Fri, Oct 06, 2006 - Page 9 News List

Same world, yet worlds apart for giving birth

For mothers in Niger, giving birth to a child is a leap of faith, as they get precious little support from husbands or the healthcare system. The contrast with what's going on in Sweden couldn't be starker

By Joanna Moorhead  /  THE GUARDIAN , LONDON

"If we could raise awareness of some of the health issues, we could save many lives," she says. "Women need to know about the danger signs in pregnancy. They need to know when to seek medical help. They need to know how important it is to get help in labour if things aren't progressing, rather than leaving it too late. And they need to know how to look after their newborns and when to take them to the health center."

In Zinder, Dr Antoinette Awaya, of Save the Children, is putting some of these measures into practice. She runs a health education program, running training courses for volunteer health workers. The volunteers learn basic information about healthcare, hygiene and feeding babies, and pass it on to other mothers in their village.

"Saving mothers' and babies' lives here needn't be expensive," she says. "There's so much that can be done through education."

"Breastfeeding, for example, saves many babies: but the tradition here is that mothers don't give colostrum, the first milk, because it looks yellow and they think it's bad," Awaya says.

"Once you get the message across that this is the best milk, that it can protect their babies from disease, they get on with it and give it: it's not that mothers are resistant to the things that could make a difference, it's that the messages aren't getting through,"she says.

Beyond education, there are other ways of using limited amounts of money to the best possible advantage. Immunizing pregnant women against tetanus, for example, protects both mothers and babies and is one of the most effective and least expensive vaccines on the planet. Treating pregnant women for malaria, which is endemic in most parts of Niger, can reduce the risk of prematurity and low birthweight by 40 percent.

Providing postnatal support costs about half the amount of providing care during birth itself, but has the potential to reduce newborn mortality by between 20 and 40 percent.

So, while there is much to be done, there are clearly cost-effective priorities. Until now, says Save the Children, child survival programs in places such as Niger have tended to concentrate on diarrhea and other vaccine-preventable diseases. What is needed now is an emphasis on preventing deaths in babies, especially those in the early days and weeks of life.

On my final day in Zinder I am at a rural health clinic. Suddenly, there is a flurry of noise and commotion: a woman is running towards us, a baby in her arms. Even from a distance you can see that this is a child in trouble.

The nurse gets up, runs over, takes the baby and disappears into a dark little consulting room. He shouts to the mother, a bit roughly, to stay out of the way. She stands at the door moaning, craning her neck, trying to look into the room to see her baby, to find out what the nurse is doing to him.

But her baby is not all right. The nurse says he is tres grave: his only hope is the Medecins Sans Frontieres hospital 20km away. The mother is lucky, as there is a Save the Children car here. She and the child are bundled in, her face contorted in panic, the baby's contorted in pain.

This, then, is what infant mortality in Africa looks like when you get close up. This is how it happens. This is how it ends.

And it does end, for this baby, about an hour later. He makes it to the hospital, but dies soon after being admitted. He had an infection. He was just four months old.

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