Sierra Leone and Ethiopia: Maternal Mortality by Jan Grarup (50 images)

View: 100 | All

They give birth like women have done for thousands of years: alone and in excruciating pain. 350 000 mothers die every year in pregnancy or childbirth. Most of them lose their lives in countries that cannot even provide basic health care like drugs to stop bleeding after delivery or emergency cesearean sections. In Sierra Leone, for example, only four gynaecologists work to save the lives of women in the whole country of almost six million people. One in eight mothers die while giving birth.

Here, it is up to women like Rugiatu Turay to take the initiative. Turay, 35, is the founder of the Amazonian Initiative Movement based in Lunsar, a small mining town east of the capital Freetown. With her members, she goes into villages where women have never seen a doctor and tries to convince them to go to the nearest health centre. Drugs and medical advice is free for pregnant women in Sierra Leone since 2010. But still, most women give birth in their huts, only assisted by traditional birth attendants who often are the same women who are responsible for the ritual of female genital mutilation.

"We only ever see the survivors", says Dr Catherine Hamlin, an Australian gynaecologist and pioneer in helping women with birth injuries. She has founded the Hamlin Fistula Hospital in Addis Abeba. In Ethiopia alone, more than 100.000 women suffer from fistulae, holes between vagina and bladder or rectum that develop after a baby's head has been pressing on the tissue for too long during birth. The following incontinence turns the women into pariahs. They are shunned by village and often their husbands too. To reach out to women in the farthest corners of Ethiopia, the Hamlin Trust has opened a further five outreach hospitals. Here, women can get help for fistula - and can also come back when they are pregnant again. With this help and with a dedicated government program of training midwives, Ethiopia was able to lower its maternal mortality rate by almost half in three decades.
« less