http://viewchange.org Videos from ViewChange.org (Filtered by topics: Birth attendant) en-us Mon, 24 Oct 2011 08:06:00 +0000 Copyright 2011 Link Media, Inc. http://www.viewchange.org/videos/the-edge-of-joy Nigeria, Africa's most populous country, has the second-highest number of maternal deaths in the world. The Edge of Joy follows doctors, midwives, nurses, and public health educators as they fight maternal death on every front, from preemptive family planning education to expanded blood transfusion services. Mon, 24 Oct 2011 08:06:00 +0000 http://www.viewchange.org/videos/the-edge-of-joy Nigeria, West Africa, Maternal health, Health, Reproductive health, Pregnancy, Maternal death, Family planning, Blood transfusion, Islam >> TITLE: Hafliwa Maganin Mutuwa >> TITLE: "Birth is the medicine for death" - Hausa Proverb >> TITLE: Kano, Nigeria >> KABIRU IBRAHIM: At about 5:30am, my wife Aisha gave birth at home. I rushed to borrow a car from my friend and took her and the baby to the local hospital. >> AISHA AMIRU: Aisha was bleeding. I poured lots of water over her. But it didn't help, and the bleeding got worse. Honestly, when we brought her to the hospital, in her own words she kept saying she was going to die, she was going to die. >> TITLE: Brown Doggy Pictures, in association with Woodlawn Avenue Productions, present: The Edge of Joy. >> VOICEOVER: Nigeria is Africa's most populous country. Its 140 million citizens are divided almost equally between Muslims in the dry desert north and Christians in the lush south. Nigeria is a land of extremes. The West African country is blessed with some of the world's richest natural resources, and is best known as America's fifth largest oil supplier. But this isn't the story of oil. This is the untold story of more than 36,000 Nigerian women who die each year while trying to have babies. This is the second highest number of maternal deaths in the world. Battling this daily crisis are Nigerian families and healthcare professionals working on the frontlines of maternal health. >> TITLE: Kano, Northern Nigeria >> SIGN: Murtala Mohammed Specialist Hospital >> SIGN: Labor room >> DR. BELLO DIKKO [Chief of Obstetrics & Gynecology, Murtala Mohammed Specialist Hospital]: So you are welcome to the labor room of Murtala Mohammed Specialist Hospital. It's one of the busiest maternity centers you can find in all of West Africa. There is at least an average of 30 deliveries in 24 hours, normal deliveries. >> VOICEOER: Dr. Bello Dikko is head of obstetrics and gynecology at Murtala Mohammed Specialist Hospital in the northern Islamic state of Kano, one of the most difficult and dangerous regions in which to be a woman. >> SIGN: Dawn shall not fall twice on a woman in labor >> TITLE: Sakina Muhammed: mother of two, in labor with twins >> AISHA BUKAR [Nurse Midwife]: I was trying to explain to her that she should bear down because she is carrying a multiple pregnancy. >> VOICEOVER: Sakina delivered her first two children at home. More than half of Nigerian women give birth outside the hospital. During this pregnancy, Sakina heard radio messages about free maternity services for prenatal care and delivery, and told her husband Muhammed. >> MUHAMMED MAKA [Sakina's Husband]: My name is Muhammed Maka. At home there is the possibility of encountering problems, so going to the hospital has its advantages. >> AISHA BUKAR: We notice she's very weak, so we set up IV 5 percent dextrose for her. >> MUHAMMED MAKA: I brought my wife Sakina to the hospital on a Saturday, and she gave birth to twins on Sunday. The first twin was a girl. >> AISHA BUKAR: No contractions, nothing. So we add just a little pitocin for her in order to encourage her to start having the pains so that she can expel the [second] fetus. >> DR. BELLO DIKKO: Because of the associated complications, the second delivery should not exceed five to ten minutes. >> AISHA BUKAR: She was telling me that the presenting part of that patient, the second twin, is breach [feet first] presentation. >> DR. BELLO DIKKO: Breach delivery, especially in a multiple pregnancy, is a very complicated delivery. There is a need for a qualified OB/GYN doctor. >> AISHA BUKAR: We even called the doctor but he was not here. But if she is about to deliver we can take the delivery. We do it. >> DR. BELLO DIKKO: The team on call -- we usually have four. Two of them must be on the ground, the doctor on duty and the first on call. So if these two are on the ground, they may likely be in the theater. So what will happen is they cannot unscrub. That is an emergency. This is an emergency. >> SIGN: Post-partum hemorrhage >> DR. BELLO DIKKO: Hemorrhage in obstetrics is one of the leading causes of maternal mortality. >> MUHAMMED MAKA: Sakina labored in pain before the second baby was born. It was close to an hour before the boy was born. He came forth having problems. >> AISHA BUKAR: He has very severe aesphesia. We need oxygen now and we don't have oxygen. I don't want the baby to die. I don't want her to miss that baby. That is why I try with all my effort to be able to help her or to help the baby too. We cannot leave him like this. He has to see a pediatric doctor. The [pediatric] unit is far. >> SIGN: Emergency Pediatric Unit >> MUHAMMED MAKA: My son needed medical attention, and we rushed into the emergency pediatric ward. >> VOICEOVER: While the second twin was being stabilized, Sakina's condition worsened. She was diagnosed with post-partum hemorrhage. >> FARIDA BABALLE [Head Nurse-Midwife, Murtala Mohammed Specialist Hospital]: She lost a lot of blood. She's a bit anemic. She has to receive a blood transfusion. They gave her this bio-plasma, about two liters, and then they gave her normal saline. I think with that, it can take her up to six hours. One of our main problems here is how to get blood. The husband has to go and donate. Before, we normally asked the Red Cross, they mobilized people to come and donate blood to the hospital. But now, due to HIV, we stopped. They have to go and check the blood group of the husband. Then they compare it to see if it's the same as hers. If it's not the same blood group -- >> MAN: "A" positive. Not the same. >> FARIDA BABALLE: -- the husband must buy the blood. So all these things take time, and delay, and it causes the death of the woman. That is the largest cause of death of the women here. >> VOICEOVER: Muhammed's search for Sakina's rare blood type took him to surrounding hospitals and private blood suppliers. One pint of blood costs 10,000 Naira, or USD$68. The average Nigerian makes about USD$94 a month. >> TITLE: Three hours later >> SIGN: Blood bag >> DR. BELLO DIKKO: It is really disheartening to see a patient dying from a preventable cause. As far as I'm concerned, hemorrhage is a preventable cause. >> SIGN: Murtala Mohammed Specialist Hospital >> VOICEOVER: Sakina received a blood transfusion in time to save her life. >> TITLE: Two days later >> TITLE: Sakina and Muhammed's second twin >> TITLE: Fatima, Sakina's mother >> WOMAN: I don't think the baby is alive. I don't think. >> MUHAMMED MAKA: We have a teaching in the religion of Islam that states, "What Allah gives, belongs to him. And what he takes also belongs to him." All of us are from Allah, and at some point, sooner or later, we shall all return to Allah. Even though we know it hurts, we can only accept its outcome. >> WOMAN: Now on examination there is color, she is pink, not dehydrated. Then the BP is 100/70 so at least it's okay. >> VOICEOVER: After eight days in the hospital, Sakina and her surviving twin daughter went home. >> TITLE: Oyo, Southern Nigeria >> SIGN: College of Medicine, University of Ibadan >> VOICEOVER: Professor Oladosu Ojengbede is Director of the Center for Population and Reproductive Health. He is one of the continent's premier women's health physicians. >> PROFESSOR OLADOSU A. OJENGBEDE [Center for Population and Reproductive Health]: One of the reasons I got into medicine was that obstetrics was a very practical subject. There's a problem, you see it, you solve it, you're happy, the family's happy, everybody's happy. I lost my mom when I was very young. I was only three years old. I saw there were very grave challenges you face when you don't have a mom. >> TITLE: Professor Oladosu a. Ojengbede, Center for Population and Reproductive Health, University College Hospital, University of Ibadan >> PROFESSOR OLADOSU A. OJENGBEDE: Most of our women live in rural areas. And so most of the births take place outside big cities. And if most births take place in rural areas, then that is where we must work. When I'm down in some villages and you think, "Could this be happening to human beings?" You become very emotional. And you feel like shedding tears. >> SIGN: Akinyele Local Government, Maternity Center, Mele >> PROFESSOR OLADOSU A. OJENGBEDE: But then you quickly remember that, look, this is something that needs to be resolved. And you are one of those who have made up their mind to resolve it. >> VOICEOVER: Professor Ojengbede is pioneering low tech and affordable health solutions. He says these innovative tools are essential to keep women from dying of preventable causes. >> WOMAN: So this is the garment we have brought that helps to save women's lives. >> VOICEOVER: One of the most effective life-saving solutions is the anti-shock garment. This full-body suit, first conceived of by NASA, is being adapted for hemorrhaging women. The professor and an international team of colleagues have proven this suit can be used to treat shock by shunting blood from the extremities and back to vital organs. Bleeding to death is the number one killer of pregnant women, including those who live in this remote village of Mele. >> PROFESSOR OLADOSU A. OJENGBEDE: In a remote area like Mele, to get immediate access to superior care may be a challenge. Mele actually in full means, "Mele-mu-cu," which means, "I will not choose death." I love the name of this village, because what we're here for is to prevent death and promote life. >> PROFESSOR OLADOSU A. OJENGBEDE: Hello! How are you and the baby? Is the baby sleeping? >> RACHEL OLATUNJI [Pregnant with fifth child]: Yes, the baby is sleeping. >> PROFESSOR OLADOSU A. OJENGBEDE: We saw a couple. The wife is currently pregnant, and she had a two-year-old baby on her back, with scabies infections on the head and arm. >> PROFESSOR OLADOSU A. OJENGBEDE: What is his name? >> RACHEL OLATUNJI: Matthew. >> PROFESSOR OLADOSU A. OJENGBEDE: Matthew! This is scabies. >> PROFESSOR OLADOSU A. OJENGBEDE: This woman says she has five kids, and indeed the current pregnancy was really not planned for. And the question was, if it was not planned for, how come they couldn't prevent it? >> TITLE: Olurim Olatunji, Rachel's Husband >> PROFESSOR OLADOSU A. OJENGBEDE: According to the gentleman, he said, "Well, I'd rather stay with my wife than go out to find another wife for sexual responsibility." It is global knowledge that the higher the number of births beyond five, the risk increases, but even doubles from five or more. And the closer the pregnancies are, shorter than two years between birth and the beginning of another pregnancy, the higher the risk. Not just for the woman, but also for the born baby and the previous births, because they are all related. >> RACHEL OLATUNJI: I have tried on my own to prevent pregnancy, but it is to no avail. Unfortunately, I wind up with unplanned pregnancies. >> VOICEOVER: Rachel, like most Nigerian women, has five children. For Rachel, like most, at least one of those pregnancies is unplanned. >> RACHEL OLATUNJI: I am very fertile. I tried to abort a pregnancy on my own with local herbs. I started having severe diarrhea, and I lost a lot of weight. I almost died. After a while, it became evident that I was still pregnant, so I started prenatal care and I accepted my fate. >> TITLE: Sunday morning church service >> ELIZABETH ADESINA [Community Birth Attendant]: When we speak of family planning, the husbands think this is a secret way of encouraging their wives to be unfaithful and start sleeping around. But if the emphasis is on preserving their wives' lives and the care of their children, they will understand. >> PROFESSOR OLADOSU A. OJENGBEDE: The men in this village are eager to improve the reproductive life of their families. >> PROFESSOR OLADOSU A. OJENGBEDE: What do we do -- what do we know so that we can make love to our wives but not have pregnancy occur? First, you can use tablets. If you use condoms all the time, they are very effective. >> PROFESSOR OLADOSU A. OJENGBEDE: We are seeking a dialogue with the men today, to have an in-depth introduction in contraception, how it impacts on health, how it impacts on the family, on income, on development. >> MAN: If a person can calculate the days very well, can there be a mistake between this time and this time for ovulation to take place? >> PROFESSOR OLADOSU A. OJENGBEDE: Well, we didn't create this place where the egg comes from, and though there's a time range, it can vary. That is why it is better not to take the risk at all. So if you're waiting for that time, and you really want to make love to your wife, what are you going to do? There's nothing you can do to satisfy the need so that a man cannot wait! And if the wife says at that very moment, "Wait, you said we shouldn't get pregnant," the man can't think right! We should not guess. We should have a decisive method. >> VOICEOVER: Every Thursday morning in Mele, preacher and community birth attendant Elizabeth Adesina opens her prenatal class with a prayer. >> TITLE: Elizabeth Adesina, Community Birth Attendant >> PROFESSOR OLADOSU A. OJENGBEDE: Faith-based practices probably see more patients in this country than the public sector facilities, simply because they provide the services within the context of understanding the values and the norms of the community they are serving. >> ELIZABETH ADESINA: Glory be to your name that she will not suffer. We will always praise your name, Father, in Jesus' name, amen. >> TITLE: Kano, Northern Nigeria >> FARIDA BABALLE: I started practicing midwifery in 1986, almost twenty-something years as a midwife. I was posted here October 2007. I was on leave at that time. When I came down there, they said they are taking me to the labor room. I said, "I don't want labor room now. All my years of service, my experience, has finished in the labor room, so please can you change me now so that I can have another area." They said no. They wanted me to be here. "We need something from you to come out and implement it here for us." I said, "It's okay." That is how God willed for me to help my fellow women. So when I came back, I sat down and said, "Oh," I asked them, "What are your statistics?" So I took three years of the register. I picked three things. What is the problem there, in the ward? And I write what my observation is there. So from that, we'll do our own assessment. This will tell us if it's the problem of the midwife, the problem of the doctors, or the problem of the community. >> FARIDA BABALLE: You see, January of last year we had eleven maternal deaths. So you know there is a problem here. >> VOICEOVER: Women die in the north because their culture often forbids them from travelling without a male escort, even when they're bleeding to death. Aisha Ibrahim, who gave birth to her eighth child at home, is one of them. In fact, knowing this precept, her husband Kabiru stayed with her. >> KABIRU IBRAHIM [Aisha's Husband]: My wife Aisha bled too much with her last two deliveries. So I made sure during this delivery I would stay close by to support her. >> VOICEOVER: But in the midst of the crisis, his car broke down, and he left to repair it. Stranded and hemorrhaging blood, Aisha had to wait for her father-in-law's permission to take a taxi to Farida's hospital with another male relative. >> AISHA AMIRU [Aisha Ibrahim's Sister-in-law]: I was there. They said she had lost so much blood. There was no more blood, that her blood was all gone. Honestly, when we brought her to the hospital, in her own words she kept saying she was going to die, she was going to die. >> NURSE: We checked her BP [blood pressure]. The BP is 70/query [too low to measure]. Some patients even die with that. >> FARIDA BABALLE: They just come at their dying minutes. They set a drip-normal saline and isoplasma for her. Then we applied the anti-shock garment. Then once you put it on, within a short time, when you check the vital signs, you find there is BP, there is pulse. The woman is coming back. >> DR. BELLO DIKKO: The anti-shock garment is just a way of buying time before you can procure blood for the transfusion of this woman. >> FARIDA BABALLE: The time that we didn't have this anti-shock garment, the woman will just go, will just die, because there is nothing we can do to help her. The only thing we can do is just to elevate the foot off the bed. Apart from that, there is nothing we can do. >> VOICEOVER: Aisha's husband, Kabiru Ibrahim, is a taxi driver in Kano and a father of thirteen. >> KABIRU IBRAHIM: When I arrived here at Murtala Mohammed Specialist Hospital, they told me about the garment they applied to control the bleeding. Then they told me she was in need of blood. >> NURSE 1: The blood is her immediate need. >> KABIRU IBRAHIM: My brother and I searched all around for her blood type. But there was none available. My calmness was rattled, of course. I was thinking, before I'm able to find the blood, I would return to find her dead. I was grateful to Allah that I had the means to purchase the blood, but it was nowhere to be found. >> NURSE 1: The minute she came, we took her blood sample for relations to go look for her blood. But still yet you can see, how many hours ago? No blood yet. >> VOICEOVER: After searching for five hours, Kabiru found two pints of Aisha's blood type. >> NURSE 2: Blood pressure is 120/80 -- it's normal. >> HALIMA BEN UMAR [PATHS2]: She was telling me how this was the worst, she suffered the most out of all the seven she had. Then I said, "Have you thought about family planning, I mean child spacing?" Then she said, "Yeah...ah, uh huh. Is it something you can do?" She said her husband would not allow her to stop giving birth. I said, "No, I'm not saying stop, I'm just saying space." Islamically, it is wrong for you to say you want to have two children, you want to have four, but Islamically you can space. >> FARIDA BABALLE: The reason why most of our people don't believe in this family planning is because sometimes they misquote religion. They say God has said, "Deliver us many and they multiply the world." >> HALIMA BEN UMAR: Sometimes I felt maybe should I talk about family planning? But I know I spaced my children. If I hadn't, I would probably have had fifteen. That would have been disastrous. >> FARIDA BABALLE: I hope a lot of things that happen will change. >> HALIMA BEN UMAR: The change is coming gradually. But I think we need to move a little faster than the rate we are moving. Islam moves with civilization. >> FARIDA BABALLE: Yes, this is what I think. >> VOICEOVER: Kano is one of the twelve northern states in Nigeria governed by Islamic law, or Sharia. Daily life in this ancient city revolves around Islamic culture. Improving reproductive health requires a delicate interplay between Islam and modern medicine. >> SIGN: Allah is the greatest >> HALIMA BEN UMAR: In this part of the country, you need to work with the religious leaders. If you want to achieve your objectives, your aims, then you need to look at, what does Islam say? How do you do it so that it becomes more acceptable? For me, I have always been an advocate of family planning. People see it as a western idea; people see it as the west trying to impose their ideas on us, so it becomes a little bit difficult. >> SAKINA MAKA: Assalamu Alaykum >> FARIDA BABALLE: Wa Alaykum Assalam. How is your day? >> SAKINA MAKA: I'm well, and how is your day? >> TITLE: Sakina and twin daughter, four months after delivery >> FARIDA BABALLE: So, what we do here is family planning birth control. Do you know what that means? >> SAKINA MAKA: It's like having control between deliveries. For example, two and a half years before having another baby. >> FARIDA BABALLE: Within those two years, your husband will save up some money. You see? If you have a baby and then, in a year, another and another every year, he wouldn't save any money, and then you're not in good health and the baby will not be healthy. That's why we use family planning. >> FARIDA BABALLE: Now there's a lot of awareness of family planning for our people. Our women are coming on their own. They don't wait for their husbands. They decide on their own health, instead of waiting for their husbands to decide on their health. >> KABIRU IBRAHIM: Aisha stayed in the hospital for sixteen days until she regained her health. Then she was discharged and we went back home. That's what happened. >> VOICEOVER: Kabiru's first wife died giving birth to their seventh child, and he has never used birth control until now. He attributes this behavior change to a deeper understanding of safe motherhood in the Islamic community. >> KABIRU IBRAHIM: Before this delivery I didn't agree with the idea of a woman taking a break, because rest comes from Allah. If Allah does not grant a break, you will surely give birth. The Muslim religion allows that she take a break to save her life, because she might lose her life in the process. That is why I agreed. >> AISHA IBRAHIM: Trial birth causes all sorts of mishaps and problems. It brings all kinds of thoughts to mind, like either you retain your life or you lose it. >> PROFESSOR OLADOSU A. OJENGBEDE: You can say, women's rights should be well protected, but the truth is, for now, we have not put in place all the structures that protect women's rights completely in developing countries. And that's what we must put into context when we're fashioning out programs and projects that would serve women. We need to find the appropriate way and culturally acceptable way of circumventing the obstructions. That challenges are enormous, and sometimes they're depressing. The frustrations are everywhere, but the resolve is stronger than the frustrations. >> TITLE: Murtala Mohammed Specialist Hospital >> DR. BELLO DIKKO: Welcome to Habibu Sadouki Blood Transfusion Center, Murtala Mohammed Specialist Hospital. What you have is a blood bank fridge, which has the capacity of keeping about 300 units of blood. It will be tested, filtered, stored, and the ones that will be needed in the maternity will immediately go to maternity. >> MAN: My message to you all is: please help keep our women alive. >> VOICEOVER: Frustrated by the lack of blood supply for maternity patients, Dr. Dikko successfully lobbied health officials for a separate maternity blood bank. Since opening in February 2009, waiting times for maternity ward patients in need of blood has been reduced by 75 percent. >> DR. BELLO DIKKO: If you go inside the blood bank now, the two fridges that you saw the other time are almost packed full. >> FARIDA BABALLE: A lot has changed. It reduces the delay in having the blood. The midwives draw the blood, they send the blood, and then it quickly saves the lives of the patients. You can see the results in our reduction of maternal mortality. There are very few deaths now. It's very low. >> VOICEOVER: The maternity blood bank began collecting blood donations one week after Sakina gave birth to her twins. >> DR. BELLO DIKKO: Each and every one of us, whether a man or a woman, came out of a woman. As long as there is one maternal death, it's a family mortality. Not an ordinary mortality. If you can reduce maternal mortality in Kano State, then definitely the denominator in the issue of maternal mortality in the whole country will definitely reduce. And if it reduces, then it will be my greatest achievement, and I can even resign and go home. >> TITLE: Dr. Bellow Dikko is part of a landmark effort to train religious leaders about reproductive health. He advocates for the right of pregnant women to travel without male escorts, and free maternity services. Farida Baballe's observational study showed maternal deaths have been nearly cut in half, from 196 in 2008 to 102 in 2009. Professor Ojengbede and international colleagues, led by Professor Suellen Miller at UC San Francisco, have tested the anti-shock garment on more than 3,000 women in Nigeria, Egypt, and Mexico. They found that women who received the anti-shock garment lost 50 percent less blood and have 64 percent fewer deaths. Pathfinder International, a non-profit organization, has trained more than 4,000 Nigerian health care providers to prevent, treat, and diagnose post-partum hemorrhage. Pathfinder has distributed 456 anti-shock garments and is collaborating with federal and state governments to scale up the project. While documenting these stories, the filmmakers worked in unison with families and healthcare workers to accurately portray pregnancy and childbirth. Several times we affected outcomes by contributing resources for transportation, cell phones, and pharmaceuticals. In the case of Sakina Maka, her husband Mohammed, an Arabic teacher, was unable to procure funding for blood after hours of searching. We gave Mohammed the 10,000 Naira needed to buy the blood. >> VOICEOVER: What do you want to be when you grow up? >> GIRL 1: I want to be a doctor. >> GIRL 2: I want to be a doctor. >> GIRL 3: A nurse. >> TITLE: Brown Doggy Pictures, in association with Woodlawn Avenue Productions: The Edge of Joy. Director and Producer: Dawn Sinclair Shapiro. Narrator: Eliza Griswold. Executive Producer: Tod Lending. Editors: Michael S. O'Brien, Melissa Sterne. Director of Photography: Nicola B. Marsh. >> TITLE: [End credits] http://www.viewchange.org/videos/viewchange-the-mothers-index Being a new mom is rewarding and challenging. But what extra burdens do mothers in poor and rural communities face? Take a tour of the world's best and worst places to be a mom, in this report from Save the Children and ViewChange.org. Fri, 29 Apr 2011 20:27:00 +0000 http://www.viewchange.org/videos/viewchange-the-mothers-index Save the Children, Maternal death, Child mortality, Childbirth, Pregnancy, Ashta no Kai, Education, Gender, Nepal, Malawi >> VOICEOVER: Next up: an all-new mother's day special. Being a new mom is rewarding and challenging -- but what extra burdens do mothers in poorer countries face? Come take a tour of the world's best and worst places to be a mom, in this new report from Save the Children and ViewChange.org.>> VOICEOVER: ViewChange is about people making real progress in tackling the world's toughest issues. Can a story change the world? See for yourself in ViewChange: The Mothers Index.>> VOICEOVER: You've heard the term "lottery of birth." More often than not, children born in rich countries win it, while those in poor countries lose. A child's life expectancy, health, education, and so much more hinges on where he or she happens to enter the world. But there's also a lottery of motherhood, and expectant moms in developing countries are facing the toughest odds. Every year, more than 350,000 women die from complications of pregnancy and childbirth -- most, simply because they don't have access to basic delivery care. >>WOMAN: Push hard!>> VOICEOVER: And the ripple effect is dramatic: when a mother dies, her children are more likely to be poor, more likely to die before the age of five, or to drop out of school if they survive. But private aid groups and governments are working hard to change the odds in the lottery of motherhood. In Sierra Leone, a place that Save the Children ranks as one of the very worst places to be a mom, a new government program is trying to turn the tide, as we see in this short film from ViewChange.>> TITLE: Where Every Pregnancy is a Gamble. Lauren Malkani and Ami Vitale, Sierra Leone>> VOICEOVER: After a brutal decade-long conflict, Sierra Leone has the highest child and maternal mortality rates in the world.>> FATIMATA KONTE [Expectant mother, Kroo Bay]: My name is Fatimata Konte. I'm 36 years old. We women suffer too much. Women in Sierra Leone suffer too much! I've lived in Kroo Bay for four years. When I wake up at 5am I get out of bed, and the kind of pain that I feel is from my waist bone down to the bottom of my belly. I cough and I'm very sick. I'm really sick but it's like this for all women. From the day a child is born, she must work. Every day I must go to the market. There I have to bargain for fruits. It's a strain to go to the market. I must sell the fruit to have money to buy food to sell for the next day. It's all I can do to survive. I work for my daughter so she can go to school. She is in class four. I want her to learn. Let her learn. I want her to be somebody.>> DR. TAGIE GBAWRU-MANSARAY [Doctor, Princess Christian Maternity Hospital]: When a woman is educated she can take care of herself, she can take care of the children, she can take care of her husband, her home. It benefits the population, the family, and it will help Sierra Leone in the long run. I'm a medical doctor, house officer here at the Princess Christian Maternity Hospital. When you're in school and you're studying to become a doctor, you read about all the fanciful techniques, all the wonderful drugs, the magic pills that you give to patients, all the different things that you can do as a doctor. When you come into the real world and you see that even basic things we don't have here -- the basic drugs, simple equipment -- and you are limited. At times you see a particular case and you think to yourself, if only I had this, if only I had that, I would have been able to save a patient's life.>> VOICEOVER: One in five children die before their first birthday, and one in eight women die during pregnancy.>> FATIMATA KONTE: I have two children and I've lost five, so this is the eighth pregnancy. So right now, I am remembering the past. I am worried this one can die too. My biggest fear is that this child will die.>> VOICEOVER: The one referral hospital in the capital of Freetown services a population of over 400,000 people.>> DR. IBRAHAM THORLIE [Doctor, Princess Christian Maternity Hospital]: Hello, good afternoon. My name is Dr. Ibraham Thorlie. In this hospital we have four gynecologists. One doctor can serve over 100,000 people.>> VOICEOVER: Though the hospital is severely understaffed, it is not the only reason so many people are dying.>> DR. IBRAHAM THORLIE: The delay starts from home. If a woman is pregnant, she wants to give birth, and the husband is not around, she cannot be taken anywhere without the husband coming, because he gives the money. If you come too late, we cannot help you.>> VOICEOVER: And, often, those patients who come too late are very close to death.>> DR. IBRAHAM THORLIE: It's a big dilemma. If the patient can pay you, then it's good. But when they cannot pay you, you need to help them.>> VOICEOVER: Rather than watching their patients die, many doctors and nurses like Rebecca pay for the worst cases from their own small salaries.>> REBECCA MASSAQUEI [Nurse, Princess Christian Maternity Hospital]: I'm a poor nurse. I don't have money to take care of this baby. But the baby should have died, because there was nobody to take care of the baby. So that's why I decided to take the baby. He will live to tell this story. So he's the victory child. That why I call his name Victor.>> VOICEOVER: Victor is one of the few lucky survivors in a place where so many die. However, the government has just launched a program providing free healthcare for pregnant women and children under five.>> DR. IBRAHAM THORLIE: Now things are picking up with the pronouncement of the free healthcare system. It's a big incentive and we hope that will surely bring a difference. But to sustain it is not an easy thing.>> FATIMATA KONTE: We women are all very happy that women will finally get treated.>> TITLE: On April 16, 2010 Fatimata Konte gave birth to a healthy baby boy.>> TITLE: [end credits]>> VOICEOVER: So where are the best and worst places to be a mom? For its "State of the World's Mothers" report, Save the Children studied 164 countries, and compiled a "mothers index." At the top of the index, women have what they need to thrive: excellent medical services, plenty of skilled health workers, and opportunities for education and advancement. But the gap between the top- and bottom-ranked countries is stark. At the bottom, one in three children suffers from malnutrition, and one in 30 women will die from pregnancy-related causes. And how does the United States stack up? Number 31. America's maternal mortality is the highest of any industrialized nation. >> VOICEOVER: But the study is also clear about solutions that work. And the very best solution for helping moms and children? More health workers on the front lines. The equation is simple: more doctors, more midwives and community health workers means more mothers and children surviving childbirth and the early years of life. Nowhere is this more clear than a place like Nepal, which is ranked 133rd on the Mothers Index. This ViewChange short film from Living Proof tells the story. >> TITLE: In one of the world's poorest places, the day a woman gives birth is the most dangerous day of her life, and her child's life. Can one woman and her baby beat the odds?>> TITLE: Dangerous Day. Living Proof, Nepal>> TITLE: Western Nepal >> TITLE: People scratch out a living in the Himalayan foothills, and life is hardest for women>> MAHESWORI: My name is Maheswori. I'm 19 years old. My husband went to India to work. Here there is no food, no rice, no nothing. Around here, there's no work. >> TITLE: Maheswori is pregnant and past due.>> MAHESWORI: I am very, very scared. Everyone has been asking about it, and that makes me even more scared. My first child was breech born, and I might just die this time. If I will live, I will live. If I will die, I will die. >> TITLE: The nearest hospital is four hours away. >> MAHESWORI: Some said take her to the hospital, some said drive her down. Everyone had opinions. But how would you get a car without money?>> TITLE: She plans to deliver in the same place she gave birth before.>> MAHESWORI: In November my daughter was born. I had the baby in our cow shed. >> TITLE: By local custom, mother and child are quarantined as "unclean.">> MAHESWORI: For 12 days after the birth, the baby and I were kept in the cow shed. On the 13th day we were allowed out. You can't take a newborn in the house, God gets angry. You're better off in the cow shed. >> TITLE: Because of Maheswori's high-risk pregnancy, an aid worker traveling with the camera crew makes a case to village elders. They consent to having a birth attendant, and she won't give birth in the cow shed. >> MAHESWORI: I am going to die. Oh my mother! I am dying ...>> WOMAN: Get me the gloves, quickly.>> MAHESWORI: I am dying ... am dying. Please ... I can't.>> WOMAN: It's a complete breech situation. Push hard!>> INDUKA KARI [CARE Program Officer]: She was completely unaware of the fact that she would need medical care because her first child was breech born. >> TITLE: She gives birth to another daughter, Seema. >> INDUKA KARI: If she hadn't gotten proper care by a trained birth attendant, she would've died. >> MAHESWORI: I'll rest for seven days, but then it's back to work. I have to pound the rice, carry water, cut grass, and chop wood. Life is tough here. >> TITLE: Living Proof. Real Lives. Real Progress. >> TITLE: In Nepal, 80 percent of births occur at home with no skilled birth attendant like Maheswori had. But support from global partners is helping train Nepal's 45,000 female health volunteers, and they are dramatically improving Nepal's health outcomes. >> VOICEOVER: If there's one overwhelming success story in maternal and child health, it can be found in Malawi, where almost half the county -- 40 percent -- lives in poverty. But, for years, the government has been investing in all sorts of new plans for life-saving care. The result? The number of deaths in children under five has been cut in half over the past 20 years. Malawi's striking results are strongly linked to efforts on the ground, house by house, community to community, to give mothers the support they need. Living Proof has this success story from Malawi>> TITLE: Grandparents Shaping Safe Childbirth. Living Proof, Malawi >> TITLE: Wacapati = Pregnancy>> TITLE: In Malawi, the word for pregnancy also means 50/50. Conventional wisdom says there is just a 50/50 chance a woman will survive childbirth. >> TITLE: Agogo = Grandparent>> TITLE: Agogos are known as the guardians of wisdom and are responsible for passing on tradition.>> TITLE: Can agogos help improve the odds of wacapati? >> TITLE: Ekwendeni, Malawi>> LYTON CHAWINGA: My name is Lyton Chawinga, and I have six grandchildren. I was born at home, in 1948. In previous days, pregnant mothers were using unsafe methods. Some would have their babies in grass huts. After giving birth, they would leave babies on the ground in the cold. We didn't know better. We had a lot of deaths. One day, hospital workers asked us to be a part of the Agogo Program.>> TITLE: The Agogo Program teaches village elders about proper natal care and helps agogos pass along those messages to their communities. >> LYTON CHAWINGA: We go to their house. We talk to both the man and the woman. We are here to chat with you about the importance of going to the hospital when you are pregnant. We show them pictures and tell them what can happen if they give birth at home. That the mother or baby can fall sick or die. >> WOMAN [Agogo]: After three months, start going for checkups. Escort each other. Many husbands refuse to escort their wives, which is not good. >> TITLE: Agogos also use traditional methods to teach modern messages. >> WOMEN: Pregnancy doesn't kill, the hospital is good, and all our children should be taken there.>> LYTON CHAWINGA: Deaths have decreased, diseases have decreased, and life has improved. I am really happy because if the student fails you are not a good teacher. I see fruits of what I teach and I am proud that I am a good teacher.>> TITLE: Living Proof: Real Lives. Real Progress. >> TITLE: With support and funding, 4,000 agogos have been trained in Malawi.>> TITLE: As a result, Ekwendeni Hospital has seen a 60 percent increase in pregnant women seeking antenatal care.>> TITLE: To accommodate them, the hospital is building a new, larger maternal ward.>> VOICEOVER: Access to health care isn't the whole story, of course. Helping women must include an investment in education. In rural Bangladesh, communities are learning the real value of empowering women. This film from Save the Children shows that giving girls a voice can be the most powerful solution of all. >> TITLE: Shilpi's Story. Save the Children, Bangladesh>> TITLE: This is Shilpi's story. Tiler Char, Barishal, Bangladesh.>> VOICEOVER: Shilpi's father died when she was very young. Her mother worked as a maid to support Shilpi and two younger sons. She earned only enough to feed them one meal a day. When Save the Children started the Girls' Voices project nearby, Shilpi joined. She met with other teenage girls to build self-confidence and learn new skills, like making a budget and saving money. Shilpi realized she could help support her family, even without working outside the home. She started her first business weaving mats. >> SHILPI: Later, I thought about how I could use the money I earn from weaving mats to do more. So I bought a small cow. After a year it gave birth. At that time we got 2 to 2.5 liters of milk from the cow every day. I sold that milk and used the money for my family. Later, when I had earned more money from weaving mats, I saved it. Our house was very small. It was awful to live there during the rainy season. So I decided we should build a new house. I sold the calf and used the money from my savings to build this house. If I had not joined "Girls' Voices" I would have been married by now, like all the other girls. Then I would not have been able to build such a big house or buy a cow. Now my plan is to buy a piece of land since we do not have any. The other plan I have is for my brother. Because he is handicapped, I am supporting his studies. That way he can get a job and earn his own living. My mother used to think if I had been a son instead of a daughter our life would have been much easier. But now she thinks "my daughter has done more for our family than a son would ever do.">> VOICEOVER: Around the world, communities are coming together, not only to save the lives of mothers and children, but to improve them. To give women real opportunities to change the courses of their lives. Basic health care can solve the most urgent crises, but a bigger sea change -- one that empowers women to learn, to marry later, and to decide when to have children -- will ultimately close the gaps in the odds that mothers face. Those changes are happening every day, country by country, and girl by girl. Sometimes, in places like India, something as simple as a bicycle can make all the difference.>> TITLE: Hubub Films Presents>> TITLE: Sone Sangvi, India>> TITLE: Pedal=Sight. Jacob Seigel-Boettner, India >> BHARATI PHAKAD DATE: My name is Bharati Phakad Date. I am 14 years old. I live in Sone Sangvi. I am going to Nimgaon Bhogi High School. I am learning in the ninth standard [grade]. My favorite actor is Mithun Chakrabothy because he always plays a humanitarian, someone who helps other people. My favorite actress is Rani Mukherjee. I like her husky voice. There are a lot of people who live on the streets. I will help them. There are so many people in this world who do not even get one meal a day. I will help them. >> TITLE: Pedal = Sight>> ARMENE MODI [Director, Ashta No Kai]: For about a couple of years, we only focused on adult women and literacy for them, and I noticed many of the girls who came to the class were very, very young girls with mangalsutra, which is a gold-and-black beaded necklace, around their necks, which in India is a symbol of matrimony, and they had babies on their hips, and I started to ask, "What's going on?" and, "Why are such young girls married off already?">> BHARATI'S MOTHER: My life, my generation, was full of darkness. I have to make sure that my daughters get a good education. It is our duty. If you are uneducated, then it is as if you only have one eye. >> ARMENE MODI: In many villages, there were only schools until seventh grade. There were no high schools. So we worked in 10 villages at that point of time, and there were only three high schools. So then I asked the parents, the mothers, "Well, what happens to the boys? How do you send the boys to school?" And they said, "Well, we give them bicycles." And I said, "Well, what about the girls?" And they said, "Oh, no. It's a waste of money to give a bicycle to a girl. She's going to turn around and get married." There's a famous Indian saying: Why water a plant that's going to grow in a neighbor's garden? So, I thought, my God, if it's only a bicycle that's keeping girls from going to school, let's go ahead and give it to them. >> BHARATI PHAKAD DATE: The bike has been really useful. Now, the time that I save commuting to school can be used to study. Also, now I can ride to school with my friends. It's a lot of fun. I used to have to walk to school. >> BHARATI'S MOTHER: Initially, she had to walk to school. It took her more than an hour. Now she can ride to school in 15 minutes. She now feels very motivated and enthusiastic to attend school. >> BHARATI PHAKAD DATE: I want to become a District Supervisor, because then I can make big decisions, and also have the power to implement them. I would be able to make decisions regarding the welfare of the poor and downtrodden. I would be able to help transform society. My name is Bharati Phakad Date. I am 14 years old. I live in Sone Sangvi. I want to eradicate poverty from this country. >> TITLE: [end credits]>> VOICEOVER: Like what you saw? Then visit ViewChange.org, Link TV's brand new multimedia website. Watch over 200 stories about new solutions to the developing world's biggest challenges, get involved with the issues, share the stories with friends, and help change the world, all at ViewChange.org>> VOICEOVER: To read the full 2011 "State of the World's Mothers" report, and to learn more about Save the Children, visit savethechildren.org.>> TITLE: [end credits] http://www.viewchange.org/videos/living-proof-ethiopia-liyas-diary Most Ethiopian women deliver their babies at home without the aid of a trained birth attendant, increasing the chances of complications for both mother and child. World Health Organization Global Ambassador Liya Kebede confronts the challenges facing mothers and newborns in her home country, and discovers how new programs are helping shift the odds in their favor. Tue, 01 Feb 2011 11:10:00 +0000 http://www.viewchange.org/videos/living-proof-ethiopia-liyas-diary Ethiopia, Public health, Childbirth, Birth attendant, Pregnancy, Maternal health, Neonatology, Africa, Living Proof, ONE Campaign >> LIYA KEBEDE: It's 3am in a remote village in Ethiopia. A woman named Kumi is in labor. The nearest clinic is hours away and her only choice is to deliver the baby on the dirt floor. Even though I grew up in Ethiopia and I knew giving birth here was dangerous, nothing prepared me for seeing it firsthand. It's literally pitch black in there. The thing is, every time a woman is delivering in a place like this, her chances of survival ... I don't even know how you survive. >> TITLE: 94 percent of women here deliver at home without a trained attendant. >> LIYA KEBEDE: Not far from Kumi, a loving father named Alemu Amallo reads to his seven-year-old daughter Amarech. Just seven months ago, his wife hemorrhaged to death during childbirth. "My wife was the love of my life," he said. Alemu now has to be both father and mother to his two little girls. He says he doesn't know what he's going to do. When a woman dies in childbirth, the whole family, the whole community, feels the effect. >> TITLE: More than 300,000 women die giving birth in the developing world each year. >> LIYA KEBEDE: And then there are the newborns. One in 32 babies in the developing world dies during the first month of life. Dr. Mulualem Gessesse is a neonatologist in my hometown, Addis Ababa. She works seven days a week and sees thousands of babies a year. While giving a tour of the facility, she had to stop to resuscitate a baby girl, just 14 hours old. She was struggling to breathe. When asked the chances of the baby surviving she held up her hand and said, "Zero." >> DR. MULUALEM GESSESSE [NEONATOLOGIST]: When you lose one, you cry. In spite of everything we are doing, it's not easy just to lose a life. >> LIYA KEBEDE: But there are glimmers of hope. The Ethiopian government and global partners have recently launched new programs to provide pregnant women with prenatal care and clean and safe delivery. Because of those efforts, a trained birth attendant arrived in time to help Kumi deliver a healthy baby girl. She named her Idalee, which means "lucky day." If these efforts can grow, my hope is that, one day soon, a healthy childbirth in my country will no longer be considered a stroke of luck. >> TITLE: Living Proof: Real Lives. Real Progress. www.one.org/livingproof http://www.viewchange.org/videos/living-proof-nepal-dangerous-day The dangers of childbirth become amplified when mothers live in remote and poverty-stricken areas. In the Himalayan foothills of Nepal, far from any clinics or hospitals, a young mother struggles with the fear of complications during the birth of her daughter. This film examines how skilled birth attendants can dramatically improve the survival odds for both the mother and child. Sun, 14 Nov 2010 17:33:00 +0000 http://www.viewchange.org/videos/living-proof-nepal-dangerous-day Nepal, Childbirth, Birth attendant, Child mortality, Maternal death, South Asia, Midwifery, Himalayas, Rural area, Gender >> TITLE: Part 1, Delivery Day >> TITLE: In one of the world's poorest places, the day a woman gives birth is the most dangerous day of her life, and her child's life. Can one woman and her baby beat the odds? >> TITLE: Western Nepal >> TITLE: People scratch out a living in the Himalayan foothills, and life is hardest for women >> MAHESWORI: My name is Maheswori. I'm 19 years old. My husband went to India to work. Here there is no food, no rice, no nothing. Around here, there's no work. >> TITLE: Maheswori is pregnant and past due. >> MAHESWORI: I am very, very scared. Everyone has been asking about it, and that makes me even more scared. My first child was breech born, and I might just die this time. If I will live, I will live. If I will die, I will die. >> TITLE: The nearest hospital is four hours away. >> MAHESWORI: Some said take her to the hospital, some said drive her down. Everyone had opinions. But how would you get a car without money? >> TITLE: She plans to deliver in the same place she gave birth before. >> MAHESWORI: In November my daughter was born. I had the baby in our cow shed. >> TITLE: By local custom, mother and child are quarantined as "unclean." >> MAHESWORI: For 12 days after the birth, the baby and I were kept in the cow shed. On the 13th day we were allowed out. You can't take a newborn in the house, God gets angry. You're better off in the cow shed. >> TITLE: Because of Maheswori's high-risk pregnancy, an aid worker traveling with the camera crew makes a case to village elders. They consent to having a birth attendant, and she won't give birth in the cow shed. >> MAHESWORI: I am going to die. Oh my mother! I am dying ... >> WOMAN: Get me the gloves, quickly. >> MAHESWORI: I am dying ... am dying. Please ... I can't. >> WOMAN: It's a complete breech situation. Push hard! >> INDUKA KARI [CARE Program Officer]: She was completely unaware of the fact that she would need medical care because her first child was breech born. >> TITLE: She gives birth to another daughter, Seema. >> INDUKA KARI: If she hadn't gotten proper care by a trained birth attendant, she would've died. >> MAHESWORI: I'll rest for seven days, but then it's back to work. I have to pound the rice, carry water, cut grass, and chop wood. Life is tough here. >> TITLE: Living Proof. Real Lives. Real Progress. >> TITLE: In Nepal, 80 percent of births occur at home with no skilled birth attendant like Maheswori had. But support from global partners is helping train Nepal's 45,000 female health volunteers, and they are dramatically improving Nepal's health outcomes. >> TITLE: In Part 2. Living Proof. Real Lives. Real Progress. www.one.org/livingproof