MaterCare: One Doctor’s Courageous but Lonely Battle to Reduce Maternal Mortality

Dr. Robert Walley is reducing maternal deaths in sub-Saharan Africa in ways that respect the dignity and rights of women.

MaterCare: One Doctor’s Courageous but Lonely Battle to Reduce Maternal Mortality

Umer Malik

Every day about 800 women across the globe die from complications related to pregnancy or childbirth. In 2013, the total number of such deaths was 289,000. Almost all of these deaths occurred in low-resource settings, in developing countries.

The risk of dying during pregnancy and childbirth in sub-Saharan Africa is 1:31, while in Canada it is 1:10,000. Most of the deaths could have been prevented. This disparity in maternal and perinatal mortalities, between developed and developing countries, is greater than any other commonly used measure of public health status.

Mothers die from postpartum hemorrhage (27%), hypertension (18%), obstructed labour/ectopic pregnancy/blood clot (11%), infection (9%), and indirect causes, such as HIV/AIDS, malaria and anemia (18%). The remaining 9% of maternal deaths are due to abortions (8%) and miscarriages. Frequently women die in unclean conditions, alone, in terror and agony without trained assistants, or access to proper life-saving care.

In 1981, Canadian OB-GYN Robert Walley began working to improve pregnancy outcomes in sub-Saharan Africa, starting in Nigeria. For over 20 years, Dr. Walley and the organization he founded, MaterCare International (MCI), have been providing an approach to reducing maternal mortality that works and that doesn’t involve promoting abortion or flooding villages with contraceptives.

MaterCare specializes in providing mothers with care that respects their dignity and offers life and hope. They do so in response to invitations from bishops in Kenya, Nigeria, Ghana, Sierra Leone and East Timor, among others. In the Apostolic Vicariate of Isiolo, Kenya, MCI has embarked on a demonstration project that is providing essential obstetrical care to rural communities, training programmes for doctors and midwives, e.g. in natural family planning and safe delivery techniques, training for traditional birth attendants, and an emergency transport system. MCI has also worked in Nigeria, Ghana, Sierra Leone, Rwanda, Haiti and Timor Leste.

Dr. Walley explains that his greatest life-changing experience as an Ob-Gyn occurred when he was at a mission hospital in southeastern Nigeria in the early 1980s. In over 40 years of practice in Newfoundland, he had never witnessed a “direct maternal death,” i.e., a death that resulted from causes directly related to pregnancy and delivery. He recounts:

“In the mission hospital, four direct deaths of young mothers occurred during one weekend. All could have been prevented. My first reaction was of sorrow, as anyone, but then as an obstetrician, I  became angry because these deaths need not have happened. They were really due to neglect, which I see as a form of violence against one group of women:  mothers. Since then I have worked to make a bit of a difference.”

Dr. Walley notes that on numerous occasions the international community has discussed the urgent need to reduce maternal mortality (MM), beginning with the first Safe Motherhood Conference in Nairobi back in the 1970s, and most recently with Millenium Development Goals 5 to reduce deaths by 75% by 2015. But none of the goals have ever been reached because the world forgets that MM is about the death of a mother and not about preventing her from being a mother. 

In Dr. Walley’s experience, the only solution to maternal survival is for women in childbirth to be cared for, one at a time, by experienced doctors and midwives, in safe, clean facilities, with adequate equipment, but also with transport able to go to a mother when life-threatening complications arise. It does not depend on the provision of contraceptives and abortion, but that is always the solution proposed by the UN and non-governmental organizations (NGOs).