Sunday, October 23, 2005

Nicholas D. Kristof: Mr. Bush, This Is Pro-Life?

The New York Times

Sunday 23 October 2005

Zinder, Niger - When I walked into the maternity hospital here, I wished that President Bush were with me.

A 37-year-old woman was lying on a stretcher, groaning from labor pains and wracked by convulsions. She was losing her eyesight and seemed about to slip into a coma from eclampsia, a complication of pregnancy that kills 50,000 women a year in the developing world. Beneath her, cockroaches skittered across the floor.

Fathi Ali rode a camel for 40 miles across the desert to reach a clinic, however before she could get proper medical attention she lost her unborn child.

"We're just calling for her husband," said Dr. Obende Kayode, an obstetrician. "When he provides the drugs and surgical materials, we can do the operation," a Caesarean section.

Dr. Kayode explained that before any surgery can begin, the patient or family members must pay $42 for a surgical kit with bandages, surgical thread and antibiotics.

In this case, the woman - a mother of six named Ramatou Issoufou - was lucky. Her husband was able to round up the sum quickly, without having to sell any goats. Moreover, this maternity hospital had been equipped by the U.N. Population Fund - and that's why I wished Mr. Bush were with me. Last month, Mr. Bush again withheld all U.S. funds from the U.N. Population Fund.

The Population Fund promotes modern contraception, which is practiced by only 4 percent of women in Niger, and safe childbirth. But it has the money to assist only a few areas of Niger, and Mrs. Issoufou was blessed to live in one of them.

Nurses wheeled her into the operating theater, scrubbed her belly and administered a spinal anesthetic. Then Dr. Kayode cut open her abdomen and reached inside to pull out a healthy 6-pound, 6-ounce boy. (A video of the delivery.)

After removing the placenta, Dr. Kayode stitched up Mrs. Issoufou. Her convulsions passed, and it was clear that she and the baby would survive. For all the criticism heaped on the U.N., these were two more lives saved by the U.N. Population Fund - no thanks to the Bush administration.

Even when they don't die, mothers often suffer horrific childbirth injuries. In the town of Gouré, a 20-year-old woman named Fathi Ali was lying listlessly on a cot, leaking urine. After she was in labor for three days, her mother and her aunt had put her on a camel and led her 40 miles across the desert to a clinic - but midway in the journey the baby was stillborn and she suffered a fistula, an internal injury that leaves her incontinent.

Village women are the least powerful people on earth. That's why more than 500,000 women die every year worldwide in pregnancy - and why we in the West should focus more aid on preventing such deaths in poor countries.

Mr. Bush and other conservatives have blocked funds for the U.N. Population Fund because they're concerned about its involvement in China. They're right to be appalled by forced sterilizations and abortions in China, and they have the best of intentions. But they're wrong to blame the Population Fund, which has been pushing China to ease the coercion - and in any case the solution isn't to let African women die. (Two American women have started a wonderful grass-roots organization that seeks to make up for the Bush cuts with private donations; its website is www.34millionfriends.org.)

After watching Dr. Kayode save the life of Mrs. Issoufou and her baby, I was ready to drop out of journalism and sign up for medical school. But places like Niger need not just doctors, but resources.

Pregnant women die constantly here because they can't afford treatment costing just a few dollars. Sometimes the doctors and nurses reach into their own pockets to help a patient, but they can't do so every time.

"It depends on the mood," Dr. Kayode said. "If the [staff] feel they can't pay out again, then you just wait and watch. And sometimes she dies."

A few days earlier, a pregnant woman had arrived with a dangerously high blood pressure of 250 over 130; it was her 12th pregnancy. Dr. Kayode prescribed a medicine called Clonidine for the hypertension, but she did not have the $13 to buy it. Nor could she afford $42 for a Caesarean that she needed.

During childbirth, right here in this hospital, she hemorrhaged and bled to death.

Somewhere in the world, a pregnant woman dies like that about once a minute, often leaving a handful of orphans behind. Call me naïve, but I think that if Mr. Bush came here and saw women dying as a consequence of his confused policy, he would relent. This can't be what he wants - or what America stands for.

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