Friday, November 14, 2014

War on (African) women

CFam actually asked the UNICEF folks about the HCG in tetanus rumor, and it was denied.

the manufacturer? Elder: The vaccines were sourced from the Serum Institute of India. A WHO pre-qualified manufacturer.

CFam also notes that Obama has increased the money to sterilize women in poor countries. Well, duh. And those women who died in a mass sterilization clinic? Well when there are incentives and quotas, you have to hurry things along and may cut corners. And note: This is India, with a free press, not China.

When I worked in Africa, our hospital got private funding from Oxfam to fund village health workers to give out WHORehydration fluid and monitor for malnutrition in young kids. We also were given an ambulance (LandRover with 4wd) that used too much gasoline, so we sold it and bought a smaller truck and used the leftover money for a well digging program so there would be safer water in the dry season.

But hey, every village had a "pill lady" to give out contraceptives. Priorities I guess.

And I confess I trolled someone yesterday: while surfing around, I ran into one of those fluffy home birth is easy type self proclaimed midwives who bragged about going around having wonderful experiences, including her wonderful experiences at an affluent Philippine birth center near Manila.

Yes, it was not about helping women survive childbirth, nor was she working in a rural area where midwives were not available, but about how the experience expanded her ego.

Wonder who paid for the trip?

The entire article lauded the traditional birth attendants, never mind that this is the reason for the high death rate among our mothers.

So as Doctor Bossy,  I pointed this out, and suggested what the moms need is not fluffy self trained "midwives" but trained midwives who could recognize transverse lie, handle a post partum hemorrhage, and monitor women so they didn't die of toxemia.

I didn't add "and who don't insist on an expensive 'gift' to do the 'free' delivery as a government midwife"

 (We lost a neighboring farmer's wife to eclampsia because she couldn't afford the gift, and figured she'd just pay a hilot when she went into labor. Unfortunately, she was expecting twins and her blood pressure soared. Joy was at our farm and arranged the local ambulance, and they did a C section when she arrived at the hospital, but she died from the brain damage from the seizure. All preventable, of course, and Dr. Angi was angry that no one picked up the problem when she started swelling up...probably because the hilot wasn't aware of it and the patient didn't have money for the government midwife's "gift")

When I worked in Liberia, JFK hospital in Monrovia had a program to train these women, and a program by Johns Hopkins to do this has lowered birth mortality in Afghanistan in recent years.

But when I worked in Zimbabwe, births were done by relatives, not regular midwives, so getting nurses to run small clinics in rural areas to do the births made more sense.

When I worked in Idaho, we had these home birth types: One was fairly good, but almost lost a patient from hemorrhage because she didn't diagnose twins which caused the flacid uterus post delivery, and the other was dumb and killed a sluggish baby by doing cpr wrong and rupturing it's liver...

One reason that I enjoyed "Call the Midwife" is that they actually run into these complications, and what lowered the death rate was that the NIH funded an ambulance to get there in a hurry when things went wrong (AKA "flying squad").

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