Launch of the 2005 Report
I have the immense privilege to stand before you, just one doctor among so many in Africa who try in the course of their daily practice to save lives.
I am here because I was filmed by the BBC doing my regular work as an obstetrician in a developing country - in my country,Chad. The documentary shows two realities. One is the reality of the conditions in which we work to provide health care in many countries in Africa. The second is the more urgent - it is the reality that too many women die in Chad, as they do throughout Africa, of pregnancy-related complications.
These complications - hemorrhage, eclampsia, infection,obstructed labor and abortion complications - occur in Europe' Land North American as well as in the developing world. However,a woman's chance of dying in Chad is 1 out of 11, while in the United Kingdom, for example, it is 1 out of 5,100, because British women have good obstetric care whenever they need it. This is the tragic inequity between women living in poor versus rich countries.
My medical colleagues and I know exactly what to do to save our patients' lives. The necessary skills, equipment and supplies are not technically sophisticated.
So, why do poor women die?
Poor women in Africa die because the services they need to save their lives are too few and too far away. Even when women do get to a hospital, the services are too often of poor quality - drugs and supplies are not available, equipment is missing or broken,and staff are not adequately trained and supported. In short, the health system does not function as it must to save lives.
The health system can, however, be improved, with immediate results.
I witnessed this in my hospital in Chad where French Cooperation provided supplies, allowing us to treat women immediately rather than waiting for their families to find money to buy supplies. While this assistance was available, we were able to save lives in a way that is not currently possible.
I have also seen health systems improved and women's lives saved in countries in Asia, Africa and Latin America where I work with Columbia University's AMDD Program. An important principle I learned and want to emphasize here is that the availability of staff, drugs and equipment is insufficient in themselves to improve systems and save lives. What is required is the combination of political will and adequate funds in add iti onto these technical improvements.
What more must be done?
The deaths of women and newborns are directly linked to underdevelopment and extreme poverty. Reducing poverty and developing infrastructure equitably are essential to saving lives.
Every partner has a role.
Governments must be accountable to their people.
Health professionals must be accountable to all the patients they serve.
I have come to understand that some health professionals neglect women who are poor or otherwise marginalized and we health professionals must combat this attitude by recognizing that all women have the right to good quality health care, no matter who they are and what their economic status may be.
The international community must be accountable to the developing world.
I leave you with two questions which are critical for all of us to consider if we want to see serious change by 2015.
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