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I have a major assignment for one of my international public health subjects where I have to choose a public health issue that affects a “resource poor” country and basically write about it, and some programs that could help, etc. Anyways, I thought I might choose a country with a high rate of maternal deaths. A maternal death, you might be able to guess, is basically when a woman dies in childbirth, in the few weeks after childbirth relating to complications from the pregnancy, or whilst pregnant due to the pregnancy.
Today I was reading through the 2005 World Health Report, produced by the World Health Organisation entitled “Make every mother and child count”. In it I found some truly staggering information, which I have decided to share with you now.
Many of you will be aware of the Millennium Development Goals (MDGs) that were produced by the United Nations (i think…) as targets in many different areas, some of which pertain to health to be achieved by 2015. The fifth goal is as follows: “improve maternal health”.
This is broken down into two targets: Target 1: reduce by three quarters the maternal mortality ratio. Target 2: achieve universal access to reproductive health.
These are by no means easy targets, however sadly, not much progress has been made in the 20 years since the MDGs were set. According to the 2005 WHR, “Pregnancy and childbirth and their consequences are still the leading causes of death, disease and disability among women of reproductive age in developing countries – more than any other single health problem.” In 2005 an estimated 529 000 women were dying each year due to pregnancy and childbirth. In Australia, this figure is about 20 per year. In fact, maternal death is probably as close as we’ll come to eradicated from the western world.
The United Nations website suggests that the “high risk of dying in childbirth continues unabated in Sub-Saharan Africa and Southern Asia”, a suggestion which is backed up by WHO whose statistics show that in Africa the lifetime risk of maternal death is 1 in 16 (compared with 1 in 2800 in the West).
Another startling statistic is that of the 529 000 maternal deaths each year, 68 000 are due to unsafe abortions. That’s almost 13%. Women may be forced into having unsafe abortions when it is illegal in their country, and when they are unable to afford or access safe abortion clinics. I have a few thoughts on this. Personally, I do not support abortion as a practice, as I believe that new life begins at fertilisation. However, I certainly do not think that making abortion illegal is a good way to reduce abortions, and believe that unsafe abortions are one of the WORST outcomes possible. How is it that societies in our world can be so unsupportive of women with children that 68 000 women were willing to risk their own lives, and lose them, due to unsafe abortions? It’s just devastating.
Overall, I truly believe that if we can almost eradicate maternal death in the west, it should also be possible everywhere else in the world. The 529 000 women who die annually due to childbirth and pregnancy is a devastating and needless loss of life. In fact, if these women were able to access health care during and in the few weeks following childbirth, maybe they wouldn’t have died?
I would encourage you to read “Make every mother and child count” (WHR, 2005).
here’s an ethical question I’ve been pondering for the last two days. In public health, morbidity and mortality is often looked at in terms of “years of life lost” instead of “percent mortality”. (actually, gets more specific as is adjusted for disability, so you might hear about disability adjusted life years – DALY). The reason is because if you only look at percent mortality, you’ll find that heart disease is the number one killer. However, when you think about it, rarely does anyone under 60 die of heart disease. It’s referred to as a degenerative disease – as in, it occurs later in life as things start to break down.
So in public health, should you put resources into heart disease?? If you look at DALYs you find that things like HIV/AIDS and even depression are much higher up the list – mostly because these are diseases that affect young people.
My question is, is it okay to put different value judgements on people’s lives based on their age? Does it matter if a 4 year old dies of diarrhea, a 28 year old dies of HIV or an 84 year old dies of heart disease? In one sense I want to say that it’s right to focus on diseases that kill younger people, as the elderly are going to die anyway… but it doesn’t really sit right with me. And I wonder whether I’ll still be saying this when I’m 70??
So, I’m home again, and having neglected this blog for the second half of my trip (sorry) I have decided to start it up again. With a different twist.
Today was my first day of my new degree – a graduate diploma of International Public Health. What is this?? apart from a really long title… well, the international bit means that we study low to middle income countries, which can be anywhere really from Africa, South America, Eastern Europe, Asia (except South Korea, Japan, etc), Sub-continental Asia (ie India, Sri Lanka, Bangladesh, etc). And “public health” is mostly about health on a population level. For example, you might be looking at a particular disease (HIV/AIDS, tuberculosis, malaria) and implementing programs to combat that disease in a country or community.
The point, is that I think there are some really interesting facts and discussions that come up in international public health that are important for Christians to know and be thinking about. So, if you’re not interested in our brothers and sisters in poorer countries, then still read, cos this might help you become interested!! and if you are read and comment – it’s important to discuss these things!!
Today I learnt that in Malawi there is one doctor for every 91,000 people who live there. In Australia there is 1 doctor per 400 residents. The WHO’s position is:
“Every woman, man, youth and child has the human right to the highest attainable standard of physical and mental health, without discrimination of any kind. Enjoyment of the human right to health is vital to all aspects of a person’s life and well-being, and is crucial to the realization of many other fundamental human rights and freedoms.”
It’s really easy to agree with this position – yes, attaining health is a human right, no there shouldn’t be any discrimination. But there is.
It’s much less easy to do something about it. What can we do? All train as doctors and move to Malawi? It might be a start. However, truthfully there are aready some NGOs that are doing awesome work in international public health. Medicins sans frontiers, world vision and oxfam are the big three. Supporting their work (prayerfully/ financially) would also help!
In class today, we were discussing a book that suggested that a person who earns $100K should be donating $5K to the poor. This caused a great stir, “but $5000 is so much! too much!”
I suggested they should give away $50K, but it was taken as a joke. What do you think?
