Human Rights Issues in the News

by Arnold Winkleried

© Amnesty International, used with permission

One of the issues the United Nations emphasizes in their Millennium Development Goals is maternal health. Their first target is to reduce the worldwide maternal mortality ratio by three quarters. According to 2005 estimates, a woman dies every minute of complications related to pregnancy and childbirth. This adds up to more than 500,000 women annually, or 10 million women per generation. Virtually all — 99 percent — of these women live and die in developing countries.

Comparison of risks of dying from treatable or preventable complications of pregnancy and childbirth over the course of a lifetime
Sweden	1 in 17,400
Developed regions	1 in 7,300
USA	1 in 6,623
Sub-Saharan Africa	1 in 22
Niger	1 in 7

The vast majority of maternal deaths can be prevented. More than 80 percent of maternal deaths worldwide are due to five direct causes: hemorrhage, sepsis, unsafe abortion, obstructed labor, and hypertensive disease of pregnancy. In about 21 percent of the cases, women die as a result of severe bleeding. May parts of the world (including northern Africa, Latin America, the Caribbean, and southeast Asia) have succeeded in reducing their maternal mortality ratio by about a third between 1990 and 2005. In sub-Saharan Africa — the region with the highest level of maternal mortality — there has been little to no progress.

One area where the situation is particularly bad is Sierra Leone, on the west coast of Africa. In its current report on Maternal Mortality in Sierra Leone, Out of Reach: The Cost of Maternal Health Care in Sierra Leone (Index: AFR 51/005/2009), Amnesty International describes the issues that pregnant women face there. The three most important are:

1. 1: Lack of information on symptoms of life-threatening complications. This lack of information can cause delay in seeking medical care.
2. 2: Lack of access to medical clinics, due to distances involved and cost of transport.
3. 3: Lack of availability of medical help, which can lead to additional delays even after treatment is sought. The lack of availability can result from insufficiencies in trained staff, electricity, clean water, and medical supplies, and from policies of only offering treatment after the patient has paid for that treatment in advance.

The primary direct causes of maternal death in Sierra Leone are due to complications that are overwhelmingly treatable, such as obstructed labor and hemorrhage. Fewer than half of deliveries have a skilled attendant. Fewer than one in five is carried out in a health facility. Six of the country’s thirteen districts have no emergency obstetric care at all.

International donors active in Sierra Leone are willing to support the government in removing financial barriers, but are reluctant because of widespread mismanagement and corruption. President Ernest Koroma had made it a priority to deal with corruption in the Ministry of Health. In 2008 the government announced a Reproductive and Child Health Strategic Plan to reduce the 2005 maternal and infant mortality rates by 30 percent by 2015.

What can I do to help?

Amnesty International asks you to take action now by writing a letter to the president of Sierra Leone. Let him know that people worldwide consider this issue to be a health and human rights crisis, and that he should honor his campaign goals of reducing maternal mortality.

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To learn more about Amnesty International and their work promoting human rights, visit them online at amnesty.org