Helping Mothers Around the World

Each year, 600,000 women die of pregnancy-related causes. JHPIEGO seeks to change that.

July 29, 2008
By Hope Keller
Photography Courtesy of JHIPIEGO

Each year, 600,000 women die of pregnancy-related causes.

Share:

It was chilly and raining hard in southern Tanzania. Shalla Ukende, riding on a bus, heard a woman scream near her.

The woman was lying in the aisle, writhing. Ukende, a midwife, knelt down and pressed on the woman’s abdomen. She felt contractions. “I said, ‘Oh my dear,’” Ukende recalls in a phone conversation from Dar es Salaam. “This woman was about to deliver.”

The bus driver pulled to the side of the road and ordered the woman to get off and have her baby outside, in the rain. Ukende faced him down.

“I said, ‘This woman is getting no air, all the passengers must go off the bus,’” Ukende recounts. “The people just listen to me.”

It took only a few minutes. With the help of the woman’s sister-in-law, Ukende delivered a healthy baby. It turned out that the woman had delivered several infants before, with assistance from relatives, but that all were stillborn.

“She was very, very happy,” Ukende says.

Shalla walking in tanzania

Ukende swaddled the baby, summoned the bus driver back on board and told him to drive them to the closest clinic. He did — and he waited while Ukende made sure the woman was put to bed and given painkillers.

Assured that the new mother was in good hands, Ukende got back on the bus and continued her journey to the south, where she was going to train women as birth attendants.

Ukende works for Jhpiego, a Baltimore-based nonprofit group affiliated with Johns Hopkins that helps women and families in poor countries around the world. One of four Jhpiego-trained midwives in Tanzania, Ukende is based in Dar es Salaam but travels around the country training women to help other women give birth.

Jhpiego has staff in 50 “low resource” countries, from Afghanistan to Zambia. “Six hundred thousand women a year die of pregnancy-related causes,” says Dr. Leslie Mancuso, Jhpiego’s president and chief executive officer, in an interview at her Fells Point office. “It’s mainly in delivery. They bleed to death.”

Jhpiego trains birth attendants to recognize the signs that a pregnant woman might be headed for trouble. “If the health workers have the skills, the women will survive,” Dr. Mancuso says. “Women want to take care of their children; they want to have healthy children like women everywhere.”

She emphasizes that women’s health is intimately connected to the health not just of their own families but also of entire societies. “That’s why we’re really passionate,” says Dr. Mancuso, who travels abroad 70 percent of the year.

In Afghanistan, where maternal mortality is increasing — one in six women now dies in childbirth — Jhpiego is setting up schools for midwives. Afghani women cannot visit male doctors and, since women were denied education for a generation, there are effectively no women physicians left in the country. Midwives are essential.

Jhpiego also trains local women health workers to test for cervical cancer and, if it is found in the early stages, to treat it. “As it is, it’s found too late in the Third World,” Dr. Mancuso says. “Once you have symptoms you’re in trouble. It’s a terrible death.”

Jhpiego, with a staff of 450, has been in the forefront of international health since its inception 35 years ago. (“Jhpiego” was originally an acronym but now is the organization’s official name.) Eighty to 85 percent of the group’s $45 million budget comes from the U.S. government — primarily U.S. AID, the Centers for Disease Control and Prevention and the Department of Defense — with the rest coming from corporate and foundation grants.

Of the total staff members, 320 are in the field; the rest are based in Baltimore.

Kelly Curran, a HIV specialist, has worked for Jhpiego for 10 years. A mother of three, she juggles the needs of her own children with those of youngsters all over the world. In February, Curran was getting ready for a two-and-a-half-week trip to Zambia and wondering if she should bring a breast pump so she could keep nursing her 13-month-old daughter when she got back. Her daughter came along on Curran’s last visit to Africa.

“I feel conflicted about weaning, but I’m looking forward to the trip to Zambia,” Curran said. “I keep in mind that what I’m doing has value and is hopefully making a difference in people’s health and people’s lives, and I hope that when [my children] are older they’ll understand why I did it and that they’ll appreciate it.”

Curran was heading for a conference that would discuss HIV counseling and testing and the relatively new practice of male circumcision to reduce the incidence of HIV transmission. “Women and children benefit from male circumcision,” she says, explaining that it reduces a man’s chance of contracting HIV by 60 percent. The practice has caught on in Zambia, with months-long waiting lists of men seeking the procedure, which Curran likens to a “surgical vaccine.”

“It’s a dramatic reduction, but not complete,” Curran says of circumcision’s effect on HIV transmission. “A vaccine would also likely be partially protective, like a flu vaccine. It’s not a guarantee.” Nearly 60 percent of AIDS cases in Africa are in women.

Reducing the incidence of HIV, cervical cancer and malaria in pregnant women and improving pre- and postpartum care: These are Jhpiego’s goals. The organization’s not-small mandate is to save mothers, families — and societies.

Says Dr. Mancuso, “If the mother lives, her children live, her family has a better life and the country is better.”

For more information about Jhpiego, visit its website at www.jhpiego.org.

Filed Under: Feature

Smart Woman Online

Navigation