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The Bele Uman Project: Saving Mothers, Saving Lives

by Prufer

Bele Uman (pronounced Beh-lay Oo-man) means Pregnant Woman in Krio, the de facto national language spoken in the Republic of Sierra Leone, a country in West Africa. But it means more than just that. It means a cherished person who gives life, a nurturer. A Bele Uman is a woman to be revered and protected.

Which is ironic because, in Sierra Leone, bele uman dem (plural bele uman) are dying in childbirth in obscene numbers. In fact, that country has the highest maternal mortality rate in the world. One in every eight women die in childbirth, according to United Nations statistics, compared to 1 in 4,800 in the U.S. and 1 in 48,000 in Ireland. Pregnant women in this impoverished country are poor, malnourished and often anemic. They live too far from hospitals and health professionals, if they can even find them. They are also mistrustful of doctors and health professionals.

Fredanna M'Cormack, an assistant professor in health promotion in CCU's School of Health, Kinesiology and Sport Studies, was born in Sierra Leone, so she knows firsthand the horror and heartbreak that is occurring in her homeland since the 12-year civil war ended in 2002.

She and colleague John Yannessa, also a CCU health promotion professor, are working together on "Bele Uman Project: Saving Mothers, Saving Lives" to help address the deadly social issue that kills on average 2,100 women per 100,000 giving birth.

Since receiving a research enhancement grant from CCU, the two have been busy trying to get the word out about Sierra Leone, raising money, gathering medical supplies and planning a trip to the impoverished country to collect data.

"It's just awful to think a young woman who gives birth may not survive," says Yannessa. "It's horrific. We are trying to really understand the dynamics of this society and help that young woman to have a voice."

To that end, M'Cormack and her sister Fredline M'Cormack-Hale, a professor at Seton Hall in New Jersey, will travel to Sierra Leone in July and August for five weeks to interview 300 women and determine what their issues are and why they don't seek the medical care that would save lives.

They plan to collect data from a representative sampling of pregnant women and better understand the social and cultural perceptions of care in rural Sierra Leone communities to help develop programs that will help lower the death numbers.

Contributing factors to the high maternal mortality rate include:

•Women are more likely to deliver at home without the assistance of a skilled physician or midwife.

•Adolescent pregnancy is a risk factor.

•Pregnant women are often malnourished or have anemia, which can cause serious complications for both the mother and child before, during and after delivery.

•Due to widespread poverty and rural conditions, delays in deciding to seek treatment, reaching a health facility and receiving treatment at the facility can all contribute to a botched delivery.

M'Cormack tells of a 17-year-old girl who was taken to a medical clinic after 30 hours of labor, only to be told by a doctor that he would not perform needed surgery because she had no money for his fee.

"I was very vocal on her behalf," says M'Cormack, who happened to be there and who raced around to raise money so the doctor would perform a caesarean section. He finally did, and both mother and child lived, though the outcome could have easily gone another way. (The young mother, Hassanatu, named the baby after Fredanna.)

M'Cormack also had a 22-year-old cousin with sickle cell anemia who died in childbirth along with her baby. "It's not 'just people' who die in childbirth, but people you know," she says.

Fueled by the tragedy of the medical crisis in her homeland, M'Cormack, who came to this country when she was 18 to attend Southern Illinois University in Carbondale, decided to focus on women's health care outcomes. For her dissertation, she concentrated on the socioeconomic outcomes of maternal mortality, factors such as poor nutrition, lack of protein, dietary anemia.

Now she and Yanessa are working hard to impact the situation with a goal of returning to the country with students studying health issues, a perfect opportunity for students to put into action global research with making a difference in the wider world.

"We hope this is the beginning of a long relationship between Coastal Carolina University and this rural area in dire need of help," says Yanessa. "We are seeking to forge partnerships. There is a lot of student opportunity here. But mostly, our goal is to save lives."

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