Human Rights

Ensuring Mother's Rights

On May 28, Safe Motherhood Day has been celebrated with the motto “Nirapad Proshob Narir Odhikar”. The White Ribbon Alliance for Safe Motherhood continues to fight for this basic right of a woman.

Tamanna Khan

According to a study, children whose mothers have died are 3 to 10 times more likely to die within two years than those who have both parents alive. A mother is just not another human being; she is the primary caregiver of a nation's future. Her death is not only a personal or social loss but also economic as her country is deprived of her paid and unpaid labour. Yet every day around the world, in this era of scientific and technological advancement, 1000 girls and women die in pregnancy and childbirth.

Although the maternal mortality rate in Bangladesh has reduced significantly, over the last 10 years, even now 194 women per 100,000 live births die every year. Most of these deaths occur due to birth complications during pregnancy, lack of pre and post-natal care, which are nothing but consequences of overall lack of awareness, ignorance and neglect of women.

Dr Farhana Ahmed, national coordinator of White Ribbon Alliance for Safe Motherhood, National Secretariat, Bangladesh, says, “Women are not dying from diseases, we cannot cure. We do not need a miracle cure to treat these diseases; prevent pregnancy related deaths that are happening. Women are dying because of very simple interventions. One of the major causes is the lack of awareness.”

	Safe Motherhood is a basic right of all women. Photo: Aye Aye Maung

Dr Ahmed's point of view is reflected in Sunamganj's Safia's case. Born in the family of a day-labourer, she was forced out of school and married off at the early age of fifteen. Within twelve months of her marriage, she conceived her first child but neither she nor any of her family members, considered the need for or benefits of any vaccinations or antenatal care. Safia continued to ignore the occasional fevers and headaches that she experienced during pregnancy. One night, when the pregnancy was at full term, she started having contractions and sought the help of a village midwife, who lacked professional medical training. The following morning, when she started having convulsions, a village doctor was brought and he administered a saline drip. Although the convulsions receded, Safia began to vomit and by afternoon she gave birth to a son. Soon after, she started to bleed and the convulsions returned. Within an hour the joy of childbirth in Safia's family was overshadowed by her death, which can only be blamed on negligence.

Ironically, health care facility was available near Safia's village. In fact, compared to the 1970s, when there were almost no community clinics available in villages, the number today stands at 10,723 according to a booklet published in 2011 by the Directorate General of Family Planning. Even though pre and post-natal services at community clinics are limited, emergency obstetric care is available in the 70 Maternal and Child Welfare Centres many of which are situated at unions and villages. Safia's death was therefore more a result of ignorance and lack of awareness about the possibilities of birth complications.

White Ribbon Alliance for Safe Motherhood (WRA) works to bring an end to this scenario. As an international coalition of individuals and organisations, WRA aims to increase public awareness of the need to make pregnancy and childbirth safe for all women and newborns worldwide. WRA advocates for safe motherhood as a basic human right.

In Bangladeshi household, usually men take the decisions about availing health care services. In our religious and social context, advice coming from imams nevertheless has more influence on the decision makers. “WRA works a lot with influencers, who have the power to get the word out and make tangible change happen in their communities,” explains Dr Ahmed. She cites how WRA works with local religious leaders for instances imams in Bangladesh, asking them to promote antenatal care, safe delivery, post-natal care, family planning and so on. The training of imams has been tagged with visits to Smiling Sun clinics in all the 64 districts of Bangladesh, so that the imams develop an idea about where they are referring the patients to, informs Dr Ahmed. This programme started two years ago has proved to be very successful, she claims.

Other channels through which WRA raises awareness about safe motherhood include pursuing members of parliament to work on this issue in their respective constituency. WRA has also trained health journalists and helped them report on maternal health. “A lot of times journalists tell us that news about maternal health doesn't sell,” says Dr Ahmed. She describes how in workshops senior journalists shared tips with their younger colleagues about getting maternal health in the news. WRA also invited policy makers in news networks so that health journalist get management support regarding their stories in future.

Currently, WRA is putting emphasis on respectful maternity care. “In Bangladesh when a poor woman enters a facility, she is not given the proper treatment. She is not greeted very well; at all stages the behaviour towards her is very disrespectful. She is scolded and abused; as a result the entire experience at a facility becomes very traumatic,” Dr Ahmed says, “Child birth is a time of joy. It is not a time when one should be in stress and apprehension about what is happening.” She rues that even though community health workers persuade women to go to health facilities, such behaviours discourage pregnant mothers from going there a second time. Other women of the community are also discouraged and thus years of work in building awareness, fails. Thus, quality and respectful health care services is just as important in preventing maternal mortality rates as educating people about safe motherhood.

A mother's death in most cases results in malnourished, educationally deprived children especially girls, who are forced to drop out of school to look after their siblings. The vicious cycle of poverty and ignorance continues as the girl child grows up into yet another uneducated mother not aware of her rights. Thus for national interest safe motherhood should be ensured for all women.