by Nicole Cheetham, Director, International Department

Last week Amnesty International released a report on maternal mortality in Burkina Faso.  The report tells us that as many as six women die every day in Burkina as a result of complications due to pregnancy or childbirth.  Poverty, shortages of supplies and trained medical staff, corruption and gender discrimination are reported as underlying causes of high rates of maternal death. 

In 1999, I began working in Burkina where Advocates had a community based program to improve reproductive and sexual health among young people in 20 villages across three rural provinces.   A couple of years into the project, my husband and I decided to have a baby and I became pregnant.  One of my colleagues who was working on the project out of the capital, Ouagadougou, also became pregnant with her first child around that same time.  In fact, my son and her daughter were born within a couple of weeks of each other.   As I came closer to delivering that December in 2001, I remember thinking about her---wondering what kind of care she was going to have access to, particularly if she were to have any complications.  I didn’t want to think that just because of her circumstances, she might not have the same chance as I would to safely bring a child into this world. 

As it turned out, she safely delivered her baby.  She was, after all, in Ouagadougou, the capital, and probably had access to the some of the best care available because she was working in the health field.  She would stand a much better chance than younger women or women who lack pre- and post-natal and obstetric care in the rural areas.  Back here in Washington, DC, my delivery, while not high-risk or particularly complicated, was still not devoid of some significant challenges. After hours and hours of labor, I finally gave in to a C-Section upon finding out that my baby’s heart was showing signs of distress.  To this day, I wonder what would have happened if I had been trying to deliver in one of the villages in Burkina---would I have made it and would my son be alive today?  Maybe so, maybe not…   

While working in Burkina, it was comforting to know that we were making a difference for young women through our program, which was empowering them to exercise their right to reproductive health.  In partnership with three youth-led associations in the provinces and Mwangaza Action, a national NGO, we provided training and support to young people and community members that ultimately translated into more young people feeling that they were able to talk to their parents about sexuality issues; improved knowledge about HIV among youth; improved knowledge on how to use a condom correctly; more awareness of where to obtain reproductive health services; and more people who did not intend to excise their future daughters---that is, to subject them to female genital cutting/mutilation.  The program was based on a community participation methodology that integrated parents, elders, religious leaders, and other community stakeholders throughout the process, thereby supporting an environment of greater access to reproductive health information and services for youth.  

Given my experiences working in Burkina, I believe that it is possible to decrease maternal mortality.  I saw change happen through community-led mobilization, despite the skeptics who said, and many still say, such changes are not possible in poor, rural communities. Yes, there is gender inequity. Yes, it is difficult for women to convince their husbands to agree to contraception or acknowledge that they need care.  Yes, reproductive health services can be too expensive or difficult to access for women. But if communities are empowered to identify problems, seek informed solutions, and mobilize for action, assumptions can be challenged, misinformation can be corrected, barriers can be removed, and norms can shift over time. 

Amnesty International’s report recommends that reproductive health care be free in Burkina Faso, as long as the quality of health care is also improved.  They also recommend that the Burkinabe government stress the importance of family planning to prevent maternal deaths, unwanted pregnancies and unsafe, illegal abortions. Finally, they note that women have a right to adequate and accessible reproductive health care and that educating women and men in Burkina Faso about this right is fundamental to ending maternal deaths.

Putting such recommendations made by Amnesty International is not easy---I’m not saying that it is.  If it were, the Millennium Development Goal 5 on improving maternal health wouldn’t be the goal with the least progress to date among the eight Millennium Development Goals.  Still today, more than half a million women die each year from complications due to pregnancy and childbirth---this is the leading cause of death for young women ages 15-19 in low- and middle-income countries. Let’s face it; we are a far cry from reaching the targets of reducing the global maternal mortality ratio by three quarters by 2015 and achieving universal access to reproductive health---but that doesn’t mean that it cant’ be done.   

I hope to be able to go back to Burkina some day.  I’d like to see my colleague and her two daughters---to compare notes and share stories.  I’d like to continue working together to improve the lives of young women and young men in the rural provinces.  I’d like to see us and the global community make a dent in maternal mortality statistics and reach that Millennium Development Goal 5 in Burkina Faso and around the world.