By Madeline Price
The face of poverty that the Australian public is constantly bombarded with, is one of a malnourished child, curled in the fetal position on the dirt floor of an hut in a poor African village. Yet this image tragically marginalises the wider picture – these malnourished children cannot exist without the women who birth them.
As many of my readers know, I am a big advocate for maternal health in the developing world. Maternal and prenatal care, coupled with the education of girls and women, are two key factors that are stepping stones for a countries’ population to diminish the poverty cycle and improve the countries’ economy. Yet, the former of these factors, was not reflected at all in the recent Federal Government Budget for 2012-2013. The Federal Government Budget (the Budget) for 2012-2013, devoted over $21 billion (1.56% of our Gross National Income) to defence. In comparison, a mere $5.2 billion (over the next four years) has been devoted to foreign aid. That is the equivalent of 0.35% of our Gross National Income (GNI) and less than 2% of our total Federal Government expenditure. We are spending almost four times more on defence than poverty eradication in a time where Australia isn’t even at war.
Granted, this years Budget has increased its expenditure on foreign aid dramatically since the 2001-2002 Budget, which devoted a mere $2.75 billion, or 0.40% of the GNI. However, as evident within the numbers alone, the 2001-2002 Budget devoted a whole 0.05% more of the GNI to foreign aid, than our current 2012-2013 Budget does. This is, however, still a far cry from the previously promised 0.5% by 2015 (one of the Australian Government’s Millennium Goal promises).
However, what may be more shocking than those low figures and the irresponsible spending of the government itself, may be the organisations and projects our foreign aid funding goes towards. As alluded to previously, the foreign aid expenditure of the government goes predominantly towards the eradication of poverty, with little, nay, no concern for such significant issues as maternal health. It must be said – there is no point attempting to eradicate poverty, when no one will live to have that first meal you provide.
Maternal health is a vitally important issue and key to assistance in the developing world. However, the Budget’s foreign aid component devotes all its expenditure to the eradication of poverty and the promotion of agriculture and education. Specifically, spending over $384 million in the Pacific region on the immunisation of children, the promotion of higher-education and providing drinkable water to one city, spending over $208 million on school equipment and enrolments in Burma and Laos, spending $97 million on the Pacific Police Service (including training and leadership programs), and $190 million in Afghanistan on improving school facilities and the Afghan National Police. Notably, none of these programs are tailored specifically towards women or girls, when, in all of the above listed countries, they are statistically more likely to suffer from poverty affliction, sex trafficking and a lacking of education.
What is most of interest, however, are the organisations that the Budget pushes its foreign aid through. UNICEF, the World Bank Group, the Asian Development Bank and the World Food Programme are the top listing organisations that the Australian Government funds with its foreign aid resources. However, these are some of the worst organisations to do so, with high administrative costs and relatively low impact in the regions requiring it. Australia’s foreign aid has little impact worldwide. The Australian Government is even phasing out funding in India and China – two of the worst hit regions for maternal health.
Take UNICEF, for instance, only 68% of their expenditure goes to their programs, programs of which are predominantly situated in highly populated areas – not the regional and rural areas where aid is most needed. Not only that, these ‘program costs’ include the costs of educating the Australian public on issues of aid awareness, so those UNICEF’s advertisements you see on television, those little change packets on QANTAS flights and those people standing outside the Valley train station are all included in the ‘program’ costs. These programs are not necessarily helping those people who need it most, they are trying to get more funds raised. To put this into monetary perspective, in 2011, UNICEF spent over $900 thousand on ‘community education’ alone. $1.2 million was spent on administrative expenses and a mere 15 times that was spent on actual overseas programs. And this is just one of the organisations that our foreign aid supports.
The Asian Development Bank, an organisation directly providing aid to only the Asia and Pacific region, emphasises even more wasted Australian aid. In 2011, $1.36 million of their budget went towards the refurbishment of their office facilities, $2.94 million went towards a technology upgrade and automation systems, and $2.6 million went towards the acquisition of vehicles, computers, furniture, office equipment and security. They also spent over $378 000 in operational expenses (salaries, relocations, travel) and $90 000 in administrative costs. For an organisation with only a $21 billion budget (the same as our defence force), these administrative and staff costs do take quite a large chunk out.
Additionally, all four of the organisations that the Budget funds through our foreign aid program, focus predominantly on the eradication of poverty and education, completely disregarding such things as maternal health.
You may be querying why I keep referring to this concept of maternal health and why it is such a big issue. Put simply, the health of women should be a forefront issue in today’s society. Consider the reproductive cycle itself – without women, there aren’t children. Shouldn’t this fact by itself be enough to push maternal health to the top of the list of global issues? Perhaps not. But consider this, over 1 700 women die each day from preventable difficulties in labour. If such organisations as the ones previously mentioned allocated funding towards maternal health, up to 90% of these deaths could be avoided.
Alternatively, if the Budget allocated our foreign aid to organisations tackling issues such as these – organisations with lower administrative costs and greater impact – these deaths could be prevented. In 2001, UNICEF itself, whilst not tackling the issue directly is happy to pursue research on it, estimated [conservatively] that women in Sub-Saharan Africa stand a one in 16 chance of dying during pregnancy or childbirth, an horrific figure in comparison to the one in 2 800 chance a woman in the developed world has. More recently, in 2005, the World Health Organisation released figures stating that 536 000 women died in pregnancy or childbirth in that year alone. Our foreign aid focuses immensely on the Asia region – these 536 000 deaths occurred in Asia and Africa combined. Obviously, our foreign aid is overlooking an immense obstruction of justice by not supporting programs directed at maternal health in Asia.
However, that face of poverty I alluded to at the beginning of this article – one of a malnourished child – can directly relate to maternal health as well. It is estimated that greater than 20% of the diseases in children below the age of five directly correlates to poor maternal health and nutrition, in addition to the quality of care throughout delivery. Furthermore, annually, over eight million babies die during delivery or their first week of life. This emphasises how maternal health relates directly to other problems of poverty, disease and education – solve one and a chain effect can occur.
By far the most reliable and confronting record of maternal mortality remains the Maternal Mortality Ratio (MMR). This measures the number of deaths to women due to pregnancy-related complications, including childbirth, per 100 000 live births. To compare, Ireland, the safest place on earth to go through pregnancy and childbirth, has a Maternal Mortality Ratio of just one. This means that, for every 100 000 births, only one woman is lost. South Asia, on the other hand, has a MMR of 490. This includes the development capital of India, which, for all its claims of progress in the economic stakes, still provides women with a one in 70 chance of dying during childbirth in her lifetime and this is one of the countries our government has decided to cut foreign aid to! Comparatively, sub-Saharan Africa has a MMR of 900, whilst Sierra Leone takes the cake at 2 100 deaths per 100 000 live births. Globally, a mere 13 developing countries account for over 70% of maternal deaths.
However, as was alluded to earlier, maternal death isn’t the only issue of concern under the broad spectrum of maternal health. For every woman who dies during childbirth or pregnancy, another 30 suffer lifelong pain, illness or permanent disability. Whilst obstructed labour, sepsis and anaemia are all widely known, the most common and horrific injury, is that of fistula. This occurs, predominantly during prolonged labour, when tissues within the birth canal are deadened from days of pressure from the baby’s skull. Following the removal of the deceased baby, these tissues slowly start to fall away, leaving gaping holes. These holes allow for leakage from the bladder and rectum into the vagina causing uncontrollable flow and incontinency. Without an operation to repair the fistula, the woman suffers abrasions to her genital area and sores down her legs due to the acidity of her urine leaking from her bowels, a foul rotting smell emitting from her body and social exclusion. Often, and specifically within rural regions where the majority of aid organisations fail to operate, the woman is branded as cursed, moved to a hut far on the outskirts of the village and forced to live out the remainder of her life fending off wild animals at night and making do within her hut during the day. Whilst figures are inaccurate due to the inability to collect adequate data, it is estimated that over 80 000 women develop fistula every year, and an unknown number commit suicide, believing it is preferable to life. These deaths are predominantly preventable if our aid funding was directed in the right direction.
Many would argue that it is too optimistic, too unreasonable, to suggest that aid funding should be redirected – another problem will always arise that the public believes the funding should be directed towards. However, maternal health is a solvable issue that impacts directly upon the wider issues of poverty and health. If women and their children begin life without difficulty, the opportunities their lives could provide them with are endless. Health is a vitally important area of aid work – if women are healthy, their children will be healthy at birth (even better, they will survive the birthing process!) and it has been proven that healthy babies grow up healthier and more receptive to education. From this, benefits continue to arise – healthy babies grow into healthier children, who are more receptive to education, leading them to learn more and receive higher paying employment opportunities, improving the economy of the entire country and leading to self-fulfilling aid programs directed by that country itself. This may seem optimistic, but it has been proven that small-scale operations targeting a simple problem (such as maternal health) can have an immense effect on larger social issues such as poverty and education.
I am ever the optimist, I accept that, and I accept that not everyone will see this as as big an issue as I do, but I ask – simply to show the Australian Federal Government that they need to review the organisations they fund – each of you who reads this to sign a petition imploring the government to review what projects and organisations they fund and direct more funding towards the issue of maternal health. My goal would be to get 1 700 women (or men) to sign this petition – names and faces to go with the 1 700 women who die in labour each day.
The link to this petition is below. I also ask you to pass this on.