Rising stars and solutions

“Come on, all of you, hold this with me. We’re all responsible for this award,” said Sen. Pia Cayetano shortly after receiving the “Rising Star Award” at the closing of the “Women Deliver” global conference in Kuala Lumpur.

Surrounded by Filipinos taking part in the confab, the senator posed for a photo with everybody around her touching the crystal star, her trophy. Among the group were outgoing congresswoman Janette Garin, government officials, NGO leaders, activists, and young people “laying hands” as it were on the symbol not just of a legislative accomplishment but also of at least two decades’ worth of struggle to establish, mandate, promote and protect a reproductive health program in the country.

Handing out the star trophy was no less than Melinda Gates, who with her husband Bill and their friend Warren Buffet have been the galvanizing force behind an unprecedented effort to rally private-sector support for public health programs.

Joining the senator onstage were two other recipients of the “Rising Star”: Imane Khachani, a Moroccan doctor working with young people on sexual and reproductive health research and advocacy, and a young man, Remy Shawa, an HIV activist who started a “Men and Gender” program in South Africa.

It had been a dizzying, dazzling three days, a smorgasbord of plenary sessions, group discussions, and workshops that took place simultaneously in the huge conference venue, film showings, brief talks at a “Speakers’ Corner,” and exhibits of various NGOs and international groups promoting their causes and programs.

Jill Sheffield, president of “Women Deliver,” summed it up by the numbers: more than 4,500 participants from 149 countries, including 411 journalists, the largest number the conference has gathered.

Sheffield also reminded the audience that there are “only 945 days left of the MDGs,” which is why a large part of the conference was devoted to crafting and imagining “a post-2015” scenario. On that year, the deadline for the achievement of the Millennium Development Goals will lapse, with governments around the world reporting on the progress they have made, or failed to make. Certainly, most governments in the developing world will fail to meet most goals, most notably Goal No. 5, which calls for drastically cutting the maternal mortality rate. Among these countries is the Philippines.

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But the conference was not only about problems. Many sessions were also about solutions to save mothers’ lives.

A major “killer” of mothers during or immediately after childbirth is postpartum hemorrhage, in which a mother could bleed to death unless she receives immediate care. Unfortunately, in much of the developing world, women live in isolated areas far from any clinic or hospital, with no roads or transportation, and often with little or hardly any prenatal care. When a complication arises, or when bleeding starts, it’s urgent that the woman be brought to a facility for the medication and attention she needs.

Obviously, a device that stops or slows down the bleeding, buying time for relatives to rush the mother to an often-faraway hospital, would be life-saving. And that’s exactly what the NASG is.

The NASG, or nonpneumatic antishock garment, looks like a scuba suit cut up into parts. Actually, it traces its provenance back to Nasa, which developed an antigravity suit for astronauts, redirecting blood to the brain in gravity-free settings to prevent them from passing out. The NASG works the same way, tightly wrapped around a woman’s legs and abdomen to slow down the bleeding and rush blood back to the heart, lungs and brain.

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“We are seeing a 50-percent reduction in deaths from hemorrhage,” said Sue Ellen Miller of the University of California in San Francisco, who led the team developing the NASG for use in “low-resource settings,” and conducted field trials in Nigeria, Zimbabwe and India.

Today a NASG suit sells for $70 each (almost P3,000), but, Miller said, since the suit can be reused about 40 times (it is washable and doesn’t need disinfecting), the cost would be “about $1.50 per life saved.”

In the years since I heard about the suit at the first “Women Deliver” conference in 2007, the team developing and distributing the NASG has met “hurdles at every point,” said Amy Patzen of PATH, which with Pathfinder is seeking to manufacture and market the NASG throughout the developing world. To win accreditation (and financing), they have been marshalling “the clinical proof, policy approval, and improving availability and affordability.” Today, they are supported by the World Health Organization and the United Nations Population Fund.

“It’s exciting to see technology meant for the Space Station being used in a village in Nigeria,” remarked Patzen. Which is why the next phase of their advocacy is to work with manufacturers in the developing world to make the suits available to more communities and women.

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A Nigerian doctor, who has been working with the NASG since 2007, said it is extremely important for health workers to know “when it is safe to remove the garment.” “If you remove it prematurely without addressing hemorrhage, you can imagine what will happen,” he said. Thus, he added, it is important for authorities to “educate the community, and not just health workers,” about the correct use of the garment, and emphasize to the woman why it is important to keep her in the garment. Usually, the NASG is kept on the woman for six-eight hours (remember, bleeding often occurs after the baby is delivered), although many women, said Miller, “don’t want to take off the suit even after a day or two, knowing that it saved their lives.”