On October 17th, Uganda joined the rest of Africa in marking Safe Motherhood Day. The Standard’s Sam Wakhakha interviewed Dr. Jean Chamberlain Froese, Executive Director of Save the Mothers, about the state of maternal health in Uganda. Below are excerpts.

The Standard: As a maternal health activist, can you give us an assessment on maternal health in Uganda?

Dr. Jean:  When I came here seven years ago, maternal health was even not on the agenda. Well mothers could die and “it’s God’s will” and that was too bad. Now, people are really aware that it’s going on; you see it in the papers and hear it on the radio. In Uganda we lose 6,000 mothers every year. In Canada, we lose 10-15. So there is a huge discrepancy.  Awareness is the first step. The next step is action. I see our students are being trained here at UCU who are now advocates. We are seeing them getting into places of influence including as Members of Parliament, journalists and ministry officials.
The Standard: Tell me about Save the Mothers?
Dr. Jean: It is a Master of Public Health Leadership programme open to professionals of all backgrounds. They get a degree at the end of the programme but keep networking long after graduation. The idea is once they graduate they become change agents in their particular field to improve the lives of Uganda’s women and children.
The Standard: What do you think can be done to improve maternal health in Uganda?
Dr. Jean: Change of attitude is the first thing, that mothers are valued. Simple things like transportation, husbands putting money away for wives. You need to plan for childbirth.
 We also need to increase the services at the health facilities If a mother has a complication, she needs to be in a place where she can receive treatment.
The Standard: Is there a correlation between the number of children a woman has and the likelihood of her having pregnancy complications?
Dr. Jean: Absolutely.  A woman who has four or more children has a higher risk   of dying of a complication than one who has had two or three.  A woman who is having her first child is actually at higher risk as well too because we don’t know if she will even be able to deliver a baby.   Later, with more children, the woman has a higher the risk of bleeding to death after delivery.
The Standard: What is the ideal number of children that a woman should bear?
Dr. Jean:  There are some people who want one child. There are those who want five. I think a manageable number in terms of safety is four. But there are some who will want to have more and some less. There are variations, not just one answer.
The Standard: Throughout your stay in Uganda, have you had any encounter with a Traditional Birth Attendant, who, by the way, attends to the majority of pregnant women in Uganda?
Dr. Jean:  I visited one yesterday. They are the nicest, most generous women. They mean well. The problem is if someone is, for example, going to fix my car, I don’t want just a nice person.  I want somebody who can really fix the brakes on my car. If a mother starts to bleed to death or cannot deliver the baby, then that TBA has nothing that she can do except to try and get the patient to hospital.   That is often when it is too late. But TBAs are a very strong cultural force. They need to have a work alternative and, I think, can even be brought into the hospitals. 
In Canada, we have these women who are called “doulas”. They are like TBAs. They give mothers moral support. I have no problem with that. But that is very different than a mother delivering in a mud hut with a TBA in the middle of the night with no resources or expertise.
The Standard: Often maternal health goes hand in hand with child health and development. Do you move into that or you just stop on maternal health?
Dr. Jean:  You don’t stop on maternal health because when you increase the health of the mother, you automatically increase the health of the child. There is no one who can care for a child better than its own mother. Investing in the mother will automatically benefit the children.
The Standard: Is it possible for Uganda to achieve this MDG by the year 2015?
Dr. Jean:  It is not possible at this time but that does not mean that we don’t work towards it. We need to keep working hard. At the end of the day, we want to cross the finish line, that is save every mother and child we possibly can.
The Standard: Save the Mothers has partnered with some hospitals. Which are these?
Dr. Jean:  We are reaching out to hospitals to help them improve quality of care. They include Kawolo, Buikwe, Naggalama and Mukono Health Centre. We were at Kawolo recently. The first time we visited, I turned on the tap in the labour suite. There was no water. There had been no water in that labour suite for ten years.  When we went there recently, the midwife went over and turned on the water. The interesting thing is that we did not physically set up the water system for them. The people in the hospital realised that there is something wrong in not having water in the labour suite. They made it a priority.
The Standard: What kind of support are you extending to them?
Dr. Jean:  We will help with equipment, training, and community outreach, that is sharing the message of women’s need to come to the health facility.
The Standard: Have you worked in any other country apart from Uganda?
Dr. Jean:  I lived and worked in Yemen from 2000 to 2005, the first years of my marriage and my own family. My husband, Thomas Froese, is a Canadian journalist who has written in both Canada and abroad to raise awareness of these developing world issues. Before our tenure in Yemen, I had taken shorter trips by myself to Zimbabwe, Zambia and Pakistan.
The Standard: Why did you choose Uganda?
Dr. Jean: In the late 1990’s, I had met Drs. Florence Mirembe and Pius Okong who were champions for safe motherhood here. We got together and asked, ‘How do we improve the situation?’ I realised that these Ugandans were very committed and they have been the backbone of this programme. People see Jean Chamberlain Froese up front, but these people have pushed things along and made it truly Ugandan and African.
The Standard: What is the relationship between UCU and Save the Mothers?
Dr. Jean:  Both give and work together.  I’m here on behalf of Save the Mothers and also am on faculty at UCU.  I’m here full-time with my family for eight months every year, while    the other four months are spent in  Canada at McMaster University. We have other volunteers from Canada who come and work here. The university also employs several other Ugandan staff in the programme. Dr. Eve Nakabembe, a very qualified Ugandan obstetrician, is the full-time Academic Director of STM, hired and approved by UCU. It’s my pleasure to work with such competent and dedicated people.
The Standard: How do you get funding?
Dr. Jean:  The university is very supportive and helps us with various things. We also get support from private donors in Canada who care about mothers and children in this part of the world.
The Standard: What is your message to the government policy makers?
Dr. Jean:  I think the message is that mothers can be saved. We can do it. We have to have the political will to make it happen and we have to work together.
Health workers need to be supported. They are not villains. They need to be valued and to have resources and equipment. Blaming health workers blindly has been one of the recent challenges in Uganda.
The Standard: Twenty years from now, people will be celebrating Safe Motherhood Day. What do you desire as the achievements, your ideal picture?
Dr. Jean: I want to see mothers being cared for by skilled Ugandans who have the equipment and resources they need during complications.  And I want women to feel valued as they go to these health facilities, so they can walk out alive and well with their baby to a family they can manage. If Uganda can have this in twenty years, it will be doing well.