Rallying for Safer Motherhood

This is the 1st time that I’ve participated in a Safe Motherhood event that featured a clown wearing stilts.
We drove out to Karatu in the Arusha Region more than 3 hours away from Moshi. We went with Mackrine Shao, Regional Coordinator for the White Ribbon Alliance (WRA). The International WRA has gained a lot of positive attention, with celebrity and political endorsements (Sarah Brown, wife of England’s prime minister Gordon Brown, is WRA’s patron, and names associated with WRA events include Melinda Gates, congresspeople and actresses). WRA-Tanzania, I’m proud to say, is quite an energetic national association.
Mrs. Shao is the epitome of a dynamic activist who seems to thrive on the sorts of political and community outreach that takes legwork.
Literally.
One Saturday morning in Karatu we celebrated Safe Motherhood Day. Although Safe Motherhood was celebrated on April 23 in other regions of Tanzania, Mrs. Shao had to postpone this region’s celebration until the District and Regional offices were ready to participate. The initial small group of participants met at the health clinic in high spirits. There were students from a youth band, a dozen NGO volunteers, our family, Mackrine and Kate (a visiting MPH student) who started the approximately 5 km rally through Karatu. By the end, we had about 100 students, 20 townsfolk, the District Medical Officer, the District Assistant Secretary (guest of honor), a theatre group, acrobat troupe, and the man on stilts.
There were a few speeches interspersed between informative entertainment. In a village where maternal and newborn death is a common tragedy, it was interesting to see the topic brought to attention with humor and honesty. Most such events in the U.S., where maternal mortality is rare (11 per 100,000 live births) are filled with powerpoint presentations, earnest lectures, and an aura of sadness.
In Tanzania, the maternal mortality statistics range from 578 deaths per 100,000 live births (Tanzania Demographic and Health Survey) to 950 deaths per 100,000 births (WHO). However, tracking maternal (and newborn) deaths is incredibly difficult- considering that about 53% of women deliver at home, with a traditional birth attendant or a relative, there are many uncounted deaths. If a woman dies on the way to the hospital, her death is not counted by the hospital. The village council is supposed to keep track of deaths and births for each village but it depends on the village, we are told. Frequently, a woman who dies from a postpartum endometritis 2 weeks after delivering is not counted among the maternal deaths.
The KCMC-Duke Women’s Health Collaboration contributed with a demonstration of emergency obstetric techniques. First, Mackrine had to reassure us that we could bring out our anatomically correct demonstration mannequins including a female pelvis and a newborn. We wanted to emphasize to the crowd the importance of delivering with a skilled health worker. Of course, we are just figuring out which health workers are actually skilled in emergency obstetrics- but women still have better odds of getting help with complications if they deliver at a health facility rather than at home. (The argument women give is that the health facilities are so understaffed and undersupplied, they would rather deliver at home knowing that there are no supplies or skilled workers, rather than travel great distances and pay money they can’t afford to deliver in similar circumstances).
To the great delight of the clapping crowd, we safely delivered the baby through the pelvis. Then the women volunteers took the newborn, wrapped in a kanga, and performed a celebratory dance around the stage to the music of the band. The man on stilts disappeared sometime during the presentations, and I don’t’ know if he was from the band, the acrobat troupe or the theatre group. However, he wasn’t needed to keep the crowd interested. After a long morning of speeches, skits, dances, and demonstrations, the rally ended quietly with many thank you’s passed around. By 2 pm, we had packed up our car for the 3 hour drive back to Moshi. Hopefully the rally made an impression on the women watching like it made on us.

I would love to download pictures and video from the day, but I will have to wait until our internet connection is able to handle it.