Friday, March 5, 2010

Destined for death? Motherhood in Yemen a game of Russian roulette

A mother is the family’s spine. She is crucial for her family’s welfare because so much depend on her. In one-way or another, her wellbeing directly reflects upon the entire family’s wellbeing. Any damage experienced to her automatically affects her offspring and the family as a whole. The greater the attention that is given to a mother, the greater the chances are for her to have healthy and strong children. The stronger the children, the more stable and solid society will be. Investing all available and required health and social recourses into motherhood’s safety is unquestionably an investment in a nation’s wellbeing.

Around the world, every minute, a female dies during pregnancy or childbirth. 99 percent of these cases happen in developing countries. According to the World Health Organization’s 2006 report on global maternal mortality rates, Yemen women face frightening odds, as 570 of every 100,000 pregnancy is fatal. These numbers make Yemen’s mortality rate one of highest in the world.

The reasons behind the deaths vary from minor and indirect causes that are easily preventable to major and direct causes that require the provision of affordable health services.

The indirect causes typically stem from poverty, ignorance, social and economic deficiencies. These causes are demonstrated by the lack of attention young girls typically receive as they carry their own children, as well as the traditions that encourage early marriages and early pregnancy. Other certain unhealthy practices are based on false beliefs or superstitions, leading to mortality rates that are effortlessly preventable.

The direct causes stem from a poor health system and\or the poor care social and physical care females receive, especially within rural areas.

Considering motherhood’s importance and newborns’ vulnerability, the National Safe Motherhood Alliance (NSMA) in Yemen, a non-profit organization working between governmental institutions and NGOs, has been diligently striving since 2008 to tackle motherhood and children’s issues, specifically aiming to decrease the high rate of maternal and infant mortality rates in Yemen.

The NSMA in Yemen works closely with the White Ribbon Alliance (WRA), a nonpartisan, non-profit and non-governmental organization that aims to decrease maternal and newborn deaths globally. NSMA is one of 15 alliances working with the WRA. The 15 alliances are united together in implementing a common goal; they seek to ensure that pregnancy and childbirth are safe for all women and newborns in every country throughout the world.

After many initiatives, discussions and consultations among several parties, the alliance was launched on the 8th of March 2008, in parallel with the International Women’s Day celebration. Governmental and non-governmental institutions’ support constituted the alliance’s foundation.

Jamila al-Sharie, NSMA general secretary, explained the alliance’s main goals. “The alliance’s essential objective is to foster and cater safe motherhood issues. We aim to raise public awareness about the issues. In addition, we focus on communicating with government and non-governmental legislators in order to have more substantial results. We care about society’s participation, but we care more about organizational and governmental participation, as they are the ones who can directly influence change and improvement.”

Since the Alliance consists of governmental and civil foundations, it enjoys an essence that makes it unique. “NSMA is distinguished because we work in association with governmental bodies and NGOs to establish more effective and tangible results,” explained Afrah al-Qershi, NSMA executive director. Concrete members from both governmental and civil institutions form NSMA’s executive board. Fundamentally, NSAMA works to fill the gaps between all the divergent and separate efforts tackling motherhood issues. It focuses on brining fundamental changes to health matters related to motherhood.

Given the general health system’s statistics, drastic fundamental changes are required. “Yemen’s state budget allocates only 3% for the heath sector. Such a small percent is inadequate to cover all of the health care shortcomings. Moreover, there are laws making childbirth free of charge across the entire country, but unfortunately the funds are not enough to complete all of the tasks necessary. The laws have still not been implemented,” cautioned al-Qershi.

NSAM builds upon the capacity of the alliance’s members, encouraging education regarding the cause. It also has conducted awareness programs and projects to enhance public knowledge about the issue in several governorates. “We established committees to work with alliance members in a number of governorates, in order to coordinate with them for the smooth implementation of our work and activities in the future. Those governorates with committees so far are located in Amran, Lahj, Aden, Taiz and Ibb. We aim at establishing committees in all Yemen’s governorates,” said al-Sharie.

The issue’s magnitude necessitates more action to be taken. “70% of maternal deaths occur in rural areas due to many factors. Those areas lack basic health services, services that are crucial to a mother’s safety. Every day, seven women die in Yemen as a result of complications related pregnancy and childbirth. Having babies is not a disease! Something is fundamentally wrong and the issue must be immediately addressed,” added al-Sharie.

Decreasing the maternal mortality rate in Yemen requires combining many factors together, working hand in hand, to address the issue. It is extremely beneficial to have an ever-growing resource from which to pull funds, however, it is just as important to continue to raise public awareness among society about the importance of monitored pregnancy and childbirth. Statistically, most complications occur within rural areas, leading educational efforts to focus on rural citizens. “Just recently we had remarkable progress by conducting several awareness raising projects in a number of governorates by committed voluntary work. Our efforts facilitated a vast increase in awareness within rural areas,” said Dr. Rami al-Maqtari, DFID project officer at NSMA.

Nevertheless, NSMA is concerned as to how to coral all concerned organizations on these issues. There is a strong desire to have all concerned bodies work jointly in their efforts to solve the issue. Therefore, NSMA is developing a Consultancy Committee, consisting of governmental and civil bodies, as well as donors, to establish effective communication among all.

Since many parties are involved in tackling the issue, such as the government, civil society groups and international donors, a medium for harmonious cooperation between all is critical. “The fact that we work in close association between all the concerned parties allows us to aim at using this multi-support to good advantage by expanding our work, conducting training courses and carrying out raising awareness programs in the most targeted areas that lack attention. Those most targeted areas are rural areas, but not necessarily. Big cities also witness this issue as well,” added al-Qershi.

“It’s not fair to let women die just because they are pregnant or just because they are becoming mothers. Every woman, rich or poor, educated or uneducated, is entitled to live through pregnancy, childbirth and afterwards in safety, no matter what. Enlightened people have a responsibility to implement such realities,” concluded al-Sharie .