A People Project

Having been involved with various VSI country programs throughout Africa and Asia, I continue to be fascinated by the nuances and distinctions between our programs in different countries. Some are hard to get off the ground, some are rife with surprises, and some are surprisingly smooth, but all of them are inspiring, mostly as a result of the people behind the scenes.

The mothers, health workers, traditional birth attendants, decision-makers at the Ministries of Health – theirs are the faces and stories that inspire us to keep working. They are also the best evidence of our efforts to improve lives and the effectiveness of our misoprostol programs.

For me, one of the things I always worry about the most when starting a new project is whether it will be accepted and embraced by the community that it is designed to serve. And often it isn’t until we are working directly with the providers who see maternal death every day that we know the real desire for and impact that a community-based project like this will have.

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A Tablet's Journey

For women in Bangladesh, misoprostol can mean the difference between a happy, healthy delivery and one marred by fear, or worse, life-threatening blood loss. When we think of pregnant women having access to misoprostol tablets, rarely do we think of a journey that involves planes, boats, rickshaws, and feet. But that’s exactly how a single box of misoprostol tablets journeys from the capital of Bangladesh, Dhaka, to women in rural Moheshkhali upazilla (district) in Cox’s Bazar.

After a one hour flight out of Dhaka, myself, five colleagues from EngenderHealth and one box of 15,000 misoprostol tablets arrived in Cox’s Bazar. Like us, the tablets were bound for Moheshkhali, a small and remote island sub-district off the coast.

1. Ferry Area: How do the tablets get to the boats?

2.

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Community Participation

As the buses arrived at the dusty and dark conference hall on a hot morning in Zaria, Nigeria, groups of women emerged, wearing matching hijab (the covering Muslim women wear over their clothing) with the names of their communities and messages about the important role of misoprostol in childbirth inscribed on them. As they made their way quietly through the entranceway, they came across photographs mounted on the wall. Fatima, from the village of Hayin Ojo, stopped and covered her mouth in awe as she focused in on the photograph of her holding a “miso baby.” The laughter came next, as the women marveled at all of their photographs.

Men were in attendance too and filed into the great hall taking their places in the center rows. The women and their babies organized by community and sat in the rows to the left of the men. Both groups talked quietly amongst themselves, reviewed the Hausa-language materials on the community-based program introducing misoprostol, and posed with their “miso babies” for photographs for the news media.

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