Voice 1
Welcome to Spotlight. I'm Liz Waid
Voice 2
And I'm Joshua Leo. Spotlight uses a special English method of broadcasting. It is easier for people to understand, no matter where in the world they live.
Voice 1
In the small village of Pitala, a woman stands in front of a tree. She holds a can of paint, and a small brush. With the brush, she paints words on the tree. When she is done, she steps back to read the words. The message is simple. It is for everyone in the village. It says that during childbirth, women should go to the hospital. The woman is satisfied. Now everyone can see the message. Everyone can encourage new mothers and fathers to get good medical help during childbirth.
Voice 2
In Pitala, this message is saving lives. But why has this message been so successful in Pitala? Today's Spotlight is on Pitala and their new message to men and women.
Voice 1
Pitala is in the African country of Malawi. Malawi has a very high rate of deaths during pregnancy and childbirth. Researchers call these deaths maternal mortality. In Malawi, more than 1100 women die for every 100,000 live births. This is the second highest number of maternal deaths in all of Africa. And when a mother dies during pregnancy or childbirth, it is much more likely that the new baby will die too.
Voice 2
Why is this rate so high in Malawi? The reason is not easy to see. Malawi has a stable government. It is not experiencing war or other conflict. But experts say that the rate is high for many reasons. One reason is that almost half of the children born in Malawi are born without the help of a trained medical person. Malawi is a very poor country. Many people believe that they cannot pay for a doctor. So they do not get care during pregnancy.
Voice 1
Poverty also affects the number of doctors. There are not enough doctors, nurses and other specialist health workers. Many doctors are trained in Malawi. But after they are trained, many of these doctors move to other countries. They hope to receive better pay.
Voice 2
But sometimes, the doctor is not the problem. In Malawi, many people believe that all first born children should be born at home. This cultural belief puts many pregnant women's lives in danger.
Voice 1
The village of Pitala is not different than other villages in Malawi. The women face many of these problems during pregnancy and childbirth. First, there is no trained medical person in the village. Instead the people trust the traditional birth attendant. This attendant has a lot of knowledge. She has successfully helped many women give birth. She has brought many healthy babies into the world. But she does not have medical training, like a midwife. And in a medical emergency, she does not have the skills to save the mother or the baby.
Voice 2
And second, the village is very poor. The people do not have the money to use a car. For a long time, there was no way to get a pregnant woman to the nearest hospital.
Voice 1
But things have slowly been changing in Pitala. The first change was in the job of the traditional birth attendant. Now the attendant cares for women during pregnancy. She gives them good advice, and watches for problems. Village chief Margret Thole talked about this change to journalist Karen Allen of the BBC. Chief Thole said,
Voice 3
"It is now the main job of the birth attendant to visit the women and give the message."
Voice 1
And what is this message? It is that women should give birth at the hospital. Chief Thole explained more,
Voice 3
"We can prepare early, and the hospital can deal with any problems."
Voice 2
The belief that the first child should be born at home is the second change in the village. The leadership in the community is united in this thinking. With their support, the traditional birth helper shares the message. Together, they teach the people the importance of giving birth in a hospital, even if it is the first born child.
Voice 1
It is often very difficult to change cultural beliefs. But the traditional attendant and the chiefs know the truth about medical care. They know the importance of having trained medical help during any childbirth. And they are using many different ways to spread this message. They even use trees! At the beginning of this program, we described the messages people write on trees. These messages tell people to go to the hospital when it is time to have a baby. But without a car in the village, how do the people get to the hospital?
Voice 2
This is the third change in the village. The village is 30 kilometers to the nearest hospital. But instead of using a car, the people use two wheels instead! They use a bicycle. They use the bicycle as an ambulance – an emergency medical vehicle. The bicycle ambulance is new in the village. And the goal of this bicycle is to save lives.
Voice 1
These changes have had a very positive effect in the village. With the support of village leaders, education and a bicycle have reduced the maternal mortality rate. In fact, since these changes, no babies or mothers have died in Pitala!
Voice 2
The United Nations Population Fund is working with communities like Pitala. They work with the communities to find solutions to high maternal mortality – like Pitala's ambulance bicycle. Also, as in Pitala, they encourage villages to change the work of traditional attendants. Many villages have now banned traditional attendants from helping during birth, unless they are trained midwives. Traditional attendants who do help at birth can be fined a goat. The parents can also be fined one goat each. Traditional birth attendants receive new training - to care for women during pregnancy, and watch for problems. Juliana Lunguzi is a UNPF officer. She talked to journalist Pilirani Semu-Banda about this work. She said,
Voice 4
"Traditional chiefs have a lot of respect in Malawi's villages. They are the champions for promoting maternal and child health. They form local village groups for safe motherhood and family planning. These groups encourage pregnant women to get care during pregnancy. They watch the health and growth of new babies closely. They are also in charge of hygiene and sanitation in the villages."
Voice 1
Like Pitala, villages that deal with the problem are saving mothers and babies. The problem of maternal mortality is still very great in Malawi. But by working together, villages can end this problem. Mr. Dzoole is a village headman. He told the UN Population Fund,
Voice 5
"Not very long ago, pregnancy and childbirth were a death sentence. That is gone now. And we plan to keep it that way."
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