The last time Faridah Luyiga Mwanje saw her sister Remie alive, she was preparing to give birth to her fourth child at a top private hospital in Kampala, Uganda. Remie bled to death as a consequence of delivery complications and because the hospital didn't have any blood on hand. When the announcement callings for donors to give B positive blood went out over hospital loudspeakers, it was already too late to save her. Remie's son survived, but has cerebral palsy. His therapies are demanding and expensive. Like his older siblings, he is now motherless.
Tragedies like Remie's are a too common occurrence in Uganda. Each day, 17 mothers die from pregnancy or birth-related complications and 106 newborns die, according to White Ribbon Alliance for Safe Motherhood. Following her sister's death, Faridah turned her grief into action and began campaigning with the White Ribbon Alliance, joining their "Act Now to Save Mothers" campaign. The essence of their work is to educate citizens about the right to health services for mothers, and then activate those citizens to demand governments keep the promises they have already made to the people. These often range from establishing rural health centers, to properly paying health workers, to ensuring medications are supplied, to keeping facilities in good repair and training health workers to treat mothers with kindness and respect.
Governments with the highest rates of mothers dying in childbirth or from pregnancy complications have all made commitments to improve as part of the Every Woman Every Child initiative but in many instances those commitments have not yet been met. In Uganda, the White Ribbon Alliance has focused on holding governments accountable for allocating sufficient funds to health centers. Faridah and her colleagues have brought together community members, district leaders and health workers around this issue and have seen tangible change arise from their actions.
Before Faridah and White Ribbon Alliance began their work in Uganda, many of the health centers had inadequate workers, and one of the regions did not have a single one of its 14 required doctors. Why? According to Faridah, "Facilities in those hospitals do not entice doctors to go there. They are dilapidated, there is no housing at the health facility so they travel so far. Health workers are underpaid and often wait several months to receive their salaries."
"We were able to show the community what the government's commitment was to their area -- 'look, this is what they said they would do' -- and the community has used this information to petition their government representatives. One district health committee went on fact-finding mission and decried the state of health care they found," she continued.
Working with citizens and health workers, White Ribbon Alliance focused attention on staff recruitment, motivation and retention issues for health workers. They were able to lobby the government to increase salaries by 13 to 18 percent across the whole country, including for midwives. Midwives are the lynch-pin for so much of the critical work being done to save mothers and newborns lives with emergency care, so including them in salary increases was an important step.
Because of the work of women like Faridah, there has been an increase in meaningful dialogue at meetings between health workers and the community. Previously, health workers would often ask for money or bark orders at patients. Thanks to increased dialogue, the community now understands that nurses and midwives are understaffed, underpaid and spend up to seven months without receiving salaries. "Many work alone with so many patients," explained Faridah. "They are only human and sometimes they 'lose it.'" Now each group has been able to explain the challenges they face to the other. Health workers have become more considerate, and the community is not as fearful because they know they are entitled to this healthcare. "
Faridah recently came to New York for the United Nations General Assembly in hopes of being heard by world leaders. "So many of us had barriers in getting visas, funding and language, but I came to talk for them who are doing whatever they can to bring about the change in their communities," she said. "I am calling on global leaders to invest in communities, to give citizens the information they need to demand better services. Health workers need training, support and good working conditions. District officials see things as priorities when citizens demand them."
"Community knowledge and demand is the fastest and most sustainable way to ensure change. We want global leaders to come and find out what our problems are. They have to ask us. We want them to give us a bigger voice." Faridah shared the stage with World Health Organization chief Margaret Chang and others to tell her story during UN week at the Accountability for Sustainable Results Leave no woman, child or adolescent behind event.
"None of us understand the true cost of a mother lost," she said. "Those lives are priceless. Only the widowers and orphans understand. They are deeply affected and will be for the rest of their lives."
This post first appeared on Global Moms Challenge.