CROSSING THE RIVER / African women on the frontline against maternal mortality - PhMuseum

CROSSING THE RIVER / African women on the frontline against maternal mortality

Valeria Scrilatti

2018 - Ongoing

Every year, in the world, 303,000 women die due to complications related to pregnancy and childbirth, and for another 10 million becoming a mother means to carry diseases throughout their lives. 66% of the global maternal mortality occurs in Subsaharan Africa only, where the World Health Organization estimates that 546 women out of 100,000 live births do not survive, compared to 12 in the developed regions of the planet.

CROSSING THE RIVER follows the everyday challenges of four African female health professionals who’re making a difference, within their communities, in promoting the women’s right to health. In African rural areas, in fact, access to healthcare facilities is hard due to poor road conditions; health staff is not enough; frequent teenage pregnancies increase complications. Safe childbirths can be obstructed also by traditional believes, and even by gender inequality.

The four protagonists of the project work in four different African countries. Betty is a midwife managing a healthcare center in the poor Ugandan Karamoja region: integrating the respect for traditional believes with modern obstetric techniques, she’s convincing many women to give birth in safe conditions.

Flaviour is a public health expert in Bonthe district, Sierra Leone (the country with the highest maternal mortality rate in the world), and she’s creating an efficient transport system for women in obstetric emergency.

Halima is a doctor in Borno, Nigeria, where Boko Haram broke down two thirds of the healthcare facilities, and women are paying the highest price of the conflict.

Natalia, a psychologist in Mozambique, sensitizes young women on the issue of HIV, which highly affects reproductive health.

I’ve been engaged in this project for two years with the aim of making a wide audience aware of the real toll maternal mortality is taking on African women and societies, as well as showing the creative ways African female health professionals are putting in place to save women and newborn babies.

Aware of the risk of falling into stereotypes, I’ve tried to report this topic with my own vision, which has been shaped thanks to the stories, thoughts and desires of the women I’ve met. Through portraits from afar in the landscape, views from helicopters and panoramas along rivers, I’ve given an important weight to the environment since it plays a crucial role in people’s lives, as it affects individual and collective identities. The conformation of the landscape, in this case, is directly related to the causes of maternal mortality and in turn it represents a challenge.

The Women Photographers Grant would allow me to add a new chapter in Central African Republic, which is currently affected by one of the most serious contemporary humanitarian crises.

The outputs will be publications on international media, a traveling photo exhibition that will be the focus of conferences on the subject of women’s health, and screenings of the videos produced with the project (the production of the exhibition has already been largely financed).

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  • Bonthe (Sierra Leone). Francess, 22, is on her second pregnancy and has faced a seven-hour boat trip to reach the hospital in Bonthe. She will undergo a caesarean section.

  • Mattru, Bonthe District (Sierra Leone). The river to cross to reach the town of Mattru, capital of the district.

  • Mattru, Bonthe District (Sierra Leone). Women at a meeting of the Mattru "Mother's Club", that was created in order to raise awareness on maternal and child health issues.

  • Karamoja region (Uganda). In Lorengechora health center, Rebecca is having a long and complicated labor. Soon, chief-midwife Betty Agan will realize that the baby’s heartbeat is irregular.

  • Ngala, Borno State (Nigeria). A woman with her child in the general hospital, next to the large site for displaced people called Arabic Camp. Before the attack of Boko Haram, it was the main hospital in Ngala.

  • Borno State (Nigeria). Women and their children walk in the middle of a sandstorm on the edge of Gamboru Ngala. The town, near the border with Cameroon, in the past suffered a long siege by the Boko Haram militia.

  • Gamboru Ngala, Borno State (Nigeria). The entrance to the primary health center in Ward C of Gamboru Ngala. After the Nigerian army regained the town to the Boko Haram terrorists, many refugees returned but very few could find their homes.

  • Gajiganna, Borno State (Nigeria). Primary health center. Yafati and her daughter Fanda escaped to Gajiganna when Boko Haram arrived in their village. During labor, Fanda had convulsions and gave birth in a car before reaching the hospital. Her child Modu Ali was born with a cerebral paralysis.

  • Karamoja region (Uganda). In Lorengechora health center, Rebecca, 35, is assisted by a midwife during labor. She is about to give birth to her sixth child and she walked five kilometers to reach the center.

  • Karamoja region (Uganda). Matany Hospital: a newborn under the heat lamp in the delivery room.

  • Karamoja region (Uganda). Betty Agan, 38, works as chief-midwife in Lorengechora rural health center. Thanks to her innovative methods and her respect for the local traditions, she has been persuading more and more mothers to give birth with her, in safe conditions, and no longer in their huts.

  • Karamoja region (Uganda). In Matany Hospital, the biggest of the region, Clementine is giving birth to her fourth child.

  • Beira (Mozambique). Manga Nhaconjo health center. Ester, 24, is in her fifth month of pregnancy for her second child. On the morning of this portrait, during her first antenatal visit, she had just discovered to be Hiv-positive.

  • Beira (Mozambique). In the area of Macurungo, the women of the Kuplumussana association are engaged in their main activity: the recovery of Hiv-positive women and children to antiretroviral therapy, providing them an economic and psychosocial support. They’ve been the first women ever, in the country, to publicly declare to be Hiv-positive without any shame.

  • Beira (Mozambique). Antonia, 13, died in the morning on February 19, 2019. She had contracted Hiv from her parents. In the last period she had undergone several hospitalizations. Before the illness became full-blown, she was attending school and loved studying.

  • Mattru, Bonthe District (Sierra Leone). Flaviour Nhawu, 34, comes from Zimbabwe and is pregnant with her first daughter. As a public health expert she has improved the referral system for obstetric emergencies in Bonthe district, a lagoon territory where transports are arduous.

  • Bonthe District (Sierra Leone). A rescue operation to transport a woman named Kadi from the peripheral health center in Bendu village to Bonthe hospital. Kadi has a complicated labor and isn’t dilated enough to give birth naturally.

  • Bonthe (Sierra Leone). A training course for midwives inside Bonthe hospital.

  • Bama, Borno State (Nigeria). A camp for internally displaced people. Halima, 25, was kidnapped by Boko Haram with her husband and children. She has lost two sons: one of them was killed by her husband's brother, who militates with Boko Haram.

  • Borno State (Nigeria). A view from the helicopter on the road to Ngala. The humanitarian crisis caused by the attacks of Boko Haram in the three Nigerian states of Borno, Yobe and Adamawa continues since 2009 and is one of the most serious in the African continent.


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