Bangladesh has one of the highest incidences of maternal mortality and obstetric fistula in the world, leaving many Bangladeshi families and communities to suffer life without mothers. HOPE Foundation is a charitable organization based in Bangladesh that offers obstetric fistula repair surgery and is training anew workforce of midwives who will help mothers not only survive, but thrive.
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In southeastern Bangladesh over 90% of women give birth at home, without a trained birth attendant. Those who typically attend births are mothers, cousins, neighbors and traditional dais who have no medical training. These women are not apt to detect an obstructed labor, and often fail to send women with complications in labor to a medical facility with enough time. As a result, maternal mortality and morbidity is high. The maternal mortality rate for the entire country of Bangladesh is 194 per 100,000 live births. The neonatal mortality rate is 24 per 1,000 births.
But the crisis doesn’t end there. At least 71,000 women in Bangladesh suffer from obstetric fistula, a childbirth injury resulting from obstructed labor and a lack of access to emergency care. Each year an additional 2,000 women develop fistula, an injury causes women to constantly leak urine or feces, which has horrendous consequences for her socially. Her community abandons her, her husband divorces her, and she is forced to live a life of isolation.
How can we make change? Obstetric fistula can be prevented if women gave birth using a skilled midwife. Yet, right now, there are no skilled midwives in Bangladesh.
Nur Begum’s story shows us the importance of having a skilled midwife at every delivery, not only in Bangladesh, but around the world. Nur became pregnant for the first time, and as her friends and family have done before her, she employed the help of a traditional birth attendant (dai). After going into labor, she found she was in great pain. The traditional birth attendant unknowingly told her she was fine, so Nur endured obstructed labor at home for four days. After the fourth day, the traditional birth attendant recognized the birth was complicated, and not knowing what to do, left Nur by herself. Nur convinced her husband to take her to the hospital where her baby, who did not survive the complicated labor, was removed.
As her labor finally ended, her urinary incontinence began. Nur leaked urine for eight years, unaware that help was available. Due to the foul smell, her husband took a second wife, with whom he now lives. Nur lives alone in the house she once shared with her husband. Her friends and family stopped visiting her because they said they could not take her foul odor. This story is all too common in rural Bangladesh, where women are not receiving the care they need, and they live out the rest of their days poor and lonely.
Fortunately, Nur received an obstetric fistula repair surgery at HOPE Foundation through the help of HOPE’s partner, Fistula Foundation. She is feeling hopeful again, and looks forward to a brighter future and a happier life.
HOPE Foundation for Women and Children of Bangladesh was established to change situations like Nur’s. HOPE runs a 40-bed charitable hospital, 8 rural medical centers and a training center to provide critical care for impoverished women and children. HOPE’s primary goal is to transform the maternal health landscape by providing antenatal and postnatal care, safe delivery, emergency obstetric care, fistula prevention education and fistula repair, family planning, midwifery training, neonatal care, village health worker training, and nutrition counseling.
Want to Learn More about why midwives are important in Bangladesh?
Join Dr. Mahmood Live
Join the upcoming BirthTV Episode with Dr. Mahmood, President and Founder of HOPE Foundation for Women and Children of Bangladesh, to understand just how critical training midwives are in Bangladesh.
Ashley Pugh is the Program Officer for HOPE’s US office. Ashley gained her Bachelor of Arts Degree in International Relations at Salisbury University where she furthermore earned four minors in Political Science, History, German and Conflict and Dispute Resolution. Upon graduation, she was awarded the Justin Y. Shen Award as the most Outstanding Undergraduate in her field. Following graduation, Ashley took a position with the International Rescue Committee as a Refugee Resettlement Case Manager, working with refugee populations from varying countries. Yearning to do work on a more global scale, Ashley decided to pursue her Masters degree. She enrolled at the University of Kent, Brussels School of International Studies and earned her Master of Arts in International Development with a specialization in law. Ashley’s background consists of work in varying international and local non-profits as well as think tanks in the fields of human rights, women’s empowerment, environmental protection, health and community development. Always passionate about global health, Ashley joined HOPE Foundation for Women and Children of Bangladesh in 2013 as a program officer. For the last two years Ashley has worked on maternal, reproductive and child health programs and expanded HOPE’s work in women’s health.