By Ash Rogers, Executive Director, Lwala Community Alliance
On Mother’s Day, we honour the women who have nurtured us, guided us, and helped us gain the skills to thrive. In recent years, as I became a mother myself, it has also turned into a period of reflection, as I ponder the bond with other women who have shared in the miracle of creating life. I feel a deeper sense of solidarity with my own mother—and with women around the world whose experience giving birth can be challenging, and sometimes fatal.
This was never more evident to me than when my story as a mother began two and a half years ago. I gave birth to my son, Wesley, in a pristine hospital in Nairobi, Kenya with my husband by my side. The doctor placed Wesley on my chest and my husband leaned in close so we could look at him together. Within seconds, the room became a buzz of frantic activity— the nurse briskly handed my baby to my husband, and asked him to step back. I was suddenly flooded with a pain more acute than anything I had even experienced during labor.
I became cold and lost the ability to move; I began to feel less and less present in the room, as if I were fading away. I remember looking up from the hospital bed at my sweet new baby and my loving husband and longing to be able to stay with them, even for just a little bit longer. I didn’t want to leave. I didn’t want to miss what was sure to be the most precious moments of my life.
As profound and terrifying as this experience was for me, it is not uncommon. In fact, the condition I was suffering from, postpartum hemorrhage, is the leading cause of maternal death in most of the world. Each day, more than 800 mothers die in childbirth. 99% of these deaths occur in developing countries and 66% occur in Sub-Saharan Africa. It is an intolerable fact that mothers are significantly more likely to die, simply because of where they are from and/or the colour of their skin.
Because I delivered with skilled clinicians, in a well-equipped health facility, I lived. Just hours later, after several interventions and a blood transfusion, I woke up, fed my beautiful baby boy for the first time, and continued the rewarding and tumultuous journey of motherhood.
The world has the technology to keep mothers alive: approximately 88% to 98% of all maternal deaths are preventable. The challenge is extending that technology to rural communities and building equitable health systems that treat all women with dignity.
At Lwala Community Alliance, we believe that all women deserve to survive childbirth. We were founded by a group of community members in rural Kenya who envisioned a health system that could reach them, and then built one. They donated community land and resources to build their own health centre and created a cadre of community health workers from amongst the traditional midwives who had been serving them for generations. Armed with new training, a mobile application, and support from a nurse, these community health workers bridge the gap between rural mothers and an intimidating health system. Lwala community health workers accompany mothers through pregnancy, ensure they deliver in a safe health facility, and follow-up regularly in those first precious days and years of a baby’s life.
Through this approach, Lwala has increased the skilled delivery rate to 97% and reduced under-5 mortality by 64% of the regional average. Now, we are in an all-out effort to expand our work and save more lives.
In fact, this year Lwala launched an initiative specifically aimed at postpartum hemorrhage. We identified the non-pneumatic anti-shock garment, a technology developed and tested by the University of California – San Francisco (UCSF), but not in active use in Kenya. This device essentially acts as a complete-body tourniquet, preserving blood flow to the vital organs of a hemorrhaging woman, and buying precious time for her to be transferred to a facility capable of providing surgical care. In partnership with UCSF, we have begun training facilities across a population of 1 million on the use of this life-saving garment.
Only days after our first training, Lwala received its first postpartum hemorrhage case. Achieng sustained a severe cervical tear while delivering her fifth child, and needed to be transferred to a facility that would be able to treat her. Thanks to the garment, clinicians had enough time to transport her to a surgical facility, saving her life, and ensuring that she would have the opportunity to celebrate another Mother’s Day.
This device is a low-cost, scalable solution that has the ability to save thousands of lives throughout Kenya. The Kenyan Ministry of Health is watching this pilot closely, and we hope it is a model that can be scaled nationally.
This Mother’s Day, as we honour the mothers closest to us with handwritten cards, flowers, and social media posts, let us also honour motherhood as a whole. Let us honour mothers across geography and race, by fighting for their dignity and equity.
*Names have been changed for privacy