Where women die daily

When the United Nations meets this week to discuss the Millennium Development Goals (MDGs) maternal mortality will be high on the agenda.

The target to cut the rate by three-quarters by 2015 is the most severely off track of all the MDGs and every year half a million women die in childbirth.

Afghanistan is one of the countries which is unlikely to meet the target. A woman dies there every 27 minutes thanks to pregnancy-related complications.

There are 1 600 maternal deaths per 100 000 live births but in the remote mountainous province of Badakhshan the rate is 6 500 per 100 000—the highest recorded rate of maternal mortality in the world.

Oxfam took top photojournalist Alixandra Fazzina to Badakhshan, where she met and photographed the families behind the statistics and the doctors, midwives and traditional birth attendants trying to save women’s lives.—Sean Kenny

UN poverty summit: just More hot air?
As world leaders prepare to gather in New York for yet another United Nations summit on poverty, one question looms large: is there any point?

The answer will depend on whether the meeting recycles old platitudes or sets out practical plans for combating deprivation, disease and illiteracy.

The summit is an attempt to renew support for the millennium development goals—the targets adopted for the reduction of global deprivation by 2015.

They include cutting child deaths by two-thirds, the rate at which mothers die in childbirth by three-quarters, extreme poverty and malnutrition by half—and making available universal primary education.

With public attention locked on to the credit crisis, and rising energy and food costs, it’s easy to lose sight of what’s at stake: 10-million children die each year from preventable, poverty-related diseases; there are 1,4-billion people in the world surviving on less than $1,25 (about R10) a day and more than 70-million primary school-age children are out of school.

The development goals are supposed to be a sort of promissory note for the world’s poor redeemable in 2015. But at the moment they have all the credibility of a subprime mortgage security. Business-as-usual projections tell their own story.

The gap between the pledges and projected outcome in 2015 is equivalent to 4,5-million child deaths, more than the entire under-five population of the UK. What can the UN summit do to change this picture? Rich countries need to stop talking and start delivering on aid and trade.

Three years ago at the Gleneagles G8 summit, countries promised a step increase in aid. Since then, aid flows have been stagnating, and research indicates developed countries are $30-billion down on their commitments. And it’s real money, not promises, that builds schools, pays health workers and funds pipes to carry clean water. The UN summit is an opportunity for recalcitrant donors to fulfil their promises.

Then there was Doha. This was supposed to be the trade talks’ “development round”. Rich countries were going to open their markets to the poorest and slash the farm subsidies that undermine developing countries’ agricultural economies. In the event, the only thing that has been slashed is the credibility of the World Trade Organisation.

It would be too much to expect the UN summit to revive the corpse of Doha. But developed countries could provide full market access for the poorest countries in other regions.

Listen to some millennium development goal enthusiasts and you’d think all that stands between the world and those targets is a lack of aid generosity and fairer trade rules. Sadly this is not the case. Developing country governments have much to answer for. Take the case of India. For almost two decades the country has been in the premier league of world economic growth. Meanwhile, the child death toll is falling at less than half the rate needed to achieve the UN target.

The economy might be booming, but 45% of India’s children are still malnourished. India may be a world leader in delivering hi-tech computer services to global markets, but a public health system that saves children from diarrhoea? Forget it.

But there are positive examples too. In Brazil, the Bolsa Familia programme provides income transfers of $35 (about R285) a month to 11-million of the poorest families. In return, they make a commitment to keep their children in school and take them for health checks.

The scheme is reducing inequality, helping to extend opportunity and breaking the transmission of poverty across generations. It’s called redistributive social justice. It works—and more countries should try it.—Kevin Watkins

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