On December 24, 2008, Adama Kamara was six months pregnant and went into premature labour. By the next day it became clear she was suffering prolonged labour. The family observed her for one day before transporting her to a government hospital in Kambia, Sierra Leone.
Transporting her to the hospital cost Le40,000 (US$13), which her husband borrowed from his neighbours. When they arrived at the hospital, Abu Kamara had to pay Le2,000 (US$0.67) for registration and Le10,000 (US$3.30) for a hospital bed, in addition to charges for medicines.
At the hospital, Adama was given an intravenous drip as well as several injections by the nurses on duty. She spent that day and the next in the hospital, and no doctor was present during that time. Abu Kamara came home on the second day and when he returned to the hospital after several hours, he found that Adama had delivered the baby, but it had not survived.
Adama was bleeding heavily. Despite the fact that this was an emergency situation and despite the government’s free care policy, there was no free medication. Abu Kamara was told he had to pay for medicines for Adama or “she will die”. He did not have the money; so he took her home. Adama was delirious and unable to speak for herself, even if she had been given the chance. She died at home the next day. Abu Kamara is still struggling to pay off the debt he incurred taking Adama to the hospital and paying for medicines.
No, this does not happen in countries like Sierra Leona alone.
In August 2007, two weeks after her baby was stillborn, Trina Bachtel, a 35-year-old white woman, died in the US. She had reportedly suffered from pre-eclampsia during her pregnancy, a condition that requires careful monitoring during prenatal care. Although insured at the time of her pregnancy, the local clinic had reportedly informed her that it required a US$100 deposit to see her, because she had incurred a medical debt some years earlier – even though the debt had since been repaid. When she fell ill, Trina Bachtel delayed seeking care, unable to afford the fee at the local clinic.
She finally received attention in a hospital 30 miles away, where her son was stillborn. She was later transferred to Columbus, Ohio, 75 miles away, where she died. The two local clinics in her area later denied having seen Trina as a patient. The associate administrator at one clinic said they may place “credit restrictions” on patients believed to be able but unwilling to pay their bills.
The story of Adama and that of Trina is one that of thousands, lakhs.
More than 300,000 mothers, sisters and daughters die each year from complications related to pregnancy and childbirth – one every 90 seconds. Most of these deaths could have been prevented. The complications are largely unpredictable, but they can be treated. The vast majority of women who die, of course, are poor and come from developing countries. In rich countries, those who do die are more likely to come from marginalised and poor communities.
Amnesty International is right when it says that this is not just a global health emergency; it is a human rights scandal. No woman needs to die because of poverty, injustice and gender discrimination. Maternal mortality reflects the cycle of human rights abuse – deprivation, exclusion, insecurity and voicelessness – that defines and perpetuates poverty.
You cannot talk of human rights at candle-lit elitist marches turning a blind eye to maternal mortality. And you cannot talk of maternal mortality sitting in an airconditioned, glass-panelled office by ignoring the fact the worst form of human rights abuse is poverty.
It's time you started talking of dignity. It's time to wage a war on poverty.
