It is every pregnant woman's greatest fear - getting sick during your pregnancy and harming your baby. For many of us, these fears are mitigated by the knowledge that we have access to good health care and caring professionals.
Melke was not so lucky. A refugee from Ethiopia, she lives in Port Elizabeth, a small coastal town in a rural province of South Africa. When she was 28 weeks pregnant, she developed high blood pressure and went to a public hospital.
In a place where she should have received care and support, Melke experienced abuse and discrimination. The nurses insulted and demeaned her, taunting her because she was a refugee. The abuse and harassment were so bad that Melke discharged herself from the hospital and sought care from a private doctor, which she could barely afford. He told her she needed to be hospitalized so that her blood pressure could be monitored and controlled.
He also told her that unless she was willing to stay in the hospital until her baby was born, she would lose the baby.
Melke was readmitted to the hospital, and again experienced verbal abuse and harassment by the nurses. But it got worse. When she began to bleed, they refused to call a doctor. Shortly thereafter, her vision began to blur and her whole body became swollen. During one terrible night, she called for help again and again, but no one came. She thought she would die.
Melke eventually had an emergency caeserian section and gave birth to a premature daughter. She was able to take her baby home two weeks later. Although her story ended happily, she told Human Rights Watch that this was "a really tough time for me. It was the worst time of my life."
Pregnant women in many places in the world experience violations of their human rights, including violence and harassment by health care workers, denial of health care, and discrimination on the basis of their race, refugee status and many other grounds. These rights violations contribute to preventable deaths and injuries.
Around the world, between 350,000 and 500,000 women die every year from preventable causes related to pregnancy and childbirth. In South Africa, the situation is particularly worrying. There, the number of maternal deaths has nearly tripled since 1998. Part of this increase is related to HIV. But our research also showed that pregnant women with complications experience problems with referrals to higher levels of care and with accessing emergency transport, like ambulances, when they need it. South Africa has enough resources to improve care substantially.
Our researcher in South Africa, documented other cases like Melke's, where women were abused by healthcare workers. Additionally, many women in South Africa don't believe they'll receive good treatment if they seek medical help in a clinic or hospital during childbirth. And if they do receive poor treatment, many don't believe the doctors or nurses will be held accountable.
Our report on maternal death in South Africa will be released later this year. We plan to use our findings to press the Health Ministry to make changes. The government needs to make sure that healthcare workers treat women with respect and that laws and policies are in place and enforced to keep women safe. We've already met with South Africa's health minister, and he supports our work.
On an international level, we consistently advocate for better policies to protect pregnant women. We were involved in both the UN Human Rights Council resolutions concerning maternal deaths, including steps the government should take to improve the situation. In May, we'll be pushing the International Commission on Information and Accountability to make sure that governments hold people accountable when women die unnecessarily in childbirth.
Our goal is to keep women like Melke safe, changing pregnancy from a time of fear, as it is in many places of the world, into a time of hope.
