The United Nations: Prioritizing medicines for mother and baby

Worldwide, mothers and their babies are dying—the greatest injustice is we have the solutions today to save them. Dr. Ndola Prata travels the globe going the last mile to reach women with essential life-saving medicines. Her conviction is borne out of experience. 

"When I was a young doctor in rural Angola, my home country," says Prata, "I watched women bleed to death in my clinic, not because I didn’t know how to treat them, but because I didn’t have the supplies and medicines I needed to do so. I still have nightmares."

Prata is a pioneer in the education of communities about misoprostol, a simple and well-tested medicine used to protect against the leading cause of maternal death, postpartum bleeding, and one of several overlooked health solutions that the United Nations’ (UN) Commission on Life-saving Commodities for Women and Children is considering this month during the General Assembly meeting in New York.

Somewhere around the world, every two minutes a woman dies in pregnancy or childbirth. Her community is left grieving, her family motherless, and her child facing a ten-fold greater risk of dying before their fifth birthday. Nearly all of these tragedies play out in developing countries – a woman often dies from a preventable cause by virtue of where she lives.

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Santé maternelle à la façon Burundaise: the opportunity of misoprostol

“You’re going to Burundi.” I remember at the time thinking, “Awesome! Looking forward to it! …Um…Where’s Burundi?” I consider myself to be pretty adept at geography. I knew Burundi was in Africa somewhere; nevertheless, I quickly began my pre-trip homework, attempting to soak up as much Burundian culture, history and politics as my web browser would allow me.

As part of this travel research, I studied up on Burundi’s history, both fascinating (kingdoms, royal scandals, bounty derived from fertile lands), and horrifying (a civil war mirroring Rwanda’s genocide but lasting more than a decade), and the fact that it’s one of the most densely populated countries in Africa (at approximately the size of Maryland, it has almost twice the amount of inhabitants -10.6 million people!). And with most women giving birth to six children in their lifetime, the risk of dying due to complications in pregnancy or childbirth is the fifth highest in the world.

And of course I researched the cuisine. As a lactose intolerant vegetarian with a strong passion for food, this is always at the top of my pre-departure checklist.

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No More Drama

I couldn’t help but think it was a bit insincere. I was the employee writing about Africa, talking intimately about the women who have benefitted from our programs, yet I had never visited the region where my work is so closely connected. I sat in the airport in Tanzania, waiting for my return flight home with a grin on my face. Well, that was amazing, was all I could think.

Deep down my inner child expected Africa would bring with it a few talking animals and beautiful sunsets, you know, the cinematic kind. But to my disappointment no singing lions ever appeared. Instead, I left Tanzania for lack-of-a-better-word “stoked” on the work of VSI. (Sorry, my California roots are showing.)

The most impressionable leg of my trip happened in the first few days:

We traveled a little over an hour to the outskirts of Dar es Salaam, Tanzania. I had hoped for some inspirational, authentic African music to accompany my travels, you know, drums and some tribal chanting, but I settled for the Celine Dion and Beyoncé emanating from the speakers of the driver’s jeep. One bumpy dirt road after another, I was grateful for the driver and the guide who accompanied us as they meticulously avoided potholes and near run-ins with large trucks and motorcycles.

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Time to Rest Another Day

“Sister Joanna,” she called from the front seat. “It has rained. Our roads, they are very bad. Are you okay?”

“Yes, yes. I am fine,” I answered.

The truck had just hit another huge bump on the dirt road. The vehicle crept forward, bouncing me out of my seat every few minutes from the holes and dips on the path. We had been stopping every five minutes to assess the safest route through muddy puddles. I had been in Ghana long enough to know that a few bumps on the road were something to be expected during site visits.

“Sister Joanna,” she called again “Today we can do three more facility visits.”

“Okay, Auntie Sofia.” I didn’t bother asking about the details, such as how far we would be traveling or what time we would get back. I knew she would take care of me and that the work would all get done. 

The sun was starting to set and we had been inching down dirt roads since early in the morning, trying to visit as many health facilities as possible.

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Steps and leaps

2011 was a great year for VSI, a great year for women, and a great year for me personally.

VSI wrapped up research projects introducing life-saving misoprostol tablets in five countries, and in that process I had the opportunity to meet women and providers benefitting from our efforts in villages and towns throughout Africa — women and providers whose stories I’ve shared over and over with colleagues, friends and family who rely on me to bring Africa to life with the voices and photos of the heroes I’ve met there.

I met Maria, an elementary nurse in Mozambique, who told me in a calm voice with pain in her eyes about her own daughter’s unsafe abortion, and how she desperately wished she’d had misoprostol tablets to give her so she didn’t have to suffer.

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