Fighting for Maternal Health in a Conflict Zone
Today is International Women's Day, and I want to highlight some key advocates from Save the Mothers' Masters of Public Health Leadership program who area working to save mothers in the Democratic Republic of Congo. They have some unique circumstances to contend with. These are the types of students that I have the privilege of meeting while working with the MPHL program. Meet Upoki David and Reta...
The
International class of 2016 has just completed all four modules of their
studies for the Masters of Public Health Leadership program, after writing
their comprehensive exams this past week. It is a time to celebrate and then
focus on completing their research projects to be able to graduate. But as
exciting as this is, two students are not happily on their way home after the
module, unlike their colleagues. I met up with David and Reta as they were
sitting on the balcony at Mirembe Hall. They were sharing tea and bread for
lunch. Neither expected to still be here on campus, but last night each of them
got a call from their families warning them of the deteriorating security
situation. The only safe way in to the
town is by flight. It is turning into a complex emergency in the area. Reta was
told by her family, “Don’t try to come by road,” and Reta says, “Now we are
stuck. We are not prepared for a flight, we don’t have the money.”
On Sunday March
4th the instability moved into their town, escalating tribal
fighting between the Hema and Lendu tribes. Everyone is staying in their homes
– not going to church yesterday, not accessing food, stores are closed, and have
little food due to the disruption of supply. Some people are fleeing the area. Their
own families are stranded, unable to venture out of their houses.
Before the
module started in February, David and Reta both travelled by bus to Uganda.
There was no concern in the town about the fighting – it was thought to be
mainly the more rural areas affected. Now all the roads are closed due to rebel
armies. Anyone trying to travel this way through rebel-held areas will likely
be attacked and killed. So now they wait, either for fighting to subside, or to
get the funds to fly home. To keep from
constantly ruminating on the situation at home for their families, they sit out
and watch people, try to socialize, pray, and spend time strategizing on how
they will work together on addressing maternal mortality issues in their area
when they return home.
David is a
pastor and Reta is a midwife, and works with the Association of Midwives in DRC.
They each have their respective circles of influence, in the church network and
with health care workers. Both have a vision now to contribute to reducing
maternal mortality in the DRC, particularly in the areas around Bunia. David
says, “We have a plan… we want to go and do something with the skills that we
have from the [MPHL] program.” They shared with me about how they hope to start
their own NGO to focus on identifying and addressing local gaps in maternal and
child health. One idea is to get a radio station to broadcast education to the
surrounding communities on different topics relating to maternal health. In
this current political climate, it is hard to travel to the rural areas around
Bunia, but radio is one way to connect easily with people. Other goals include
holding a conference to share knowledge on the issues of maternal mortality
with other health care workers.
How
does war affect health care in the area?
Reta: “We can’t close the hospital, but
with security problems, mothers won’t be able to come, to access hospital.”
They will likely stay in their rural area and deliver with a traditional birth
attendant, someone without skills training to identify and manage complications
of birth. David mentions how patient care is affected as many medical personnel
have fled. This is one contributor to higher mortality rates for mothers in
DRC. As of 2015, the maternal mortality ratio in DRC is 693 maternal deaths per
100,000 births.[1]
Uganda’s rate is about half of this.[2]
Currently there
are many displaced persons within the DRC, fleeing areas of conflict. There is
a camp located close to the general hospital in Bunia. Reta and David see the
opportunity in this. They can go to the IDP (Internally Displaced Persons) camps
and access many people whom would otherwise be difficult to reach in their
rural communities. They can use this opportunity to assess issues affecting
women and to pass along health education information to people. They especially
hope to focus on teaching about antenatal care, how to prepare for delivery,
when to seek care.
David says,
“It’s not easy in terms of resources but we have human resources, ourselves….
It’s our women who are dying, our children and babies who are dying.” In
collaboration with the District Health Leaders they hope to bring some healing
for women to a troubled area. David and Reta are some of the few MPHL trained
students in the DRC, returning to a conflict zone.
In terms of
material resources, they already have a motorcycle, which is essential for
accessing any village with poor roads. They will need to raise funds for fuel
and a computer to use for their work. Corruption is always a big problem, so
they want to ensure that they can manage their own resources with trustworthy
people.
As they were
studying for the MPHL program there were definite obstacles to overcome. It can be costly to travel back and forth
from Uganda, about $150 USD for transport and visa each time. They would run into issues with submitting
their assignments online – there might be no power, no network. David and Reta are
to be commended for completing their work in spite of the challenges they face.
They continue to show so much passion and determination for saving the lives of
women in their country, even in the midst of conflict.
Pray for them!
-
For peace in Ituri province and
the DRC
-
For the start-up of their own
local non-governmental organization
-
For the material resources to
do their work
-
For good, faithful leaders in
their area
-
For safety and health
In general:
-
Pray for many of our MPHL
students and alumni dealing with political instability and insecurity in their
regions – Kenya, South Sudan.
[1] Maternal Mortality Estimation Interagency Group. “Trends in
maternal mortality (WHO, UNICEF, UNFPA, the World Bank and the United Nations
Population Division).” In Democratic Republic of the Congo: country profiles.
Global Health Observatory Data. Retrieved from http://www.who.int/gho/countries/cod/country_profiles/en/
on March 6, 2018.
[2] Maternal Mortality Estimation Interagency Group. “Trends in
maternal mortality (WHO, UNICEF, UNFPA, the World Bank and the United Nations
Population Division).” In Uganda: country profiles. Global Health Observatory
Data. Retrieved from http://www.who.int/gho/countries/uga/country_profiles/en/
on March 6, 2018.
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