Safe birth and healthy children for all women

Dr. Benazir Patil joined us at the 2008 Breakfast for Global Health to share her experiences in India, on PATH’s Sure Start project. Through Sure Start, Dr. Patil is working to give even the poorest women access to basic care when they are pregnant and during birth—and helping them learn to keep their babies healthy. In the vast slums of India, her passion is changing lives.

Below, she tells her story in her own words.

Childbirth: a dangerous journey

I am thankful for the chance to talk to you about my work, because PATH is making such a difference to so many people in my country.

My work with mothers and newborns is not just work for me. It is my life-breath and my passion, to reach out to every mother and newborn.

Why? Because of women like my own mother, who lost a baby due to complications from a pregnancy when I was just a little girl.

That experience scared me, it stayed with me. I thought—if the health of mothers and babies in well-off families like mine was at risk, then the health conditions for Indian women living in poverty must be terrible.

Later, when I was just 22 years old, my mother died from an illness. I felt her loss terribly, and I still do. Losing her made this passion for women and children—it became like a force behind me. I felt that I could not let her down.

Then, eight years ago, I had another frightening experience, when I was pregnant with my son, Roshan.

I remember during the months of my pregnancy, I felt very precious about the child that was growing inside of me. This gave me a great sense of creation.

It made me realize how my mother, how every mother feels when the baby grows inside her womb. How she would be looking for more information, ideas on how to ensure the growth of the baby and also how to nurture the baby once it is born.

Though I was very well looked-after during my pregnancy, at the last minute I suffered from a hemorrhage and I had to go in for a Caesarean section. It was really quite frightening.

Fortunately, I had a very healthy baby and I came out all right too.

I was lucky, because I had access and the means to seek out quality care, and I had a safe delivery, despite the complications. Now it is my goal that all women, regardless of their economic situation, be able to give birth safely and have healthy children.

The high cost of poverty

Now, I know that some of you may have been to India. Many people fly into Mumbai—otherwise known as Bombay—and their first impression of India is of the vast slum that surrounds the international airport.

I am thankful for the chance to talk to you about my work, because PATH is making such a difference to so many people in my country.

Many people live in this slum. Mothers just like me, with children just like mine.

People move from rural areas to the cities to make a living. They end up in these huge urban slums because this is the only place that they can afford to live.

Normally, it is one family member who migrates first from the rural areas, and ensures wages for himself and then gradually the rest of the family members follow.

So, even if the entire family comes together, the room available in the slum remains the same and that leads to congested living conditions. We find five or six people living in a small space of 10 by 10—about 100 square feet, with hardly any basics like clean water, sewers, and electricity.

From what I understand, 100 square feet, the size of these small huts, is about the size of an average bathroom in a house here in Seattle! Imagine living with six of your family members in that much space.

Life isn’t easy for a woman trying to survive and raise a family in these conditions. Every day, she is expected to feed herself and her family with an income of less than one or two dollars per day.

Women in these slums do tough jobs like carrying stones in a quarry and working in construction. Or they work long days being a maid or do even smaller jobs like rolling cigarettes at home.

And before and after their workday, a lot of their energies are also spent in fetching and storing water, managing the cooking for the entire extended family and looking after the children at home.

A sure start for young lives

In the Sure Start project, we work with young pregnant women, new mothers, and their newborns in these slums. We reach out to these women through trained health workers who are from the community itself. These health workers have a rapport with the people living there. They understand their mindset and their challenges.

Our health workers are dynamic young women. They meet the pregnant women and mothers on a regular basis, making sure there is an early registration of the pregnancy at a nearby clinic or hospital.

The health worker makes sure the women are getting regular checkups and she provides the women information on care during their pregnancies.

She helps them understand warning signs that can indicate dangerous complications. Recently, we had a mother named Manisha in a slum in Pune who was suffering from eclampsia—otherwise known as hypertension. She had learned about this condition from her health worker, so she knew how to recognize it. She was also clear that it could lead to serious complications.

She saw swelling on her feet and in her eyes, and because she knew that swelling was a danger sign, she knew she needed to go to the hospital right away for treatment. This understanding empowered her! She insisted to her family that she should get medical care immediately. The health worker who had worked with her felt proud that she was able to empower an illiterate mother with such valuable information, make her understand how a simple thing like swelling could threaten her life.

Another important feature of our work is helping families detect signs of danger when the baby is coming. We talk to families about the importance of certain injections for the mother, so that she and her baby are saved from infections like tetanus, which can lead to death.

We talk to the mother about taking iron tablets to avoid severe anemia, which can result in premature births, which can lead to the death of the mother or the baby—or both.

We also tell the mothers about looking out for things like bleeding, so she knows she should rush to the doctor immediately if that happens.

Many women give birth at home because they don’t know that they have the right to give birth in a hospital. So if women do have complications while giving birth in the slums, it is then nearly impossible for them to find transportation to a health facility.

So, most important, we make the family understand the significance of having a skilled doctor around when the baby is being born. We help them understand the importance of getting the mother-to-be to the hospital in time.

So we work hard to make sure a baby is safely born and the mother is well.

From healthy mothers to healthy babies

After a baby is born, then we focus on simple interventions that will keep the baby safe and healthy.

Migrants who come to the slums are from rural areas and they continue to follow their cultural practices, like giving a baby honey and sugar syrup immediately after it is born. They do this because they do not believe in giving colostrum—that first breastmilk—to the baby. They believe that it is too thick and heavy and the baby will not be able to digest it.

Just letting mothers know that they should immediately breast-feed their newborn, or keep their new baby warm, these are simple but crucial things we can do.

And again, we do not only talk to the mother about these issues, but also to the husband, and then to the mother-in-law as well. It is the husband and the mother-in-law who are the decision-makers in the family, so we need them to understand these things too.

We also work to create community support groups to help new mothers learn from one another and share their experiences with other new mothers. And we help communities organize and advocate for better access to health services for all their residents.

We can do anything

So what do we expect to achieve?

Over the course of five years, we hope to reach more than a million mothers and newborns!

We will protect the mothers through immunization, good preventative care, and good diet, which will happen through good practices that we share with them.

We will make sure women have safe deliveries with skilled attendants in the hospital.

We will make sure that every newborn is a healthy newborn.

This will prevent so much disease, so much illness. It will prevent mothers and babies from dying.

As I said earlier, I felt so lucky when I had my baby. I felt so fortunate to have come through all of that safely with my boy.

And these feelings have instilled a passion in me to work towards this goal of helping all the mothers and babies in my country be healthy. This will not only help ensure healthy families. It will also serve as a strong foundation for our country.

And we feel, in India, that with your help, we can build that strong foundation. And if we do that, we can do anything.