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Birth in Laos: 300 Midwives/6.5 mn People

Reading this UNFPA article from 2009 about birth in Laos, I was shocked to see that only 86 midwives were to be found in the whole country.

A later 2012 article shows that, with the inclusion of the first 2 cohorts of midwives trained in decades, the number is around 300.   In training midwives, the government has made a commitment to improving maternal health. Progress is being made but much more needs to be done.

Here’s some points from the articles:

  • Women in rural areas give birth at home to avoid the 3-4 day trek to a hospital or because the rainy season makes travel impossible.
  • Health centers are understaffed and community health workers lack midwifery skills
  •  Laos has the highest rates of maternal death in Southeast Asia
  • 18-20 per cent of all Lao births are attended by health personnel
  • Average day: two families lose a mother and nearly 20 babies are stillborn
  • Each week: 100 infants die many due to insufficient neonatal care
  • 2 per cent of Lao GPD is spent on health
  • A “free” visit to a Lao clinic/hospital can cost a family up to one month’s salary in expenses for transportation, accommodations, food and medicine.

 

Yoga Reduces Depression in Pregnant Women

In addition to being a clean birth kit advocate, I am a prenatal yoga teacher in New Haven, CT.  I was happy to see this article showing how beneficial yoga can be for pregnant women.

Prenatal yoga may help women cope with depression

Yoga

Photo : University of Michigan Health System

It is estimated that about one in five pregnant women experience major depression, and now new research has suggested that yoga maybe beneficial for pregnant women.

Researchers  say that the study is the first to provide evidence that mindfulness yoga may be an effective alternative to pharmaceutical treatment for pregnant women showing signs of depression.

The findings were published in Complementary Therapies in Clinical Practice.

Women who showed signs of depression and who were between 12-26 weeks pregnant participated in 10-week 90-minute mindfulness yoga sessions that focused on poses for the pregnant body, as well as support in the awareness of how their bodies were changing to help their babies grow.

Researchers found that the women who participated saw mentionable reduction in depressive symptoms and a stronger attachment to their babies in the womb.

During pregnancy, hormones rage and depression and anxiety have become a serious health concern. A variety of factors contribute to women experiencing persistent irritability, feelings of being overwhelmed and inability to cope with stress.

If the aforementioned symptoms are left untreated to, health risks, for both the mom and baby, can include poor weight gain, preeclampsia, premature labor and trouble bonding with the new baby.

Lead author Maria Muzik said developing feasible alternatives for treatment is critical.

“Unfortunately, few women suffering from perinatal health disorders receive treatment, exposing them and their child to the negative impact of psychiatric illness during one of the most vulnerable times,” Muzik said.

Previous studies show that many pregnant women are reluctant to take antidepressants, although proven to effectively treat these mood disorders, out of concern for their infant’s safety.

Evidence suggests women are more comfortable with nontraditional treatments, including herbal medicine, relaxation techniques and mind-body work.

Yoga continues to grow in popularity but in the United States, many classes concentrate on yoga as “exercise,” omitting the practice of being fully present in the moment and aware, authors say.

Meanwhile, mindfulness yoga – which combines meditative focus with physical poses – has proven to be a powerful method to fight stress and boost energy.

Read more at http://www.counselheal.com/articles/2470/20120808/yoga-reduces-depression-in-pregnant-women-boosts-maternal-bonding.htm#m60YG7Qw7Krw9xyG.99

Clean Birth Kits as “Frugal Technology”

This is an interesting summary from the Lancet about the impact of high tech medical equipment exported to the third world. Makes you think. An astounding 40% of medical equipment in the developing world is broken compared to 1% in the developed world.  Well-intentioned equipment from first world donors accounts in part for this.

Instead of high-end tech, the study suggests that “frugal technologies” like a rural ambulance made of a motorbike and stretcher sidecar are better bets.  The report also points to improvements in sanitation and roads as a ways to positively impact health.

I feel pretty good about the frugality of clean birth kits.  Low tech, focus on hygiene through education.  And they don’t break.

Here’s the whole article:

Technologies for Global Health

Published August 1, 2012

Collaboration between The Lancet and Imperial College London, UK, has resulted in a new Commission, which examines how medical technology should best be used to improve health in low- and middle-income countries. The report concludes that in many cases, medical technology—almost exclusively developed in rich countries—is simply inappropriate for use in poorer nations.

Executive summary

According to hospital inventories, an estimated 40% of healthcare equipment in developing countries is out of service, compared with less than 1% in high-income countries. The inappropriate deployment of medical technologies from wealthy countries plays a major part in this high failure rate.

Instead of relying on hand-me-down technologies from wealthier countries, which can be costly, inappropriate for local conditions, and even dangerous, the authors urge a renewed effort towards developing what they call “frugal technologies”—cost-effective technologies that are developed specifically to cope in local conditions. Examples of frugal technologies which have been developed to meet local needs include: the Jaipur foot, a rubber prosthetic for people who have lost their leg and foot below the knee; PATH’s Uniject injection system, which allows once-only use of needles for injectable contraceptives; and the eRanger, a durable rural ambulance, based around a motorbike and stretcher sidecar (which can be modified to carry one or two people).

The report also advocates a wider understanding of what we mean by medical technologies, pointing out that technological improvement to sanitation and road conditions could also have a far-reaching impact on public health in many low- and middle-income countries. Furthermore, the authors argue that advances in technology need to be accompanied by innovation to have a significant effect on health—this includes the development of effective delivery mechanisms and novel approaches to financing.

How to Get Girls Involved in Improving Maternal Health

This week a CleanBirth.org gained a highly-motivated high school intern.  Thanks Marla!  I know that your passion and energy will make a difference.

Before bringing Marla on-board, I researched projects motivating youth from the US to support youth in the developing world.   I love the UN’s Girl Up campaign, which shows in an engaging, accessible way how  (and why) girls can help their peers around the world.  Marla said that she could “relate to” the Girl Up video on utube.  That’s a big accomplishment — crossing the divide between US teens and girls in Africa.  Making kids feel connected to other people’s suffering in a way that empowers, not alienates.

An article by Scott Seider at Boston University “Social Justice in the Suburbs: Engaging Privileged Youth in Social Action” talks about the need to educate students about these issues in the right way.  In his study of “83 high school students from an affluent Boston suburb” taking a course on social justice, he found that kids can feel overwhelmed by the hugeness of poverty, protective of their own wealth, and alienated from both the poor and those working to fight poverty.  Too much negative information can cause them to stop listening.  What’s need is smaller a dose information and bigger one of hope.

As an adult, the issues surrounding poverty seem too huge. That is why I cose clean birth kits: they are tangible and specific; they aim to stamp out a particular problem.  I’m not taking on global maternal health, instead I’m focused on birth-related infections in 50 villages in Southern Laos. Because I can do that.

Marla and I will bear these lessons in mind as we reach out to her peers.  She has shared that smaller group settings are more conducive to question-asking and getting people interested.  So we’ll do that.  We will keep the focus positive and show the kids that, though poverty is overwhelming, there are things we can do.

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