Saving Mothers

Today, I’m writing to invite you to a special event coming up next month. It’s the Saving Mothers annual benefit!

What: The Saving Mothers Annual Benefit — a night of food, fun and entertainment in support of Saving Mothers. There will be a silent auction, and all proceeds from the event will go toward our ongoing health programs in Guatemala and Liberia.

When: June 28, 2011 @ 7-9:30 p.m. EST

Where: The Mason Jar, 43 E. 30th, New York City

Tickets are $40 if you buy ahead online, or $50 at the door. If you’re a Saving Mothers member, tickets are $35. Two drinks free with admission!

If you’re in the New York metro area, come support Saving Mothers next month! We look forward to seeing you there.

Contestants were asked to address a key issue related to high maternal mortality rates and to submit a short video on their ideas. The winners receive $10,000 and the opportunity to present in front of the Consortium of Universities for Global Health.

The winners were announced last week: three graduate students from Johns Hopkins School of Engineering: Sean Monable, Maxim Budyansky, and Matthew Means. Their submission was a pen-like device that screens preganant women and children for conditions like gestational diabetes and anemia. The device would be ideal for use in the developing world, given its simplicity and the fact that it costs less than half a cent per test.

The device works like this: a health care worker uses the pen to mark a strip of paper, which he/she gives to a pregnant woman. The pregnant woman urinates on the strip — very similar to taking a home pregnancy test — and the strip changes color to indicate a positive result. There are different pens for different conditions, including gestational diabetes, pre-eclampsia, and anemia. According to ABC, pre-eclampsia and eclampsia account for 76,000 maternal deaths and 500,000 infant deaths per year. Current means of detection are far too expensive to be widely utilized in the developing world.

Congratulations to the winning team, and to everyone who submitted videos suggesting ways to improve conditions for women and children around the world!

It’s inspiring to see university students dedicating themselves to such an important cause and coming up with innovative solutions. Check this out to read a little bit more about the winners and their device. In the meantime, I’ll be looking around online for some of the videos made by contestants to share with you here at Saving Mothers.

Happy Monday!

It’s no secret that we’re big fans of Nicholas Kristof here at Saving Mothers. Over the years, he has done an amazing job of bringing attention to key pubic health issues around the globe.

For Mother’s Day, Kristof wrote a poignant piece for the New York Times titled “Mothers We Could Save.” The article uses the example of Hinda Hassan, a woman in Somaliland — a mother of eight who died giving birth to her ninth child. The birth attendants were ill equipped for her difficult labor, and after many hours and several transfers between facilities, she died. 

It’s a tragic story, but not an uncommon one. There are many things that went wrong in this scenario — the lack of training on the part of the birth attendants, the lack of proper equipment, etc. But Kristof highlights one key element: the lack of access to contraception for women like Hinda Hassan.

Kristof discusses the importance, not only of increasing the contraceptive options available to women in resource-poor settings, but of moving beyond their availability to their acceptance and usage. Improving conditions for mothers and children is a different challenge in Africa than it is in the U.S. Kristof urges discussion of these differences, encouraging his readers to understand the complexity of improving public health in this region and drawing attention to how far we still have to go to to win the battle against maternal mortality.

It’s a pretty important message to share on Mother’s Day. Thanks again, Mr. Kristof.

So remember to celebrate your mother with a special card from Saving Mothers! Today is the last day to purchase physical cards (we’ll be selling electronic cards up until the weekend) Visit our website to read about the details and buy your card today!

Last week, I read an article about Mama: Together for Safe Births in Crises, a new type of social media tool developed by the Women’s Refugee Commission and M4ID to connect maternal health practitioners in areas affected by crises to other healthcare providers and experts using Facebook and text messaging. The overarching goal is to save the lives of women in conflict and post-conflict settings through faster, easier health information exchange.

Why the focus on women in crisis? One simple reason: care is that much more difficult to access during times of war or natural disasters, and in their aftermath. Pregnant women are incredibly vulnerable in these situations. 

Many maternal health practitioners lack adequate training or the necessary tools to aid women through difficult labors. But amazingly, most do have access to the internet, which makes a social networking tool potentially invaluable in providing key health information. Through Mama’s service, health care providers can post questions on the the Mama Facebook page and receive answers to their pressing questions immediately.

This service is new, and its effectiveness is still uncertain, but it is definitely an innovative way to improve the quality of maternal care worldwide. The use of social media to improve health care is still being explored, and I for one will be very interested to see how tools like Mama use Facebook to help health care providers reduce maternal morbidity and mortality.

Additional reading:

Using Social Media to Save Women’s Lives, Huffington Post

Mama: Together for Safe Births in Crises - Saving Women’s Lives through Social Media, Care2.com

This week, Saving Mothers is kicking off our annual Mother’s Day Campaign to raise funds to support its ongoing maternal health initiatives around the world.  

It works like this:

1) You decide that you’d like to send your fantastic mom a special Mother’s Day card, making a $25 donation in her name to Saving Mothers

2) You visit the Saving Mothers website to fill out the relevant information

3) Your mother receives her card on May 8th (either electronically or in the mail, according to your preference). Happy Mother’s Day!

And that’s it! A simple way to show appreciation for your awesome mom while making a meaningful contribution to maternal healthcare.

Today, Melinda Gates wrote an article for the Huffington Post about breaking the silence around stillbirths — defined as the death of a baby at 28 weeks gestation or more. Maternal, neonatal and child health is one of the key priorities established by the Gates Foundation.

In her article, Gates highlights the ongoing and underexposed issue of women giving birth to stillborn babies. About 2.6 million stillbirths occur each year, and nearly 50% occur after the mother has gone into labor. According to Gates, we can and should do a better job of providing care for these mothers and their unborn children.

Gates points to the Lancet Stillbirth Series, a new collection of reports and findings made by scientists and experts in the field of maternal and neonatal care.

Take a minute and check out their website for further reading on the challenge of reducing stillbirths around the world — it’s a key issue that hasn’t received the attention it deserves. Let’s hope that, thanks people like Melinda Gates, that can change.

This is the fourth update from Kiran Chawla, an OBGYN volunteering with Saving Mothers in Liberia.

As much as helping patients makes my heart soar — it was the teaching I did today that made me smile from cheek to cheek.

Post-call and running on EMPTY, the day started as each day starts here with rounding on the patients. But today marked the beginning of a new routine: my daily AM sonogram lessons. The attendings are learning AND enjoying it.

I taught Meszenzai, I taught Swaray, and the faces of these men changed. The possible management implications — how to approach a myomectomy, how to handle ovarian masses, etc. They were like kids in a candy store, just wanting more and more and more. And all I wanted to do was give and give and give. It was wonderful.

Emily was adorable… she worked with the midwives sheltering me on my post-call day. Calling Jallah for the active issues… hoping that I could go home and rest. But my drive to want to do more, to push for more, to make my time here fruitful made me stay.

We headed to lunch early, hoping to meet Dr. Johnson, but our meeting was cancelled last minute. Instead, we met Pastor Peter and Pastor Sam. The trip to Bong was settled, the details settled soundly as only they can in Liberia. It was exciting, we were going to meet, teach and spend time with the midwives, the true traditional birth attendants.

Then I was off to teach the PA students about normal labor and the 3 P’s. They were impressive and knew the anatomy very well. Application is where they faltered. 

When I returned to the hospital, our septic patient was worse… Dr. Jallah and I decided to operate to remove the infection and the uterus. But we needed clearance from the “The Bossman.” So, I scanned her, the pus was up to her liver and spleen. Dr. Jallah called Dr. Johnson while the patient waited gasping.

To occupy myself while I waited to operate, I went to visit Catarina, Prince and the boys, Charlie and Leo. We ate, we laughed, we just caught up… It was wonderfully perfect. They are my dream. They are the life I want with Ian. Happily married partners. Equal, loving, and joyful. They have sacrificed so much, but it is seemingly worth it. They exude happiness… How I love to be around it.

The call came at 11 p.m. The procedure was approved and the OR was ready. The pus was rancid — it was everywhere, just pouring out of her. The uterus was yellow and ‘sour.’ The hysterectomy was hard, the tissue was poor… I was praying to Waheguru (God) that she would make it. Jallah was grateful we did it together and I was grateful for the ability to help.

Tomorrow, I will train the TBAs — the change of scenery is much needed.

The day started so beautifully. Teaching.

The ultrasound machine is really nice — transvaginal probe, abdominal probe, color Doppler, power Doppler — but no one knows how to use it. Well, none of the active attendings do.

So Dr. Jallah, Dr. Wong and I lined up the patients… one by one, patient by patient, and we scanned them. Every patient got a full gynecological scan: abdominal probe of the pelvis and kidneys, transvaginal probe of the uterus and adnexa. Each image labeled, each structure measured. Knob-ology reviewed. From start to finish, they LOVED it. I was so very happy.

The lessons continued with Dr. Meszenzai and Dr. Swaray. They were flustered and annoyed with the images and the tedious nature of it all, but they seemed to understand the basics — at least they were intrigued enough to say they want to learn more tomorrow.

Then as the day ended, my first night on call began. The count: 3 ceseareans, 1 vacuum, and an EOU.

During the night, I pushed the partograph, I demanded NO episiotomy. I resuscitated baby after baby just hoping they would gain the knowledge for the next time, because for this child… it was too late.

As the night went on, I only wished my time here was more constant, more regular, and that I had more ability to help.

This is the second blog post from Kiran Chalwa, an OBGYN working with Saving Mothers in Liberia.

My first day gone… Oh what a long long day. I feel like I have been here for a week.

I delivered one baby via c-section, did rounds with the gynecology patients, taught the doctors some ultrasound techniques, and saw plenty of patients in the OPD (outpatient department).

The work is hard and plentiful, but so very rewarding.

I see so many gaps in the health care that is provided here. I want to make it better and to take better care of the patients.

My first c-section was perfect. My patient walked up to the delivery table after being in labor for days… her spinal went in, I scrubbed in and MAGIC: crying, screaming, pink and naughty ‘bebe’ — a ‘bebe’ that would not dilate the cervix, and not deliver vaginally.

But in the end… PERFECTION — a healthy baby and mom.

This is the first post from Kiran Chawla, an OBGYN currently working for Saving Mothers in Liberia. Kiran will be sending us updates about her work in the field, so stay tuned.

Each time coming here is so different but so the same. I am so excited — the work, the people, my friends… everything & all of it. I can’t wait to walk the streets, eat the food and enjoy each moment of it all. The ride from the airport is so wonderful — seeing the futbol games, the new homes, the children playing on the side of the road, families coming from church…girls selling Plums (mangos), corn, cucumbers…

Children selling peanuts, & fuel… Wedding parties taking photos, couples flirting, people living. It is all so awesome to see and be apart of it all again. I cannot wait for the work, to help the people…I am so exceptionally excited.

“More than a million mothers and newborn babies are dying each year from easily prevented birth complications.”

What really gets to me here is the “easily prevented” part.

It’s too easy for me to believe that our world is a cruel place. It only takes looking at events like the recent earthquake and tsunami in Japan to realize that, in spite of our best efforts, many things are out of our control. But maternal mortality is often something we can control, but it still evades our grasp.

With all of the advances — social, scientific, etc.— that we have made in the modern world, there is no reason that over a million women and children should be dying from easily preventable birth complications.

It always seemed devastating to me that women and children could die — would die — because they didn’t have access to basic care. One of the reasons I got involved with Saving Mothers was because of this idea that there are relatively easy solutions for serious health issues — and that providing basic things, like clean water or inexpensive medicines, can make a huge difference in the lives of many.

A recent report from the organization Save the Children highlights the tragedy of this situation in the developing world. In a Reuters review, the reporter stated that “midwives trained in just eight procedures, including keeping newborns warm and fed, could immediately cut newborn deaths by more than a third in the 68 countries with the worst neonatal mortality rates.” There’s a clear solution here: educate midwives and give them incentive to work in the places where they are needed.

Of course, that’s easier said than done. How do you actually get these services to the people who need them most? It’s a complex and fascinating question. One that Saving Mothers is striving to answer.

Coming up soon, we will be sharing more posts from the field from OBGYN Kirin Chawla. Kirin is currently in Liberia and will be chronicling her volunteer experience with Saving Mothers.

More food for thought: A lovely piece on NPR about a midwife working in Afghanistan.

Over the weekend, I read an article in the Huffington Post by Christy Turlington discussing maternal health legislation in the US. Most people probably know Christy Turlington as a supermodel, but she’s also the founder of the organization Every Mother Counts and directed/produced a documentary on maternal mortality entitled “No Woman, No Cry.” Ms. Turlington is currently touring the US screening her film and her article in the Huffington Post deals with the issue of maternal mortality in the US, specifically with the introduction of H.R. 894.

Earlier this month, U.S. Representative John Conyers, Jr. (D-Michigan) introduced H.R. 894, the Maternal Health Accountability Act of 2011. The bill would provide grants to states intented to improve maternal health and data collection on mortality rates. As a condition of receiving grants, States would be required to:

• Require health professionals and facilities to report pregnancy-related deaths
• Investigate and develop case findings and summaries for each occurence
• Establish review committees with ob-gyns, nurses, social workers, health care facility representatives and other relevant stakeholders to recommend prevention strategies
• Disseminate findings and recommendations

Additionally, the Department of Health and Human Services (HHS) would be required to:

• Research disparities in maternal care, risks, and outcomes, and improve the capacity of the performance measures to measure disparities
• Expand access to services that have been demonstrated to improve the quality and outcomes of maternal care for vulnerable populations
• Compare the effectiveness of various interventions to reduce maternal health disparities

It’s important legislation, but it remains to be seen whether the House has an appetite for taking on this kind of project in the current political environment. The issue of maternal mortality in the U.S. is below the radar for most Americans, which adds to the challenge of pushing a bill like this through. So it’s nice to see someone as visible as Christy Turlington championing the cause. Looking forward to seeing her full film when it’s released later this spring.

Have you heard of Lynsey Addario?

I hadn’t, until just this past week. Lynsey Addario was one of the four American journalists working for the New York Times who was kidnapped and held hostage in Libya for six days by forces loyal to Colonel Qaddafi. It’s a pretty harrowing story, and it’s pretty incredible that all four journalists finally made it home to safety (you can read their account here). Anyway, today a friend sent me an article in Jezebel talking about Lynsey, who was the only woman journalist to be captured, and it piqued my interest. It turns out she’s a pretty amazing woman. With no previous experience, Lynsey began taking photographs professionally in the mid ’90s, focused on humanitarian issues. Since then, she has made a name for herself as a photojournalist, covering conflicts in Darfur, Congo, Afghanistan, and Iraq, as well as shooting features in many other countries. She has won a Pulitzer prize and a MacArthur fellowship.

It’s kind of shocking how accomplished this woman is.

Anyway, she has a wonderful website that gives an idea for the flavor of her work. In particular, I was drawn to her series of photos of Mama Seesay, a young woman from Sierra Leone who died from a post-partum hemorrhage. The series is entitled “Maternal Mortality in Sierra Leone: One Woman’s tale of Dying to Give Birth.” The pictures are beautifully taken and deeply sad. Sierra Leone has an average of 900 maternal deaths per 100,00 live births (compare to roughly 11 per 100,000 in the US) and seeing photographs like this really brings this message home.

It’s wonderful that someone as gifted as Lynsey is bringing attention to the issue. So check out the pictures. Tell us what you think.