WEBVTT

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Previously in life… While a lot
has been done on (inaudible)

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the rights of woman have not been addressed, they\'re
not educated or informed about there own health.

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Educating girls and educating women is the best investment and
purely economic terms that one can do in any poor country.

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Many developing countries are
incorporating again in their national

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(inaudible) developing goal reports.
The issues of reproductive health.

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[sil.]

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Mother is a mother. She is the most important
person in the child\'s life. The most important.

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There\'s no one else like her.

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Just a few days before she died, she said
that \"I should take care of the children.\"

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\"My children\" she said. \"Educate them,
guide them\" this is what she told me.

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My wife was very attached
to my children and to me.

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She loved us a lot.

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It was two in the morning in 1999.
Majeda Begum, wife of Bilal Hussain

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went into labor with her fourth child. Bilal
had no money to take her to the hospital.

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He left his three children with their
mother and went in search of money.

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Half an hour later when he came back
to the slum, his wife is already dead.

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The child was never born.

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When my wife died, I wasn\'t at home.

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I only came home half an
hour after her death.

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My elder son came and asked me, \"dad, why
don\'t you take mum to the hospital.\"

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I answered son \"we don\'t have the money for the hospital,
but do one thing take her to the clinic instead.\"

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But he said that he couldn\'t move her.

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So I said to him \"I tell you what,
I\'ll go and try to find some money,

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I\'ll be back in half an hour, nothing will change by then,
I\'ll be back in half an hour and will take her then.\"

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[non-English narration]

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In the four years since Majeda\'s death
according to the World Health Organization,

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more than eighty thousand women have died during
pregnancy or in childbirth in Bangladesh,

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that\'s 50 mothers dying every day.
Like many developing countries,

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Bangladesh faces many problems
poverty, overpopulation,

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and the lack of health and education services
particularly women\'s health services.

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Despite all these odds, Bangladesh is determined to cut
its maternal mortality rate bringing it down from 20,000

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to 5000 thousand a year over the next decade.
The question is, will it be able to deliver.

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[music]

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[music]

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Every year according to the
World Health Organization

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over 5,29,000 women worldwide die
in childbirth and in pregnancy.

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For over 20 years, governments UN agencies

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and NGOs have pledged to bring
down the number of women dying.

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Maternal mortality rate is considered one of the
most important indicators of a nation\'s development.

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Now in the millennium development
goals, 189 countries

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renewed their commitment in 2000 to reducing
maternal mortality by 75% percent by 2015.

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Right now you will find

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that the (inaudible) the development and the
promotion of this millennium development good

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(inaudible) brought you a
lot of development partners

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and this is because we now
appreciate that without addressing

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maternal mortality reduction in
strengthening systems to support this

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essential element of human health.

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We are not going to achieve sustainable
development in the effected economies.

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In developed countries, WHO statistics

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show that a mother\'s risk of dying from
pregnancy related causes is one in every 2800.

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In Bangladesh, the risk is 1 in 59.

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The Bangladesh health ministry is
acutely aware of the problems.

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In my country, the 130 million people

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uh… is very thickly populated country.
So umm… in the deliveries,

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uh… or the labor in the… in the
country, is still we\'re trying to go

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uh… but it is still umm… there
is a lot of uh… problems.

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And moreover the 90% of the
delivery occurs in the home,

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which is not at all uh… nicely attended.
So we\'re… we\'re trying to pile up

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this delivery system.

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The tragedies of maternal mortality
don\'t end with the death

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of individual women. The families they
live behind especially the children

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go on suffering the consequences. Before
Majeda\'s death, Bilal used to work in a factory.

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After her death, he remarried
and had two more children.

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But then he suffered a stroke that left him paralyzed
waist down and his family life deteriorated.

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[non-English narration]

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After I got married again, in the
beginning she loved my children a lot.

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But now she has started
causing trouble with them.

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For want of peace and quiet, my daughter has left
the house and I have started taking my son with me.

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[non-English narration]

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Bilal now supports his family by begging.

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His younger son Farooq
accompanies him while he begs.

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Bilal\'s loyalties are divided
between his two families.

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If a mother dies, what happens to her
new baby? What happens to her siblings?

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What happens to the community
on whom some, you know,

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charge would be levied? What happens to the
husband, how does he proceed with his life?

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Who looks after the children? Now the
richer people may me able to afford

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better health care and maybe somebody
to take care of the children,

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but the poor people they just get into worst
poverty and it becomes a vicious circle.

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The death of Bilal\'s first wife Majeda

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has had a profound effect on his children.
Bilal\'s 13-year-old daughter is now a housemaid

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and seldom returns home. His 15-year-old son
Masood collects scrap and works full time.

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With their education cut short, their
chances for the future remain bleak.

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Maternal mortality, I mean, just imagine

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if our mothers died at birth,
what would have our lives been.

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A nation cannot progress with
mothers dying in large numbers.

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A 99% percent of maternity deaths
take place in developing countries

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and most of them are preventable.

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A few kilometers down the road in the heart
of the city is the Dhaka Medical Hospital,

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one of the best hospitals in Bangladesh. Because
90% of births traditionally happen at home,

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the Bangladeshi women who do end up here are
emergency cases rushed into the obstetric ward

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when things go wrong. Often
though it\'s too late.

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One in six maternal deaths
are caused by eclampsia.

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Eclampsia or fits is caused by high blood pressure,
but is easily preventable if detected early.

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With the majority of Bangladeshi
births taking place at home,

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by the time women are brought to the eclampsia
unit here, most lose their babies, many die,

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and others suffer permanent
brain damage or paralysis.

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While maternal mortality is a key
development indicator in poor countries,

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maternal morbidities the disabilities that result
from birth complications are often overlooked.

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A recent WHO report shows that more
than 50 million women worldwide suffer

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from poor reproductive health and
maternal morbidities. In Bangladesh alone

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the UN Population Fund estimates six million women
suffer from maternal morbidities such as fistula.

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For one woman who dies, 16 much more women

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suffer from many disabilities
like obstetric fistula,

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that means hole in the bladder and rectum,
there may be prolapse of the uterus,

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uterus distends and hang outside,
there may be chronic pelvic pains,

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the woman suffer from pain, they cannot walk
properly, they cannot (inaudible) their husband

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because they have difficult intercourse and
sometimes that leads to family break downing

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and many maternal (inaudible)
becomes infertile.

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[sil.]

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Dr. Sayeba Akhter

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has done more than 250 operations
on women with obstetric fistula.

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Today is 22-year-old
Muneera\'s first operation.

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When I talk about the maternal morbidity, maternal
morbidity is not a physical or medical problems only,

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but it is a lots of social impact.

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It has impacts in psychological and
social uh… health of the woman.

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When, I mean, woman had maternal
morbidities, she cannot continue

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the proper family lives, she
(inaudible) of the family.

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One such outcast is 22-year-old Rena.
Over the past eight years,

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she and her four-year-old daughter have become
familiar figures of the Dhaka Medical Hospital.

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Rena was married when she was 13.
By the age of 14,

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Rena was pregnant and had an obstructed
delivery, which ruptured her vagina.

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Her first baby died.

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Rena developed fistula and lost control
of her bowel and bladder movements.

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She\'s already had six operations, but is still not cured.
Like many young girls whose pelvic bones are underdeveloped,

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obstructed delivery left Rena damaged.

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My husband\'s family were very unkind to me.

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They say things like, \"what use is
this wife, she can\'t make a family,

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she can\'t do anything, what good is she do
us\" but it was only my husband\'s family

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that was like this.

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[music]

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After her obstetric fistula, Rena had two
more children but her husband disowned her.

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Now whenever she\'s not at
the hospital in Dhaka,

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she lives with her mother in a village in
Narsingdi District three hours from Dhaka.

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Childhood was the best time for me.
Before I was married, I was happy.

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Since I got married,
it\'s all being downing.

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[sil.]

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Rena\'s mother has had to sell most of her land and
livestock to pay the costs of Rena\'s treatment.

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With the family\'s funds running out, Rena has
given her youngest daughter up for adoption.

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The family has learned the hard way.
Rena\'s sister Mukta

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is already 20, but after the
problems her sister faced,

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she refuses to get married young. Breaking with
tradition in villages like this is difficult.

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Government figures show that 58% percent of
girls in Bangladesh below the age of 19,

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are either pregnant or mothers and UN
figures show that it\'s teenage girls

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who face three times more risk of maternal
mortality and morbidity than women in their 20\'s.

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In some of the developing
countries is part of the culture,

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is part of the underdevelopment of
woman, the inequities that exist,

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the early marriages for… for… for… for
young girls that are still underdeveloped

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whose body are not yet ready to give births,
these are the issues that have to be addressed.

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I do wonder what it would be like

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if I were a man and I know that if I were a man,
I would never treat another woman like this.

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Since I\'ve been treated this way, I\'m sure I
would never treat another woman like this.

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[non-English narration]

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It\'s cultural practices like the social pressures
for early marriage of girls that are the root cause

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of the high maternal mortality rate in South Asia as
well as for some of the lowest levels of education,

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health, and nutrition for girls and women.

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Religious leaders are aware of the issues and say
that religion should be no barrier to women\'s rights.

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[non-English narration]

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I think the right given to women in Islam
who (inaudible) the right given to them

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by any other religion that I am aware of.

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Men and woman complete one another
and make each other whole.

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Men cannot without the help of women
(inaudible) nation or community or a family.

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Like similarly women cannot perform their
duties without the assistance of men

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but together they can make a
home, a society or a country

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beautiful, fruitful, and functional.
For this reason,

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men have a lot of
responsibilities towards women.

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Bangladesh has made
significant progress recently

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in reducing maternal mortality.
According to the UN population fund,

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the number of women dying in childbirth
is almost halved in the last 13 years

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down from 60 to 32 out of
every 10,000 deliveries.

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One of the government\'s first steps was to focus on
empowerment of women and invest heavily in goals

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and adolescent education. Primary
and secondary enrollment of girls

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went up dramatically. For the first time
ever more girls than boys now attend both

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primary and secondary school
and in the rural areas,

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the government\'s also training skilled birth attendants
and community midwives to perform safer deliveries

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and teaching them to refer complicated
cases to health facilities.

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Over the last ten years, maternal
mortality reduction has not reduced.

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We\'re continuing to lose a woman
to maternal mortality at the rate

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of 1 per minute. This is unforgivable

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because the interventions that are required
to save these woman lives are available

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and they\'re known to the global health
community. They\'re easy to implement

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and they can become a pivotal part of
any health system, no matter how poor

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the country. It is a question of priorities
even for the developing economies.

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So that I believe that it is feasible,

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it is possible if the countries
wanted deadly enough.

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For Rena and her family

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it\'s all come too late.

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I hope my daughter does
well and develops herself.

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I hope that I can educate her and she can
possibly be a nurse or even a doctor.

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These are my dreams. Maybe I can\'t
achieve them. At the moment,

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I can\'t even educate her but I\'ll try
my best and I\'m doing all that I can.

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Maybe I can make her a nurse, if
she can pass her matriculation,

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she could be a nurse. Just because
I\'m uneducated does not mean

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that I want my daughter to be
uneducated, that\'s all that I want.

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But Rena also tries to make sure that other women
don\'t have to go through what she went through.

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Rena\'s neighbor 18-year-old
Rasheeda was married last year.

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She is now five months pregnant, but
like other women in the village

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Rasheeda has not been for an antenatal
check up yet according to UNICEF

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15 out of every 100 women risk
complications giving birth.

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Rena\'s had a long day trying to convince
Rasheed\'s family to take her for a check up.

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When Rena first visited this district hospital,
it had no emergency obstetric care facilities.

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Last year, the government established
an emergency unit as well as a Maternal

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and Child Welfare Clinic. It has
taken a long time for governments

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in developing countries to appreciate the
important link between investment in health care

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and maternal mortality
reduction and development

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because development is
normally associated with

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a human capital that is… that is a
technical or that is of a high level

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such as the… the… trading
of engineers, doctors.

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Where as the natural effect what
contributes to economic development

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into the gross domestic product of a country
and therefore, the tendency the… the economy

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is how productive individuals in the economic
are, no matter at what level they\'re.

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In Bangladesh\'s rapidly
expanding towns and cities,

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the government\'s using a different approach.
They\'re trying to change a culture

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of risky home birth and women\'s
reluctance to attend antenatal clinics,

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instead they\'re taking health services to the
communities themselves especially in the slums.

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In a slum,

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though we have many facilities, in
the districts and the Dhaka city,

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big cities we\'ve got the facilities.
But due to the… their ignorance

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and the… due to their (inaudible)
their own, they don\'t like

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to sometimes they don\'t like
to come to the hospitals.

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So this thing, we have to go for their
awareness, particularly the mother-in-laws,

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their husbands. They\'ve got
(inaudible) don\'t like to come.

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This is the thing.

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Every day sister Samantha Biswas examines
patients in slums across the city.

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Many come to her for
reproductive health care.

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With volunteers in the massive media campaign,
community awareness about maternal health

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is slowly increasing, but there
is still a long way to go.

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There\'s a very close link between empowering
women and reducing the number of women who die

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during childbirth. In educated women,

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we\'ll know what to do during
pregnancy and post pregnancy

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to protect herself and the baby.
Empowering woman

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to ensure that they have (inaudible) over
what happens to their bodies, will ensure

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that they blend their families properly, they don\'t get
married before their bodies are ready for marriage

00:20:30.000 --> 00:20:34.999
and they\'re not sexually violated.

00:20:35.000 --> 00:20:39.999
One of the effects of globalization
is that there are now more

00:20:40.000 --> 00:20:44.999
job opportunities for women. More than a
million women under the age of 25 now work

00:20:45.000 --> 00:20:49.999
in garment industries in Bangladesh.
A quarter of them are unmarried.

00:20:50.000 --> 00:20:54.999
Opportunities like these are empowering women
economically and helping to break the cycle of poverty

00:20:55.000 --> 00:20:59.999
and maternal mortality in Bangladesh.

00:21:00.000 --> 00:21:04.999
As long as there is no gender
equality or no full gender equality,

00:21:05.000 --> 00:21:09.999
women will not get the same right to
health as men get or as they deserve.

00:21:10.000 --> 00:21:14.999
Safe motherhood is a human right and
every woman is authorized to this right,

00:21:15.000 --> 00:21:19.999
no woman should die if
that can be prevented

00:21:20.000 --> 00:21:25.000
while she\'s bringing another
person to the world.

00:21:45.000 --> 00:21:53.000
[music]

00:21:55.000 --> 00:21:59.999
[non-English narration]

00:22:00.000 --> 00:22:04.999
I often remember my wife. And when I do,

00:22:05.000 --> 00:22:09.999
I go to the Hossainpur graveyard.
I buried here in Hossainpur.

00:22:10.000 --> 00:22:14.999
Whenever I think about my wife, I go to Hossainpur,
I just go to visit her grave and then I come back

00:22:15.000 --> 00:22:19.999
and anyone mentions clinics,

00:22:20.000 --> 00:22:24.999
I miss her more.

00:22:25.000 --> 00:22:29.999
For more information on maternal
mortality visit our website

00:22:30.000 --> 00:22:35.000
www.tve.org/lifeonline.