09/17/2014 02:39 pm ET Updated Nov 17, 2014

Right Cause, Wrong People

Want a better world? Of course, who doesn't? But how to get there...

Behind the marketing of competing charity brands with their celebrity ambassadors, behind the obscure decisions of wealthy foundations and donor governments, the vexed question of how best to 'do development' is far from agreed. We've all heard the loud voices, spouting in the media about 'waste of money' and 'funds going to corrupt leaders'. Some quieter voices confide privately that 'it's better to let them die dear'; I've heard that in fundraising conversations - from a church warden in Somerset, as well as from a leading arts philanthropist in London.

International development professionals meanwhile try to keep going, believing they are doing a good job, or the best job possible - and naturally enough wanting to hang on to those jobs. Myself included. What we don't so often hear is the voices of the people who live in those countries being 'developed'. In particular we rarely hear from those girls and women surviving on very little, denied education, denied the right even to say who has sex with them, or when. Even today there are parts of sub-Saharan Africa where a girl is more likely to die in childbirth than to go to secondary school.

You would think, to look at the line-up of international worthies who turn up again and again on panels at international meetings, that they would have made more progress in changing this situation by now. I've been on the global maternal health circuit for a decade. Year after year I've seen the same old suspects, who are generally white, middle class, middle aged and male, board the plane for Malaysia, or Brazil, or New York or Geneva, at vast expense, in order to talk to each other, again. They might as well charter a plane!

It's not that we don't need meetings; when a woman's risk of dying in childbirth is up to a hundred times higher in one country than in another, the more attention the better. It's that we are sending the wrong people, or not enough of the right people.

What I've seen in the last ten years is that the people who really can make change happen are the leaders in the countries which want and need it most. Sometimes they do emerge from extreme poverty, but more often they are the next generation - educated, urban and passionately committed to saving the lives of their fellow girls and women. These are the people with the power to bring deep and lasting change in their own countries, rather than short-term fixes determined in London or New York.

The barriers between these inspirational people and the corridors of power are legion - money, language, visa restrictions, entrenched hierarchies to name a few. The barriers are institutional too, a legacy of our colonial past. I've heard UKAID people say in public meetings that there are no strong leaders in African countries. I've also been at global meetings where African and Asian colleagues were asked to stand up, be applauded - and then sit down again, while the usual suspects carried on their conversation on the panel. But when we do hear them the impact is profound (think Malala).

I've been fortunate to work with some of these leaders in recent years. Rose Mlay is a midwife in Tanzania who has brought 4,000 organizations and individuals together to speak with one voice to persuade the government to end maternal deaths. She has brushed aside remarks from Ministers ('what's all the fuss, just a few women dying...') to build a powerful coalition that recently had a 90-minute meeting with the prime minister. Since then, and for the first time in Tanzania, specific budgets have been allocated to make sure that women will get the C-sections and blood banks needed to save their lives in obstetric emergencies.

Another such leader is Tonte Ibraye, a young Nigerian man whose sister died recently after trying to save money by giving birth at home. He has spearheaded a campaign which has won the first ever national government commitment to make respect for women's rights and dignity during birth the norm - and in one state, communities are now working with officials and health workers to put 'respectful maternity care' into practice. A help line for women to 'break the silence' about the shocking treatment they get has just been launched. Similarly, Aparajita Gogoi has steadily built an alliance of many thousands in seven states of India to push the government to keep its promises in providing safe places for women to give birth. It is the relationships built over many years between the huge team of volunteers she leads and the often paranoid government hospital administrators which have enabled change to come via the constructive back and forth of suggestions and improvements, more suggestions and improvements...

Time and again I have seen how the actions of citizens, especially when funded and supported, really makes a lasting difference to the lives of women. The trouble is, these actions are rarely recognized, massively underfunded and often unsupported by the wealthy donors. The good news is that the numbers dying in childbirth have come down by half in recent years, but this is after decades of neglect. Fifteen years ago the global Big Cheeses set 2015 as the target date for the eight 'Millennium Development Goals' (MDGs), one of which was reducing deaths in childbirth by two thirds, and providing universal access to reproductive health. We have failed to meet it, and the death rate for mothers in many countries remains a global disgrace.

Now that the MDGs have reached their own sell-by date the goal posts are being moved. Instead we are going to have the SDGs, the 'Sustainable Development Goals'. Says who? What for? How? Teams of development pros have been meeting frantically since 2012 to hammer it out. An 'Open (sic) Working Group' has just come up with 169 targets and 17 Goals. Even the insiders are baffled.

This is why White Ribbon Alliance, a global network of advocates for maternal health, has created a tabloid newspaper called CITIZENS POST. Our bit of making the world better is through preventing the scandalous deaths of women in childbirth, and so in the run up to the great annual UN jamboree in September, we are calling on the prominent few at the helm of global health to make space for those who are doing exactly that in their own countries.

CITIZENS POST comes now because we have begun the 500 day countdown to the MDGs (Millennium Development Goals). The front page of the first edition of CITIZENS POST carries a mock police line-up of UN agency leaders. The headline is "The Return of the Usual Suspects... Citizens say 'move over' to UN speakers." The by-line is Rev Olution.
We'll soon see.

(Download CITIZENS POST second edition)

Follow #CitizensPost to find out if the global leaders at the UN make space for citizen leaders.