We’ve all heard it before in one form or another: “Don’t get between a mother and her baby,” “There is nothing better (or worse depending on your position!) than a fired up mom” or “Mothers are their kids’ best advocates. However you phrase it, I see evidence of this everywhere I go for my work as Save the Children’s CEO and, I guess, Mom-in-Chief. It plays out whether I’m in Washington, DC or Lexington, Kentucky or the Bekka Valley of Lebanon. And during my trip last week to rural Nepal, I saw it again in full force.
This blog first appeared in the Huffington Post
Giving birth ranks among the scariest moments for any mother. It certainly was for me. I was living in Hong Kong at the time when my second of three children was born. And he was born in a hurry. He came so fast that I actually thought I’d give birth in our car on the way to the hospital! Fortunately, that didn’t happen and I safely delivered my son Patrick surrounded by a team of well-trained doctors and nurses, not to mention my loving (and relieved!) husband by my side.
But I’m one of the lucky ones.
As new research released today by Save the Children reveals, 40 million women give birth without any trained help whatsoever. What’s more, 2 million women give birth entirely alone.
I met one
As world leaders gather this week to discuss the achievement of the Millennium Development Goals and the Post-2015 Framework, no subject of conversation will be more important than the need for more frontline health care workers. In the last two decades, the world has made tremendous progress in reducing child and maternal mortality, due in no small part to the contributions of the local health worker delivering lifesaving care. Millions of people in impoverished countries are alive today because a midwife was by their side when they gave birth, or they were vaccinated as infants by a nurse, or because their families learned from a community health worker to adopt healthy behaviors like breastfeeding, hand washing, birth spacing, and sleeping under a mosquito net.
I saw the lifesaving power of local health workers first-hand last month when I visited Save the Children’s programs in Pakistan, a country with some of the worst health indicators on the planet. According to our latest State of the World’s Mothers report, the lifetime risk of maternal death–the probability that a 15 year old woman will eventually die from a maternal cause–is 1 in 110 in Pakistan. Compare this to the United States, where it’s 1 in 2,400 and you see my point. Pakistan’s children aren’t any better than their moms. For every 1,000 children born, 72 of them will die before they reach the pivotal age of five, more than ten times the rate of their American counterparts.
But as harrowing as these statistics are, you would never know it from visiting the maternal and child health clinic in Haripur district. It is one of the most impressive facilities I have seen anywhere in the world at the primary care, or village, level. The spotlessly clean unit is staffed by two female doctors and several nursing staff as well as a pharmacist–all health care workers. A warehouse stocked with supplies is available on-site and the facility provides services 24/7 as needed. Women come here for prenatal visits, for family planning counseling and products, and to give birth in a simple, clean and safe facility with excellent care. Three women were in labor the day I visited and when I saw the care they received, I knew I would have felt comfortable having one of my own children there.
Unfortunately, not everyone in Pakistan–or the rest of the world for that matter–is as lucky to have a health worker in such close proximity. By some estimates, there is a shortage of at least 1 million frontline health workers in the developing world. And many existing health workers are not trained, equipped and supported to deliver basic lifesaving care close to the community. The consequence of failing to close this gap is grave. Every 3 seconds, a child’s death is prevented thanks to care provided by a frontline health worker. When a health worker is not accessible, the situation is, predictably, far less rosy.
The challenge for all of us in the business of saving mothers’ and children’s lives is to ensure that every person, no matter where they live in the world, is within reach of a health worker. We can–and should–start at the UN General Assembly, and continue the drumbeat at the Third Global Forum on Human Resources for Health in Recife, Brazil in November. But, it will take more than a few high-level meetings to make this a reality. That’s why Save the Children, in partnership with the Frontline Health Workers Coalition, created The REAL Awards, a first-of-its-kind, annual global awards platform designed to develop greater respect and appreciation for the lifesaving care that health workers provide in the U.S. and around the world. Anyone can take a few moments to nominate an inspiring health worker and help spread the word about the countless unsung heroes who go above and beyond the call of duty. It will make a REAL difference.
During my visit last week to see Save the Children’s work in Pakistan firsthand, I was able to introduce the launch of an important series of papers by the prestigious journal The Lancet, following up on initial research done in 2008 by Drs Robert Black and Zulfigar Bhutta. That original series first defined the link between malnutrition and child mortality, describing the impact that hunger and malnutrition has on a child’s ability to survive simple but dangerous diseases like pneumonia and diarrhea.
Establishing that link was an important scientific step for highlighting children’s urgent nutrition needs. This latest research expands further on the health impacts—and, importantly, the economic impacts—of malnutrition, particularly in the first 1000 days of a child’s life, from conception through age 2.
As I highlighted in my opening remarks at the official launch event, 45% of worldwide under 5 deaths have malnutrition as an underlying factor.
That statistic is shocking enough. But since more and more child deaths are occurring in the first few years when nutrition plays such a crucial role, that percentage is actually going up around the world. In Pakistan, 35% of under 5 mortality can be linked to malnutrition and 44% of children are stunted and suffering from chronic malnutrition and hunger—showing that an empty belly early on can decide
the course a child’s life.
Malnutrition is not just a health issue but a long-term issue for a country’s development. The studies in The Lancet show that, on average, a high rate of malnutrition can cause
As we sat and spoke with women at the counseling session on a warm day in Pakistan last week, it was clear to me that these women knew what they wanted—for themselves, for their families, and especially for their children. About 20 women, some in bright shalwar kamaz and others in dark burkas, sat under the shade next to a health facility. We discussed a topic important to millions of women the world over: how to build their families and plan for the future by thinking carefully about when to have children.
I was frankly surprised at the openness and candor of the women as I asked them sensitive questions about the decisions they make themselves and with their husbands, and the pros and cons of the available options. Pakistan remains a conservative society in many ways, but here the women demonstrated knowledge and understanding about the issue, and recognized how important it is to have the right to make reproductive decisions for their families. A mother’s choices have dramatic impact on the well-being of her children, which is why Save the Children works on the issue of family planning
with women around the world. For any mother, the health of her children—especially newborns—is affected by the age at which a mother first gives birth, adequate time between births, and the number of children she has.
This session was part of a comprehensive project Save the Children is implementing with the government in Haripur district, which rehabilitates health units to provide basic health services for pregnant mothers and newborns. The facility we visited earlier in the day is one of the most impressive facilities I have seen anywhere in the world at the primary care, or village, level. The spotlessly clean unit is staffed by two female doctors and several nursing staff as well as a pharmacist. A warehouse stocked with supplies is available on-site and the facility provides services 24/7 as needed. Women come here for prenatal visits, for family planning counseling and products, and to give birth in a simple, clean and safe facility with excellent care. Three women were in labor the day I visited and when I saw the care they received, I knew I would have felt comfortable having one of my own children there. In fact, in this district, almost 30% of mothers choose to give birth in the two primary care units that are part of this program. The other 71 facilities in the area account for about 60% of births and a small percentage of women go to district level hospitals. Clearly, many women in Haripur are choosing the quality and service they now find right in their own communities.
The challenge for our team in Pakistan now is how to expand our efforts beyond the two model centers, working with the government to implement the improvements we’ve made here across the entire district. We need to bring this effective model of health services to other poor communities where far too many children are still dying in the first critical month of life. If you would like to learn more about our maternal and newborn health programs, and the local health workers who are making a difference, please click here.
Early this month I took my first trip to Abuja, Nigeria. Despite visiting almost 60 countries with Save the Children, I had never been to the West African nation. It is a country of over 162 million, one of the most populous in the region and seventh most populous in the world. With an average family size of almost 7, it has the highest population growth in Africa-today, one out of every four inhabitants of the African continent is a Nigerian. While Nigeria may top the charts in these ways, it also unfortunately has the second-highest number of under-5 deaths. I wanted to understand about why so many children, and especially newborns, are dying in Nigeria.
The following blog first appeared on The Huffington Post.
Awards season is in full swing.
On Sunday night, Hollywood’s elite came together and celebrated last year’s accomplishments on the Big and Small screens at the 70th annual Golden Globe Awards. While millions from around the world tuned in and debated whether the most deserving winners were chosen, a smaller, but no less important, awards program was about to take place just a short drive south of the action.
The inaugural REAL Awards honorees were announced last night in Laguna Niguel, Calif., where nine U.S.-based health workers were named for their extraordinary service in health care. They may not be household names, but they matter enormously to the patients they serve. People like Carri Butcher, our winner in the hospice care category, who created a day spa at her own home in Arkansas for her dying patients so they could be treated to a little pampering before they passed. Or Esther Madudu, a midwife in rural Uganda, who is one of the nine global honorees we named last September. Esther’s clinic often has no power, so she delivers babies in the middle of the night by the light of her mobile phone screen.
The REAL Awards is a chance to shine the spotlight on the men and women who go to work every day to perform the greatest role of all — saving the lives of others. They may not grace the covers of magazines, but their work still deserves to be celebrated, especially since they’re needed now more than ever.
We’re currently experiencing a severe shortage of doctors in this country. While we can’t ignore this crisis, one way to address it, at least in the short term, is to rely more on other health workers — nurses, physician assistants, nurse practitioners, community health workers, pharmacists — to perform the tasks that don’t require a doctor, as a recent New York Times editorial suggests.
No one knows the importance of health workers more than those in the developing world, where the dearth of doctors is even more stark. By some estimates, the world is short more than millions of health workers, including one million frontline health workers, who deliver care in some of the hardest-to-reach communities, oftentimes with limited resources. In fact, frontline health workers are the first — and often, only — point of contact to the health care system for millions of people.
Their role is invaluable. It is estimated that every three seconds, a child death is prevented thanks to care provided by a
December 12, 2012
During my last visit to Chandreshwori Primary School in Pyuthan, a Sponsorship Impact Area in western Nepal, I met Rebati. With her welcoming smile, Rebati works at the school and is very popular among the teachers and students.
I was interested in talking with Rebati after learning that her son, Bikash, is enrolled in the sponsorship program and attend she schools Early Childhood Care and Development (ECCD) Center. Rebati told me that Bikash has already received two letters from his sponsor and happily shares the sponsor’s name, though the foreign pronunciation was difficult for her, and what they had written.
33 year-old Rebati left her studies while she was still in the 10th Grade. She lives with her mother-in-law and two sons, while her husband of seven years works in India as a watchman.
Her duties at the school include cleaning, serving tea and water to the teachers and students and ringing the bell for the lessons. She also often goes to the local Save the Children field office to collect sponsors letters, medicines and materials.
She has been trained by Save the Children in health and sanitation and is happy to see the changes in the school as a result of the sponsorship programs; better classroom management, an ECCD center and improvements in teachers from the trainings. Children also receive regular health care, stationery and study in a child friendly environment.
Some of Rebati’s neighbors look down on her work at the school, but it has no impact on her. She proudly states, “I feel very happy when children call me aunty and I see them growing up with good education.” She says she wants to work in the school as long as her health allows her to.
When asked about her hopes for the future, she shares, “I want my boys to complete their schooling, study medicine, and become doctors or medical assistants. I always dreamt of becoming a nurse and serving sick people.” She is very grateful to Save the Children for our sponsorship program and for giving hope to many mothers like her.
Interested in joining our community of sponsors? Click here to find out more.
I spent last week at the Clinton Global Initiative and the UN General Assembly meetings in New York. There was much talking about issues of international development, about the rights of children to an education, about stopping children dying from preventable things like pneumonia, about making sure that the world is free from hunger. But in the midst of all this talking, I noticed that there was simply not enough of one thing—not enough shouting. We need louder voices to make changes on what really needs to be done for poor children and families around the world. Simply put, we need more people to care and speak out. Loudly.
The following blog first appeared on The Huffington Post.
Can the sound of a child’s heartbeat inspire the world to save children’s lives? Can it inspire you? Children’s heartbeats recorded in Malawi and Guatemala inspired the band OneRepublic to write a song with a beat like no other. If “Feel Again” grabs you enough to download it, you can help save children’s lives.
The song provides the soundtrack to Save the Children’s new Every Beat Matters campaign. The aim is to raise awareness about the millions of children around the world who die needlessly before their 5thbirthday, and what can be done to save them. The timing is right for this campaign launch, and not just because it’s Infant Mortality Awareness month. Yesterday, the United Nations released their latest child mortality estimates, which show — for the first time — that child deaths have fallen below 7 million per year. While this figure is still far too high, it reflects the tremendous progress the world has made in reducing preventable child deaths. We can and must now finish the job.