 Committed people like Dr. Shershah Syed are giving new hope to problems concerning maternal health. As part of the Millennium Development Goal programme, Pakistan is committed to bringing down its Maternal Mortality rate by 2010. According to the World Health Organisation, maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.
The status of maternal health is poor in Pakistan. An estimated 30,000 women die each year due to pregnancy related causes. It is estimated that about 500 maternal deaths occur per 100,000 live births each year in Pakistan. Recent estimates by WHO and UNICEF place the figure at around 270/100,000 live births. However, social scientists believe that in reality the rate may be higher because of under registration of deaths and absence of cause of death information. Of the average fertility rate of 4.1 children per woman, one of the highest in South Asia, one in 23 Pakistani women die in childbirth, compared to one in 5,000 women in developed countries.
The death of a woman in childbirth is a tragedy, an unnecessary and wasteful event that carries with it a huge burden of grief and pain. Pregnancy is not a disease and pregnancy related morbidity and mortality are preventable. However, half a million women die each year due to pregnancy related complications and 95% of them come from the developing world. The lifetime risk of a woman dying of pregnancy-related causes in developing countries is 1:40 as compared to 1:3600 in developed world.
Several factors contribute for this high maternal mortality rate, including malnutrition, iron deficiencies, haemorrhage, hypertension, unsafe abortion, infections and obstructed labour which result in stillbirths, birth defects and mental retardation and infant deaths.
In the rural areas of Pakistan, around 48 percent of lactating mothers have a calorie intake of 70 percent less than the recommended level which affects 34 percent of pregnant women. In addition, 45 percent of Pakistani women suffer from iron deficiencies. Apart from this, sixty-five percent of Pakistani women deliver their babies at home and only eight percent of home births are supervised by a trained attendant.
Another important reason that contributes to the high rate is the attitude of the society in general and of the rural population in particular towards women. There is little or no education about motherhood to the female population. Girls are usually married off at an early age and their lack of awareness about the implications of pregnancy-related issues makes them an easy prey to the complications.
However, all these causes are mostly preventable through proper understanding, diagnosis and management of labour complications. Several organisations, both public and private, have taken up the issue and are playing their part in the health sector of the country. There are also those who are working on an individual level and have gathered much public support in this regard.
One of such healers is Dr. Shershah Syed who recently received recognition for his work on saving lives of women from Pakistan’s rural areas by the Clinton Global Initiative.
Shattered by the sight of women dying unnecessarily in childbirth, Dr. Shershah decided to devote his career to helping impoverished women. A medical specialist from Ireland, Syed today is a famous Pakistani ob-gyn. With government support nine years ago, Dr. Shershah started a top-level maternity wing in a public hospital in Orangi, an impoverished Karachi neighborhood that by some reckonings is the largest slum in the world. The hospital now handles 6,500 deliveries a year and accepts women from hundreds of miles away. In addition, Dr. Shershah is hitting up friends to try to build a new maternity hospital in Karachi where he has so far built a wing to repair fistulas free of charge and to train midwives.
 Fistula is an injury during labour, caused by complications in childbirth which leads to continued involuntary leakage of wastes from the mother. Fistula affects millions of women and girls worldwide, and becomes an unpleasant and painful condition that leads to the death of the child and often the mother. Dr Shershah is actively involved in treating patients with fistula. In collaboration with the United Nations Population Fund (UNFPA), Syed runs nine centres all over Pakistan where doctors, nurses and midwives are trained in the management of fistula patients.
These centres also provide educational material for nurses, midwives and paramedics in Urdu and Sindhi languages. Dr Shershah has also managed to run a programme with collaboration of a number of agencies including the UNICEF to train nurses, midwives and doctors. The Nursing Midwifery Tutors Training Programme is currently running all over Pakistan.
People in the West are outraged by oppression of women in parts of Pakistan. But some of the greatest suffering of women here isn’t political or religious. It comes simply from inattention to maternal healthcare. However, there is hope that with people like Dr Shershah Syed, things will no more remain the same and instead the country will move towards a bright and healthy future. 
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