by Vanessa N Glavinskas

Rotary International News

In Nigeria, one out of every 18 women dies as a result of childbirth. The country has the second-highest maternal mortality rate in the world.

That's why the Rotarian Action Group for Population Growth and Sustainable Development targeted the northern Nigerian states of Kaduna and Kano with a pilot program aimed at reducing maternal mortality by preventing and treating obstetric fistula, a serious birth injury. From 2005 until 2010, the project, partly supported by a grant from The Rotary Foundation, reduced maternal death by 60 percent in participating hospitals, reached 1 million women of childbearing age, and repaired obstetric fistulas for 1,500 Nigerian women.

"We have to empower women, and women cannot be empowered if they can't make their own choices in antenatal care and child spacing," says Dr. Robert Zinser, CEO of the Rotarian Action Group for Population Growth and Sustainable Development and member of the Rotary Club of Ludwigshafen-Rheinschanze, Germany.

Zinser has been to Nigeria nearly 20 times to work on maternal and child health projects, including the northern Nigeria pilot focused on the prevention and treatment of fistulas. An obstetric fistula is a birth injury that can cause stillbirth and, in the mother, chronic incontinence, infection, nerve damage, or death. The primary cause is labor that goes on for too long, often for days. Because 70 percent of Nigerian women deliver at home, often without access to proper medical care, long labors that would be prevented in the developed world are more common.

According to the World Health Organization, "prevention is the key," Zinser says. "We insisted on a comprehensive approach of better antenatal care" that includes training, equipment, quality, hygiene, and benchmarking.

The project also included surgery to repair damage from fistula. Many women with the injury don't know it can be repaired, so Rotarians created a series of radio programs that explained the condition, its causes, and the available treatment.

"People listened, and village women found out their fistulas could be repaired at the Rotary center. We repaired 1,500 fistulas, 500 more than our goal," Zinser says.

The action group is now preparing to replicate the project in the states of Abuja and Onoda, with plans to eventually establish the model in other central and southern Nigeria states.

Zinser is adamant that the project can be implemented in other areas with high maternal mortality. "We must save the mothers so that the mothers can save the world," he says.

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The action group has a team of medical experts available to help clubs propose and implement projects in the area of maternal health. To learn more about this or how to start a project like the Nigeria pilot, visit maternal-health.org.

Your contributions to The Rotary Foundation help support projects such as this.