Wednesday, September 23, 2009

NYT 'Half the Sky'

NYT "Half the Sky' Contest

“If you educate a girl, you educate a nation”, I read on the front of a school as we made our way out of the rural village in Zambia. I remember laughing at the irony. You see, I was well into my second month of traveling from one rural village to the next, assisting in the implementation of a maternal health program aimed at reducing maternal death from postpartum hemorrhaging with the simple drug misoprostol. I had met countless women since arriving in Zambia - incredible, courageous, intelligent women. But not educated.

At first they were too young to safely walk the long distances to school. Then they were too old to not be married. Somewhere along the way, the possibility for these girls to be something more than a mother was...just...forgotten. So there I was, deep into the Zambian bush, trying to safeguard the one thing they could hold onto - motherhood - using education as my only tool.

I will probably never view pregnancy and childbirth quite the same either. In the US, pregnant women ‘glow.’ They go to the doctor for regular checkups and pack a bag to prepare for the delivery - all well before the due date. In most of the rural areas I worked in, it is very surprising to see any woman above the age of 17 without a protruding belly and another child strapped on her back; no one asks these women how far along they were or if it was a girl or boy. If these women packed a bag, they were packing soap, clean cloths, and an umbilical clamp because these things are not provided by the health facility (however, most women don't get to pack bags at all. It is estimated that 50-75% of women in the rural communities don't even make it to a health facility. They give birth on a dirt floor, perhaps with someone to help if they are lucky).

Postpartum hemorrhaging (PPH) attributes to over one third of maternal deaths - a striking fact since PPH is such a basic complication of childbirth that it's practically unheard of in our world. The deciding factor? A drug called misoprostol that can be easily taken orally immediately after the birth to prevent PPH. For women delivering at home, having the equivalent of aspirin tablet in misoprostol is a life-saving factor.

My last site visit this summer was the weekly antenatal (pre-birth) clinic at the health center. Nearly thirty women were waiting to meet with Sister Hilda, the only trained provider, and I was told this was a "light" day. On average, Hilda will counsel 50 women a week. Now, thanks to the efforts of groups like Venture Strategies, misoprostol education is included in the antenatal sessions. Simply handing out tablets without the education would be pointless. Now, after their individual appointments and screenings, women are given the choice of taking Misoprostol home with them. An overwhelming number agree to do so, tucking the packet into the corner of their chitenge as they leave the facility.

As we seek to empower "half the sky," it's important to remember that it comes in many forms, and always starts with education itself.

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