March 8: International Women's Day

Today is International Women's Day. (Dear male readers: please do not groan, "Why do we not get an international men's day?" Every other day is men's day.) The 100th International Women's Day, to be specific.

A day to honor the important role women have in each of our lives, our society, our world. A day to remind ourselves to help those women who continue to be oppressed, be it by culture, family, poverty, lack of opportunity.

And for us, a day to speak out against maternal death, which exacts a staggering toll on women's lives -- an estimated 500,000 deaths a year. Deaths due to antepartum & postpartum hemorrhage, infection, pre-eclampsia/eclampsia, not to mention unsafe abortions.. the list goes on.

Sumera with the organizer of the event

Our posters advocating for the government to invest into Emergency Obstetrics

The Tanzania chapter of the White Ribbon Alliance for Safe Motherhood, an international NGO dedicated to safe pregnancy and childbirth, organized a rally to raise awareness about women's health and women's rights, in nearby Arusha. Hundreds of women (and men, though mostly women) marched through Arusha before gathering in the football stadium to deliver performances and skits, showcase traditional dances, and listen to both invigorating and sobering speeches by various governmental officials and personal testimonials from those touched by maternal diseases, including a man who lost his wife to PPH.

As the only health care providers partaking in the program, our group, the KCMC-Duke Collaboration, chose to focus our time in the spotlight on post-partum hemorrhage, the #1 cause of maternal death in Tanzania. PPH has a multitude of causes (I can spare you the details), but what's important to know is that many of the causes can easily be addressed with simple interventions AND critical knowledge on emergency obstetrics. Because 54% of Tanzanian women have home births (due to distance to a health-care facility and cost of delivering there), we started our skit with a traditional birth attendant (as interpreted by our fantastic Head of Labor Ward, Sister Meleo) lamenting the death of a mama whose flowing blood she could not stanch -- because the evil spirits wanted the mama to die. Sumera and I played wailing relatives -- our lines consisted of "he!", "nini??" (which means what?!?!) and "uuuuuuu-wiiiii" (which is a very typical Swahili wail) -- while Bariki and Sister Dora (midwife extraordinaire and ringleader of roleplays) played the angry husband and despairing mother of the dead patient, respectively.

Very intense, I know -- I'll confess the death scene was my contribution to conceiving our skit -- but important to showcase honestly how suddenly death happens and how, with the very same mama in the next scenario, management by a midwife (played by Dora) trained in emergency obstetrics leads to an efficient, skillful resuscitation and a mama who lives to take care of not only this new mtoto (baby), but also her many watoto at home. (And hey, it worked, because our entire presentation is to be on Tanzanian TV!!)

Dora concluded our role-play with a touching speech reminding all of us to think of all the mothers who die (needlessly), consequently the motherless children, and how emergency obstetrics training is a necessity for all Tanzanian health care providers.

It was a wonderful day for all of us, and for me, renewed my commitment to continue to improve the lives and health of women -- especially in a place like Tanzania, where maternal mortality is anywhere between 500 (gov't estimate) to 900 (more reasonable estimate) per 100,000 live births.