The import and urgency of BlogHers Act -- to improve maternal health and reduce maternal mortality worldwide -- hit me hard when I read this piece of news about my home country, India. According to a report on maternal mortality in 2005 -- put together by WHO, UNICEF, UNFPA and the World Bank --- 117,000 women died due to pregnancy or child-birth related issues in a year, the largest number of maternal deaths in a single country.
Just to make sure we are not too quick to condemn, let's put the figure in perspective. India is not at the bottom of the maternal health ladder. Its maternal mortality ratio or MMR (that measures the number of maternal deaths for every 100,000 live births) is 450, not bad compared to Afghanistan, Bangladesh, Kenya and Cameroon, among others.
To be fair, we can argue that given the MMR, India's dubious distinction of 117,000 maternal deaths may be a factor of its 1 billion population, making it look bad next to smaller nations like Congo and Nigeria or even Pakistan. Hmmm....
If population is the spoilsport multiplying factor, how did China, India's competitor-in-chief and its more populous brother, manage an MMR of 45 compared with our 450? Also, the lifetime risk of maternal deaths in India is 1 in 70, compared with China's 1 in 1,300. Given their economic and, if I may dare say, cultural comparability, I'd argue our numbers should have been far closer.
We can drown ourselves in figures and charts all we want, but India has a big problem at hand as far as maternal health is concerned. Its current rate of reduction is not good enough to meet one of UN's Millennium Development Goals of slashing maternal mortality by three-quarters by 2015. According to the maternal mortality report (2005), maternal deaths have decreased at less than one per cent annually between 1990 and 2005, far below the 5.5 percent decline required to achieve this MDG.
Now, going by sheer numbers, it's rather easy to figure that an improvement in India's figures can pull up figures globally.
To me, this goes far beyond numbers and how they make India "look" or "compare" internationally. So many women dying doing something so basic, essential and crucial, in a country that prides itself for being scientific, rational and spiritual at the same time, reeks of misplaced priorities. As UN official Paul Hunt has been quoted as saying: "For a middle-income country of its stature, the rate of maternal deaths in India is shocking".
That's my point: the paradox of India's professed love for its goddesses and mothers but its inexplicable callousness towards women, its emphasis on education and dowry at the same time. This is what, and not just the numbers, that makes India a classic case. Crack the India problem, and half the job is done.
It's hard to grasp India's apparent neglect of maternal health in isolation. It's a function of several socio-cultural-economic factors, including the preference for boys over girls (more about that in my next post) and malnutrition, which results from traditions of patriarchy and dowry, poor education, lack of economic/financial independence, you name it. India has 933 females for every 1000 men, 54 percent women are literate compared with 75 percent men, and the female workforce is half that of men.
And, speaking more universally, childbirth is taken so much for granted, that few stop to gauge the enormity of the risks involved. Women are delivering babies all the time, aren't they?
Speaking of women's health in general, India presents unique problems that need to be addressed simultaneously, but it also has its advantages. It has functional governments in place, its people are eager to get things done, its citizens are gaining more access to resources, and it wants its masses -- both men and women -- educated, employed and equal. More women are getting educated and independent, and more are taking their health seriously.
I would like to believe that this is not just a woman's problem -- [Aside: I think we should start with making it compulsory in India for spouses to be present during prenatal tests, delivery, and postnatal care.]-- but going by the way things are, this is our battle and we might as well take control of it.
Traditionally, Indian women (specially wives and mothers) tend to put their families ahead of themselves, even neglecting their own health and well-being. I am all for selfless service and family values, as long as those values are shared by all family members, who take care of each other proportionate to the need rather than for the sake of preserving traditional roles. I don't doubt that Indian women will ultimately choose to take themselves more seriously, but we need to keep the focus and pressure on. India is fertile ground for the BlogHers Act to take shape.
For more on Indian women and health: National Family Health Survey
A few BlogHers and organizations writing/doing something about it (Please feel free to add to the list):
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