Although I have seen medical systems around the world, I never got to understand the differences in decision making until I came to Guyana as resident physician. The care the residents offer is far beyond my expectations for the resource limited environment they are provided with. New cutting techniques of airway management and disease management have all been strategically adapted to the capabilities of their A&E. Still they continue to excel while I struggled to keep up.
After the providers, the pregnant mothers came for their monthly prenatal education class. I witnessed as one of the nurses who just participated in the class accurately and eagerly taught these pregnant women ways they can space their next pregnancy to promote better health for them and their babies.
This was the first day of fieldwork. We taught the Standard Days Method to over 80 people in a couple of different sessions. The first group that participated in the study consisted of 12 providers, who were health agents, nurses, and physicians. This lesson went really well. The enthusiasm of the group was palpable and the discussion was enlightening.
Anta Ba is a 26-year-old woman living in Guédiawaye, a poor urban area of Senegal’s capital, Dakar. In a new CSIS video, Anta explains why she decided to access family planning, despite her husband’s opposition, and why these services matter for her own life and for women’s health and empowerment in Senegal.

May 15, 2015 | Charisma Magazine

african family
We know that 1 in 39 women are at risk to die in childbirth in sub-Saharan Africa this year. Moreover, pregnancy and childbirth are the leading cause of death for girls age 15-19 worldwide. (Flickr | Emilio Labrador)

C.S. Lewis once penned, "Prayer. It doesn't change God's mind. It changes me." At Hope Through Healing Hands, we provide clinical care for vulnerable populations worldwide through medical missions. We also promote awareness and advocacy for maternal, newborn and child health in developing nations. We pray for mothers and children around the world, not because it changes God's mind, but because it changes our own.

We know that 1 in 39 women are at risk to die in childbirth in sub-Saharan Africa this year. Moreover, pregnancy and childbirth are the leading cause of death for girls age 15-19 worldwide. We know this is a preventable tragedy. This is why we have launched the Faith-based Coalition for Healthy Mothers and Children Worldwide. We are galvanizing leaders in the evangelical community across the nation who are athletes, actors, artists, authors, pastors, academic and nonprofit leaders to rethink and reconsider the critical importance of maternal and child health in developing nations with a special emphasis on healthy timing and spacing of pregnancies as a part of that continuum of care.

What do we mean by healthy timing and spacing of pregnancies? Becoming pregnant at age 15-19 creates twice the risk of death to a mother as becoming pregnant at age 20-24. In Ethiopia, the average age of marriage is 16. This means so many young girls are at risk of severe complications and death if their pregnancy debut is before 20. Even if they survive, they face a high risk of fistula or other disability. If these young married women can simply "time" their first pregnancy in their early 20s, they have a substantially better chance at having a safe pregnancy, delivery and healthy baby.

And if the young woman can have the opportunity to "space" her children, just three years apart, the child is twice as likely to survive the newborn stage.

The Mother & Child Project: Raising Our Voices for Health and Hope (Zondervan, 2015) chronicles the stories of women in Ethiopia, Burundi, Kenya, India and Uganda. They share their stories about how healthy timing and spacing of families has saved their own lives, the lives of their children, or the stability of their families. Authors like Christine Caine, Natalie Grant, Mary Beth Chapman, and Michael Gerson talk about their experiences in developing nations with stories and anecdotes to demonstrate why this issue is so critical to combatting modern day slavery, sex trafficking, the orphan crisis and mother-to-child transmission of HIV/AIDS.

Healthy timing and spacing of pregnancies means combating both maternal and infant mortality worldwide. It is a critical tool to save lives, empower women and promote sustainability for families, communities and even nations.

What can you do as a believer for these women and children? How can you be a part of saving lives and creating sustainable, lasting change for millions worldwide?

First, pray. And, when you pray, consider Amy Grant's simple prayer in "Greet the Day" on her album How Mercy Looks from Here:

"Lord, lead me to the ones I need.

And, to the ones who need me."

This is a simple prayer that may change the way you encounter your own daily experiences. This prayer opens your eyes to those who cross your path that you may need in your life, and opens your heart to those who may very much need you and your voice.

Secondly, promote awareness. Talk with family and friends about these issues. Tweet this article; ask friends on Facebook to join you in prayer for these women and children. Lead a Bible Study or book club with The Mother & Child Project: Raising Our Voices for Health and Hope and its companion 4-week discussion guide.

And finally, join the chorus of voices. Advocate. King Lemuel's mother in Proverbs 31 advises him to "Speak up for those who cannot speak for themselves; speak up for the poor and the destitute." She knew the wisdom and the righteousness of uplifting those on the margins. We are called as believers to raise our voice for the voiceless, and to let our elected leaders, such as our president, senators and congressional representatives, know that we want them to support foreign assistance, less than 1 percent of the U.S. Budget, on behalf of vulnerable populations around the world.

Let's lift our voices together to protect and increase funding for maternal, newborn, and child health worldwide to save lives as we strive to care for the "least of these," as commanded in Scripture.

Jenny Eaton Dyer, Ph.D., is the executive director of Hope Through Healing Hands a Nashville-based global health organization, founded and chaired by Senator Bill Frist, M.D., committed to improving the quality of life for communities around the world using health as a currency for peace.

This piece originally appeared on Charisma Magazine.

May 10, 2015 | Marie Claire

The Mother & Child Project Book CoverIn this exclusive excerpt from The Mother and Child Project: Raising Our Voices for Health and Hope, the model-turned-advocate opens up about her mission.

The day I became a mother was also the day I became a maternal health advocate. After a healthy pregnancy and a birth that went exactly the way I'd hoped, I was unprepared for everything to change in a heartbeat. My placenta wouldn't detach, and I hemorrhaged. I didn't know it at the time, but this happens every day to women all over the world.

If you live in a country where skilled midwives and doctors are plentiful and you deliver in a well-staffed and stocked health care facility, as I did, then chances are you'll be fine. If you live in a country where most women deliver at home without a skilled attendant or in a facility where staff members don't have the skills or supplies to treat you, then you may join the ranks of the 287,000 women who die every year from entirely preventable or treatable complications. I was one of the lucky ones, and I realized I had been given a great opportunity to serve other women and make pregnancy and childbirth safe for every mother.

"Every two minutes, somewhere in the world, a mother dies from complications related to pregnancy and childbirth."

After my daughter's birth, I researched the multidimensional physical, social, economic, political, and cultural conditions that cause women to have poor maternal health. I learned that every two minutes, somewhere in the world, a mother dies from complications related to pregnancy and childbirth. I learned that in some parts of the world the main barrier is transportation, while in others it's lack of education, medications, or trained staff. In some cultures, women aren't allowed to seek medical care without permission, and in others they can't access family planning. I learned that child marriage, female genital mutilation, and teen pregnancy are all directly linked to maternal death and that when mothers die in childbirth, they leave, on average, four orphaned children. It was a steep learning curve that helped me decide the direction I wanted my advocacy to take.

I created a documentary, No Woman, No Cry, that highlighted the maternal health crisis from the perspectives of mothers and health care providers in four countries, including the United States. I wanted audiences to resonate with the fact that while 99 percent of maternal deaths occur in developing countries, 800 mothers per year die right here in America, where we rank sixtieth in the world for maternal mortality.

The documentary was released in 2010 to audiences who were enthusiastic about helping find solutions. That's why I founded Every Mother Counts, a nonprofit organization focused on raising awareness about maternal health and mortality, funding grants that make a direct difference in improving maternal health and providing opportunities for people to get involved.

Currently, Every Mother Counts funds grants and projects in seven countries to address three main barriers that impact maternal health and health care everywhere—lack of transportation, education, and training, as well as supplies. We are addressing one or more of these gaps in Malawi, Uganda, Indonesia, Haiti, India, and the United States and will continue to identify and support programs that are designed to make services accessible to mothers around the world.

"We already have the treatments, medications, and therapies necessary to prevent up to 98 percent of maternal deaths."

As daunting as the statistics are, we know that we already have the treatments, medications, and therapies necessary to prevent up to 98 percent of maternal deaths. We just need to make the health and lives of girls and women a priority. Every Mother Counts believes that together we can make pregnancy and childbirth safe for every mother.

Printed with permission from The Mother and Child Project: Raising Our Voices for Health and Hope.

Christy Turlington Burns is an advocate for maternal health. She is the founder of Every Mother Counts and the producer of No Woman, No Cry, a documentary about the problems of maternal health in the developing world.

This post appeared on Marie Claire.

May 8, 2015 | Relevant Magazine

Garbage dumps make horrible delivery rooms—but Cristina had no choice. As she went into labor, her mother’s wood-and-tin shack in a Philippines garbage dump served as birthing center, delivery room and nursery.

I wasn’t prepared to see a newborn there. I had gone to the dump with a team from Compassion International to see how one of our partner churches in Cebu City ministers to families who live in extreme poverty. Cristina lay exhausted on a mat spread over a cane floor inches above the dirt. Her son, Jonel, was an hour-and-a-half old. He slept next to her, swaddled in a T-shirt.

I considered the realities that Cristina and her son faced in a home in the middle of the garbage. Platitudes are anemic at a time like that. I knew God had placed our team right there at that precise moment. The time was opportune for the Church to be the Church.

The First-Responder Church

When the Church works right, her effectiveness is unsurpassed. Nowhere is that more evident than when the Church is a first responder. Nowhere is the need for a first responder more urgent than for an expectant mother or mother with an infant in the grip of abject poverty.

Abject poverty is the stupid, debilitating poverty that weakens bodies, stunts hope and perpetuates itself across generations. While her infant may only weigh a few pounds, the load of an impoverished mother is heavy. She is the last to go to bed and the first to get up in the morning. Too often she is the last to eat, if she eats at all. Too often she is uneducated, because the opportunity was given to a male in the family. And too often her opinion doesn’t count, even when it comes to family planning and the spacing of her children.

This is where the Church can be her best, not just because she can do something for the poor, but because she will walk closely with the poor. There is a world of difference between the two.

Walking With the Poor

In Compassion International’s partnership with local churches in some of the world’s most impoverished communities, “with” is the operative word. Hundreds of the 6,500-plus churches with which Compassion partners implement a Child Survival Program that walks side by side with mothers-to-be and new moms. From the womb through toddlerhood, the church assigns a Child Survival Specialist to nurture a one-to-one, woman-to-woman relationship. The experience is life changing.

For many of these moms, just the idea that they actually matter is transformative in its own right. Her physical health in pregnancy is monitored bi-weekly through home visits by her Child Survival Specialist. The assurance of an attended birth takes away her isolation and eliminates the fear of delivering a child alone.

And after delivery, the Child Survival Specialist maintains a regular schedule of relationship and care. Everything from nutrition and health to toddler development and home safety is explored in bi-weekly visits.

Walking with also brings mothers together. Each month, moms in the Child Survival Program gather at the local church, where the woman-to-woman relationship is magnified in a women-to-women community. In an environment of relationship and trust, the church contextualizes the concepts of family planning and birth spacing. For many women, this is their first hint that they can directly influence their own family’s future. What should be obvious actually flies in the face of messages they receive in their neighborhoods.

The Church’s first-responder approach counters negative patterns of family planning and mistrust that have permeated communities for generations. In the spiritual context of Jesus’ teachings and inside a community of support, mothers receive a new message of freedom that expresses itself in all areas of life from personal grace to expressions of freedom and influence in life’s most intimate decisions.

Paul’s declaration in 2 Corinthians 3:17, “Now the Lord is the Spirit, and where the Spirit of the Lord is, there is freedom,” finds practical applications in the Church. Freedom in Jesus to discover self-worth and relationship with Him. Freedom to escape illiteracy. Freedom to learn a marketable skill. And freedom and instruction on the specifics of family planning. A mom learns how to have critical conversations with her husband, and in many cases, the Child Survival Specialist will accompany and assist her.

When the Church works right, the peripheral vision of a mother in poverty begins to widen to the personal benefits of literacy, solid child development and healthy spacing and timing of pregnancy.

The Journey Ahead

Back in the Philippines, our staff and the church pastor secured an immediate place for Cristina and Jonel in Compassion’s Child Survival Program. Now the local church would rally around Cristina to help her develop income-generating skills. They would train and assist her in nutrition, health checkups and the life-forming needs of an infant as he grows.

The church and its Child Survival volunteers would do everything in their power to keep Jonel from being one of almost 19,000 kids under five who die every day from causes that rarely affect our children in the United States. Cristina and Jonel would receive loving, Jesus-centered care. Compassion would be accessible for Cristina. But more important, the church would walk with her and her son through their journey ahead.

As we stood there with Cristina and Jonel, I prayed. Not a quick, expected “bless them” prayer, but a heartfelt, Spirit-led plea to Jonel’s heavenly Father. As our interpreter translated, I asked God that Jonel’s life would have value. I thanked God that his mother had come to Christ and had been baptized a month earlier. I prayed that Jonel’s parents would love him the way Jesus does and that he would come to know Jesus as early as possible.

Once again, I realized how relentlessly the Church tracks down poverty in the most rancid of spaces. Because the Church is there, because the Church is a first responder, I left confident that Christina and Jonel were going to make it. This was the Church at her best. This was the Church working the way it should and building a future—even when the future was just an hour-and-a-half old.

Taken from The Mother And Child Project. Copyright 2015. Used by permission of Zondervan. All rights reserved.

Santiago (Jimmy) Mellado is the president and CEO of Compassion International, a leading authority in holistic child development through sponsorship.

Read this piece on relevantmagazine.com
May 8, 2015 | Spirituality & Health

An excerpt from The Mother & Child Project

When I watch mourners in Kenya, Malawi, Uganda, and many other countries walk down the road behind the wooden casket of a mother and child held high on the shoulders of men in the village, I am reminded again,

This is not a cause. This is an emergency.

Pregnant women all over the developing world ask two tragic questions: “Am I going to die?” and “Who will take care of my children?”

How can women be asking these questions when they are young and full of life?

There is a compassionate mandate for mothers to live and for children to survive — and thrive — in the arms of their mother. One can judge the morality of a country by the way it cares for its women and children. If ever there was something worth fighting for, keeping mothers and babies alive and together tops them all. But —

The statistics of maternal and infant death are gut-wrenching, vivid, and real. One in thirty-nine women in sub-Saharan Africa are dying during pregnancy or childbirth. There is a moral mandate to provide accurate information and the resources necessary for life while honoring a woman and family’s cultural and faith values.

Through no fault of their own, 222 million women have limited ability to influence the timing or spacing of their pregnancies, leaving these women and their children vulnerable.

When a woman’s cries and wailings are heard, the numbers stop being just statistics and become the stories of real people. Numbers are numbing. As one Rwandan woman told me, “Numbers are statistics. Numbers are statistics with the tears wiped off.”

But there is hope, and the answer is to keep mothers alive by equipping them to have pregnancies timed and spaced in ways that promote health, including prenatal care, a skilled attendant at birth, and a host of other supportive interventions, so that the mothers and fathers can care for their children. Because every child deserves a family.

But how?

The keys to information and transformation lie in a frequently overlooked source. For families to receive what they need, they can go to the church, which becomes an outpost not just for spiritual health, but for physical health as well.

Recently, I was working in Rwanda alongside Juliette, a health volunteer who trains church members to, in turn, become trainers volunteering in their communities. Although from different parts of the globe, Juliette and I both are part of the PEACE Plan movement, an initiative of Saddleback Church of Lake Forest, California, where Pastor Rick Warren has launched 20,000 ordinary members of the church to travel globally. To do this, he has empowered and linked churches in 197 countries. Using a train-the-trainer approach, the PEACE Plan has equipped more than 500,000 ordinary people in church pews—or wooden benches—at the most grassroots levels to identify, prioritize, and act on problems in their own communities through the local churches.

Juliette, along with another trainer, simply walks to seven homes— some of them up to an hour away—to talk to women about pregnancy, about the value of timing and spacing pregnancy, directing them to tools that are in keeping with their Christian faith.

When Juliette ducks through the piece of fabric that hangs at the front door of each home she visits, she is comfortable and credible. Armed with a teaching plan and genuine compassion for her neighbors, she listens and teaches basic hygiene principles, HIV prevention, and healthy pregnancy.

Volunteering four hours a week, Juliette has reduced the maternal mortality rate in her neighborhood. She is an expert, even though her formal education ended before the fifth grade. Early on, Juliette taught me about dying mothers, dying babies, and the indescribable pain of both. I always listen when she speaks. She proves that when the church is involved, information is accessible to the local community. The church is indispensable in terms of access to health care training and in terms of reliability and accuracy of message.

Juliette had my attention when she said, “Maybe one of the reasons we don’t name our babies for one month after birth is that we’re not sure they will survive.” Juliette spoke stoically, as if her storehouse of tears had been emptied at the graves of too many. I swallowed hard. She continued to teach from a well-crafted lesson plan that was both accurate and personal.

“Our bodies are tired and weak. Today we will be talking about pregnancy and how to get healthy before getting pregnant and how to make sure our bodies are ready so that our babies can survive.” The lesson plan was clear, and fifty trainers—both women and their husbands—had come to hear it.

“There are medicines and methods to help you. We must be more intentional in preparing our bodies for our babies, for their sake and for ours. I am a Christian, and I use pills to help me. There is nothing wrong with using techniques or tools. I’m not interfering with God’s will if I take medicine. When there is information and resources for timing and spacing of pregnancies and I withhold it because I am afraid of offending others, I am telling people they can die.”

Then Juliette taught the class a biblical principle that is empowering and life-changing. She spoke about stewardship. “Every gift we have comes from God. God also gave me ways to be pregnant. He gave me eggs, and I’m responsible for them.”

The idea of stewardshipof being accountable to God for the gifts he has given me and seeing scientific knowledge as a gift he has given to influence my life practices — is not new. All truth is God’s truth.

This is the type of training that equips laypeople to deliver the message in churches all over the world. At least two things stand in the way of helping women and children survive and thrive through healthy timing and spacing of children, yet there is a solution that is underused and fully available everywhere. Every woman and family needs this:

Accurate knowledge and resources that honor a woman and family’s cultural and biblical values, and a distribution channel that is accessible and trusted to deliver the information and resources.

One of the reasons women do not have what they need is that they can’t access it. I have seen villages where there is no post office, school, or hospital, but there is a church. And this is the hope. Churches can provide accurate information closest to the people who need it.

Alongside the suffering, there are churches filled with people who are willing and able to make a difference. There is a group of people in the faith community that can tackle any problem at a grassroots level. Mobilizing ordinary members in churches everywhere to train others brings information, tools, and hope. Referrals are made to tertiary settings when the challenges are complex. For timing and spacing of pregnancies, church-based grassroots education and interventions launch an idea to scale-up possibilities. Life and mind-set change rarely happens in a government office, but it can happen in a church.

The church is the greatest untapped source of information and hope in the twenty-first century. And today 4,800 Rwandan trainers teaching church-based classes and making home visits in Rwanda provide proof that the church is a distribution giant ready to serve. Churches are located in communities where women and children are needlessly dying.

Churches are a trusted source of information. Churches are accessible, available, and influential in communities. It’s time to look to the church for help in solving the problems of maternal and child health.

Elizabeth Styffe, RN, MN, PHN, is the global director for HIV&AIDS and Orphan Care Initiatives at Saddleback Church in Lake Forest, California. She and her husband have seven children, including three adopted from Rwanda.

This excerpt appeared in Spirituality & Health

Hope Through Healing Hands is proud to create and lead the Faith-Based Coalition for Healthy Mothers and Children Worldwide. We launched the coalition with the support of the Bill & Melinda Gates Foundation to shine a light on the disparity of maternal & child health in developing nations. Moreover, we hope to educate and activate faith leaders and all people of faith to consider the critical importance of healthy timing and spacing of pregnancies as a life-saving mechanism for both moms and their children.

A mama knows best, so let’s let her decide

By Rachel Held Evans

May 07 2015

May 7, 2015 | Washington Post

A mama knows the difference between a playful coo and a hungry whimper, or between a real fever and a valiant attempt to get out of school. A mama can spot a secret in the curl of a smile, an impending illness in the subtle tilt of a head. A mama knows the rhythms of the household — the pitter-patter of toddler feet on the floor, the hurried scratches of forks against empty plates.

And she knows the rhythms of her own body, when it is heavy with milk, sore from cramps, in need of rest.

A mama keeps a running mental inventory, willing there to be enough food for each belly, enough money for the girls to go to school, enough medicine at the clinic. A mama knows what is best for her family, and so a mama is strongest when she is empowered to make good decisions for them.

But not every woman gets to choose. Not every mother gets the chance to do what she knows is best for herself and her family.

There are more than 220 million women in developing countries who don’t want to get pregnant, but who lack access to family planning information and contraceptives. Every year, nearly 300,000 of them will die during pregnancy or from complications giving birth. Far too many mothers will bury their babies before they even get to know the sound of their laughter. More than 2.6 million babies will be stillborn, and another 2.9 million will die before they are a month old.

Giving women the opportunity to time their pregnancies and space out their children through effective, low-cost contraception is key to turning around these heartbreaking numbers.

Not only does access to family planning information and contraception improve the health of mothers and children, it also improves the economies of their households. When a woman has fewer children and more time to work harvesting crops or growing her fledgling business, she brings more resources into the home so her children can be fed and her kids can go to school. A poor family confronted by a drought or famine is more likely to survive with a smaller household and fewer mouths to feed.

These are things that every mother knows instinctively, and yet ensuring that every woman has access to the contraception options she wants is not always a top priority on the global health agenda.

That’s because conversations about contraception, particularly here in the United States, tend to be religiously and politically charged. Some people seem to think that family planning is just code for abortion, when it’s not. Others presume that giving women access to contraception is encouraging promiscuity, even though most of the women who use oral contraception are married. Words like “entitled,” ‘’selfish” and even “slut” get thrown around all too easily.

A woman who wants to live long enough to see her children grow up isn’t being selfish. A woman who wants to provide an education for her girls as well as her boys isn’t acting entitled. A woman who wants to space out her pregnancies so her newborns have a better shot at life isn’t a slut. We cannot allow simplistic, self-focused narratives about contraception and family planning to keep us from helping these women.

For those of us who identify as pro-life, it’s not enough simply to oppose abortion. We must also actively advocate for and invest in those specific actions that not only curb the abortion rate but also save the lives of women and children worldwide. Increasing access to family planning information and contraceptives will result in fewer women and girls dying in pregnancy and childbirth, fewer unintended pregnancies, fewer abortions and fewer infant deaths.

As Christians, we are called to reorient our perspective around the needs of those whom Jesus called “the least of these.” When we lean in close, we learn that they aren’t all that different from ourselves. The mothers of sub-Saharan Africa chuckle the same way over the antics of their mischievous children as do mothers here in America. The women of Southeast Asia share the same instincts and intuition as women in Europe.

A baby’s death is no less tragic when it happens quietly on a dirt floor than when it happens in a high-tech hospital. We may have dissimilar circumstances, but we share a common humanity, a shared dream of raising healthy and happy families.

A mama knows when it is time to grow a family and when it is time to wait. A mama knows how far the rations will stretch, how much school uniforms cost, how long she ought to nurse her baby. And a mama knows how to bring every good thing to that little boy whose head nestles into her soft, waiting shoulder.

This Mother’s Day, let’s give her the chance to do it.

(Rachel Held Evans is the author of “Evolving in Monkey Town” and “A Year of Biblical Womanhood.” This piece was adapted from her contribution to “The Mother & Child Project: Raising Our Voices for Health and Hope,” recently released by Zondervan.)

This article appeared in the Washington Post.

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