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Senegal Tests Controversial Maternal1 Health Drug
A controversial drug that can save women from bleeding to death after delivery has shown promising2 results in trials conducted in Senegal.
Everyday, according to the World Health Organization (WHO), an estimated 1,000 women die each day during complications with pregnancy3 and childbirth. WHO research shows 99 percent of these cases occur in developing countries where a quarter die from severe post-delivery bleeding.
The drug misoprostol, sold under the name Cytotec in the United States, may offer an easy and cost-effective solution. It is sold in tablet form and remains4 stable at room temperature, which makes it practical in hotter climates. Misoprostol trials have been conducted in developing countries such as Nepal, Afghanistan, Nigeria and Senegal to help women without access to proper healthcare facilities or trained staff.
Doctor Bocaf Daff is in charge of the reproductive health division at the Ministry5 of Health and Prevention in Senegal. He has been leading a USAID-funded research project on misoprostol since 2008. They have tested its use after the delivery of more than 300 babies at community health clinics in two regions in Senegal.
Dr. Daff says patients were very willing to take part in the study, and in 80-85% of all cases the tests were successful. But to be sure their findings are consistent, they need to expand to a larger scale and ensure that all staff is skilled in how to follow the procedures accurately6.
Controversy7
Misoprostol is a controversial drug within the sexual and reproductive health communities. It was originally developed in the 1980's to treat ulcers8, but is also commonly used to terminate pregnancy.
Dr. Daff says he knows it can be very dangerous, if it is misused9 to perform abortions10. So health care providers have to be careful. But Dr. Daff says he is confident that misoprostol can be used without problems if medical personnel are properly trained.
Reducing the rate of maternal deaths by three quarters between 1990 and 2015 is one of the eight Millennium11 Development Goals. In most of sub-Saharan Africa, less than two thirds of women have access to a skilled health worker during delivery. This puts them at much greater risk of complications. And when a woman dies, the chances her own baby will survive are slim.
Saving lives
Thilde Knudsen is a midwife and leader of the Intersectional12 Working Group on Sexual and Reproductive Health for the aid group Doctors Without Borders. Her group uses misoprostol for postpartum hemorrhaging in countries around the world.
"It plays a tremendous role in saving women's lives, because a lot of maternal death, especially in Africa are due to PPH - so postpartum hemorrhage - and to have a drug that can be administered by lesser13 skilled staff and be kept without a cold chain, so without a refrigerator, it is definitely one step forward in having that accessible in a delivery facilities for example in Africa and that will help," said Knudsen.
In Senegal specifically, UNICEF estimates that for every 100,000 live births 410 mothers will die. In developed nations this number is closer to nine. Dr. Daff is confident the rate of maternal deaths in Senegal has gone down, but he does not yet have exact numbers.
Dr. Daff says his job is to fight against maternal mortality and child deaths in Senegal, and he will use whatever means he can. A woman who is hemorrhaging post-delivery and is more than 15 kilometers from the nearest hospital or health clinic might die before she gets help. He says that if they have the chance to test a drug that may help these women, then why not.
Awaiting approval
The World Health Organization has not formally approved misoprostol for treating postpartum hemorrhaging. Dr. Daff says that might make things easier but does not really matter.
He says many times they've approved something that actually puts doctors behind, and other times they deny something that later proves to be good. So somewhere along the way countries have to take control of their own research; to experiment, validate14 and test whatever may help in the development of science.
With a testing protocol15 that is validated16 by an ethics17 committee, Dr. Daff says there is no stopping his group from continuing their research into reducing maternal mortality.
1 maternal | |
adj.母亲的,母亲般的,母系的,母方的 | |
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2 promising | |
adj.有希望的,有前途的 | |
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3 pregnancy | |
n.怀孕,怀孕期 | |
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4 remains | |
n.剩余物,残留物;遗体,遗迹 | |
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5 ministry | |
n.(政府的)部;牧师 | |
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6 accurately | |
adv.准确地,精确地 | |
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7 controversy | |
n.争论,辩论,争吵 | |
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8 ulcers | |
n.溃疡( ulcer的名词复数 );腐烂物;道德败坏;腐败 | |
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9 misused | |
v.使用…不当( misuse的过去式和过去分词 );把…派作不正当的用途;虐待;滥用 | |
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10 abortions | |
n.小产( abortion的名词复数 );小产胎儿;(计划)等中止或夭折;败育 | |
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11 millennium | |
n.一千年,千禧年;太平盛世 | |
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12 intersectional | |
adj.交叉(点)的,区际的 | |
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13 lesser | |
adj.次要的,较小的;adv.较小地,较少地 | |
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14 validate | |
vt.(法律)使有效,使生效 | |
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15 protocol | |
n.议定书,草约,会谈记录,外交礼节 | |
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16 validated | |
v.证实( validate的过去式和过去分词 );确证;使生效;使有法律效力 | |
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17 ethics | |
n.伦理学;伦理观,道德标准 | |
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