues to boom in Ethiopia, it is critical that improvements are made to women’s access to family planning, safe abortions and labor and delivery care which would significantly reduce the number of women dying and having serious injuries during childbirth.
The alarmingly high ratios of health care professionals per patients is another factor in high maternal mortality rates in Ethiopia. It is estimated that only 34% of women have received prenatal care and 57% of women have received no pre or postnatal care during pregnancy. Source: Marie Stopes Ethiopia.
Seeing a huge, unmet need for family planning and reproductive services, Marie Stopes International begin working in Ethiopia in 1990. Marie Stopes International works to provide sexual and reproductive healthcare to millions of underserved women around the world and has been delivering family planning, safe abortion, and maternal health services to the world’s poorest and most vulnerable women for over 35 years.
“Women are dying because of lack of services and information. Having better access to family planning helps improve the lives of women and their families”.
– Marie Stopes Ethiopia Director Abeba Shibeau
Marie Stopes works in seven administrative states in Ethiopia, and runs a three-tier level of service throughout the country through Marie Stopes clinics, Blue Star franchises (600 Blue Star clinics in Ethiopia) and a call center that works nationwide. Before Marie Stopes entered Ethiopia, only 13% of the private sector clinics provided services in family planning yet the demand for contraceptives to space and limit children was and remains high. Only 29% of married women in Ethiopia are actively using contraceptives (Marie Stopes, Ethiopia) and an enormous unmet need exists for family planning.
Marie Stopes has filled this need by providing a call center and clinics that offer education, information and low-cost contraceptive options, pre and post natal care, HIV/AIDS prevention, diagnosis and treatment of sexually transmitted infections, and safe abortion when permitted, to woman and their families.
Expectant mothers checking in at a Marie Stopes Clinic in Addis Ababa.
“Ethiopia is a much better place to be a mother today than when my mother gave birth”.
– Nurse Shewaye, the Central Area Manager for all Marie Stopes Clinics in Addis Ababa.
An expectant mother relaxes a bit at a Marie Stopes clinic with her husband and son.
Another area that is helping save lives of women in Ethiopia and around the world is the provision of safe abortions.
Worldwide, one woman dies every 11 minutes from an unsafe abortion. Yet providing access to reproductive healthcare is one of the simplest and cheapest ways to save women’s lives. The World Health Organization (WHO), estimates that 5.5 million African women have an unsafe abortion every year. As many as 36,000 of these women die from the procedure, while millions more experience short- or long- term illness and disability. (Source: Guttmacher Institute)
Infographic on the impact of unsafe abortions. Source: Marie Stopes International
In 2005, Ethiopia expanded its abortion law making abortion legal for cases of rape, incest, fetal impairment, and if the pregnancy or delivery endangers a woman’s life. A woman may also legally terminate a pregnancy if she is a minor or physically or mentally unable to raise a child. Despite the changes in the law, almost 6 in 10 abortionsin Ethiopia are unsafe causing 13% of all maternal deaths.
A woman entering a place to have an unsafe abortion in Ethiopia. Source: Marie Stopes.
Progress has been made yet continued expansion of affordable and accessible family planning and reproductive services is critically needed especially for rural women who represent 82% of all women of reproductive age in Ethiopia.
There are many reasons for pursuing an unsafe abortion however most of the time it is due to the false belief that it is the cheapest method while in fact many of these underground illegal abortions cost more than a safe one.
Furthermore, religion, fear and cultural issues are other reasons why women especially young and rural ones, will pursue an unsafe abortion and risk their lives.
The Make Women Matter Campaign
As the deadline for the Millennium Development Goals draws to a close, Marie Stopes International has launched a new campaign calledMake Women Matter. The goal of the campaign is to ensure that maternal mortality remains at the top of the world agenda for future development goals. It also calls for achieving women’s rights and empowerment, universal access to sexual and reproductive health and rights, and ending unsafe abortion.
World leaders will be meeting in New York this September during UN Week to discuss the future of MDGs. To ensure that maternal health gets the critical attention it deserves, please spread the word by sharing this post. You can also personally make a difference by signing Marie Stopes petition at change.org by clicking here.
#makewomenmatter
Newborn baby in Hawassa, one of 10-20% of Ethiopia’s 3 million children born in a health facility.
Material in this post was provided by Marie Stopes in Ethiopia and the UK. To learn more about Marie Stopes International, please visit their webpage here. #makewomenmatter
USAID, Achieving the MDGs: The Contribution of fulfilling the unmet need for family planning, Washington DC: Futures Group International, 2006.
“If she wasn’t bleeding, she would have suffered like I did and delivered at home,” said Fasika’s* mother Menesch at a Lie and Wait center for expectant mothers in rural Ethiopia.
Menesch was inside the room with her expecting daughter Fasika while nursing her three-month-old daughter on a chair. It was Menesch’s eighth child who, like all the rest, she delivered at home with no trained labor assistant.
Menesch cradling her with-child in her lap at the Lie and Wait house in rural Ethiopia.
Fasika was a mere 15 years old with baby fat still surrounding her cheeks and a shy smile that often looked down at her largely pregnant belly. Meeting Fasika and her mother on the last day of my trip was the defining moment of my two weeks of reporting on maternal and newborn health in Ethiopia.
