Kampala — John Donne, my favourite poet and I share a few similarities. We were both born at home under a cacophony of church bells and sirens respectively. Unlike the Rev John Donne, the decision to give birth to me at home was one enforced on my parents by the government of the day. There was a curfew that night and no excuse was excuse enough to break it.
My mother was among the 70% of sub-Saharan women who would deliver at home that year. Mother and I were lucky, however, because we were attended to by my grandmother, a highly skilled birth attendant, and my father, a young budding paediatrician then. Such good fortune does not befall the vast majority of African mothers and children.
In the year of my birth, 30 years ago, there were roughly half a million mothers who succumbed to pregnancy-related complications worldwide.
That year, for every 100,000 of us Ugandan babies born alive, roughly 500 mothers died in child birth or pregnancy-related complications. Countries in sub-Saharan Africa that year averaged roughly 1,000 maternal deaths per every 100,000 live births.
My own mother survived, but only just. Countless other women did not or were permanently disabled from what is supposed to be the most noble and natural act a woman can ever take part in. Those damning figures are one of the few statistics that have remained unchanged throughout medical and world history.
Today, roughly the same mothers will die in Uganda and sub-Saharan Africa as they did in my year of birth. This is despite seemingly impossible feats that have been accomplished elsewhere in the 30 years since. For example, small pox has been eradicated, polio is on its way out, the Cold War ended, apartheid was kicked out of South Africa and Africa has hosted a World Cup.
In addition, Kampala then had just hosted an Organisation of African Union (OAU) summit, similar to the one being hosted today. African presidents and bureaucrats have since come and gone, but to this day a woman in sub-Saharan Africa still has a one in 16 chance of dying in pregnancy or childbirth, compared to a one in 4,000 risk in a developed country. This is the largest difference between poor and rich countries of any health indicator. Reducing maternal deaths is clearly not rocket science.
Poor maternal health or death due to pregnancy and its complications has a devastating effect on newborn and child health. A child who is tragically left motherless at birth is 10 times more likely to die within two years of their mother's death. Yearly, eight million babies continue to die before or during delivery or in the first week of life.
At least 20% of the burden of disease in children below the age of five is related to poor maternal health and nutrition, as well as quality of care at delivery and during the newborn period. Ensuring that every pregnant woman sees and gives birth in the presence of a skilled worker is extremely important to ensure survival. Empowering that provider with the skills and means to give effective curative and preventive interventions is imperative in tackling maternal and child mortality. Such interventions are cheap, easily available and have been widespread in developed nations for more than 30 years.
Up to 70% of all newborns and countless mothers would survive childbirth if every mother and child had access to antibiotics for infections, sterile blades to cut umbilical cords, drugs for preventing and stopping bleeding during childbirth, and mothers understood the importance of immediate, and exclusive breastfeeding and skin-to-skin contact to keep their babies warm.
Clearly, strengthening and optimising the continuum of care between maternal and child health is extremely vital to reducing unnecessary deaths. Tools and technologies for early identification of dangerous conditions, as well as strategies to more rapidly diagnose and treat mothers and babies, also provide a significant ability to achieve maximum health impact.
Universal access to these interventions should be the goal of all African governments if they are to tackle the two Millennium Development Goals that have proven difficult to achieve; ensuring maternal survival and reducing child mortality.
Maternal and child deaths, though equally tragic, are not as dramatic and headline grabbing as say terrorist attacks. It took almost 30 years and countless mother and child deaths to place maternal and child health on the AU agenda.
It should not take two equally tragic events to remove it. Let the next 30 years be remembered as the period when preventable maternal deaths and child deaths became a thing of a distant past. In order to achieve this we need to remember John Donne's words: "Every death diminishes me so ask not for whom the bell tolls. It tolls for thee."
The writer is the general secretary, Uganda Paediatric Association

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