When Scottish actor Ashley Jensen visited Tanzania as a Save the Children ambassador, she was made painfully aware of the challenges facing her fellow mothers in a country where one in 20 babies die before reaching their first birthday.
t she also witnessed a groundbreaking technique helping women save their own infants' lives.
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It takes a lot for me to leave my husband Terry and four-year-old son Frankie for even a few hours these days. I love spending time with my wee boy. However, now that I'm a mum, I've become more aware of the fact that there are millions of children around the world who don't have the same access to healthcare that my son does.
Every year one million babies die on their first - and only - day of life. New research by Save the Children shows half of those deaths around the world could be prevented if the mother and baby had access to free healthcare and a skilled midwife. Health workers with midwifery and newborn care skills have the expertise to help premature babies survive and deal with complications. Yet 40 million women give birth each year without a midwife present.
So, although I knew I would miss my wee Frankie, it was with these distressing facts in mind that I travelled to Tanzania as an ambassador for Save the Children, in order to understand better the problems mothers and newborns face. I also wanted to find out how the charity's newborn health programmes are saving the lives of mothers and babies in the country. We would visit remote regions where basic healthcare was scarce and neonatal services almost non-existent.
More babies die on the first day of life in Tanzania than any other country. Around half a million babies born each year there don't make it through their first month, and one in 20 die before their first birthday. Maternal mortality is also high, with 454 women in every 100,000 dying in pregnancy. It's heartbreaking.
The healthcare available to mothers in Tanzania is in stark contrast to what Western women take for granted. Though now living in the UK, I was based in LA for six years, working on Ugly Betty and the sitcom Accidentally On Purpose, and was lucky enough to experience a very privileged lifestyle. I gave birth to my wee boy at Cedars Sinai hospital in Beverly Hills, and couldn't have wished for a better experience.
During pregnancy, I had the best care: advice on what to eat, what I may or may not be feeling, what my baby ought to be doing and what to do if he's not. I was guided every step of the way. However, even that experience proved too much of a challenge for some women. One mum-to-be in my birthing class ran out of the room because she was too squeamish to watch a video of a live birth. The ladies I met there spent lots of time planning their lavish baby showers and discussing what colour they would paint the nursery.
And then suddenly, here I was in Africa meeting women who had no roofs on their mud huts, let alone comprehensive pre-natal care or access to different shades of paint. Armed with plenty of mosquito spray and snack bars, the Save team and I had landed in Tanzania's capital city, Dar es Salaam, to a toasty 80 degree heat. Driving at a snail's pace along the capital's congested roads, we had passed people selling mangos and cashews, children walking home from school and women balancing laundry and water vessels on their heads.
At 4am on our first morning we headed to the airport for a domestic flight to Mtwara, in the southeast of the country, to visit a KMC ward. KMC stands for Kangaroo Mother Care - a technique which essentially creates a makeshift incubator using mother-to-baby skin-to-skin contact. Since incubators are not readily available in Tanzania, Save the Children have trained mums in this technique as a cheap but effective alternative.
At Mtwara Regional Hospital we were greeted by around 20 immaculately dressed mothers all holding their equally immaculately dressed babies and toddlers. They were the unit's success stories - children who had survived being born too early. Their happy smiles warmed my heart. Some of them were still wearing the cute knitted caps which are used to regulate their body temperature in the ward.
The KMC ward itself is small with just six beds, and the mums I met were sitting quietly with their babies. Seeing their wee ones strapped to their chests stopped me in my tracks.
It's fascinating that something as simple as a mother holding her baby close to her skin has proved to be an effective substitute for an incubator. In the last five years, since they started trialling KMC, Save the Children has prevented the deaths of more than 3000 premature babies across the country.
With the help of a Swahili translator I spoke to 29-year-old Asha, who was cradling her two babies, Zahara and Zolea. She'd given birth to triplets but had sadly lost one. When they were born, the babies weighed just 1220 grams and 910 grams respectively. Their little heads were just visible above the fabric of their mother's brightly coloured shawl. As Asha spoke, she gently adjusted them; the nurses here teach mothers where to place their babies so that they can enjoy the full benefit of her body heat.
The day she went into labour, Asha had to make the 20km journey to hospital on the back of a motorbike. "I was in pain on the motorbike," she told me. "When I arrived I gave birth immediately. The entire labour was on the bike. It was hard work."
Now, she told me proudly, she was learning how to care for her daughters. "I know how to put them in position," she said ,smiling. "I can tell if they have a fever, can recognise the signs and ask the nurse for help. If they pass a stool I know and can assist them. I feel very happy because my babies are healthy and if I wasn't here they would not have been this healthy. I feel very safe in the hospital."
Asha explained that it was hard work having the babies strapped to her body for 24 hours a day (once they get bigger, the father or another family member is allowed to incubate them for short periods of time), but her calm demeanour was impressive. I'm not sure how I'd cope in that situation.
The most isolated village I visited was Mnyangara, about 90km from the nearest town of Lindi, which is also in the southeast of the country. Over the last year, Save the Children has trained 392 health workers in the Lindi region and provided them with the skills they need to stop preventable deaths linked to childbirth and among newborn babies, but there is still a long way to go. The places where Save the Children works are remote. It took our convoy around an hour-and-a-half to wind along the uneven, sandy track. Mongooses ran across the road in front of us and I saw monkeys in the trees.
Mnyangara is home to around 1500 people, and the arrival of a group of white people in Jeeps caused a stir among the villagers. The Chief and his elders welcomed us, and we were taken to his mud hut where, as a courtesy, we were asked to introduce ourselves and sign a registry.
The air smelled of ash from the constantly burning fires, while chickens, dogs and goats ran around freely. The people here survive mostly on a diet of maize, dried fish, mangos and cashews but they have no healthcare facilities, no electricity and their nearest water supply is the river, a 30-minute walk away. On the day of our visit, the temperature was a sweltering 100 degrees and I was very thankful for the bottles of water we had brought with us.
One little boy, who sucked constantly on a dusty mango stone, followed us around all afternoon. When I first saw him he was standing by an open fire, holding a foot-long machete. He couldn't have been older than three or four but nobody seemed to think he was in any danger. It was surreal.
The Chief introduced me to Fatouma, who told me she had been in labour for 24 hours with twins. She was utterly exhausted at the end of it because the "traditional" way of the elders is to shake the mother to get the baby out. She took off her scarf and demonstrated to me how they wrap the cloth around the woman's upper body to grip and then shake vigorously.
She gave birth to one twin in her mud hut and was then put in a bicycle basket so that her brother and husband could transport her to the nearest health centre. She was in that bike basket in labour for three hours. By the time she arrived at the health centre she'd lost a lot of blood and almost died. She gave birth to the second twin but both her babies died within a year from illnesses that can be prevented with basic healthcare.
I showed her a photo of Frankie and she told me that she was seven months pregnant and worried about making that same traumatic journey again. No woman should have to go through that.
I also visited a health dispensary in a village called Mkanga II, where the nurses, Anne and Rose, faced unique challenges. They worked with no water or electricity so if you went into labour after dark or needed stitches it was fraught - they'd have to stitch you up by the light of an oil burner. They also endured the added danger of lions wandering in from the bordering wildlife reserve. Rattlesnakes were another potential hazard. Compared with the dilemma of what colour to paint the nursery, the challenges faced by Tanzanian mothers-to-be are huge.
But there were some light-hearted moments too. We visited a dispensary in Kitomanga where babies are weighed and vaccinated. Mothers are also offered advice on pregnancy, as well as antenatal and post-natal check-ups. It's another of Save the Children's ongoing success stories and some of the mothers I met had travelled for three hours to get there.
Outside the weight station clinic, I met a little boy aged around five years old. When he caught sight of me he looked worried: I don't think he'd been in touching distance of a white person before, and he was visibly shaken. He actually recoiled, and when I made eye contact he cried. I shook hands with his mum, to show him that I was friendly, but even that was difficult for him. He turned to his mother and said something that made everyone laugh. It was translated for me. He'd asked: "Is it a human being?"
I wanted to reassure him that I wasn't a scary monster, so I took pictures of him on my iPhone and he was delighted to see his face on the screen. He touched my hand, so I won him over in the end.
What affected me the most as I travelled around Tanzania was the realisation that no matter where you are in the world, what level of society or culture you're in, children are children. They all start as innocent little people and all have their own characters.
In Mkanga, a curious crowd of children gathered around me. They'd been playing football but when I took a photo of one of them on my phone, they all wanted one. They giggled when they saw themselves and made funny faces. It was a highlight of my trip, and so lovely to see them laughing.
When I got home, I gave Frankie an extra special hug. In Tanzania, it's a battle for a child to make it past five years old, let alone to adulthood. The majority of babies die from infection from dirty equipment or a lack of antibiotics. Newborns are often not helped to take their first breaths as health workers haven't got the skills required. That's why funding for Save's Kangaroo Mother Care wards is so important - any amount you can donate will make a huge difference. As Nurse Rose from the Mkanga health centre said when discussing the care she gives her patients: "Conditions are improving but we need so much more. It makes me happy when I know we have a mother who has given birth to a healthy baby in good condition. I want that for all my mothers."
That shouldn't be too much to ask, should it? n
How you can help
The first cry, first feed, first cuddle … For a parent, the first day of a child's life should be a time of excitement, wonder and hope. A day they will remember forever. But childbirth is often complicated and a newborn child is frighteningly vulnerable. Every year, one million babies around the world die on their first - and only - day of life, and 2.9 million die in their first month. Maybe they have trouble starting to breathe, the delivery is obstructed or they are exposed to infections or hypothermia.
The death of one baby is a tragedy. The death of a million a year is an outrage. Many of these deaths are preventable, with the help of a trained and equipped midwife. Help save the life of a newborn baby today.
You can help Save the Children end first-day deaths. Donate to make sure a newborn baby gets life-saving treatment on the day they are born:
- £3 could buy 10 tubes of antiseptic cream, preventing life-threatening infection in newborn babies
- £5 could buy life-saving antibiotics such as Amoxicillin to save a child from diseases such as sepsis, pneumonia and meningitis
- £10 could buy three clean birth delivery kits to equip a midwife - including a sterile razor blade, clamp, soap and disposable gloves
- £50 can pay to train a community health worker to give life-saving medicine and care to newborn babies and mothers