Thursday, July 9, 2009

Maternal mortality in Peru

Those who doubt that poverty and inequality are "life" issues would do well to look at the latest report from Amnesty International on maternal mortality in Peru. Below is my translation of AI Peru's statement on their findings.

Hundreds of poor peasant and indigenous women are dying in Peru because they do not receive the same health services as the rest of the women in that country, Amnesty International concludes in its new report presented on July 9th.

The report, titled "Deficiencias fatales. Las barreras a la salud materna en Perú" (“Fatal Flaws: barriers to maternal health in Peru”), examines the high maternal mortality rates among poor and indigenous women in rural Peru and evaluates the impact of the government’s latest policies to deal with the problem.

Peru has one of the highest maternal mortality rates in the entire American continent. According to official data, 185 women in Peru die for every 100,000 live births. The United Nations gives an even greater number, 240. Most of these women are campesinas, poor and indigenous.

“The maternal mortality rates in Peru are scandalous”, says Silvia Loli, director of Amnesty International in Peru. “The death of so many women from preventable causes is a violation of human rights. The Peruvian government is obviously not fulfilling its obligation to provide maternity health care to all women, regardless of who they are or where they live.”

In its report, Amnesty International highlights the fact that pregnant women are dying in Peru due to the difficulties they must overcome: lack of access to emergency obstetrical care, lack of information on maternal health, and lack of health personnel who speak the indigenous languages.

According to the 2007 census of indigenous communities, almost 60% of the communities that participated in the census did not have access to a medical center.

“Health care for pregnant women in Peru is like a lottery: if you are indigenous and poor, you have no chance of winning,” Silvia Loli said.

José Meneses Salazar, a 24-year-old resident of Ccarhuacc (Huancavelica), one of the poorest areas of Peru, lost his mother nine years ago as a result of [complications from] labor. She avoided going to get medical examinations for fear of being mistreated by [medical] personnel. When she went into labor, the midwife at the nearest health center was on leave, so José’s father and other family members assisted with the delivery. After the baby was born, the placenta did not come out and they didn’t know what to do. After two hours, the woman died. The newborn girl survived.

The report also evaluates the impact of various government policies designed to reduced the maternal mortality rates, such as increasing the number of homes for expectant mothers – places where women who live a great distance from a medical center can stay before delivery, greater support for vertical birthing, a common practice among indigenous women in Peru, and teaching health professionals Quechua.

Women and medical professionals consulted by Amnesty International in Peru believe that these new initiatives are positive but they complain that they are not being applied effectively and they doubt that they are having real results.

In its report, Amnesty International concludes that even though there are three times as many homes for expectant mothers as there were eight years ago, only half of these are located in rural areas where the women have the greatest need for emergency obstetrical assistance.

Women and local civic organizations have told Amnesty International that the training of health professional in vertical birthing methods is not sufficiently widespread. According to the Defensoría del Pueblo de Perú, last year over 45% of health care personnel stated that they had not received adequate training.

On the other hand, there have been official initiatives to teach Quechua to health services personnel, but its use is not generalized and many women in the indigenous communities whose mother tongue is not Spanish cannot communicate with them.

“The official initiatives to reduce maternal mortality are good news,” Silvia Loli states, “but the absence of clear responsibility for accomplishing them, as well as the lack of vigilance and effective allocation of resources put the whole initiative at risk.”

Amnesty International has asked Peruvian authorities to allocate resources to maternal mortality and to reproductive health care, giving priority to the areas that have the highest mortality rates, so that all women will be guaranteed equal access to emergency obstetrical assistance in the case of complications during labor. It has also recommended increasing the training of medical personnel and that a linguistic support service be available to indigenous women in all medical centers.

FULL TEXT OF REPORT:

Warning: Large PDF files!

English: Fatal Flaws: barriers to maternal health in Peru
Español: Deficiencias fatales. Las barreras a la salud materna en Perú

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